WorldWideScience

Sample records for main findings health

  1. Main findings

    International Nuclear Information System (INIS)

    2014-01-01

    Licensing regimes vary from country to country. When the license regime involves several regulators and several licenses, this may lead to complex situations. Identifying a leading organisation in charge of overall coordination including preparation of the licensing decision is a useful practice. Also, if a stepwise licensing process is implemented, it is important to fix in legislation decisions and/or time points and to identify the relevant actors. There is considerable experience in civil and mining engineering that can be applied when constructing a deep geological disposal facility. Specific challenges are, however, the minimization of disturbances to the host rock and the understanding of its long-term behavior. Construction activities may affect the geo-hydraulic and geochemical properties of the various system components which are important safety features of the repository system. Clearly defined technical specifications and an effective quality management plan are important in ensuring successful repository implementation which is consistent with safety requirements. Monitoring plan should also be defined in advance. The regulatory organization should prepare itself to the licensing review before construction by allocating sufficient resources. It should increase its competence, e.g., by interacting early with the implementer and through its own R and D. This will allow the regulator to define appropriate technical conditions associated to the construction license and to elaborate a relevant inspection plan of the construction work. After construction, obtaining the operational license is the most important and crucial step. Main challenges include (a) establishing sufficient confidence so that the methods for closing the individual disposal units comply with the safety objectives and (b) addressing the issue of ageing of materials during a 50-100 years operational period. This latter challenge is amplified when reversibility/retrievability is required

  2. Study design, objectives, hypotheses, main findings, health consequences for the population exposed, rationale of future research

    Energy Technology Data Exchange (ETDEWEB)

    Trnovec, T.; Kocan, A. [Slovak Medical Univ., Bratislava (Slovakia); Bencko, V. [Charles Univ., Prague (Czech Republic); Langer, P. [Institute of Experimental Endocrinology SAS, Bratislava (Slovakia); Berg, M. van den [Rijksuniversiteit Utrecht (Netherlands); Bergman, A. [Stockholm Univ. (Sweden); Hustak, M. [Air Force Military Hospital, Kosics (Slovakia)

    2004-09-15

    In Slovakia, the Chemko Chemical Company, based in Strazske, in the Michalovce district, produced PCBs between 1959 and 1984, in the amount of more than 21,000 tons of commercial mixtures (Delor 103, 104, 105, 106, Delotherm DK and DH, Hydelor 137). PCBs were used for similar industrial purposes as in the west. Improper disposal from the Chemko plant via release of effluent directly into the Laborec River resulted in long-term contamination of sediment. As a result eastern Slovakia, the Michalovce district in particular, is recognized as one of the areas all over the world most heavily polluted with PCBs. Historical studies show that blood and adipose PCB levels were higher in Czechoslovakia than elsewhere in the 1970's and 1980's. Current data indicate that persons who eat locally raised food - pork, beef, poultry, eggs - in this district have elevated serum concentrations of PCBs. Environmental exposure to organochlorines in the Michalovce district indicate association with higher rates of certain cancers, but an inverse association with risk of breast cancer. An increased prevalence of thyroid disorders in the polluted area was also reported. This ''experimental setting in nature'' has attracted international scientific teams and two projects in the area are ongoing: Evaluating Human Health Risk from Low-dose and Long-term PCB Exposure, 5{sup th} FP Project QLK4-2000-00488, 2001- 2004; PCBRISK (http://www.pcbrisk.sk/) and Early Childhood Development and PCB Exposures in Slovakia, NCI/NIH, R01-CA96525 University of California, Davis, USA. This paper is serving as an introduction to papers of a session reporting on various health outcomes associated with PCB exposure. The objectives of the PCBRISK project were targeted at an evaluation of the human health risks of low-dose and long-term exposure to a group of persistent organochlorine pollutants, including polychlorinated biphenyls (PCBs) and their metabolites, organochlorine

  3. Main Findings: Lessons to be Learnt

    International Nuclear Information System (INIS)

    2010-01-01

    This section summarizes the main lessons to be learnt from the workshop: 1 - Workshop Methodology: This method of work has proven to be successful. Participants appreciated the high level of interaction with the other colleagues, especially in view of the variety of expertise that was represented at the workshop. The method also affords the participants the opportunity to learn about the status of waste management in the host country, and to come into contact with the main actors. Conversely, the method also affords the host country programme added visibility at the international level. 2 - National Regulations and International Guidance and Bases for Criteria and Regulatory Judgement: There is reasonable consensus amongst national regulations on fundamental regulatory objectives, but much less agreement on the most appropriate criteria. Consensus is nationally and internationally hampered by the lack of common definition of concepts and terms. International guidance is interpreted in different ways in each country. International guidance is rather difficult to interpret, understand and apply. It is important that stakeholders understand the bases for regulatory judgements. 3 - Optimisation: The fundamental goals of optimisation need to be clarified. Optimisation of long-term vs. short-term safety remains problematic. The process of performing optimisation is more important than the numerical or scientific result. A transparent, stepwise and iterative process of decision making is essential for optimisation. The basic, broad rules for decision making and involvement of stakeholders need to be defined in advance. 4 - Technical Indicators for Safe Performance: The relative importance of different safety indicators varies with timescale. There is still much to be done before reaching consensus on the relative importance of different time frames. More discussion is needed on time cut-offs for regulatory compliance. More discussion on the meaning and applicability of

  4. A Systematic Review of Consent Procedures, Participation Rates, and Main Findings of Health-Related Research in Alternative High Schools from 2010 to 2015

    Science.gov (United States)

    Johnson, Karen E.; Morris, Marian; Rew, Lynn; Simonton, Amanda J.

    2016-01-01

    There is a well-established link between educational attainment and health. Alternative high schools (AHSs) serve students who are at risk for school dropout. Health-related research conducted in AHSs has been sparse. Achieving high participation rates is critical to producing generalizable results and can be challenging in research with…

  5. A Systematic Review of Consent Procedures, Participation Rates, and Main Findings of Health-Related Research in Alternative High Schools From 2010 to 2015.

    Science.gov (United States)

    Johnson, Karen E; Morris, Marian; Rew, Lynn; Simonton, Amanda J

    2016-02-01

    There is a well-established link between educational attainment and health. Alternative high schools (AHSs) serve students who are at risk for school dropout. Health-related research conducted in AHSs has been sparse. Achieving high participation rates is critical to producing generalizable results and can be challenging in research with adolescents for reasons such as using active consent. These challenges become greater when working with vulnerable populations of adolescents. In this systematic review, we examined health-related studies conducted in AHSs between 2010 and 2015. Results indicated that (1) health-related research in AHSs has increased over the past 5 years, (2) AHS students continue to experience significant disparities, (3) active consent is commonly used with AHS students, (4) 42% of studies reported participation rates or provided enough information to calculate participation rates, and (5) school nurses are missing from health-related research conducted in AHSs. Implications for future research and school nursing are discussed. © The Author(s) 2015.

  6. Find a Health Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — HRSA Health Centers care for you, even if you have no health insurance – you pay what you can afford based on your income. Health centers provide services that...

  7. Third national inventory of nuclear liabilities - main findings, lessons learned

    International Nuclear Information System (INIS)

    Cantarella, Jacques; Roger, Brigitte

    2013-01-01

    The safe management of a country's radioactive substances in both the short and the long term implies a cost to its present society and necessitates financial resources to cover these costs. Once they are needed, these financial resources may prove to be insufficient or even completely lacking, leading to a nuclear liability. By virtue of article 9 of the Belgian law of 12 December 1997, the Belgian Government wishes to avoid the occurrence of such nuclear liabilities. This law charges ONDRAF/NIRAS, the Belgian Agency for Radioactive Waste and Enriched Fissile Materials with the mission to draw up a register of the localisation and the state of all nuclear sites and all sites containing radioactive substances, to estimate the costs of their decommissioning and remediation, to evaluate the existence and adequacy of the provisions for financing these future or current operations and to update the resulting inventory of nuclear liabilities on a five-yearly basis. This paper outlines the methodology put in place by ONDRAF/NIRAS to accomplish this assignment and highlights some of the results of this third inventory. It then focuses on the main recommendations ONDRAF/NIRAS made to the Belgian Government on the field of avoiding potential nuclear liabilities. (authors)

  8. Cardiovascular Health and Arterial Stiffness: The Maine Syracuse Longitudinal Study

    Science.gov (United States)

    Crichton, Georgina E; Elias, Merrill F; Robbins, Michael A

    2014-01-01

    Ideal cardiovascular health is a recently defined construct by the American Heart Association (AHA) to promote cardiovascular disease reduction. Arterial stiffness is a major risk factor for cardiovascular disease. The extent to which the presence of multiple prevalent cardiovascular risk factors and health behaviors is associated with arterial stiffness is unknown. The aim of this study was to examine the association between the AHA construct of cardiovascular health and arterial stiffness, as indexed by pulse wave velocity and pulse pressure. The AHA health metrics, comprising of four health behaviors (smoking, body mass index, physical activity, and diet) and three health factors (total cholesterol, blood pressure, and fasting plasma glucose) were evaluated among 505 participants in the Maine-Syracuse Longitudinal Study. Outcome measures were carotid-femoral pulse wave velocity (PWV) and pulse pressure measured at 4 to 5-year follow-up. Better cardiovascular health, comprising both health factors and behaviors, was associated with lower arterial stiffness, as indexed by pulse wave velocity and pulse pressure. Those with at least five health metrics at ideal levels had significantly lower PWV (9.8 m/s) than those with two or less ideal health metrics (11.7 m/s) (P<0.001). This finding remained with the addition of demographic and PWV-related variables (P=0.004). PMID:24384629

  9. Mortality and health policy: main issues for the 1980s.

    Science.gov (United States)

    1984-01-01

    This paper reviews the progress and prospects for mortality reduction in the major regions of the world. The goals for mortality reduction as expressed in the World Population Plan of Action and other official international documents are presented and progress towards the attainment of those goals at the regional level is appraised. A quick review of trends in life expectancy at birth is then presented and major causes of death for developing and developed countries are summarized. The interrelationships between mortality and health levels and differentials, and development are considered. Factors leading to a sustained high mortality level or contributing to its decrease are investigated. Some factors reviewed are gross national product (GNP), structure of economic growth, dependency on foreign economies, recession, development strategies, education and agricultural development. For developed countries, focus is on per capita GNP, life styles associated with development and industrial pollution. Demographic, economic and social consequences of mortality and health improvement are then examined and main findings on differentials in mortality by sex, socioeconomic characteristics and geographical location are presented for developed and developing countries. The effects of selected health programs in areas like immunization, nutrition, maternal and child health, sanitation, environmental control and life-style interventions are considered and basic elements of primary health care strategy discussed. Primary health care strategies are characterized by some basic elements, including active community participation, provision of curative, preventive and health promotion services and use of paramedical personnel. The obstacles for health policy implementation are examined. A review is made of characteristics of the social system e.g. power structure, and a closer look is taken at specific characteristics of the health system such as health care management, planning and

  10. THE MAIN GENERAL HEALTH INDICATORS OF PRETERM NEWBORNS

    OpenAIRE

    Елена Николаевна Никулина; Светлана Ивановна Елгина; Юлия Александровна Липкова; Сергей Викторович Липков

    2017-01-01

    Objective – to determine the main health indicators in preterm newborns. Materials and Methods: Premature newborns and full-term newborns (160 and 1408, respectively) were investigated with clinical, instrumental, and statistical methods. Anthropometric parameters, somatic health, vulvar anatomy were considered to be the main criteria for general health. Results: The indicators of general health (physical development, somatic health, vulvar anatomy) in premature and full-term newborns...

  11. School Health: Findings from Evaluated Programs.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

    This publication presents findings from evaluations of many school health programs from across the United States. Each program includes at least one of the following eight components of a comprehensive school health program: health education, clinical services, counseling and mental health services, school environment, school food programs,…

  12. Malawi : Country Procurement Assessment Report, Volume 1. Main Findings and Recommendations

    OpenAIRE

    World Bank

    2004-01-01

    The Malawi Country Procurement Assessment Report is a joint undertaking between the Malawi Government and the World Bank to analyze the country procurement system and recommend appropriate actions to improve the efficiency, economy and transparency of the system. This report is divided into (a) an Executive Summary, (b) Main Report on Findings and Recommendations, and (c) Annexes. Since th...

  13. Normal anatomy and MR findings of fetal main organs at MR imaging

    International Nuclear Information System (INIS)

    Xia Liming; Zou Mingli; Feng Dingyi; Hu Junwu; Qi Jianpin; Wang Chengyuan

    2005-01-01

    Objective: To investigate normal anatomy and MR findings of fetal main organs. Methods: Forty-seven fetus underwented fast MR imaging, SSFSE sequence was used, the normal anatomy and MR findings of fetal main organs was observed in different gestational age. The organs included: brain, lungs, heart, liver, spleen, gastrointestinal tract, urinary collecting systems, bladder, bones, spine, and subcutaneous fat. Results: Results of MR in 47 fetus showed that the main organs had developed by 20-week-old fetus, about 20 weeks gestation, cerebral cortical surface was smooth, no cortical gyri and sulci, then cortical gyri and sulci developed slowly. The lungs, trachea, bronchus, gastrointestinal tract, renal collecting system and bladder showed high signal intensity; the heart, great vessels, liver, spleen, bones and muscles appeared hypointense; the kidneys appeared isointense, the spine had developed and subcutaneous fat was seen in 20-week-old fetus, the subcutaneous fat increased with fetus maturating. Conclusion: Normal anatomy and MR findings of fetal main organs were clearly showed by fast MR imaging, and they are different from the newborns. (authors)

  14. Cadmium exposure and health risks: Recent findings

    Energy Technology Data Exchange (ETDEWEB)

    Elinder, C.G. [Huddinge Hospital (Sweden). Dept. of Renal Medicine; Jaerup, L. [Stockholm City Council (Sweden). Dept. of Environmental Health

    1996-08-01

    Environmental and/or occupational exposure to cadmium give rise to a tubular kidney dysfunction which may proceed to more generalized renal damage and bone disease if exposure has been high and prolonged. Recent scientific work shows that early renal effects develop at lower levels of exposure than previously anticipated. Previous risk assessments for cadmium were mainly based on studies on healthy male workers. The general population, however, also include particularly susceptible groups such as elderly and individuals with illnesses (e.g. diabetes) that may predispose to cadmium-induced health effects. A significant proportion of the general population displays early signs of toxicity already at urinary cadmium concentrations around 3 nmol mmol{sup -1} creatinine. In addition to early tubular effects, cadmium may exert direct or indirect effects on mineral metabolism and the mineralization of the skeleton at relatively low levels of exposure. This may have important health implications, as poor and easily fractured bone is a major problem among the elderly in all industrialized countries. 41 refs, 4 figs

  15. Health risk assessment of China’s main air pollutants

    Directory of Open Access Journals (Sweden)

    Jian Sun

    2017-02-01

    Full Text Available Abstract Background With the rapid development of China’s economy, air pollution has attracted public concern because of its harmful effects on health. Methods The source apportioning of air pollution, the spatial distribution characteristics, and the relationship between atmospheric contamination, and the risk of exposure were explored. The in situ daily concentrations of the principal air pollutants (PM2.5, PM10, SO2, NO2, CO and O3 were obtained from 188 main cities with many continuous air-monitoring stations across China (2014 and 2015. Results The results indicate positive correlations between PM2.5 and SO2 (R 2 = 0.395/0.404, P  0.05 for both 2014 and 2015. Additionally, a significant relationship between SO2, NO2, and CO was discovered using regression analysis (P < 0.0001, indicating that the origin of air pollutants is likely to be vehicle exhaust, coal consumption, and biomass open-burning. For the spatial pattern of air pollutants, we found that the highest concentration of SO2, NO2, and CO were mainly distributed in north China (Beijing-Tianjin-Hebei regions, Shandong, Shanxi and Henan provinces, part of Xinjiang and central Inner Mongolia (2014 and 2015. Conclusions The highest concentration and risk of PM2.5 was observed in the Beijing–Tianjin–Hebei economic belts, and Shandong, Henan, Shanxi, Hubei and Anhui provinces. Nevertheless, the highest concentration of O3 was irregularly distributed in most areas of China. A high-risk distribution of PM10, SO2 and NO2 was also observed in these regions, with the high risk of PM10 and NO2 observed in the Hebei and Shandong province, and high-risk of PM10 in Urumchi. The high-risk of NO2 distributed in Beijing-Yangtze River Delta region-Pearl River Delta region-central. Although atmospheric contamination slightly improved in 2015 compared to 2014, humanity faces the challenge of reducing the environmental and public health effects of air pollution by altering the present

  16. Advanced Health Management System for the Space Shuttle Main Engine

    Science.gov (United States)

    Davidson, Matt; Stephens, John; Rodela, Chris

    2006-01-01

    Pratt & Whitney Rocketdyne, Inc., in cooperation with NASA-Marshall Space Flight Center (MSFC), has developed a new Advanced Health Management System (AHMS) controller for the Space Shuttle Main Engine (SSME) that will increase the probability of successfully placing the shuttle into the intended orbit and increase the safety of the Space Transportation System (STS) launches. The AHMS is an upgrade o the current Block II engine controller whose primary component is an improved vibration monitoring system called the Real-Time Vibration Monitoring System (RTVMS) that can effectively and reliably monitor the state of the high pressure turbomachinery and provide engine protection through a new synchronous vibration redline which enables engine shutdown if the vibration exceeds predetermined thresholds. The introduction of this system required improvements and modification to the Block II controller such as redesigning the Digital Computer Unit (DCU) memory and the Flight Accelerometer Safety Cut-Off System (FASCOS) circuitry, eliminating the existing memory retention batteries, installation of the Digital Signal Processor (DSP) technology, and installation of a High Speed Serial Interface (HSSI) with accompanying outside world connectors. Test stand hot-fire testing along with lab testing have verified successful implementation and is expected to reduce the probability of catastrophic engine failures during the shuttle ascent phase and improve safely by about 23% according to the Quantitative Risk Assessment System (QRAS), leading to a safer and more reliable SSME.

  17. The Irish Study of Sexual Health and Relationships Main Report

    OpenAIRE

    Layte, Richard; McGee, Hannah; Quail, Amanda; Rundle, Kay; Cousins, Grainne; Donnelly, Claire; Mulcahy, Fiona; Conroy, Ronán

    2006-01-01

    SEX and sexuality are core dimensions of the human experience and an important determinant of well-being. An individual’s sexual behaviour and sexual health cannot be separated from their social and cultural context. This is brought out in the World Health Organisation’s (WHO) definition of sexual health. It is concerned not just with the absence of disease or dysfunction but with a broad definition of health: “Sexual health requires a positive and respectful approach to sexuality and sexual ...

  18. Atmospheric Deposition: Sampling Procedures, Analytical Methods, and Main Recent Findings from the Scientific Literature

    Directory of Open Access Journals (Sweden)

    M. Amodio

    2014-01-01

    Full Text Available The atmosphere is a carrier on which some natural and anthropogenic organic and inorganic chemicals are transported, and the wet and dry deposition events are the most important processes that remove those chemicals, depositing it on soil and water. A wide variety of different collectors were tested to evaluate site-specificity, seasonality and daily variability of settleable particle concentrations. Deposition fluxes of POPs showed spatial and seasonal variations, diagnostic ratios of PAHs on deposited particles, allowed the discrimination between pyrolytic or petrogenic sources. Congener pattern analysis and bulk deposition fluxes in rural sites confirmed long-range atmospheric transport of PCDDs/Fs. More and more sophisticated and newly designed deposition samplers have being used for characterization of deposited mercury, demonstrating the importance of rain scavenging and the relatively higher magnitude of Hg deposition from Chinese anthropogenic sources. Recently biological monitors demonstrated that PAH concentrations in lichens were comparable with concentrations measured in a conventional active sampler in an outdoor environment. In this review the authors explore the methodological approaches used for the assessment of atmospheric deposition, from the analysis of the sampling methods, the analytical procedures for chemical characterization of pollutants and the main results from the scientific literature.

  19. Medicine and health information in Galician daily press. The health news in the main Galician newspapers

    Directory of Open Access Journals (Sweden)

    Lic. Carmen Costa Sánchez

    2008-01-01

    Full Text Available The aim of this paper is to study the health and medicine information published during a week in the four newspapers more spreaded in Galicia. The journalism has the responsibility of informing about health with quality criterions, instead of considering health a superficial, anecdotic and secondary subject. The appearance of the specific sections and the incorporation of the journalists specialized in health to the editorial staffs of the Spanish main generalist newspapers are beginning a process in depth in this way. But what is happening with the press of the autonomous regions? Which is the informative processing of medicine and health information in Galician daily press?, we asked. Descriptive, quantitative and content analysis will make possible to think about the information coverage of this kind of facts for making a diagnostic of the situation and for proposing its necessary improvement.

  20. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    Science.gov (United States)

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H M G; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Main Determinants of Supplementary Health Insurance Demand: (Case of Iran)

    Science.gov (United States)

    Motlagh, Soraya Nouraei; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Ghaderi, Hossein

    2015-01-01

    Introduction: In the majority of developing countries, the volume of medical insurance services, provided by social insurance organizations is inadequate. Thus, supplementary medical insurance is proposed as a means to address inadequacy of medical insurance. Accordingly, in this article, we attempted to provide the context for expansion of this important branch of insurance through identification of essential factors affecting demand for supplementary medical insurance. Method: In this study, two methods were used to identify essential factors affecting choice of supplementary medical insurance including Classification and Regression Trees (CART) and Bayesian logit. To this end, Excel® software was used to refine data and R® software for estimation. The present study was conducted during 2012, covering all provinces in Iran. Sample size included 18,541 urban households, selected by Statistical Center of Iran using 3-stage cluster sampling approach. In this study, all data required were collected from the Statistical Center of Iran. Results: In 2012, an overall 8.04% of the Iranian population benefited from supplementary medical insurance. Demand for supplementary insurance is a concave function of age of the household head, and peaks in middle-age when savings and income are highest. The present study results showed greater likelihood of demand for supplementary medical insurance in households with better economic status, higher educated heads, female heads, and smaller households with greater expected medical expenses, and household income is the most important factor affecting demand for supplementary medical insurance. Conclusion: Since demand for supplementary medical insurance is hugely influenced by households’ economic status, policy-makers in the health sector should devise measures to improve households’ economic or financial access to supplementary insurance services, by identifying households in the lower economic deciles, and increasing their

  2. National Survey of Prison Health Care: Selected Findings.

    Science.gov (United States)

    Maruschak, Laura; Chari, Karishma A; Simon, Alan E; DeFrances, Carol J

    2016-07-01

    This report presents selected findings on the provision of health care services in U.S. state prisons. Findings on admissions testing for infectious disease, cardiovascular risk factors, and mental health conditions, as well as the location of the provision of care and utilization of telemedicine are all included. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  3. Reliability and main findings of the FEES-Tensilon Test in patients with myasthenia gravis and dysphagia.

    Science.gov (United States)

    Im, Sun; Suntrup-Krueger, Sonja; Colbow, Sigrid; Sauer, Sonja; Claus, Inga; Meuth, Sven G; Dziewas, Rainer; Warnecke, Tobias

    2018-05-26

    Diagnosis of pharyngeal dysphagia caused by myasthenia gravis (MG) based on clinical examination alone is often challenging. Flexible endoscopic evaluation of swallowing (FEES) combined with Tensilon (edrophonium) application, referred to as the FEES-Tensilon Test, was developed to improve diagnostic accuracy and to detect the main symptoms of pharyngeal dysphagia in MG. Here we investigated inter- and intra-rater reliability of the FEES-Tensilon Test and analyzed the main endoscopic findings. Four experienced raters reviewed a total of 20 FEES-Tensilon-Test videos in randomized order. Residue severity was graded at 4 different pharyngeal spaces before and after Tensilon administration. All interpretations were performed twice per rater, 4 weeks apart (a total of 160 scorings). Intra-rater test-retest reliability and inter-rater reliability levels were calculated. The most frequent FEES findings in MG patients before Tensilon application were prominent residues of semi solids spread all over the hypopharynx in varying locations. The reliability level in the interpretation of the FEES-Tensilon test was excellent regardless of the raters' profession or years of experience with FEES. All 4 raters showed high inter- and intra- reliability levels in interpreting the FEES-Tensilon Test based on residue clearance (kappa=0.922, 0.981). Degree of residue normalization in the vallecular space after Tensilon application showed the highest inter- and intra-rater reliability level (kappa=0.863, 0.957) followed by the epiglottis (kappa=0.813, 0.946) and pyriform sinuses (kappa=0.836, 0.929). Interpretation of the FEES-Tensilon Test based on residue severity and degree of Tensilon clearance, especially in the vallecular space, is consistent and reliable. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Find Your Passion, Lead with Purpose: A Health Informaticians' Guide.

    Science.gov (United States)

    Househ, Mowafa

    2017-01-01

    Health Informatics is an ever evolving, changing and dynamic field that has become the disruptive innovation shaping the future of healthcare. Health informaticians face a number of challenges in the workplace such as gaining acceptance and recognition from other healthcare providers and overcoming the resistance of healthcare providers from using technology in clinical practice. Being a health informatician is not for the faint hearted, especially as resistance to the role of health informaticians continues from both healthcare providers and hospital administrators. As health informaticians move from behind the scenes to the front line of todays modern healthcare organization, more leadership training is needed for health informaticians in dealing with the changing demands of the healthcare industry and rapid changes in technology innovations. Waking up everyday with the same passion and purpose to lead others and drive change within healthcare organizations requires the health informatician to find the internal passion that will be transformed into external actions guiding the health informatician in how they lead, communicate, work, think, and treat others within the workplace. The purpose of this paper is to help health informaticiains tap into and develop their passion for the field of health informatics so that they can lead with purpose to improve how healthcare is practiced and delivered, making a lasting change in the overall healthcare system.

  5. Service Quality: A Main Determinant Factor for Health Information System Success in Low-resource Settings.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-01-01

    With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.

  6. Climate Change and Health: Transcending Silos to Find Solutions.

    Science.gov (United States)

    Machalaba, Catherine; Romanelli, Cristina; Stoett, Peter; Baum, Sarah E; Bouley, Timothy A; Daszak, Peter; Karesh, William B

    2015-01-01

    Climate change has myriad implications for the health of humans, our ecosystems, and the ecological processes that sustain them. Projections of rising greenhouse gas emissions suggest increasing direct and indirect burden of infectious and noninfectious disease, effects on food and water security, and other societal disruptions. As the effects of climate change cannot be isolated from social and ecological determinants of disease that will mitigate or exacerbate forecasted health outcomes, multidisciplinary collaboration is critically needed. The aim of this article was to review the links between climate change and its upstream drivers (ie, processes leading to greenhouse gas emissions) and health outcomes, and identify existing opportunities to leverage more integrated global health and climate actions to prevent, prepare for, and respond to anthropogenic pressures. We conducted a literature review of current and projected health outcomes associated with climate change, drawing on findings and our collective expertise to review opportunities for adaptation and mitigation across disciplines. Health outcomes related to climate change affect a wide range of stakeholders, providing ready collaborative opportunities for interventions, which can be differentiated by addressing the upstream drivers leading to climate change or the downstream effects of climate change itself. Although health professionals are challenged with risks from climate change and its drivers, the adverse health outcomes cannot be resolved by the public health community alone. A phase change in global health is needed to move from a passive responder in partnership with other societal sectors to drive innovative alternatives. It is essential for global health to step outside of its traditional boundaries to engage with other stakeholders to develop policy and practical solutions to mitigate disease burden of climate change and its drivers; this will also yield compound benefits that help address

  7. Ruthenium release at high temperature from irradiated PWR fuels in various oxidising conditions. Main findings from the VERCORS program

    International Nuclear Information System (INIS)

    Ducros, G.; Pontillon, Y.; Malgouyres, P.P.; Taylor, P.; Dutheillet, Y.

    2005-01-01

    Fission product release and transport in case of PWR severe accident is a major topic in reactor safety assessment due to the potential radiological consequences for surrounding populations and the environment. In this context, the Institute for Radiological Protection and Safety (IRSN) and Electricite de France (EDF) have supported the VERCORS analytical test program which was performed by the ''Commissariat a l'Energie Atomique'' (CEA). It is usually considered as complementary to the PHEBUS FP in-pile integral experimental program. 25 annealing tests were performed between 1983 and 2002 on irradiated PWR fuels under various conditions of temperature and atmospheres (oxidising or reducing conditions).The influence of the nature of the fuel (UO 2 versus MOX, burn-up) and the fuel morphology (initially intact or fragmented fuels) have also been investigated. These led to an extended data base allowing on the one hand to study mechanisms which promote fission products release, and on the other hand to enhance models implemented in severe accident codes. Among all the fission products investigated, ruthenium is of specific concern because of its high radiological effects due essentially to the combination of both its short and long half-life isotopes (i.e. 103 Ru and 106 Ru respectively), but also by its ability to generate volatile gaseous oxides (RuO 3 , RuO 4 ) in very oxidising conditions, in particular in the case of air ingress accidents. Important uncertainties still remain on the release and transport of this element in such situations, and investigations on this open issue are notably carried out in the SARNET European framework. The present communication gives a general overview of the VERCORS program and presents more deeply the main findings concerning the ruthenium release. Its global behaviour is analysed on the basis of several comparative tests: same UO 2 sample (35 and 50 GWd/t) under hydrogen or steam conditions, similar MOX sample (40 GWd/t) under

  8. [Evaluation of women's health care programs in the main institutions of the Mexican health system].

    Science.gov (United States)

    Enciso, Graciela Freyermuth; Navarro, Sergio Meneses; Martínez, Martín Romero

    2015-01-01

    The aim of this study was to analyze the institutional capacity for provision of women's health care services in Mexico in accordance with prevailing regulations. A probabilistic national sample of health care institutions was used to compare performance rates according to services packages based on analysis of variance. No package showed outstanding performance. Adequate performance was seen in referral and counter-referral centers for uterine cervical cancer, childbirth care, breast cancer diagnosis, family planning counseling, and training in sexual and reproductive health. The lowest performance was seen in the prevention of uterine cervical cancer, obstetric urgencies, family and sexual violence, and promotion of family planning. All the institutions showed low performance in the prevention of breast cancer, promotion of family planning, and management of family and gender violence. The Ministry of Health's leadership needs to be strengthened in order to overcome resistance for the institutions to adhere to the prevailing regulations.

  9. Finding toxicological information: An approach for occupational health professionals

    Directory of Open Access Journals (Sweden)

    Franco Giuliano

    2008-08-01

    Full Text Available Abstract Background It can be difficult for occupational health professionals to assess which toxicological databases available on the Internet are the most useful for answering their questions. Therefore we evaluated toxicological databases for their ability to answer practical questions about exposure and prevention. We also propose recommended practices for searching for toxicological properties of chemicals. Methods We used a systematic search to find databases available on the Internet. Our criteria for the databases were the following: has a search engine, includes factual information on toxic and hazardous chemicals harmful for human health, and is free of charge. We developed both a qualitative and a quantitative rating method, which was used by four independent assessors to determine appropriateness, the quality of content, and ease of use of the database. Final ratings were based on a consensus of at least two evaluators. Results Out of 822 results we found 21 databases that met our inclusion criteria. Out of these 21 databases 14 are administered in the US, five in Europe, one in Australia, and one in Canada. Nine are administered by a governmental organization. No database achieved the maximum score of 27. The databases GESTIS, ESIS, Hazardous Substances Data Bank, TOXNET and NIOSH Pocket Guide to Chemical Hazards all scored more than 20 points. The following approach was developed for occupational health professionals searching for the toxicological properties of chemicals: start with the identity of the chemical; then search for health hazards, exposure route and measurement; next the limit values; and finally look for the preventive measures. Conclusion A rating system of toxicological databases to assess their value for occupational health professionals discriminated well between databases in terms of their appropriateness, quality of information, and ease of use. Several American and European databases yielded high scores and

  10. Information-searching behaviors of main and allied health professionals: a nationwide survey in Taiwan.

    Science.gov (United States)

    Weng, Yi-Hao; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Shih, Ya-Hui; Chiu, Ya-Wen

    2013-10-01

    There are a variety of resources to obtain health information, but few studies have examined if main and allied health professionals prefer different methods. The current study was to investigate their information-searching behaviours. A constructed questionnaire survey was conducted from January through April 2011 in nationwide regional hospitals of Taiwan. Questionnaires were mailed to main professionals (physicians and nurses) and allied professionals (pharmacists, physical therapists, technicians and others), with 6160 valid returns collected. Among all professional groups, the most commonly used resource for seeking health information was a Web portal, followed by colleague consultations and continuing education. Physicians more often accessed Internet-based professional resources (online databases, electronic journals and electronic books) than the other groups (P < 0.05). In contrast, physical therapists more often accessed printed resources (printed journals and textbooks) than the other specialists (P < 0.05). And nurses, physical therapists and technicians more often asked colleagues and used continuing education than the other groups (P < 0.01). The most commonly used online database was Micromedex for pharmacists and MEDLINE for physicians, technicians and physical therapists. Nurses more often accessed Chinese-language databases rather than English-language databases (P < 0.001). This national survey depicts the information-searching pattern of various health professionals. There were significant differences between and within main and allied health professionals in their information searching. The data provide clinical implications for strategies to promote the accessing of evidence-based information. © 2012 John Wiley & Sons Ltd.

  11. Personality Characteristics, Job Stressors, and Job Satisfaction: Main and Interaction Effects on Psychological and Physical Health Conditions of Italian Schoolteachers.

    Science.gov (United States)

    Zurlo, Maria Clelia; Pes, Daniela; Capasso, Roberto

    2016-08-01

    The study proposed an application of the transactional model of stress in teaching elaborated by Travers and Cooper in 1996, and aimed to investigate the influence of personality characteristics (coping strategies, type A behaviors), situational characteristics (sources of pressure), and perceived job satisfaction in the prediction of teachers' psychophysical health conditions. The Italian version of the Teacher Stress Questionnaire was administered to 621 teachers. Logistic regression was used to evaluate significant main and interaction effects of personality characteristics, situational characteristics, and perceived job satisfaction on teachers' self-reported psychophysical health conditions. The findings highlighted specific coping strategies (focused on the problem, on innovation, and on hobbies and pastimes) and dimensions of job satisfaction (related to intrinsic aspects of job and to employee relations) buffering the negative effects of several job stressors. Type A behaviors and coping strategies focused on mobilized social support, suppression of stress, and not confronting the situation had main and interactions with negative effects on psychophysical health. Findings confirmed the necessity to run multi-factor research to analyze the different combinations of individual and situational variables implicated in negative health outcomes and to highlight the most significant buffering or increasing associations. © The Author(s) 2016.

  12. Main drivers of health expenditure growth in China: a decomposition analysis.

    Science.gov (United States)

    Zhai, Tiemin; Goss, John; Li, Jinjing

    2017-03-09

    In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation. Demographic data on population size and age-composition were obtained from the Department of Economic and Social Affairs of the United Nations. Age- and disease- specific expenditure and prevalence rates by age and disease were extracted from China's National Health Accounts studies and Global Burden of Disease 2013 studies of the Institute for Health Metrics and Evaluation, respectively. Growth in health expenditure in China was mainly driven by a rapid increase in real expenditure per prevalent case, which contributed 8.4 percentage points of the 11.6% annual average growth. Excess health price inflation and population growth contributed 1.3 and 1.3% respectively. The effect of population ageing was relatively small, contributing 0.8% per year. However, reductions in disease prevalence rates reduced the growth rate by 0.3 percentage points. Future policy in optimising growth in health expenditure in China should address growth in expenditure per prevalent case. This is especially so for neoplasms, and for circulatory and respiratory disease. And a focus on effective interventions to reduce the prevalence of disease in the country will ensure that changing disease rates do not lead to a higher growth in future health expenditure

  13. Health implications of petroleum refinery air emissions: Part I main report : Final : Executive summary

    International Nuclear Information System (INIS)

    2003-03-01

    This report provides a review of recent public health risk assessments performed in the field of petroleum refineries, and epidemiological or community health studies of populations residing close to petroleum refineries. The objective was to identify and access information concerning possible health impacts specific to this industry. The small number of studies performed on the topic as well as shortcomings in study design, concomitant exposure to other industrial sources and somewhat inconsistent findings make the data difficult to interpret. Potential concerns include short-term respiratory effects from exposure to sulphur dioxide and other substances, and cancer risks from benzene and other substances. There was very limited support for these findings in epidemiology studies of populations in the vicinity of petroleum refineries. This review provides additional support concerning cardiac and respiratory effects of air pollution including particulate matter (PM) and ground level ozone

  14. CLINICAL EXAMINATION IN GYNECOLOGY CONSULT X LABORATORY FINDINGS: EVIDENCE OF THE MAIN INFECTIONS OF THE REPRODUCTIVE TRACT

    Directory of Open Access Journals (Sweden)

    J. S. Sodré

    2016-07-01

    Full Text Available Sexually transmitted infections (STIs are among the most common public health problems worldwide. The study aimed to identify gynecological infectious etiology, based on the clinical complaint of the patient and later compare with the results released by the clinical laboratory, clinically analyzing external gynecological changes and clinical complaints of patients seen in primary care. This is a documentary, descriptive, and quantitative research, conducted in a primary care unit of the Sinop municipality in 2015. Women assisted by the Extension Project Team “Nursing care: A health promotion tool sexual and reproductive” participated in this work. The clinical examination data were collected in gynecological care and preventive examinations and recorded in a structured form. The number of preventive examinations in 2015 was 100 samples. The age of the women participating in the survey that stood out was 20 to 29 years old. Analyzing aspects of the cervix of patients who performed the Pap smear: 82 (82% were complete, 5 (5% showed some change, 6 (6% were friable, 5 (5% were not displayed having been surgically removed and 2 (2% were not displayed. According to this survey, of the 20 amendments in the laboratory results, 14 (70% examinations portrayed resemblance to the clinical description of the gynecological examination. The infectious agent of higher prevalence compared with the clinical description of abundant leucorrhea was Gardinerella vaginalis represented in 09 reports of cervical cytology. There was 68 (68% negative Schiller test and 8 (8% positive Schiller test and 24 (24% women, unfortunately, did not perform the test for lack of material during collection at the unit. It is concluded that investment in health education is necessary, with groups that address women's health, emphasizing the importance of prevention as well as the return of the woman to take the laboratory results and/or post-therapeutic assessment; promoting the

  15. Cardiovascular health and cognitive function: the Maine-Syracuse Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Georgina E Crichton

    Full Text Available Smoking, physical inactivity, and poor diet, along with obesity, fasting glucose and blood pressure have been independently associated with poorer cognitive performance. Few studies have related scales representing a combination of these variables to multiple domains of cognitive performance. The aim of this study was to investigate the association between overall cardiovascular health, incorporating seven components, and cognitive function.A cross-sectional analysis employing 972 participants, from the Maine-Syracuse Longitudinal Study was undertaken. Four health behaviors (body mass index, physical activity, diet, smoking and three health factors (total cholesterol, blood pressure, and fasting plasma glucose were measured. Each was categorized according to the American Heart Association definitions for ideal cardiovascular health, except diet, for which two food scores were calculated. A Cardiovascular Health Score was determined by summing the number of cardiovascular metrics at ideal levels. Cognitive function was assessed using a thorough neuropsychological test battery.Cardiovascular Health Score was positively associated with seven out of eight measures of cognitive function, with adjustment for age, education, and gender. With further adjustment for cardiovascular and psychological variables, these associations remained significant for Visual-Spatial Memory, Working Memory, Scanning and Tracking, Executive Function and the Global Composite score (p<0.05 for all. Ideal levels of a number of health factors and behaviors were positively associated with global cognitive performance.Increasing cardiovascular health, indexed by a higher number of metrics at ideal levels, is associated with greater cognitive performance. Smoking, physical activity, and diet are important components of cardiovascular health that impact upon cognition.

  16. Finding and Evaluating Online Resources on Complementary Health Approaches

    Science.gov (United States)

    ... health care provider. Read more information about health fraud Protecting Yourself (FDA) El Fraude en la Salud ( ... Torre-Díez I, López-Coronado M. Privacy and security in mobile health apps: a review and recommendations. ...

  17. School-Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program.

    Science.gov (United States)

    Basurto-Dávila, Ricardo; Meltzer, Martin I; Mills, Dora A; Beeler Asay, Garrett R; Cho, Bo-Hyun; Graitcer, Samuel B; Dube, Nancy L; Thompson, Mark G; Patel, Suchita A; Peasah, Samuel K; Ferdinands, Jill M; Gargiullo, Paul; Messonnier, Mark; Shay, David K

    2017-12-01

    To estimate the societal economic and health impacts of Maine's school-based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic. Primary and secondary data covering the 2008-09 and 2009-10 influenza seasons. We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis. We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model. The program was associated with higher immunization among children and lower immunization among adults aged 18-49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations. SIV may be a cost-beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups. © Health Research and Educational Trust.

  18. Identification and Hierarchy of Main Electronic Health Record Components in Occupational Medicine

    Directory of Open Access Journals (Sweden)

    Dorin TRIFF

    2010-12-01

    Full Text Available Starting from the legal requirements relating to structuring of medical records in occupational medicine and international requirements regarding the certification of electronic health records we have focused on structuring and then evaluating an EHR model in occupational medicine that integrates the main functions and certification criteria required by the European and US certification bodies. The application we designed, called Medmun, structured for use in occupational medicine practices based on the model of medical file provided by the Romanian legislation, integrates both necessary components of occupational medicine practice for administration of characteristic information related to socio-economic unit, work place, health surveillance as well as components of specific EHR functionality. The application has been submitted for free evaluation by specialist physicians of five counties over a period of nine months and subsequently assessed using a questionnaire on the usefulness of specific functional components in the EHR occupational medicine practice. The model was positively evaluated after experimental employment by occupational health practitioners. They consider that absence of legislative support for EHR implementation in medical practice is the main obstacle to the use of such applications in occupational medicine practice.

  19. Human Health Effects of Trichloroethylene: Key Findings and Scientific Issues

    Science.gov (United States)

    Jinot, Jennifer; Scott, Cheryl Siegel; Makris, Susan L.; Cooper, Glinda S.; Dzubow, Rebecca C.; Bale, Ambuja S.; Evans, Marina V.; Guyton, Kathryn Z.; Keshava, Nagalakshmi; Lipscomb, John C.; Barone, Stanley; Fox, John F.; Gwinn, Maureen R.; Schaum, John; Caldwell, Jane C.

    2012-01-01

    Background: In support of the Integrated Risk Information System (IRIS), the U.S. Environmental Protection Agency (EPA) completed a toxicological review of trichloroethylene (TCE) in September 2011, which was the result of an effort spanning > 20 years. Objectives: We summarized the key findings and scientific issues regarding the human health effects of TCE in the U.S. EPA’s toxicological review. Methods: In this assessment we synthesized and characterized thousands of epidemiologic, experimental animal, and mechanistic studies, and addressed several key scientific issues through modeling of TCE toxicokinetics, meta-analyses of epidemiologic studies, and analyses of mechanistic data. Discussion: Toxicokinetic modeling aided in characterizing the toxicological role of the complex metabolism and multiple metabolites of TCE. Meta-analyses of the epidemiologic data strongly supported the conclusions that TCE causes kidney cancer in humans and that TCE may also cause liver cancer and non-Hodgkin lymphoma. Mechanistic analyses support a key role for mutagenicity in TCE-induced kidney carcinogenicity. Recent evidence from studies in both humans and experimental animals point to the involvement of TCE exposure in autoimmune disease and hypersensitivity. Recent avian and in vitro mechanistic studies provided biological plausibility that TCE plays a role in developmental cardiac toxicity, the subject of substantial debate due to mixed results from epidemiologic and rodent studies. Conclusions: TCE is carcinogenic to humans by all routes of exposure and poses a potential human health hazard for noncancer toxicity to the central nervous system, kidney, liver, immune system, male reproductive system, and the developing embryo/fetus. PMID:23249866

  20. The management of health and safety at Atomic Weapons Establishment premises. Pt. 2: Detailed findings

    International Nuclear Information System (INIS)

    1994-10-01

    A review of the management of health and safety and the standards of risk control at premises run by Atomic Weapons Establishment plc (AWE) in the United Kingdom was completed in January 1994. This second volume of the review report records the findings relating to the eight health and safety topics chosen as the focus of the review because they provide evidence from AWE's key areas of activity. The topics are: Layard identification and risk assessment; operations; maintenance; research and experimentation; new facilities and modifications; decommissioning and waste; emergency preparedness; and health and safety specialist function. The Health and Safety Executive review team spent time at each of the four main AWE sites and observed an emergency exercise at Aldermaston. A report on the emergency exercise is included as an appendix. (UK)

  1. 11-Year Trends in Pregnancy-Related Health Indicators in Maine, 2000–2010

    Directory of Open Access Journals (Sweden)

    David E. Harris

    2014-01-01

    Full Text Available The objective of this study is to understand health and demographic trends among mothers and infants in Maine relative to the goals of Healthy People 2020. Pregnancy risk assessment monitoring system (PRAMS data from Maine for 2000–2010 were used to determine yearly values of pregnancy-related variables. Means (for continuous variables and percentages (for categorical variables were calculated using the survey procedures in SAS. Linear trend analysis was applied with study year as the independent variable. The slope and significance of the trend were then calculated. Over the study period, new mothers in Maine became better educated but the fraction of households with incomes <$20,000/year remained stagnant. Maternal prepregnancy BMI increased. Average pregnancy weight gain decreased but the number of women whose pregnancy weight gain was within the recommended range was unchanged. The rates of smoking and alcohol consumption (before and during pregnancy increased. The Caesarean section rate rose and the fraction of infants born premature (<37 wks gestation or underweight (<2500 gms remained unchanged. The fraction of infants who were breast-fed increased. These results suggest that, despite some positive trends, Maine faces significant challenges in meeting Healthy People 2020 goals.

  2. Emotional and social perception of main caregiver in a rural health district

    Directory of Open Access Journals (Sweden)

    Fabiola Yonte Huete

    2012-03-01

    Full Text Available Cross-sectional observational study of 50 caregivers of dependent patient immobilized. We analyzed the sociodemographic characteristics, type and characteristics of care, social, emotional and quality of life of main caregivers. Sociodemographic and care characteristics related to dependent patient immobilized was also studied. Objective: Describing the profile of dependent patient immobilized and their caregiver, and the emotional and social characteristics perceived by the main caregiver. Results: The age of dependent patient immobilized is rising particulary in women, with mental deterioration and dementia as principal diseases. The most of main caregivers are women, married women and daughters of dependent patient immobilized patients, with primary studies, in the middle age. They work almost the complete day in patient care, having less than two hour for themselves. The lack of money is the principal need felt it. The most of caregivers suffer mild to moderate stress and higher anxiety levels than general population, especially in females. Caregiver perceived quality of life is lower than general population too. Conclusions: To know the profile of dependent patient immobilized patient´s caregiver and the factors perceived burden caregiver´s, it is important developing interventions and plans to improve their quality of life related to health in order to reduce the syndrome of main caregiver.

  3. Interventions to assist health consumers to find reliable online health information: a comprehensive review.

    Directory of Open Access Journals (Sweden)

    Kenneth Lee

    Full Text Available BACKGROUND: Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. PURPOSE: To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. DATA SOURCES: PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus 'gray literature' search engines; and manual review of reference lists of selected publications. STUDY SELECTION: Publications were selected by firstly screening title, abstract, and then full text. DATA EXTRACTION: Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design Model. Two eligible gray literature papers were also reported. DATA SYNTHESIS: Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. LIMITATIONS: While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn. CONCLUSIONS: The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for

  4. Interventions to assist health consumers to find reliable online health information: a comprehensive review.

    Science.gov (United States)

    Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery D; Emmerton, Lynne M

    2014-01-01

    Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus 'gray literature' search engines; and manual review of reference lists of selected publications. Publications were selected by firstly screening title, abstract, and then full text. Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design) Model. Two eligible gray literature papers were also reported. Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn. The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for assisting health consumers to find reliable online health information, and to assess outcomes via objective measures.

  5. Finding a balance: health promotion challenges of military women.

    Science.gov (United States)

    Agazio, Janice Griffin; Buckley, Kathleen M

    2010-09-01

    In this study, we explored what may determine, or predict, United States military women's health promotion behaviors. Using a descriptive correlational design grounded in Pender's Health Promotion model, 491 military women completed instruments measuring their demographic variables, perception of health, definition of health, self-efficacy, and interpersonal influences to determine the significant factors affecting participation in health promotion activities. The outcome indicated that self-efficacy and interpersonal influences were the most influential in determining health promotion. This research illuminates some of the challenges working women face in meeting health promotion activities and how best to support their ability to participate in healthy behaviors.

  6. AZALEP a randomized controlled trial of azathioprine to treat leprosy nerve damage and Type 1 reactions in India: Main findings.

    Science.gov (United States)

    Lockwood, Diana N J; Darlong, Joydeepa; Govindharaj, Pitchaimani; Kurian, Royce; Sundarrao, Pamidipani; John, Annamma S

    2017-03-01

    azathioprine in the treatment of nerve damage and giving a higher dose for 48 weeks to patients. These findings highlight the difficulty in switching off leprosy inflammation and the need for better treatments for reactions and nerve damage. There is also a research need to identify patients who have recurrences and optimize treatments for them. Patients with recurrences may benefit from combined treatment with steroids and azathioprine. We have also shown that significant numbers of patients treated with steroids develop adverse effects and this needs to be highlighted in leprosy programmes. Research is needed to identify patients who do not respond to steroid treatment and develop alternative treatments for them. ClinicalTrials.gov This trial was registered with the Indian Council of Medical research clinical Trial register as a clinical trial Number-REFCTRI/2016/12/007558.

  7. Pathways of undue influence in health policy-making: a main actor's perspective.

    Science.gov (United States)

    Hernández-Aguado, Ildefonso; Chilet-Rosell, Elisa

    2018-02-01

    It is crucial to know the extent to which influences lead to policy capture-by which the policy-making process is shifted away from the public interest towards narrow private interests. Using the case study of Spain, our aim was to identify interactions between public administration, civil society and private companies that could influence health policies. 54 semistructured interviews with key actors related to health policy. The interviews were used to gather information on main policy actors as well as on direct and subtle influences that could modify health policies. The analysis identified and described, from the interviewed persons' experiences, both the inappropriate influences exerted on the actors and those that they exerted. Inappropriate influences were identified at all levels of administration and policy. They included actions for personal benefits, pressure for blocking health policies and pressure from high levels of government in favour of private corporations. The private sector played a significant role in these strategies through bribery, personal gifts, revolving doors, negative campaigns and by blocking unfavourable political positions or determining the knowledge agenda. The interviewees reported subtle forms of influence (social events, offers of technical support, invitations, etc) that contributed to the intellectual and cultural capture of health officials. The health policy decision-making processes in Spain are subject to influences by stakeholders that determine a degree of policy capture, which is avoidable. The private sector uses different strategies, from subtle influences to outright corruption, taking advantage in many cases of flexible legislation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Main health risks associated with Moroccan fishery products exported to European Union countries

    Directory of Open Access Journals (Sweden)

    S. Dahani

    2018-01-01

    Full Text Available The export of fishery products constitutes a very significant axis of the exchanges with certain countries, especially the countries of the European Union (EU. In Morocco, the exported fish products are controlled by the veterinarians of the National Office of the Health Security of Food products (NOHSF according to a procedure which is based on documentary control, identity and physical control and possibly analytical control. This control is complemented by monitoring plans. Currently, the product control has become a more demanding task due to the significant volume of fish production, the lack of means and human resources, hence the need for a novel approach to the control of fishery products based on risk analysis, which involves the establishment of appropriate controls aiming at guaranteeing that the products are safe. The objective of this work is the hierarchization of the main health risks associated to the fishery products exported to EU countries by Morocco. This approach is based on an overall analysis and statistical analysis using principal components analysis (PCA of the health profile of the notifications of the Rapid Alert System for the foodstuffs and feeding stuffs (RASFF from 1981 to 2015. This work allowed the development of a criticality matrix which specifies the health profile of species of products exported to EU countries via Morocco according to species, of danger and type of product. The control of fishery products based on risk analysis is a very important approach for the Moroccan competent authority.

  9. Mental health, sexual identity, and interpersonal violence: Findings from the Australian longitudinal Women's health study.

    Science.gov (United States)

    Szalacha, Laura A; Hughes, Tonda L; McNair, Ruth; Loxton, Deborah

    2017-09-30

    We examined the relationships among experiences of interpersonal violence, mental health, and sexual identity in a national sample of young adult women in Australia. We used existing data from the third (2003) wave of young adult women (aged 25-30) in the Australian Longitudinal Study on Women's Health (ALSWH). We conducted bivariate analyses and fit multiple and logistic regression models to test experiences of six types of interpersonal violence (physical abuse, severe physical abuse, emotional abuse, sexual abuse, harassment, and being in a violent relationship), and the number of types of violence experienced, as predictors of mental health. We compared types and number of types of violence across sexual identity subgroups. Experiences of interpersonal violence varied significantly by sexual identity. Controlling for demographic characteristics, compared to exclusively heterosexual women, mainly heterosexual and bisexual women were significantly more likely to report physical, sexual, and emotional abuse. Mainly heterosexual and lesbian women were more likely to report severe physical abuse. Mainly heterosexual women were more than three times as likely to have been in a violent relationship in the past three years, and all three sexual minority subgroups were two to three times as likely to have experienced harassment. Bisexual women reported significantly higher levels of depression than any of the other sexual identity groups and scored lower on mental health than did exclusively heterosexual women. In linear regression models, interpersonal violence strongly predicted poorer mental health for lesbian and bisexual women. Notably, mental health indicators were similar for exclusively heterosexual and sexual minority women who did not report interpersonal violence. Experiencing multiple types of interpersonal violence was the strongest predictor of stress, anxiety and depression. Interpersonal violence is a key contributor to mental health disparities

  10. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    Science.gov (United States)

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    not risk factors for accidental awareness: ASA physical status; race; and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from 5th National Audit Project - the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home#pt. © 2014 by the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. This article is being published jointly in Anaesthesia and the British Journal of Anaesthesia.

  11. Measuring Self-perceived Social Health of Iranians; Finding from Iran Social Health Survey

    Directory of Open Access Journals (Sweden)

    kambiz Abachizadeh

    2017-06-01

    Full Text Available Background: The novelty of the study is to measure self-perceived social health of Iranians as one of the main dimensions of health.Materials and Methods: This cross-sectional study was conducted in all provinces of Iran in September 2014 with 10500 participants to measure self-perceived social health on a scale from 33 to 165 arranged in three areas; family, friends and relatives, and community. Area of "family" was measure in a range from 6 to 30; area of "friends and relatives" was from 9 to 45; and area of "community" was from 19 to 95. The psychometrics of scale was examined in separate previous study.Results: From a total of 10500 participants, 10244 fulfilled questionnaire (Response rate= 97.6%. 49.2% of participants were male. Mean of the total social health score was 99.91; area of "family" was 22; area of "friends and relatives" was 27.6; and area of "community" was 51.2. The main factors negatively influences on social health were low house size, unemployment, being divorced or widow and being at the age of 18-30. There was no significant relationship between social health score and educational level.Conclusion: It is magnificently attained that standardized social health rate in the present study was 3.9% lower than the rate has been estimated in comparison to similar previously conducted study in three big cities of Iran, two years earlier. Area of "community" is also the main accountant for this drop. To continue monitoring the social health of Iranians, we recommend conducting the next rounds every 3-5 years.

  12. Stakeholder Perspectives on a Culture of Health: Key Findings.

    Science.gov (United States)

    Acosta, Joie D; Whitley, Margaret D; May, Linnea Warren; Dubowitz, Tamara; Williams, Malcolm V; Chandra, Anita

    2017-06-01

    Since 2013, the Robert Wood Johnson Foundation (RWJF) has embarked on a pioneering effort to advance a Culture of Health. The Culture of Health action framework is founded on a vision in which "everyone in our diverse society leads healthier lives now and for generations to come." To put the Culture of Health vision into action, RWJF asked RAND Health to support the development of an action framework and measurement strategy. This article summarizes the stakeholder engagement efforts that RAND used to inform this work. It draws on a series of interviews and focus groups that RAND researchers conducted with stakeholders both within and outside the United States. It should be of interest to RWJF, as well as to those individuals and organizations interested in advancing the Culture of Health action framework. Given that RWJF is focused on using the Culture of Health action framework and measures to catalyze national dialogue about content and investments to improve population health and well-being, the study should be beneficial to a range of national, state, and local leaders across a variety of sectors that contribute to health as described by the Culture of Health action framework.

  13. Health Information on the Web: Finding Reliable Information

    Science.gov (United States)

    ... NutritionBalancing Your Food PlateFollow the U.S. Department of Agriculture’s MyPlate and other guidelines to get a balanced ... Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health ...

  14. Main Educational Stressors and theirs Relationship with General Health of Medical Residents

    Directory of Open Access Journals (Sweden)

    Nahid Khajehmougahi

    2009-03-01

    Full Text Available Background: In the age of information and technology application, troublesome regulations and traditional  procedures for medical education may cause serious stresses and be a threat to the general health (GH of the students of medicine.Purpose: To determine the relationship between educational stressors and the general health of residents studying at the Ahwaz Jundishapour  University of Medical Sciences (Alums.Method: In this cross sectional study, the study group was consisted  of  ll4 cooperative residents (69% of all residents in the hospital, who were being trained in a variety of different specialties.  The instruments used were the Educational Stressors Questionnaire, including 45 four-choice items and a General  Health Questionnaire. When the questionnaires were completed, the results were analyzed through Pierson Correlation Coefficient using the SPSS.Results: The residents mentioned their educational stressors as follows: lack of an arranged curriculum, troublesome educational regulations, deficient educational instruments, and inadequate clinical instruction. of all the subjects, 43 ( 37.6% appeared to have problems in GH,and significantly positive correlation (pfindings suggest basic changes in the current medical instructional techniques.Keywords: educational stressor, general health, medical residents, medical  education

  15. Chernobyl NPP accident consequences cleaning up participants in Ukraine -health status epidemiologic study main results

    International Nuclear Information System (INIS)

    Buzunov, V.; Omelyanetz, N.; Strapko, N.; Ledoschuck, B.; Krasnikova, L.; Kartushin, G.

    1996-01-01

    The Epidemiologic Studies System for Chernobyl NPP Accident consequences cleaning up participants (CNPP ACCP) health status was worked out and than improving in Ukraine after the CNPP Accident. The State Register of Ukraine both with several other Registers are the organizational, methodological and informational basis here. The ACCP health status worsening ,-was registered in dynamics through the post-accidental period i.e. the nervous system, digestive system, blood circulation system, respiratory system, bone-muscular system, endocrine and genitourinary systems chronic non-tumoral pathology both with mental disorders amount increase. In cohort study the differences of morbidity formation were fixed among emergency workers with different radiation exposure doses. The dependence of leukemia morbidity on presence in 30-km zone duration was noticed, it's access manifested 5 years after the participance in ACC. The ACCP disablement increase with main reason of general somatic diseases, and annual mortality growth are registered. But that doesn't exceed the mortality rate among population of working age in Ukraine

  16. Magnitude estimate of occupational risks located in a radiative facility and its main health impacts

    International Nuclear Information System (INIS)

    Alves, Alice dos Santos; Gerulis, Eduardo; Carneiro, Janete C.G.G.

    2014-01-01

    The work routine of Radiopharmacy Center (CR) personnel of the Institute of Energy Research and Nuclear (IPEN / CNEN-SP) includes singularities not exist in other professions. Relevant examples to this study can be cited: exposure to physical, chemical, biological hazards, to accidents and ergonomic risks. The objective of this study is to conduct a quantitative and qualitative evaluation of occupational exposure existing in the workplace and its impact on the health of occupationally exposed individuals (IOE's). The proposed methodology was based on systematic observation and a questionnaire to the managers of each practice held at CR. The evaluation process involved three steps: a) characterization of exposure; b) identification of the main points of exposure and possible routes of exposure; c) quantifying of exposure. Seventeen occupational agents related to the tasks of different groups of IOE's were identified. Ionizing radiation (physical risk) and the situations that cause stress (ergonomic risk) had the highest frequencies. According to the applied methodology risks was considered mostly acceptable. Quantification of exposure was basically referring to physical risk agent (Ionizing radiation), because it is a radioactive installation. Based on the records analyzed, not was observed health risks to workers arising from the activities undertaken

  17. Finding what works in health care: standards for systematic reviews

    National Research Council Canada - National Science Library

    Eden, Jill

    2011-01-01

    .... Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms...

  18. Workplace Health Promotion and Mental Health: Three-Year Findings from Partnering Healthy@Work.

    Science.gov (United States)

    Jarman, Lisa; Martin, Angela; Venn, Alison; Otahal, Petr; Blizzard, Leigh; Teale, Brook; Sanderson, Kristy

    2016-01-01

    This study aimed to investigate the association between mental health and comprehensive workplace health promotion (WHP) delivered to an entire state public service workforce (~28,000 employees) over a three-year period. Government departments in a state public service were supported to design and deliver a comprehensive, multi-component health promotion program, Healthy@Work, which targeted modifiable health risks including unhealthy lifestyles and stress. Repeated cross-sectional surveys compared self-reported psychological distress (Kessler-10; K10) at commencement (N = 3406) and after 3 years (N = 3228). WHP availability and participation over time was assessed, and associations between the K10 and exposure to programs estimated. Analyses were repeated for a cohort subgroup (N = 580). Data were weighted for non-response. Participation in any mental health and lifestyle programs approximately doubled after 3 years. Both male and female employees with poorer mental health participated more often over time. Women's psychological distress decreased over time but this change was only partially attributable to participation in WHP, and only to lifestyle interventions. Average psychological distress did not change over time for men. Unexpectedly, program components directly targeting mental health were not associated with distress for either men or women. Cohort results corroborated findings. Healthy@Work was successful in increasing participation across a range of program types, including for men and women with poorer mental health. A small positive association of participation in lifestyle programs with mental health was observed for women but not men. The lack of association of mental health programs may have reflected program quality, its universality of application or other contextual factors.

  19. Workplace Health Promotion and Mental Health: Three-Year Findings from Partnering Healthy@Work.

    Directory of Open Access Journals (Sweden)

    Lisa Jarman

    Full Text Available This study aimed to investigate the association between mental health and comprehensive workplace health promotion (WHP delivered to an entire state public service workforce (~28,000 employees over a three-year period. Government departments in a state public service were supported to design and deliver a comprehensive, multi-component health promotion program, Healthy@Work, which targeted modifiable health risks including unhealthy lifestyles and stress. Repeated cross-sectional surveys compared self-reported psychological distress (Kessler-10; K10 at commencement (N = 3406 and after 3 years (N = 3228. WHP availability and participation over time was assessed, and associations between the K10 and exposure to programs estimated. Analyses were repeated for a cohort subgroup (N = 580. Data were weighted for non-response. Participation in any mental health and lifestyle programs approximately doubled after 3 years. Both male and female employees with poorer mental health participated more often over time. Women's psychological distress decreased over time but this change was only partially attributable to participation in WHP, and only to lifestyle interventions. Average psychological distress did not change over time for men. Unexpectedly, program components directly targeting mental health were not associated with distress for either men or women. Cohort results corroborated findings. Healthy@Work was successful in increasing participation across a range of program types, including for men and women with poorer mental health. A small positive association of participation in lifestyle programs with mental health was observed for women but not men. The lack of association of mental health programs may have reflected program quality, its universality of application or other contextual factors.

  20. Patients find success haggling as health-care costs climb.

    Science.gov (United States)

    Costello, Daniel

    2002-01-01

    In small but growing numbers, Americans are taking an innovative approach to controlling health-care costs: They're haggling with their doctors. Fed up with mounting health bills, consumers ae getting as much as 30% off everything from eye exams to fertility procedures just by agreeing to pay upfront. Others are holding their doctors over a barrel by waiting a few months to pay the bill. Already, a new cottage industry of middlemen who negotiate healthcare bills for patients report their haggling business is up as much as 25% in the last two years.

  1. Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

    Science.gov (United States)

    Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

    2013-01-01

    Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

  2. Interpreting Statistical Findings A Guide For Health Professionals And Students

    CERN Document Server

    Walker, Jan

    2010-01-01

    This book is aimed at those studying and working in the field of health care, including nurses and the professions allied to medicine, who have little prior knowledge of statistics but for whom critical review of research is an essential skill.

  3. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. © The Author(s) 2016.

  4. Developing and sustaining leadership in public health nursing: findings from one British Columbia health authority.

    Science.gov (United States)

    Mills, Leslie; Wong, Sabrina T; Bhagat, Radhika; Quail, Donna; Triolet, Kathy; Weber, Tannis

    2012-12-01

    To develop clinical leadership among front-line public health nurses (PHNs). This paper describes a quality improvement process to develop clinical leadership among front-line PHNs. Three activities were undertaken by a working group consisting mainly of front-line staff: engaging PHNs in an online change-readiness questionnaire, administering a survey to clients who had ever used public health services delivered by one Vancouver Community Infant, Child and Youth (ICY) program team and conducting three group interviews with public health providers. The group interviews asked about PHN practice. They were analyzed using thematic content analysis. This quality improvement project suggests that PHNs (n=70) strongly believed in opportunities for system improvement. Client surveys (n=429) and community partner surveys (n=79) revealed the importance of the PHN role. Group interview data yielded three themes: PHNs were the "hub" of community care; PHNs lacked a common language to describe their work; PHNs envisioned their future practice encompassing their full scope of competencies. PHNs developed the "ICY Public Health Nursing Model," which articulates 14 public health interventions and identifies the scope of their work. Developing and sustaining clinical leadership in front-line PHNs was accomplished through these various quality assurance activities. Copyright © 2013 Longwoods Publishing.

  5. Workplace health promotion and utilization of health services: follow-up data findings.

    Science.gov (United States)

    Deitz, Diane; Cook, Royer; Hersch, Rebekah

    2005-01-01

    This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

  6. Communication of urgent public health messages to urban populations: lessons from the Massachusetts water main break.

    Science.gov (United States)

    Wang, C Jason; Little, Alison A; Holliman, Jaime Bruce; Ng, Chun Y; Barrero-Castillero, Alejandra; Fu, Chong Min; Zuckerman, Barry; Bauchner, Howard

    2011-10-01

    To study when and how an urgent public health message about a boil-water order reached an urban population after the Massachusetts water main break. In-person surveys were conducted in waiting areas of clinics and emergency departments at a large urban safety net hospital within 1 week of the event. Of 533 respondents, 97% were aware of the order; 34% of those who lived in affected cities or towns were potentially exposed to contaminated water. Among those who were aware, 98% took action. Respondents first received the message through word of mouth (33%), television (25%), cellular telephone calls (20%), landline calls (10%), and other modes of communication (12%). In multivariate analyses, foreign-born respondents and those who lived outside the city of Boston had a higher risk of exposure to contaminated water. New modes (eg, cellular telephones) were used more commonly by females and younger individuals (ages 18 to 34). Individuals who did not speak English at home were more likely to receive the message through their personal networks. Given the increasing prevalence of cellular telephone use, public officials should encourage residents to register landline and cellular telephone for emergency alerts and must develop creative ways to reach immigrants and non-English-speaking groups quickly via personal networks.

  7. ls with Chronic Conditions Want More Guidance from Health Professionals in Finding Quality Online Health SourcesIndividua

    Directory of Open Access Journals (Sweden)

    Cari Merkley

    2016-04-01

    Full Text Available Objective – To explore how and when individuals with chronic health conditions seek out health information online, and the challenges they encounter when doing so. Design – Qualitative study employing thematic analysis. Setting – Urban Western Australia. Subjects – 17 men and women between 19 and 85 years of age with at least 1 chronic health condition. Methods – Participants were recruited in late 2013 at nine local pharmacies, through local radio, media channels, and a university's social media channels. Participants were adult English speakers who had looked for information on their chronic health condition(s using the Internet. Semi-structured face-to-face interviews were conducted with each participant, audio recorded, and transcribed. The transcripts were coded in QSR Nvivo using two different processes – an initial data-driven inductive approach to coding, followed by a theory driven analysis of the data. Main Results – Three major themes emerged: trust, patient activation, and relevance. Many of the participants expressed trust both in health professionals and in the efficacy of search engines like Google. However, there was uncertainty about the quality of some of the health information sources found. Searching for information online was seen by some participants as a way to feel more empowered about their condition(s and treatment, but they reported frustration in finding information that was relevant to their specific condition(s given the volume of information available. Low health literacy emerged in participant interviews as an intrinsic barrier to effective online searches for health information, along with low patient motivation and lack of time. The many extrinsic barriers identified included difficulty determining the quality of information found, the accessibility of the information (e.g., journal paywalls, and poor relationships with health care providers. Conclusion – Individuals look for online health

  8. Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda.

    Science.gov (United States)

    Holvoet, Nathalie; Inberg, Liesbeth

    2014-07-01

    In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  9. Physical health of the student as the main value of pedagogical process

    Directory of Open Access Journals (Sweden)

    Deminskaya L.A.

    2012-07-01

    Full Text Available The features of physical health of students are considered. Factors which influence on the physical health of children of school age are rotined. Methodical experience of teachers of physical education is presented. It is determined maintenance of concept «Physical health». The methods of estimation of the functional state of organism of schoolboys are selected. It is set that the axiological going near the health of students requires knowledge of methods of control after the functional state of organism and methods of development of physical health. It is marked that the modern teacher of physical education can not execute the educational, educate and health tasks of pedagogical process without knowledge of level of development of physical health and physical preparedness of students. It is marked that the modern teacher of physical education must know and able to estimate the indexes of physical health and physical preparedness of organism of children level.

  10. Social media and patient health outcomes. Findings from the yearbook 2014 section on consumer health informatics.

    Science.gov (United States)

    Staccini, P; Douali, N

    2014-08-15

    To provide a review of the current excellent research published in the field of Consumer Health Informatics. We searched MEDLINE® and WEB OF SCIENCE® databases for papers published in 2013 in relation with Consumer Health Informatics. The authors identified 16 candidate best papers, which were then reviewed by four reviewers. Five out of the 16 candidate papers were selected as best papers. One paper presents the key features of a system to automate the collection of web-based social media content for subsequent semantic annotation. This paper emphasizes the importance of mining social media to collect novel data from which new findings in drug abuse research were uncovered. The second paper presents a practical method to predict how a community structure would impact the spreading of information within the community. The third paper presents a method for improving the quality of online health communities. The fourth presents a new social network to allow the monitoring of the evolution of individuals' health status and diagnostic deficiencies, difficulties or barriers in rehabilitation. The last paper reports on teenage patients' perception on privacy and social media. Selected papers not only show the value of using social media in the medical field but how to use these media to detect emergent diseases or risks, inform patients, promote disease prevention, and follow patients' opinion on healthcare resources.

  11. Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information.

    Science.gov (United States)

    Champlin, Sara; Mackert, Michael; Glowacki, Elizabeth M; Donovan, Erin E

    2017-07-01

    While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low ( n = 13) and adequate ( n = 14) health literacy patients, and health professionals ( n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.

  12. How to optimize tuberculosis case finding: explorations for Indonesia with a health system model

    Directory of Open Access Journals (Sweden)

    Mahendradhata Yodi

    2009-06-01

    Full Text Available Abstract Background A mathematical model was designed to explore the impact of three strategies for better tuberculosis case finding. Strategies included: (1 reducing the number of tuberculosis patients who do not seek care; (2 reducing diagnostic delay; and (3 engaging non-DOTS providers in the referral of tuberculosis suspects to DOTS services in the Indonesian health system context. The impact of these strategies on tuberculosis mortality and treatment outcome was estimated using a mathematical model of the Indonesian health system. Methods The model consists of multiple compartments representing logical movement of a respiratory symptomatic (tuberculosis suspect through the health system, including patient- and health system delays. Main outputs of the model are tuberculosis death rate and treatment outcome (i.e. full or partial cure. We quantified the model parameters for the Jogjakarta province context, using a two round Delphi survey with five Indonesian tuberculosis experts. Results The model validation shows that four critical model outputs (average duration of symptom onset to treatment, detection rate, cure rate, and death rate were reasonably close to existing available data, erring towards more optimistic outcomes than are actually reported. The model predicted that an intervention to reduce the proportion of tuberculosis patients who never seek care would have the biggest impact on tuberculosis death prevention, while an intervention resulting in more referrals of tuberculosis suspects to DOTS facilities would yield higher cure rates. This finding is similar for situations where the alternative sector is a more important health resource, such as in most other parts of Indonesia. Conclusion We used mathematical modeling to explore the impact of Indonesian health system interventions on tuberculosis treatment outcome and deaths. Because detailed data were not available regarding the current Indonesian population, we relied on expert

  13. Hospitality Invites Sociability, Which Builds Cohesion: a Model for the Role of Main Streets in Population Mental Health.

    Science.gov (United States)

    Izenberg, Jacob M; Fullilove, Mindy Thompson

    2016-04-01

    The aim of this study was to investigate the contribution of main streets to community social cohesion, a factor important to health. Prior work suggests that casual contact in public space, which we call "sociability," facilitates more sustained social bonds in the community. We appropriate the term "hospitality" to describe a main street's propensity to support a density of such social interactions. Hospitality is a result of the integrity and complex contents of the main street and surrounding area. We examine this using a typology we term "box-circle-line" to represent the streetscape (the box), the local neighborhood (the circle), and the relationship to the regional network of streets (the line). Through field visits to 50 main streets in New Jersey and elsewhere, and a systematic qualitative investigation of main streets in a densely interconnected urban region (Essex County, New Jersey), we observed significant variation in main street hospitality, which generally correlated closely with sociability. Physical elements such as street wall, neighborhood elements such as connectivity, inter-community elements such as access and perceived welcome, and socio-political elements such as investment and racial discrimination were identified as relevant to main street hospitality. We describe the box-circle-line as a theoretical model for main street hospitality that links these various factors and provides a viable framework for further research into main street hospitality, particularly with regard to geographic health disparities.

  14. Periodontal Health Status and Associated Factors: Findings of a Prenatal Oral Health Program in South Brazil

    Directory of Open Access Journals (Sweden)

    Marta Silveira da Mota Krüger

    2017-01-01

    Full Text Available Objective. The aims of this study were to evaluate the periodontal health of pregnant women and to investigate the association of periodontal status with demographic and socioeconomic characteristics, as well as medical and dental history. Materials and Methods. A total of 311 pregnant women were interviewed to obtain sociodemographic data along with medical and dental histories. Clinical examinations were performed to record the presence of visible plaque, gingival bleeding, and caries activity. The periodontal condition was evaluated by Community Periodontal Index of Treatment Needs (CPITN in one tooth of each sextant (16, 11, 26, 36, 31, and 46. Results. After the adjustment analysis, the presence of visible plaque remained the main determinant of gingival bleeding (OR = 2.91, CI = 1.91–4.48. First-trimester pregnancy status was also a predictor, with a lower prevalence of gingival bleeding observed in the second (OR = 0.87, CI = 0.77–0.99 and third (OR = 0.82, CI = 0.73–0.93 trimesters. Conclusion. In pregnant women, the presence of dental plaque and first-trimester pregnancy status were the main implicated factors predicting gingival bleeding.

  15. Emotional and social perception of main caregiver in a rural health district

    OpenAIRE

    Fabiola Yonte Huete; María Belén Yonte Huete; Mª Teresa Meneses Jiménez

    2012-01-01

    Cross-sectional observational study of 50 caregivers of dependent patient immobilized. We analyzed the sociodemographic characteristics, type and characteristics of care, social, emotional and quality of life of main caregivers. Sociodemographic and care characteristics related to dependent patient immobilized was also studied. Objective: Describing the profile of dependent patient immobilized and their caregiver, and the emotional and social characteristics perceived by the main caregiver. R...

  16. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies.

    Science.gov (United States)

    Vosoogh Moghaddam, A; Damari, B; Alikhani, S; Salarianzedeh, Mh; Rostamigooran, N; Delavari, A; Larijani, B

    2013-01-01

    Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5(th) 5-years economical, social and cultural plan (5(th)5YDP:2011-2015), listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5(th)5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5th plan. The strategies of 5(th)5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization.

  17. The roles of resilience and childhood trauma history: main and moderating effects on postpartum maternal mental health and functioning.

    Science.gov (United States)

    Sexton, Minden B; Hamilton, Lindsay; McGinnis, Ellen W; Rosenblum, Katherine L; Muzik, Maria

    2015-03-15

    Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. The relevance of context in understanding health literacy skills: Findings from a qualitative study.

    Science.gov (United States)

    McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

    2017-10-01

    Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences. To describe individuals' experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations. A longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS-EU-47-Item Questionnaire. Findings are presented from the first round of data collection. Twenty-six participants purposefully selected from a CVD risk reduction programme at three separate time points. Four key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health-care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health-care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side-effects. Findings are relevant for health-care providers in order to enhance the patient-provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  19. Main findings and summary of answers from the regulators' forum questionnaire on regulation for geologic disposal. Support document to the Tokyo workshop, 20-22 January 2009

    International Nuclear Information System (INIS)

    2008-01-01

    The last decade has seen significant progress in several countries on the siting of repositories for deep disposal of long-lived radioactive waste. In parallel with this, regulatory authorities have developed and expanded the regulations that will be applied, firstly in deciding applications to proceed with repository development and, secondly, to provide the basis for ongoing supervision of repository development work. A workshop to be held in Tokyo 20-22 January 2009 will examine current issues in regulation for geological disposal of long-lived radioactive waste. A questionnaire was developed and sent to regulatory organisations in order to collect relevant data and structure the workshop along the themes of highest interest. The questionnaire answers are summarised herein along with the main findings in order to inform the discussions that will be held in the Tokyo workshop. (authors)

  20. Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Chen, Jie; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2014-01-01

    This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short-stayed (≤ 10 years) and long-stayed (>10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign-born adults (18-64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic-regression two-part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long-stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long-stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short-stayed documented immigrants may encounter difficulties getting health insurance coverage. Copyright © 2013 John Wiley & Sons, Ltd.

  1. CRED REA Coral Health and Disease Assessment at Hawaii Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 17 sites at...

  2. CRED REA Coral Health and Disease Assessment at Molokai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  3. CRED REA Coral Health and Disease Assessment at Oahu, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at Oahu...

  4. CRED REA Coral Health and Disease Assessment at Lehua Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  5. CRED REA Coral Health and Disease Assessment at Maui Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 11 sites at...

  6. CRED REA Coral Health and Disease Assessment at Kaula Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  7. CRED REA Coral Health and Disease Assessment at Niihau Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  8. CRED REA Coral Health and Disease Assessment at Lanai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  9. Product policy - the main component of the marketing mix in the Romanian health services.

    Science.gov (United States)

    Coculescu, B I; Purcarea, V L; Coculescu, E C

    2016-01-01

    The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

  10. Dr. North and the Kansas City Newspaper War: Public Health Advocacy Collides with Main Street Respectability.

    Science.gov (United States)

    Kovarik, Bill

    A case study examined a 1920 controversy between two newspapers. One of the last vestiges of the era of "yellow journalism" was the editorial "war" between the Kansas City "Star" and the Kansas City "Post" which culminated in a 1921 showdown. The "Star," a champion of main street interests and…

  11. Main characteristics of patients of primary health care services in Brazil

    Directory of Open Access Journals (Sweden)

    Ione Aquemi Guibu

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To characterize patients of primary health care services according to demographic and socioeconomic aspects, habits and lifestyle, health condition, and demand for health services and medicines. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, a cross-sectional study carried out between 2014 and 2015. Interviews were conducted with patients over the age of 17 years, with a standardized questionnaire, in primary health care services of a representative sample of cities, stratified by regions of Brazil. The analysis was performed for complex samples and weighted according to the population size of each region. RESULTS A total of 8,676 patients were interviewed, being 75.8% women, most of them aged from 18 to 39 years; 24.2% men, most of them aged from 40 to 59 years; 53.7% with elementary school; 50.5% reported to be of mixed race ethnicity, 39.7%, white, and 7.8%, black. Half of patients were classified as class C and 24.8% received the Bolsa Familia benefit. Only 9.8% had health insurance, with higher proportion in the South and lower in the North and Midwest. The proportion of men who consumed alcohol was higher than among women, as well as smokers. The self-assessment of health showed that 57% believed it to be very good or good, with lower proportion in the Northeast. The prevalence of chronic diseases/conditions, such as hypertension (38.6%, dyslipidemia (22.7%, arthritis/rheumatism (19.4%, depression (18.5%, diabetes (13.6%, and others are higher in these patients them among the general population. Medicines were predominantly sought in the health care service or in pharmacies of the Brazilian Unified Health System. CONCLUSIONS It was possible to characterize the profile of patients of Primary Health Care, but the originality of the

  12. The Main Correlations of the Hungarian’s Health Status and Food Consumption

    Directory of Open Access Journals (Sweden)

    Bakos Izabella Mária

    2016-11-01

    Full Text Available It is a general socio-political objective of the mid- and long term food industry development strategy of Hungary to promote healthy food production and consumption. The realization of the strategy of the domestic food industry increasingly promotes healthy eating, for example consuming natural, domestic, fresh ingredients, prepared foods, in order to improve the overall health of the population (EFS, 2014-2020. Our study presents the regional tendencies of staple food consumption in Hungarian regions and the changes in indicators reflecting the health status of the population. Furthermore, our hypothesis states that there is a statistically provable correlation between the annual food consumption of Hungarian households per capita and the health status, on regional level.

  13. Is self-selection the main driver of positive interpretations of general health checks?

    DEFF Research Database (Denmark)

    Bender, Anne Mette; Jørgensen, Torben; Pisinger, Charlotta

    2015-01-01

    OBJECTIVE: To investigate if the lower mortality among participants of a health check followed by lifestyle intervention of high risk persons is explained by self-selection. METHODS: All persons residing in the study area (Copenhagen; Denmark) were randomized to intervention (n=11,629) or control...... group (n=47,987). Persons in the intervention group were invited for a health check and individual lifestyle counselling. At baseline, 52.5% participated. Differences between participants and control group in 10-year all-cause and disease specific mortality was assessed. In survival analyses we...... was seen both for lifestyle related and non-lifestyle related diseases....

  14. Increasing Use of Research Findings in Improving Evidence-Based Health Policy at the National Level

    Directory of Open Access Journals (Sweden)

    Meiwita Budiharsana

    2017-11-01

    Full Text Available In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program and policy-makers and the information offered by researchers. A close dialogue is needed between the users (program managers, policy makers and planners and the suppliers (researchers and evaluators to ensure that the evidence-based supplied by research is useful for programs, planning and health policy.

  15. Working towards Men's Health: Findings from the Sefton Men's Health Project

    Science.gov (United States)

    Robinson, Mark; Robertson, Steve; McCullagh, Jo; Hacking, Sue

    2010-01-01

    Objective: To evaluate a health improvement initiative aimed at enhancing the health of men in deprived areas. Design: A healthy lifestyle programme was undertaken with men to increase their health knowledge, and encourage behaviour modification and access to health improvement services. A peer mentoring programme was implemented and a training…

  16. The main findings of the third Russian international conference on nuclear material protection, control and accounting, Obninsk, RF, 16-20 May, 2005

    International Nuclear Information System (INIS)

    Kondratov, S.

    2005-01-01

    Full text: The first and the second Russian international conferences on MPC+A held in 1997 and 2000 correspondingly, under the Russian-American program of the MPC+A cooperation proved to be a useful tool for Russian, American specialists and experts from a number for sharing their opinions and exchanging achievements in this sensitive area. The recommendation to hold the next third MPC+A conference in Russia was formulated in the final document of the second conference in 2000. The results of the Russian-American cooperation are especially valuable since they demonstrate how much can be done due to the joint efforts of even previously adversarial countries. This paper gives a summary of the main findings of the third Russian conference on the MPC+A with a specific emphasis on physical protection of the Russian nuclear materials and nuclear facilities. Besides the physical protection, materials accounting, education and training of personnel, security culture and some other associated topics of the conference are also addressed. (author)

  17. Densities and sizes of the main masticatory muscles in computed tomography compared with clinical findings related to temporo mandibular joint (TMJ) dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Raustia, A.M.; Pyhtinen, J.; Virtanen, K.K.

    1986-03-01

    Computed tomography (CT) has a good resolution capacity and is an excellent method for measuring tissue densities. The aim here was to compare the densities and sizes of the main masticatory muscles, the masseter, medial pterygoid and lateral pterygoid muscles, as obtained with CT, with clinical findings in patients with TMJ dysfunction (25) and controls (29). The densities of the masseter muscles and the medial pterygoid muscles showed no statistical difference between the patients and controls, while the lateral pterygoid muscles of the patients had densities that were only almost significantly higher than those of the controls. The masseter muscles on the patients who more often had signs of bruxism in their dentition were statistically significantly thicker than in the controls, but the widths of the medial pterygoid muscles gave no statistical difference between the groups. The results seem to indicate that in addition to the bone density changes associated with functional disorders of the masticatory system, there may be also density and size changes in the masticatory muscles which are detectable by CT.

  18. Densities and sizes of the main masticatory muscles in computed tomography compared with clinical findings related to temporo mandibular joint (TMJ) dysfunction

    International Nuclear Information System (INIS)

    Raustia, A.M.; Pyhtinen, J.; Virtanen, K.K.; Oulu Univ.

    1986-01-01

    Computed tomography (CT) has a good resolution capacity and is an excellent method for measuring tissue densities. The aim here was to compare the densities and sizes of the main masticatory muscles, the masseter, medial pterygoid and lateral pterygoid muscles, as obtained with CT, with clinical findings in patients with TMJ dysfunction (25) and controls (29). The densities of the masseter muscles and the medial pterygoid muscles showed no statistical difference between the patients and controls, while the lateral pterygoid muscles of the patients had densities that were only almost significantly higher than those of the controls. The masseter muscles on the patients who more often had signs of bruxism in their dentition were statistically significantly thicker than in the controls, but the widths of the medial pterygoid muscles gave no statistical difference between the groups. The results seem to indicate that in addition to the bone density changes associated with functional disorders of the masticatory system, there may be also density and size changes in the masticatory muscles which are detectable by CT. (orig.) [de

  19. Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

    Science.gov (United States)

    Munro, Neil; Duckett, Jane

    2016-06-01

    To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  20. Quantification of diabetes consultations by the main primary health care nurse groups in Auckland, New Zealand.

    Science.gov (United States)

    Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert

    2016-09-01

    Diabetes prevalence continues to increase, with most diabetes patients managed in primary care. This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand. Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006-2008. On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.

  1. Workplace Health Promotion and Mental Health: Three-Year Findings from Partnering Healthy@Work

    OpenAIRE

    Jarman, Lisa; Martin, Angela; Venn, Alison; Otahal, Petr; Blizzard, Leigh; Teale, Brook; Sanderson, Kristy

    2016-01-01

    This study aimed to investigate the association between mental health and comprehensive workplace health promotion (WHP) delivered to an entire state public service workforce (~28,000 employees) over a three-year period. Government departments in a state public service were supported to design and deliver a comprehensive, multi-component health promotion program, Healthy@Work, which targeted modifiable health risks including unhealthy lifestyles and stress. Repeated cross-sectional surveys co...

  2. Main meal frequency measures in the Health Behaviour in School-aged Children study

    DEFF Research Database (Denmark)

    Pedersen, Trine Pagh; Holstein, Bjørn E; Laursen, Bjarne

    2015-01-01

    OBJECTIVES: To estimate agreement between questionnaire-based frequency measures from the Health Behaviour in School-aged Children study (HBSC) and 7-day 24-h recall measures of breakfast, lunch and evening meals among 11-15-year-olds, and examine whether disagreement between the two methods varied...... for the breakfast measure: per cent agreement 0.70-0.87, kappa 0.43-0.65. Fair agreement for the lunch measure: per cent agreement 0.53-0.84, kappa 0.26-0.54. High per cent agreement for the evening meal measure (0.83-0.95) but poor kappa agreement (0.14-0.19). Being immigrant predicted disagreement between the two...... methods for week day breakfast OR (95 % CI) 2.17 (1.16-4.04) and lunch 2.44 (1.33-4.48). CONCLUSIONS: We found good to moderate agreement between frequency and 7-day 24-h recall measures for breakfast, a fair agreement for lunch and for evening meal the two agreement methods provided different results...

  3. [Health literacy of adults in Germany: Findings from the German Health Update (GEDA) study].

    Science.gov (United States)

    Jordan, Susanne; Hoebel, Jens

    2015-09-01

    In today's information society, health literacy (HL) is considered important for health maintenance and disease management. In this context, dealing with health information is fundamental and requires different cognitive and social skills. The aim of this study was to investigate the distribution of HL levels in the adult population of Germany, and to identify associations with health behaviours and health status. The analyses were based on data from the German Health Update (GEDA) study, a cross-sectional survey of the German-speaking adult population of Germany, which was conducted from October 2013 to June 2014. Health literacy was assessed with the short form of the European Health Literacy Questionnaire (HLS EU-Q16), along with questions about socio-demographics, health behaviours, and health status. The HLS-EU-Q16 index could be calculated for 4845 respondents. According to the criteria of the HLS-EU-Q16, more than half of the adults had "adequate" HL (55.8 %). Every third person (31.9 %) had "problematic" and almost every eighth person (12.3 %) had "inadequate" HL. We found significant differences in HL by educational level, but no differences in HL by sex and age group. Certain health behaviours were positively associated with health literacy. A low HL level was associated with poorer physical and mental health. The results point to a need for action to improve HL in the adult population. The strengthening of health literacy should not solely aim at the promotion of individual skills, but also give high priority to the development of health-literate settings.

  4. Finding online health-related information: usability issues of health portals.

    Science.gov (United States)

    Gurel Koybasi, Nergis A; Cagiltay, Kursat

    2012-01-01

    As Internet and computers become widespread, health portals offering online health-related information become more popular. The most important point for health portals is presenting reliable and valid information. Besides, portal needs to be usable to be able to serve information to users effectively. This study aims to determine usability issues emerging when health-related information is searched on a health portal. User-based usability tests are conducted and eye movement analyses are used in addition to traditional performance measures. Results revealed that users prefer systematic, simple and consistent designs offering interactive tools. Moreover, content and partitions needs to be shaped according to the medical knowledge of target users.

  5. Correlates of consumer trust in online health information: findings from the health information national trends survey.

    Science.gov (United States)

    Ye, Yinjiao

    2011-01-01

    The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

  6. Main competences and skills to perform Essential Public Health Operations, offered by Schools of Public Health in four European countries

    DEFF Research Database (Denmark)

    Otok, Robert; Foldspang, Anders

    2016-01-01

    ) in each of the four countries, France, Poland, Portugal and the UK, reported the strength of intellectual and practical competences as well as skills to perform essential public health operations (EPHOs), offered by their education and training programmes. RESULTS: The self-reports indicated substantial...... education and training....

  7. Finding and Exploring Health Information with a Slider-Based User Interface.

    Science.gov (United States)

    Pang, Patrick Cheong-Iao; Verspoor, Karin; Pearce, Jon; Chang, Shanton

    2016-01-01

    Despite the fact that search engines are the primary channel to access online health information, there are better ways to find and explore health information on the web. Search engines are prone to problems when they are used to find health information. For instance, users have difficulties in expressing health scenarios with appropriate search keywords, search results are not optimised for medical queries, and the search process does not account for users' literacy levels and reading preferences. In this paper, we describe our approach to addressing these problems by introducing a novel design using a slider-based user interface for discovering health information without the need for precise search keywords. The user evaluation suggests that the interface is easy to use and able to assist users in the process of discovering new information. This study demonstrates the potential value of adopting slider controls in the user interface of health websites for navigation and information discovery.

  8. THE NATIONAL AUTHORITY FOR ANIMAL HEALTH AND FOOD SAFETY, THE MAIN BODY INVOLVED IN FOOD SAFETY IN ROMANIA

    Directory of Open Access Journals (Sweden)

    PETRUTA-ELENA ISPAS

    2012-05-01

    Full Text Available This paper is intended to present the role, functions and responsibilities of the National Authority for Animal Health and Food Safety as the main body involved in food safety in Romania. It will be also exposed the Regulation 178/2002 of the European Parliament and the Council, the general food ”law” in Europe, and Law 150/2004, which transposed into Romanian legislation Regulation 178/2002.

  9. Australian Government health advisory groups and health policy: seeking a horse, finding a camel.

    Science.gov (United States)

    Russell, Lesley M; Boxall, Anne-Marie; Leeder, Stephen R

    2008-11-17

    Since its election, the Rudd Labor Government has created 10 new advisory bodies in the health portfolio, in addition to the 100 or more that were already established. An expansive and devolved advisory system could improve the health policy-making process, but only if it is integrated into the processes of government. We outline eight simple and practical measures that, if implemented, would make Australia's health advisory system more transparent and effective. Past experience shows that the most important factor governing the impact of health policy advisory bodies is political leadership.

  10. Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

    Science.gov (United States)

    Dyess, Susan MacLeod

    2015-01-01

    It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

  11. Health beliefs and practices of young people in a multicultural community: Findings from a child-centered ethnography

    Science.gov (United States)

    Reeve, Suzanne

    2009-12-01

    This dissertation presents an analysis of the health-related beliefs and behaviors of thirteen fourth, fifth, and sixth grade children, as evidenced through photo self-documentation, semistructured interview responses, and more than a year of ethnographic observations in home, school, and other settings. The ethnic, language, and socioeconomic backgrounds of the children and their families vary widely. I focus on three research questions: (1) How do children and families come to understand personal health, including related nutritional topics, in a multicultural community? (2) What are some of the main developmental influences on their learning---including its relation to their understanding of science and their life circumstances? (3) How do the understandings of children and families connect to health and nutritional behaviors? The analysis shows greater diversity in the meanings these young people assigned to the concepts "healthy" and "unhealthy" than has been acknowledged in significant segments of the existing literature. The findings also show that children draw extensively on experiences from formal schooling and their non-school everyday lives and practices in talking about health-related concepts. Case studies of two children detail the specific ways in which health-related learning takes shape in their home, school, and community environments. The dissertation concludes with implications of these findings for science education, such as increasing the amount and conceptual sophistication of content related to health in the science classroom, in accordance with a broader emphasis on making science teaching relevant to students' local and personal contexts.

  12. eHealth for Remote Regions: Findings from Central Asia Health Systems Strengthening Project.

    Science.gov (United States)

    Sajwani, Afroz; Qureshi, Kiran; Shaikh, Tehniat; Sayani, Saleem

    2015-01-01

    Isolated communities in remote regions of Afghanistan, Kyrgyz Republic, Pakistan and Tajikistan lack access to high-quality, low-cost health care services, forcing them to travel to distant parts of the country, bearing an unnecessary financial burden. The eHealth Programme under Central Asia Health Systems Strengthening (CAHSS) Project, a joint initiative between the Aga Khan Foundation, Canada and the Government of Canada, was initiated in 2013 with the aim to utilize Information and Communication Technologies to link health care institutions and providers with rural communities to provide comprehensive and coordinated care, helping minimize the barriers of distance and time. Under the CAHSS Project, access to low-cost, quality health care is provided through a regional hub and spoke teleconsultation network of government and non-government health facilities. In addition, capacity building initiatives are offered to health professionals. By 2017, the network is expected to connect seven Tier 1 tertiary care facilities with 14 Tier 2 secondary care facilities for teleconsultation and eLearning. From April 2013 to September 2014, 6140 teleconsultations have been provided across the project sites. Additionally, 52 new eLearning sessions have been developed and 2020 staff members have benefitted from eLearning sessions. Ethics and patient rights are respected during project implementation.

  13. [Socioeconomic differentials in health and health related behaviors: findings from the Korea Youth Panel Survey].

    Science.gov (United States)

    Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song

    2005-11-01

    This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health

  14. Mental Health Status of Double Minority Adolescents: Findings from National Cross-Sectional Health Surveys.

    Science.gov (United States)

    Chiang, Szu-Ying; Fleming, Theresa; Lucassen, Mathijs; Fenaughty, John; Clark, Terryann; Denny, Simon

    2017-06-01

    Little population-based work has been published about the mental health of adolescents with both sexual/gender (SG) and ethnic minority (i.e. double minority) status. This study aimed to provide an overview on their mental health. Analysis of data from a total of 17,607 high school students from New Zealand's 2007 and 2012 cross-sectional nationally representative Adolescent Health Surveys, including a total of 1306 (7.4%) SG minority participants, of whom 581 (3.3%) were also an ethnic minority. SG minority status, minority ethnicity, and female sex were associated with higher mental distress and poorer well-being. Generally speaking, double minority students reported poorer mental health than SG majority students of the same ethnicity, but reported better mental health than SG minority New Zealand European students. Explanations and future directions for research were suggested to further explore how double minority students negotiate mental health in the context of their communities/cultures in New Zealand.

  15. Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

    Science.gov (United States)

    Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

    2014-01-01

    Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

  16. Fire Health Main

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This model combines stand density index (SDI), basal area loss, drought stress, and insect and disease surveys using an equal weight overlay. SDI determines the...

  17. Health and wealth in Mesoamerica: findings from Salud Mesomérica 2015.

    Science.gov (United States)

    Mokdad, Ali H; Gagnier, Marielle C; Colson, K Ellicott; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Haakenstad, Annie; Palmisano, Erin B; Anderson, Brent W; Desai, Sima S; Gillespie, Catherine W; Murphy, Tasha; Naghavi, Paria; Nelson, Jennifer; Ranganathan, Dharani; Schaefer, Alexandra; Usmanova, Gulnoza; Wilson, Shelley; Hernandez, Bernardo; Lozano, Rafael; Iriarte, Emma

    2015-07-14

    Individual income and poverty are associated with poor health outcomes. The poor face unique challenges related to access, education, financial capacity, environmental effects, and other factors that threaten their health outcomes. We examined the variation in the health outcomes and health behaviors among the poorest quintile in eight countries of Mesoamerica using data from the Salud Mesomérica 2015 baseline household surveys. We used multivariable logistic regression to measure the association between delivering a child in a health facility and select household and maternal characteristics, including education and measures of wealth. Health indicators varied greatly between geographic segments. Controlling for other demographic characteristics, women with at least secondary education were more likely to have an in-facility delivery compared to women who had not attended school (OR: 3.20, 95 % confidence interval [CI]: 2.56-3.99, respectively). Similarly, women from households with the highest expenditure were more likely to deliver in a health facility compared to those from the lowest expenditure households (OR 3.06, 95 % CI: 2.43-3.85). Household assets did not impact these associations. Moreover, we found that commonly-used definitions of poverty do not align with the disparities in health outcomes observed in these communities. Although poverty measured by expenditure or wealth is associated with health disparities or health outcomes, a composite indicator of health poverty based on coverage is more likely to focus attention on health problems and solutions. Our findings call for the public health community to define poverty by health coverage measures rather than income or wealth. Such a health-poverty metric is more likely to generate attention and mobilize targeted action by the health communities than our current definition of poverty.

  18. Future of Health: Findings from a survey of stakeholders on the future of health and healthcare in England.

    Science.gov (United States)

    Corbett, Jennie; d'Angelo, Camilla; Gangitano, Lorenzo; Freeman, Jon

    2018-04-01

    This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly. The survey provided a rich and varied dataset based on responses from 300 stakeholders in total. A wide range of fields were represented, including public health, social care, primary care, cancer, genomics, mental health, geriatrics, child health, patient advocacy and health policy. The respondent group also included a number of professional and private stakeholder categories, such as clinicians, policy experts, academics and patient and public representatives. The study findings validate a number of prominent health research priorities currently visible in England, such as antimicrobial resistance, the burden of dementia and age-related multi-morbidity, digital health and genomics. Interest in these areas and other themes, such as mental health, health inequalities and transforming health service models, cut across multiple disciplinary boundaries. However, it is clear that there are a variety of views among stakeholders on the relative importance of these areas of focus, and the best approach to manage their emergence in the coming decades. The full dataset of survey responses, for which permission to share was given, is a useful resource for those seeking to engage with a particular issue in more depth. The dataset can be found on NIHR's website at: http://nihr.ac.uk/news-and-events/documents/quotes.xls.

  19. Using findings in multimedia learning to inform technology-based behavioral health interventions.

    Science.gov (United States)

    Aronson, Ian David; Marsch, Lisa A; Acosta, Michelle C

    2013-09-01

    Clinicians and researchers are increasingly using technology-based behavioral health interventions to improve intervention effectiveness and to reach underserved populations. However, these interventions are rarely informed by evidence-based findings of how technology can be optimized to promote acquisition of key skills and information. At the same time, experts in multimedia learning generally do not apply their findings to health education or conduct research in clinical contexts. This paper presents an overview of some key aspects of multimedia learning research that may allow those developing health interventions to apply informational technology with the same rigor as behavioral science content. We synthesized empirical multimedia learning literature from 1992 to 2011. We identified key findings and suggested a framework for integrating technology with educational and behavioral science theory. A scientific, evidence-driven approach to developing technology-based interventions can yield greater effectiveness, improved fidelity, increased outcomes, and better client service.

  20. Screening and monitoring of main diseases a modern strategy of health maintenance in personnel of radiation dangerous plants

    International Nuclear Information System (INIS)

    Takhauov, R. M.; Karpov, A. B.; Kubat, I. I.; Maslyuk, A. I.; Semenova, Y. V.; Freidin, M. B.; Trivozhenko, A. B.; Litvinenko, T. M.

    2004-01-01

    Population health is greatly determined by social factors, mode of life, ecological situation, amount and quality of medical assistance. The analysis of reasons of health troubles increase in population should be done taking into account the above aspects. Main consideration should be given to the development of measures aimed at the highest possible decrease of technogenic and anthropogenic factors influence on a human. Thereupon a complex programme of main diseases screening and monitoring in the personnel of the Siberian Group of Chemical enterprises (SGCE) to be the biggest one among Russian atomic plants has been developed. The purpose of the present paper is to determine main diseases at the earliest stage, the decrease of death rate, as well as the complex estimation of technogenic factor influence on the personnel of radiation dangerous plants nand their offsprings. In this case a long-term effect of low doses seems to be the main risk factor. Taking into account the structure of death rate causes of the population of industrialized countries as well as the spectrum of stochastic effects of ionizing radiation, the screening of cardiac ischemia and arterial hypertension, localization of cancer and congenital malformations have been chosen as the program priorities. Algorithm of instrumental laboratory screening of a particular disease includes modern diagnostic tests. Groups ar risk are formed taking into account a complex of exogenous and endogenous risk factors (age, chronic diseases, bad habits, length of service at a radiation dangerous plant, dose loads, hereditary factors) and on the basis of the screening examination results. The information obtained is entered in the list of database of the Regional Medico dosimetric Register of the SGCE personnel and Seversk residents followed by analysis and monitoring of groups ar risk. (Author) 4 refs

  1. Associations of social support and stress with postpartum maternal mental health symptoms: Main effects, moderation, and mediation.

    Science.gov (United States)

    Schwab-Reese, Laura M; Schafer, Ellen J; Ashida, Sato

    2017-07-01

    Poor maternal mental health during the postpartum period can have significant effects on the health of mothers, infants, and families. The findings from cross-sectional studies suggest that stress and social support are related to maternal mental health. This study contributes to the literature through the use of longitudinal data, and examines moderation and mediation among these factors. In 2012-2013, mothers completed surveys assessing stress, social support, and depressive and anxiety symptoms following birth (n = 125), and 3 months (n = 110) and 6 months (n = 99) after birth. The authors examined temporal associations, moderation, and mediation of social support on the relationship between stress and postpartum depressive and anxiety symptoms using modified Poisson regression models and the counterfactual approach to mediation. Current levels of stress and social support were associated with depressive and anxiety symptoms, both independently and when considered together at multiple time points. Social support did not strongly moderate or mediate the relationships between stress and maternal mental health. Interventions to reduce current perceptions of stress and increase social support for mothers during the postpartum period may help improve maternal mental health symptoms. Efforts are needed to assess the current needs of mothers continuously.

  2. Walking, sustainability and health: findings from a study of a Walking for Health group.

    Science.gov (United States)

    Grant, Gordon; Machaczek, Kasia; Pollard, Nick; Allmark, Peter

    2017-05-01

    Not only is it tacitly understood that walking is good for health and well-being but there is also now robust evidence to support this link. There is also growing evidence that regular short walks can be a protective factor for a range of long-term health conditions. Walking in the countryside can bring additional benefits, but access to the countryside brings complexities, especially for people with poorer material resources and from different ethnic communities. Reasons for people taking up walking as a physical activity are reasonably well understood, but factors linked to sustained walking, and therefore sustained benefit, are not. Based on an ethnographic study of a Walking for Health group in Lincolnshire, UK, this paper considers the motivations and rewards of group walks for older people. Nineteen members of the walking group, almost all with long-term conditions, took part in tape-recorded interviews about the personal benefits of walking. The paper provides insights into the links between walking as a sustainable activity and health, and why a combination of personal adaptive capacities, design elements of the walks and relational achievements of the walking group are important to this understanding. The paper concludes with some observations about the need to reframe conventional thinking about adherence to physical activity programmes. © 2017 John Wiley & Sons Ltd.

  3. Predicting Consumer Effort in Finding and Paying for Health Care: Expert Interviews and Claims Data Analysis.

    Science.gov (United States)

    Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif

    2017-10-12

    For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. The aim of this study was to determine the factors that result in consumer effort when finding accessible health care. Having an understanding of these factors will help define requirements when designing health information systems. A panel of 12 subject matter experts was consulted and the data from 60 million medical claims were used to determine the factors contributing to effort. Approximately 60 million claims were processed by the health care insurance organization in a 12-month duration with the population defined. Over 292 million diagnoses from claims were used to validate the panel input. The results of the study showed that the number of people in the consumer's household, number of visits to providers outside the consumer's insurance network, number of adjusted and denied medical claims, and number of consumer inquiries are a proxy for the level of effort in finding and paying for care. The effort level, so measured and weighted per expert panel recommendations, differed by diagnosis. This study provides an understanding of how consumers must put forth effort when engaging with a health care system to access care. For higher satisfaction and acceptance results, health care payers ideally will design and develop systems that facilitate an understanding of how to avoid denied claims, educate on the payment of claims to avoid adjustments, and quickly find providers of affordable care. ©Sandra Long, Karen A. Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.10.2017.

  4. CHIS - Information concerning the health insurance of frontalier workers who are family members of a CHIS main member

    CERN Multimedia

    2014-01-01

    We recently informed you that the Organization was still in discussions with the Host State authorities to clarify the situation regarding the health insurance of frontalier workers who are family members (as defined in the Staff Rules and Regulations) of a CHIS main member, and that we were hoping to arrive at a solution soon.   After extensive exchanges, we finally obtained a response a few days ago from the Swiss authorities, with which we are fully satisfied and which we can summarise as follows: 1) Frontalier workers who are currently using the CHIS as their basic health insurance can continue to do so. 2) Family members who become frontalier workers, or those who have not yet exercised their “right to choose” (droit d’option) can opt to use the CHIS as their basic health insurance. To this end, they must complete the form regarding the health insurance of frontaliers, ticking the LAMal box and submitting their certificate of CHIS membership (available from U...

  5. Causes, consequences, and policy responses to the migration of health workers: key findings from India.

    Science.gov (United States)

    Walton-Roberts, Margaret; Runnels, Vivien; Rajan, S Irudaya; Sood, Atul; Nair, Sreelekha; Thomas, Philomina; Packer, Corinne; MacKenzie, Adrian; Tomblin Murphy, Gail; Labonté, Ronald; Bourgeault, Ivy Lynn

    2017-04-05

    This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries-Jamaica, India, the Philippines, and South Africa-that have historically been "sources" of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study. Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically. Shortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration. Consequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.

  6. Public Health Risks in Urban Slums: Findings of the Qualitative 'Healthy Kitchens Healthy Cities' Study in Kathmandu, Nepal.

    Directory of Open Access Journals (Sweden)

    Helen Elsey

    Full Text Available Communities in urban slums face multiple risks to their health. These are shaped by intermediary and structural determinants. Gaining a clear understanding of these determinants is a prerequisite for developing interventions to reduce the health consequences of urban poverty. With 828 million people living in slum conditions, the need to find ways to reduce risks to health has never been greater. In many low income settings, the kitchen is the epicentre of activities and behaviours which either undermine or enhance health.We used qualitative methods of semi-structured interviews, observation and participatory workshops in two slum areas in Kathmandu, Nepal to gain women's perspectives on the health risks they faced in and around their kitchens. Twenty one women were interviewed and four participatory workshops with a total of 69 women were held. The women took photographs of their kitchens to trigger discussions.The main health conditions identified by the women were respiratory disease, gastrointestinal disease and burn injuries. Women clearly understood intermediary (psychosocial, material and behavioural determinants to these health conditions such as poor ventilation, cooking on open fires, over-crowding, lack of adequate child supervision. Women articulated the stress they experienced and clearly linked this to health conditions such as heart disease and uptake of smoking. They were also able to identify protective factors, particularly social capital. Subsequent analysis highlighted how female headed-households and those with disabilities had to contend with greater risks to health.Women living in slums are very aware of the intermediary determinants-material, behavioural and psycho-social, that increase their vulnerability to ill health. They are also able to identify protective factors, particularly social capital. It is only by understanding the determinants at all levels, not just the behavioural, that we will be able to identify

  7. Factors associated with Taiwanese lesbians' breast health-care behavior and intentions: Qualitative interview findings.

    Science.gov (United States)

    Wang, Ya-Ching; Griffiths, Jane; Grande, Gunn

    2017-09-01

    This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South, and East Taiwan) between August 2012 and October 2012. Interviews were audio recorded with participants' consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians' breast health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care providers' lack of knowledge of multiple gender diversity, and their attitudes toward lesbians. Conversely, their partners' support was a factor facilitating the women's breast health-care behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians' breast health.

  8. Finding the Right Fit: Understanding Health Tracking in Workplace Wellness Programs

    DEFF Research Database (Denmark)

    Chung, Chia-Fang; Jensen, Nanna Gorm; Shklovski, Irina

    2017-01-01

    Workplace health and wellness programs are increasingly integrating personal health tracking technologies, such as Fitbit and Apple Watch. Many question whether these technologies truly support employees in their pursuit of better wellness levels, raising objections about workplace surveillance...... and further blurring of boundaries between work and personal life. We conducted a study to understand how tracking tools are adopted in wellness programs and employees' opinions about these programs. We find that employees are generally positive about incentivized health tracking in the workplace, as it helps...... raise awareness of activity levels. However, there is a gap between the intentions of the programs and individual experiences and health goals. This sometimes results in confusion and creates barriers to participation. Even if this gap can be addressed, health tracking in the workplace...

  9. [Effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China].

    Science.gov (United States)

    Fan, Ming-Yue; Tang, Xu; Huang, Wei; Dai, Hua; Liu, Xing-Can; Xia, Yin-Yin; Meng, Pan; Zhang, Rui-Yuan; Guo, Yu-Ming; Cheng, Shu-Qun

    2017-04-01

    To investigate the effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China. The main urban area of Chongqing was divided into polluted area and clean area according to the air pollution data shown on the Environmental Protection Agency Website of Chongqing between 2010 and 2015. A cluster sampling method was used to select 695 third- or fourth-grade children from 2 primary schools in the clean or polluted area as study subjects, with 313 children from the clean area and 382 children from the polluted area. Pulmonary function was examined for all children and a standard American epidemiological questionnaire (ATS-DLD-78-C) was used to investigate the prevalence of respiratory diseases and symptoms. Compared with the clean area, the polluted area had significantly higher concentrations of inhalable particles (PM 10 ), fine particulate matter (PM 2.5 ), and nitric oxide (NO X ) (Ppolluted area had significantly higher risks of cough (OR=1.644), cough during cold (OR=1.596), expectoration during cold (OR=2.196), persistent expectoration (OR=1.802), and wheezing (OR=2.415). The boys and girls in the clean area had significantly higher forced vital capacity and forced expiratory volume in one second than those in the polluted area (PAir pollution in the main urban area of Chongqing is associated with the increased prevalence of respiratory symptoms in school-aged children and has certain effect on children's pulmonary function.

  10. The Association of Benefit Finding to Psychosocial and Health Behavior Adaptation Among HIV+ Men and Women

    Science.gov (United States)

    Littlewood, Rae A.; Vanable, Peter A.; Carey, Michael P.; Blair, Donald C.

    2008-01-01

    Psychological and behavioral adaptation to HIV is integral to long-term survival. Although most research on coping with HIV has focused on factors associated with poor adaptation, recent research has expanded to include positive concomitants of adaptation, such as benefit finding. This study examined the occurrence of benefit finding among HIV+ men and women and evaluated the potential relevance of benefit finding to positive health behavior and psychosocial adaptation. HIV+ participants (N = 221) recruited during outpatient care completed self-report assessments of benefit finding, social support, depression, HAART adherence, substance use, and physical activity. In a series of multivariate analyses that controlled for demographic and health status variables, benefit finding was associated with lower depression scores, greater social support, and more physical activity, but showed no association to HAART adherence or substance use. The association of benefit finding to depression was partially mediated by differences in social support. Thus, benefit finding may improve psychological adjustment by motivating patients who experience stress-related growth to seek improved social support. PMID:18157689

  11. E-health in low- and middle-income countries: findings from the Center for Health Market Innovations.

    Science.gov (United States)

    Lewis, Trevor; Synowiec, Christina; Lagomarsino, Gina; Schweitzer, Julian

    2012-05-01

    To describe how information communication technology (ICT) is being used by programmes that seek to improve private sector health financing and delivery in low- and middle-income countries, including the main uses of the technology and the types of technologies being used. In-country partners in 16 countries directly searched systematically for innovative health programmes and compiled profiles in the Center for Health Market Innovations' database. These data were supplemented through literature reviews and with self-reported data supplied by the programmes themselves. In many low- and middle-income countries, ICT is being increasingly employed for different purposes in various health-related areas. Of ICT-enabled health programmes, 42% use it to extend geographic access to health care, 38% to improve data management and 31% to facilitate communication between patients and physicians outside the physician's office. Other purposes include improving diagnosis and treatment (17%), mitigating fraud and abuse (8%) and streamlining financial transactions (4%). The most common devices used in technology-enabled programmes are phones and computers; 71% and 39% of programmes use them, respectively, and the most common applications are voice (34%), software (32%) and text messages (31%). Donors are the primary funders of 47% of ICT-based health programmes. Various types of ICT are being employed by private organizations to address key health system challenges. For successful implementation, however, more sustainable sources of funding, greater support for the adoption of new technologies and better ways of evaluating impact are required.

  12. Findings from the oral health study of the Danish Health Examination Survey 2007-2008

    DEFF Research Database (Denmark)

    Kongstad, Johanne; Ekstrand, Kim; Qvist, Vibeke

    2013-01-01

    , carried out in mobile units by three trained and calibrated dental hygienists. The data were processed with descriptive statistics and mono- and bivariate analyses. Results. The mean age was 54.1 years and 60% were women. The mean number of natural teeth was 26.6; the mean DMFT/DMFS values were 18...... rate was more common among females than males (17.7% vs 10.4%) and this was reflected by the reported frequency of dry mouth. Conclusion. This extensive cross-sectional study provides a platform for obtaining future knowledge of the impact of health- and lifestyle-related factors on oral diseases...

  13. Transitioning to a Data Driven Mental Health Practice : Collaborative Expert Sessions for Knowledge and Hypothesis Finding

    NARCIS (Netherlands)

    Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

    2016-01-01

    The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard

  14. Can tuberculosis case finding among health-care seeking adults be improved?

    DEFF Research Database (Denmark)

    Rudolf, F; Haraldsdottir, Thorny Linda; Mendes, M S

    2014-01-01

    SETTING: The Bandim Health Project study area in Bissau, Guinea-Bissau. OBJECTIVE: To assess the potential usefulness of predictors (elsewhere applied) and clinical scores (TBscore and TBscore II) based on signs and symptoms typical of tuberculosis (TB) in case finding. DESIGN: Observational...

  15. Marriage characteristics and reproductive health of adolescents in Turkey: findings from Demographic and Health Surveys 1998 and 2008.

    Science.gov (United States)

    Tezcan, Sabahat; Adali, Tuğba

    2012-01-01

    Adolescent marriage is an important issue given its social and medical consequences. This study focuses on the recent trends in adolescent marriage and reproductive health in Turkey to provide insights for action. Data from the Demographic and Health Surveys of 1998 and 2008 were used. Adolescent marriage and reproductive health indicators were assessed for urban-rural residences, demographic regions and educational levels. Logistic regression was used to predict marriage and birth in adolescence. Despite the decrease in the proportion of married adolescents from 1998 to 2008, the findings suggest no improvement in some marriage characteristics. In both surveys, over 60% of ever-married adolescents had been pregnant at least once. There is an increase in contraceptive use and antenatal care. Our findings showed that in Turkey, women living in rural areas, from poor households, with more traditional parental families, with less education, and who are not working are more likely to get married in their adolescent ages.

  16. 'Ecological embeddedness' and Its Public Health Implications: Findings From an Exploratory Study.

    Science.gov (United States)

    Lewis, Marina; Townsend, Mardie

    2015-06-01

    Western culture over the last two centuries has become significantly ecologically 'dis-embedded', with nature increasingly reduced to resources for human use. The consequence is global environmental degradation, including accelerating climate change. Much recent research supports associations between nature contact and human health and well-being, and between feelings of nature-connectedness and pro-environmental attitudes and behaviours. The oft-cited Ottawa Charter for Health Promotion (WHO, Ottawa Charter for Health Promotion, 1986) emphasises human-environment inextricability; however public health discourse and response has not fully engaged with this recognition. This qualitative study explored the attitudes, motivations, and experiences-including formative influences-of six individuals whose behaviour was congruent with recognition of human-nature interconnectedness; such individuals may be understood as ecologically embedded. Key aspects of participants' experience, identified through grounded theory thematic analysis, were (i) connecting with nature (especially in childhood); (ii) seeing the threat and taking it personally; (iii) the nature of reality; (iv) dedicated beyond the ego-oriented self; and (v) sustaining the eco-centric self. The findings highlight the necessity for cross-sectoral advocacy at all levels of government policy development focused on recognition of human-environment connectedness, especially bridging health, planning and education policies affecting children. Only thus will both population health and ecological health on which population health depends be possible.

  17. What matters most?: evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states

    Directory of Open Access Journals (Sweden)

    Monica Viegas Andrade

    2013-01-01

    Full Text Available This study analyzes how different health dimensions defined by the EQ-5D-3L instrument affect average individual preferences for health states. This analysis is an important benchmark for the incorporation of health technologies as it takes into consideration Brazilian population preferences in health resource allocation decisions. The EQ-5D instrument defines health in terms of five dimensions (mobility, daily activities, self-care activities, pain/discomfort, and anxiety/depression each divided into three levels of severity. Data came from a valuation study with 3,362 literate individuals aged between 18 and 64 living in urban areas of Minas Gerais State, Brazil. The main results reveal that health utility decreases as the level of severity increases. With regard to health issues, mobility stands out as the most important EQ-5D dimension. Independently of severity levels of the other EQ-5D-3L dimensions, the highest decrements in utilities are associated with severe mobility problems.

  18. Environmental Noise Annoyance and Mental Health in Adults: Findings from the Cross-Sectional German Health Update (GEDA Study 2012

    Directory of Open Access Journals (Sweden)

    Friederike Hammersen

    2016-09-01

    Full Text Available The health implications of environmental noise, especially cardiovascular effects, have been studied intensively. Research on associations between noise and mental health, however, has shown contradictory results. The present study examined associations between individual levels of noise annoyance due to noise from various sources in the living environment and mental health of adults in Germany. It evaluated whether these associations persisted after adjusting for potential covariates. Data were obtained from the cross-sectional “German Health Update” study 2012 (GEDA 2012, a national health interview survey among adults in Germany conducted by the Robert Koch Institute (n = 19,294. Noise annoyance questions referred to overall noise and that from road traffic, neighbours, and air traffic. Mental health was measured with the five-item Mental Health Inventory. Bivariate analysis showed associations between high levels of noise annoyance and impaired mental health for all noise sources except air traffic. After adjusting for covariates (sociodemographic factors, chronic disease, and social support, both men and women who reported high overall noise annoyance showed more than doubled odds of impaired mental health compared to those who were not annoyed. The odds of impaired mental health in the highest noise annoyance category from road traffic and neighbours were also significantly increased. These findings indicate that high noise annoyance is associated with impaired mental health and that this association can vary with the source of environmental noise. Further research on covariates of this association is necessary. Particularly, longitudinal data are required to establish the direction of associations and to address questions of causality.

  19. Belief in life after death and mental health: findings from a national survey.

    Science.gov (United States)

    Flannelly, Kevin J; Koenig, Harold G; Ellison, Christopher G; Galek, Kathleen; Krause, Neal

    2006-07-01

    The present study examined the association between belief in life after death and six measures of psychiatric symptomology in a national sample of 1403 adult Americans. A statistically significant inverse relationship was found between belief in life after death and symptom severity on all six symptom clusters that were examined (i.e., anxiety, depression, obsession-compulsion, paranoia, phobia, and somatization) after controlling for demographic and other variables (e.g., stress and social support) that are known to influence mental health. No significant association was found between the frequency of attending religious services and any of the mental health measures. The results are discussed in terms of the potentially salubrious effects of religious belief systems on mental health. These findings suggest that it may be more valuable to focus on religious beliefs than on religious practices and behaviors in research on religion and mental health.

  20. Effects of light quality on main health-promoting compounds and antioxidant capacity of Chinese kale sprouts.

    Science.gov (United States)

    Qian, Hongmei; Liu, Tianyu; Deng, Mingdan; Miao, Huiying; Cai, Congxi; Shen, Wangshu; Wang, Qiaomei

    2016-04-01

    The effects of different light qualities, including white, red and blue lights, on main health-promoting compounds and antioxidant capacity of Chinese kale sprouts were investigated using light-emitting diodes (LEDs) as a light source. Our results showed that blue light treatment significantly decreased the content of gluconapin, the primary compound for bitter flavor in shoots, while increased the glucoraphanin content in roots. Moreover, the maximum content of vitamin C was detected in the white-light grown sprouts and the highest levels of total phenolic and anthocyanins, as well as the strongest antioxidant capacity were observed in blue-light grown sprouts. Taken together, the application of a colorful light source is a good practice for improvement of the consumers' acceptance and the nutritional phtyochemicals of Chinese kale sprouts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2012-12-01

    The 2012 EBRI/MGA Consumer Engagement in Health Care Survey finds continued slow growth in consumer-driven health plans: 10 percent of the population was enrolled in a CDHP, up from 7 percent in 2011. Enrollment in HDHPs remained at 16 percent. Overall, 18.6 million adults ages 21-64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA. When their children were counted, about 25 million individuals with private insurance, representing about 14.6 percent of the market, were either in a CDHP or an HSA-eligible plan. This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. While CDHP enrollees, HDHP enrollees, and traditional-plan enrollees were about equally likely to report that they made use of quality information provided by their health plan, CDHP enrollees were more likely to use cost information and to try to find information about their doctors' costs and quality from sources other than the health plan. CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees. It is clear that the underlying characteristics of the populations enrolled in these plans are different: Adults in a CDHP were significantly more likely to report being in excellent or very good health. Adults in a CDHP and those in a HDHP were significantly less likely to smoke than were adults in a traditional plan, and they were significantly more likely to exercise. CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to be highly educated. As the CDHP and HDHP markets continue to expand and more enrollees are enrolled for longer periods of time

  2. Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

    Science.gov (United States)

    Sranacharoenpong, Kitti; Hanning, Rhona M

    2011-10-01

    The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the

  3. Mental health functioning among men who use the Internet specifically to find partners for unprotected sex

    Directory of Open Access Journals (Sweden)

    Hugh Klein

    2013-02-01

    Full Text Available Previous studies have shown a link between mental health functioning and involvement in HIV risk practices. The present research examines how well one specific group of men who have sex with other men (MSM fare in terms of their mental health functioning, and then focuses on how mental health functioning relates to HIV risk practices in this population. The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Depression is more common among men in this population than in the adult male population-at-large. All other measures of mental health functioning that were examined (self-esteem, impulsivity, current life satisfaction, optimism about the future indicated low rates of mental health problem. Contrary to expectations, in nearly all instances, mental health functioning was not related to HIV risk practices. More work needs to be done to understand the causes of depression among these men, and to assess how, if at all, depression relates to risk practices in this population. These findings suggest that factors other than mental health problems must be considered if one wishes to understand HIV risk taking in this population.

  4. Marketing health educators to employers: survey findings, interpretations, and considerations for the profession.

    Science.gov (United States)

    Gambescia, Stephen F; Cottrell, Randall R; Capwell, Ellen; Auld, M Elaine; Mullen Conley, Kathleen; Lysoby, Linda; Goldsmith, Malcolm; Smith, Becky

    2009-10-01

    In July 2007, a market research report was produced by Hezel Associates on behalf of five sponsoring health education profession member organizations and the National Commission for Health Education Credentialing. The purpose of the survey was to learn about current or potential employers' knowledge, attitudes, and behaviors toward health educators and the health education profession and their future hiring practices. This article presents the background leading up to the production of this report, the major findings of the survey of employers, recommendations from the market research group regarding core messages, and implications for the profession having discovered for the first time information about employers' understanding of professionally prepared health educators. The article discusses the umbrella and key messages that may be incorporated into a marketing plan and other recommendations by the firm that should assist health educators in marketing the profession. Furthermore, this article presents reactions by leaders in this field to these messages and recommendations and concludes with next steps in this project and a call for the overall need to market the profession of health education.

  5. Autoconceito dos professores: principais factores usando modelos de Análise de Dados Multivariada Teachers' self-concept: finding main factors and clusters by EDA models

    Directory of Open Access Journals (Sweden)

    Vitor Franco

    2008-01-01

    Full Text Available O autoconceito tem sido considerado uma dimensão muito importante da personalidade do professor, da sua prática e do seu desenvolvimento pessoal (MARKUS; WURF, 1987; SIMÕES, 2001. A investigação que apresentamos foi efectuada com 281 professores de Ciências da Natureza, do terceiro ciclo do Ensino Básico, em Portugal, usando o ICAC- Inventário Clínico do Auto Conceito (VAZ-SERRA, 1986. Na análise dos dados obtidos foram usados diferentes métodos de Análise Multivariada, apresentando-se os resultados da análise factorial de correspondências e nos modelos de classificação hierárquica baseados no coeficiente de afinidade. Os resultados obtidos: 1 confirmam a importância de dois grandes factores presentes no Autoconceito: aceitação social e auto-eficácia; 2 caracterizam estes principais factores no que se refere ao Autoconceito clínico dos professores; 3 mostram como esses factores são determinantes na forma como cada professor constroi o seu autoconceito.The self-concept has been considered as a very important dimension on teacher's personality, practice and development (MARKUS; WURF, 1987;SIMÕES, 2001. The present research concerns a sample of 281 teachers of Natural Science of the Third Cycle of Basic Education from Portugal that responded to the I.C.A.C. - Self-Concept Clinical Inventory (VAZ-SERRA, 1986. In the analysis of the questionnaires different multivariate data analysis methods have been used. This paper describes some results issued from correspondence analysis and hierarchical clustering models based on the affinity coefficient. The results obtained: 1 confirm the importance of two general main factors / types which are present in self-concept: social acceptance and self-efficiency; 2 characterise these main factors when teachers'clinical self-concept is concerned and 3 show how determinant these factors are for the building of self-concept that allow us to differentiate teachers.

  6. The incidence of health financing in South Africa: findings from a recent data set.

    Science.gov (United States)

    Ataguba, John E; McIntyre, Di

    2018-01-01

    There is an international call for countries to ensure universal health coverage. This call has been embraced in South Africa (SA) in the form of a National Health Insurance (NHI). This is expected to be financed through general tax revenue with the possibility of additional earmarked taxes including a surcharge on personal income and/or a payroll tax for employers. Currently, health services are financed in SA through allocations from general tax revenue, direct out-of-pocket payments, and contributions to medical scheme. This paper uses the most recent data set to assess the progressivity of each health financing mechanism and overall financing system in SA. Applying standard and innovative methodologies for assessing progressivity, the study finds that general taxes and medical scheme contributions remain progressive, and direct out-of-pocket payments and indirect taxes are regressive. However, private health insurance contributions, across only the insured, are regressive. The policy implications of these findings are discussed in the context of the NHI.

  7. Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project.

    Science.gov (United States)

    Labonté, Ronald; Sanders, David; Packer, Corinne; Schaay, Nikki

    2014-01-01

    The 4-year (2007-2011) Revitalizing Health for All international research program (http://www.globalhealthequity.ca/projects/proj_revitalizing/index.shtml) supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a 'research user' from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacity-enhancement meetings were organized to refine methods and to discuss and assess cross-case findings. Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups), secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action) was found in many of the cases. Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include:1. Well-trained and supported community health workers (CHWs) able to work effectively with marginalized communities2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation) and formal (though program management structures)3.

  8. Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

    Directory of Open Access Journals (Sweden)

    Ronald Labonté

    2014-08-01

    Full Text Available Background: The 4-year (2007–2011 Revitalizing Health for All international research program (http://www.globalhealthequity.ca/projects/proj_revitalizing/index.shtml supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a ‘research user’ from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacity-enhancement meetings were organized to refine methods and to discuss and assess cross-case findings. Objective: Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups, secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. Results: Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action was found in many of the cases. Conclusions: Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include: 1. Well-trained and supported community health workers (CHWs able to work effectively with marginalized communities 2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation and formal

  9. Findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2011-12-01

    SEVENTH ANNUAL SURVEY: This Issue Brief presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey. This study is based on an online survey of 4,703 privately insured adults ages 21-64 to provide nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with EBRI's findings from earlier surveys. ENROLLMENT CONTINUES TO GROW: The survey finds continued growth in consumer-driven health plans: In 2011, 7 percent of the population was enrolled in a CDHP, up from 5 percent in 2010. Enrollment in HDHPs increased from 14 percent in 2010 to 16 percent in 2011. The 7 percent of the population with a CDHP represents 8.4 million adults ages 21-64 with private insurance, while the 16 percent with a HDHP represents 19.3 million people. Among the 19.3 million individuals with an HDHP, 38 percent (or 7.3 million) reported that they were eligible for a health savings ccount (HSA) but did not have such an account. Overall, 15.8 million adults ages 21-64 with private insurance, representing 13.1 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA but had not opened the account. When their children are counted, about 21 million individuals with private insurance, representing about 12 percent of the market, were either in a CDHP or an HSA-eligible plan. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether their plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about treatment options and costs; talked to their doctor about prescription drug options and costs

  10. Social capital dynamics and health in mid to later life: findings from Australia.

    Science.gov (United States)

    Yiengprugsawan, Vasoontara; Welsh, Jennifer; Kendig, Hal

    2018-05-01

    The influence of social capital has been shown to improve health and wellbeing. This study investigates the relationship between changes in social capital and health outcomes during a 6-year follow-up in mid to later life in Australia. Nationally representative data from the Household, Income and Labour Dynamics in Australia (HILDA) survey included participants aged 45 years and over who responded in 2006, 2010 and 2012 (N = 3606). Each of the three components of social capital (connectedness, trust and participation) was measured in Waves 2006 and 2010 and categorised as: 'never low', 'transitioned to low', 'transitioned out of low' and 'consistently low'. Health outcomes in 2012 included self-rated overall health, physical functioning, and mental health based on the Short Form 36-item health survey (SF-36). Multivariable logistic regression assessed changes in social capital (measured in 2006 and 2010) predicted poor health (measured in 2012), adjusting for covariates. Consistently low trust was significantly associated with higher odds of transitions into poor physical functioning (AOR 1.54; 95% Confidence Interval 1.06-1.22), poor mental health (AOR 1.59; 95% CI 1.08-2.36) and poor self-rated health (AOR 1.86; 95% CI 1.27-2.72). Transition into low trust was also a predictor of poor self-rated health after adjusting for covariates (AOR 1.74; 95% CI 1.11-2.73). Changes in social connectedness in both directions (transitioned out of and into low) were statistically associated with poor self-rated health (AORs 1.40; 95% CI 1.00-1.97 and 1.61; 95% CI 1.11-2.34, respectively) after adjusting for confounders as well as other social capital components. Our longitudinal findings reveal social capital dynamics and effects on health in mid to later life. Social trust and connectedness could be important enablers for older persons to be more active in the community and potentially benefit their health and wellbeing over time.

  11. Recruiting community health centers into pragmatic research: Findings from STOP CRC.

    Science.gov (United States)

    Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B

    2016-04-01

    uninsured patients, limited clinic capacity to prepare mailings required by the study protocol, discomfort with randomization, and concerns about delaying program implementation at some clinics due to the research requirements. Our findings address an important research gap and may inform future efforts to recruit community health centers into pragmatic research. © The Author(s) 2015.

  12. Oncology nursing: Finding the balance in a changing health care system.

    Science.gov (United States)

    Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin

    2006-01-01

    Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.

  13. [Oral health hygiene education programme for nursing personnel to improve oral health of residents in long-term care facilities 2010 in Frankfurt/Main, Germany].

    Science.gov (United States)

    Czarkowski, G; Allroggen, S; Köster-Schmidt, A; Bausback-Schomakers, S; Frank, M; Heudorf, U

    2013-06-01

    Many studies have shown the urgent need for improving oral health hygiene in nursing home residents. Deficits in the knowledge of the personnel about dental and oral hygiene are often cited as one of the causes. Therefore, an oral health education programme was provided to the personnel of 20 nursing homes in Frankfurt/Main. Here the results of the assessment of the impact of the education programme on knowledge and attitudes of the personnel as well as on oral health of the residents are presented. In May/June 2010, 471 nurses in 20 nursing homes in the Frankfurt/Main, Germany, received a two-hour education programme on oral health. The lessons were held by dentists with special education in geriatric dentistry. The personnel were asked to complete a questionnaire regarding knowledge and attitudes on oral health care before the education programme and 4-6 months afterwards. The oral health status of 313 residents (i. e., about 10% of the total residents) was examined by two dentists. Before and 4-6 months after education of the caregivers, the following data were recorded in the residents: number of teeth, caries, plaque index (PI), sulcus bleeding index (SBI), community periodontal index of treatment needs (CPITN) and denture hygiene index (DHI). By attending the lessons, good improvements in knowledge of the caregivers could be obtained. The education programme was rated as very good/good by 85% of the nurses, having reduced their fear of oral care in the seniors and having gained more competence in practical oral hygiene procedures. Mean age of the residents was 80±13 years. About 32% of the residents were edentulous. Teeth were carious in 53% of the residents. Initially, one half of the residents exhibited plaque index>2, in 29% of the residents a severe and in 59% of them a very severe parodontitis was found (CPITN 3 or, respectively, 4). At 4-6 months after the education programme, an improvement in oral and dental hygiene of the residents could be

  14. The physical health of people with schizophrenia in Asia: Baseline findings from a physical health check programme.

    Science.gov (United States)

    Thongsai, S; Gray, R; Bressington, D

    2016-06-01

    WHAT IS KNOWN ON THE SUBJECT?: Physical health problems, especially cardiovascular disease and metabolic disorders are far more common in people with severe mental illness (SMI) than the general population. While there are a considerable number of studies that have examined the physical health and health behaviours of people with SMI in Western countries, there have been few studies that have done this in Asia. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unhealthy body mass index (BMI) values were observed in 44% of Thai service users diagnosed with schizophrenia despite desirable levels of exercise and relatively good diets being reported by the majority of participants. Being prescribed two or more antipsychotics was significantly associated with greater body weight and a higher BMI than in people prescribed only one antipsychotic. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals in Asia should be particularly aware of the additional risks of obesity that seem to be associated with antipsychotic polypharmacy when they are promoting the physical health of people with schizophrenia. Introduction People with schizophrenia have worse physical health than the general population, and studies in developed countries demonstrate that their health behaviours are often undesirable. However, as no similar studies have been conducted in Asian countries with emerging healthcare systems, the physical health promotion challenges in these settings is unknown. Aim To identify and explore relationships between cardiometabolic health risks, lifestyle and treatment characteristics in people with schizophrenia in Thailand. Method This cross-sectional study reports the baseline findings from a physical health check programme using the Thai version of the Health Improvement Profile. Results Despite desirable levels of exercise and relatively good diets being reported by most of the 105 service users, unhealthy body mass index values were observed in 44% of

  15. Principais achados de colonoscopias realizadas em caráter de urgência e eletivas Main finding on emergency and electie colonoscopies

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Marques dos Santos

    2009-03-01

    . Digestive hemorrhage was the main signal noticed by the doctors who asked for the exam. With a high incidence of polyps, and mostly in sigmoid, just evidenced the how important the retosigmoidoscopy is. It is a relatively safe and cheaper procedure in comparison to the colonoscopy and can be performed during the simple consultation. The low incidence of angiodisplasia could be explained by a relatively low average age, differing from literature.

  16. Phthalate esters in main source water and drinking water of Zhejiang Province (China): Distribution and health risks.

    Science.gov (United States)

    Wang, Xiaofeng; Lou, Xiaoming; Zhang, Nianhua; Ding, Gangqiang; Chen, Zhijian; Xu, Peiwei; Wu, Lizhi; Cai, Jianmin; Han, Jianlong; Qiu, Xueting

    2015-10-01

    To evaluate the distributions and health risks of phthalate esters in the main source water and corresponding drinking water of Zhejiang Province, the concentrations of 16 phthalate esters in water samples from 19 sites were measured from samples taken in the dry season and wet season. The concentration of the total phthalate ester congeners in source water ranged from 1.07 μg/L to 7.12 μg/L in the wet season, from 0.01 μg/L to 1.58 μg/L in the dry season, from 1.18 μg/L to 15.28 μg/L from drinking water in the wet season, and from 0.16 μg/L to 1.86 μg/L from drinking water in the dry season. Of the 16 phthalate esters, dimethyl phthalate, dibutyl phthalate, di-(2-ethyl-hexyl) phthalate, di-iso-butyl phthalate, bis-2-n-butoxyethyl phthalate, and dicyclohexyl phthalate were present in the samples analyzed, dominated by di-iso-butyl phthalate and di-(2-ethyl-hexyl) phthalate. The concentrations of phthalate esters in the wet season were all relatively higher than those in the dry season, and the drinking water had higher concentrations of phthalate esters than source water. The phthalate ester congeners studied pose little health risk to nearby citizens. Environ Toxicol Chem 2015;34:2205-2212. © 2015 SETAC. © 2015 SETAC.

  17. Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative.

    Science.gov (United States)

    Mokdad, Ali H; Palmisano, Erin B; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Johanns, Casey K; Schaefer, Alexandra; Desai, Sima S; Haakenstad, Annie; Gagnier, Marielle C; McNellan, Claire R; Colombara, Danny V; López Romero, Sonia; Castillo, Leolin; Salvatierra, Benito; Hernandez, Bernardo; Betancourt-Cravioto, Miguel; Mujica-Rosales, Ricardo; Regalia, Ferdinando; Tapia-Conyer, Roberto; Iriarte, Emma

    2018-01-01

    Results-based aid (RBA) is increasingly used to incentivize action in health. In Mesoamerica, the region consisting of southern Mexico and Central America, the RBA project known as the Salud Mesoamérica Initiative (SMI) was designed to target disparities in maternal and child health, focusing on the poorest 20% of the population across the region. Data were first collected in 365 intervention health facilities to establish a baseline of indicators. For the first follow-up measure, 18 to 24 months later, 368 facilities were evaluated in these same areas. At both stages, we measured a near-identical set of supply-side performance indicators in line with country-specific priorities in maternal and child health. All countries showed progress in performance indicators, although with different levels. El Salvador, Honduras, Nicaragua, and Panama reached their 18-month targets, while the State of Chiapas in Mexico, Guatemala, and Belize did not. A second follow-up measurement in Chiapas and Guatemala showed continued progress, as they achieved previously missed targets nine to 12 months later, after implementing a performance improvement plan. Our findings show an initial success in the supply-side indicators of SMI. Our data suggest that the RBA approach can be a motivator to improve availability of drugs and services in poor areas. Moreover, our innovative monitoring and evaluation framework will allow health officials with limited resources to identify and target areas of greatest need.

  18. Medicinal Plant Use and Health Sovereignty: Findings from the Tajik and Afghan Pamirs

    Science.gov (United States)

    Karamkhudoeva, Munira; Ruelle, Morgan; Baumflek, Michelle

    2010-01-01

    Medicinal plants are indicators of indigenous knowledge in the context of political volatility and sociocultural and ecological change in the Pamir Mountains of Afghanistan and Tajikistan. Medicinal plants are the primary health care option in this region of Central Asia. The main objective of this paper is to demonstrate that medicinal plants contribute to health security and sovereignty in a time of instability. We illustrate the nutritional as well as medicinal significance of plants in the daily lives of villagers. Based on over a decade and half of research related to resilience and livelihood security, we present plant uses in the context of mountain communities. Villagers identified over 58 cultivated and noncultivated plants and described 310 distinct uses within 63 categories of treatment and prevention. Presence of knowledge about medicinal plants is directly connected to their use. PMID:21258436

  19. Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform.

    Science.gov (United States)

    Felland, Laurie E; Grossman, Joy M; Tu, Ha T

    2011-05-01

    Lingering fallout--loss of jobs and employer coverage--from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Hospitals with significant market clout continued to command high payment rate increases from private insurers, and tighter hospital-physician alignment heightened concerns about growing provider market power. High and rising premiums led to increasing employer adoption of consumer-driven health plans and continued increases in patient cost sharing, but the broader movement to educate and engage consumers in care decisions did not keep pace. State and local budget deficits led to some funding cuts for safety net providers, but an influx of federal stimulus funds increased support to community health centers and shored up Medicaid programs, allowing many people who lost private insurance because of job losses to remain covered. Hospitals, physicians and insurers generally viewed health reform coverage expansions favorably, but all worried about protecting revenues as reform requirements phase in.

  20. Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2009-12-01

    FIFTH ANNUAL SURVEY: This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21-64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21-64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment

  1. Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding

    Directory of Open Access Journals (Sweden)

    Vincent Menger

    2016-01-01

    Full Text Available The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM, suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

  2. Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding.

    Science.gov (United States)

    Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

    2016-01-01

    The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM), suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

  3. Introduction of a child and adolescent mental health link worker: education and health staff focus group findings.

    Science.gov (United States)

    Hunter, A; Playle, J; Sanchez, P; Cahill, J; McGowan, L

    2008-10-01

    Policy guidance suggests that outcomes for adolescents with mental health problems can be improved by secondary education services (SES) and child and adolescent mental health services (CAMHS) working more closely. This study reports on staff experiences of the introduction of a mental health link worker (MHLW). The findings of two focus groups are presented, conducted with staff from CAMHS and SES. These focus groups formed part of the overall wider evaluation of the MHLW role. The groups explored staff perceptions and experiences following the introduction of the MHLW, and elicited their views on the effectiveness of this innovative role. Qualitative methods were employed, and analysis was conducted using the principles of grounded theory and the constant comparative method. The findings revealed that the MHLW was well received by both groups, despite the identification of potential barriers. A number of key themes emerged, which included the ability of the link worker to improve communication and to encourage mutual understanding between services. The issues raised by these themes are discussed and recommendations are made for future practice and research.

  4. Debate on GMOs health risks after statistical findings in regulatory tests.

    Science.gov (United States)

    de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

    2010-10-05

    We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries.

  5. Retention of health workers in rural Sierra Leone: findings from life histories.

    Science.gov (United States)

    Wurie, Haja R; Samai, Mohamed; Witter, Sophie

    2016-02-01

    Sierra Leone has faced a shortage and maldistribution of staff in its post-conflict period. This long-standing challenge is now exacerbated by the systemic shock and damage wrought by Ebola. This study aimed to investigate the importance of different motivation factors in rural areas in Sierra Leone and thus to contribute to better decisions on financial and non-financial incentive packages, here and in similar contexts. This article is based on participatory life histories, conducted in 2013 with 23 health workers (doctors, nurses, midwives and Community Health Officers) in four regions of Sierra Leone who had worked in the sector since 2000. Although the interviews covered a wide range of themes, here we present findings on motivating and demotivating factors for staff, especially those in rural areas, based on thematic analysis of transcripts. Rural health workers face particular challenges, some of which stem from the difficult terrain, which add to common disadvantages of rural living (poor social amenities, etc.). Poor working conditions, emotional and financial costs of separation from families, limited access to training, longer working hours (due to staff shortages) and the inability to earn from other sources make working in rural areas less attractive. Moreover, rules on rotation which should protect staff from being left too long in rural areas are not reported to be respected. By contrast, poor management had more resonance in urban areas, with reports of poor delegation, favouritism and a lack of autonomy for staff. Tensions within the team over unclear roles and absenteeism are also significant demotivating factors in general. This study provides important policy-focused insights into motivation of health workers and can contribute towards building a resilient and responsive health system, incorporating the priorities and needs of health workers. Their voices and experiences should be taken into account as the post-Ebola landscape is shaped.

  6. Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

    Science.gov (United States)

    Simmons, R; Phillips, J F; Rahman, M

    1984-01-01

    An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

  7. Low Back Pain Prevalence and Associated Factors in Iranian Population: Findings from the National Health Survey

    Directory of Open Access Journals (Sweden)

    Akbar Biglarian

    2012-01-01

    Full Text Available Background. There are very few studies that had a sample size sufficient to explore the association between factors related to low back pain in a representative sample of the Iranian population. Objective. To examine the relationship between sociodemographic factors, smoking, obesity, and low back pain in Iranian people. Methods. We used Iranian adults respondents (n=25307 from the National Health Survey. Adjusted odds ratios and 95% confidence intervals were estimated by using logistic regression. Results. The prevalence of low back pain was found in 29.3% of the studied sample. High age, female sex, being married, obesity, low-economic index, being smoker, in a rural residence, and low educational attainment, all increased the odds of low back pain. Conclusions. Our findings add to the evidence on the importance of obesity in relation to low back pain. These results can be used as a basis to reinforce health programs to prevent obesity.

  8. Assessment of Health Effects of Exogenous Urea: Summary and Key Findings.

    Science.gov (United States)

    Dickerson, Aisha S; Lee, Janice S; Keshava, Channa; Hotchkiss, Andrew; Persad, Amanda S

    2018-05-01

    Urea has been utilized as a reductant in diesel fuels to lower emission of nitrogen oxides, igniting interest in probable human health hazards associated with exposure to exogenous urea. Here, we summarize and update key findings on potential health effects of exogenous urea, including carcinogenicity. No definitive target organs for oral exposure were identified; however, results in animal studies suggest that the liver and kidney could be potential target organs of urea toxicity. The available human-subject literature suggests that the impact on lung function is minimal. Based on the literature on exogenous urea, we concluded that there was inadequate information to assess the carcinogenic potential of urea, or perform a quantitative assessment to derive reference values. Given the limited information on exogenous urea, additional research to address gaps for exogenous urea should include long-term cancer bioassays, two-generation reproductive toxicity studies, and mode-of-action investigations.

  9. Finding a path through the health unit: practical experience of Ugandan patients.

    Science.gov (United States)

    Mogensen, Hanne O

    2005-01-01

    Finding one's way through a health facility is not necessarily an easy task for Ugandan patients. Our understanding of how people succeed in doing so, and of the obstacles they encounter on their way, is incomplete if we focus only on the cognitive level of the clinical encounter. Much research in public health and medical anthropology implicitly works with the notion that agency is located in the mind and that cognitive understanding is a precondition for practice. Based on material from eastern Uganda, this article explores the practical experience of Ugandan patients and their relatives and reflects upon the ways in which this notion of agency has often caused us to confuse the spectator's point of view with the actor's point of view. Thus, as Pierre Bourdieu has argued, we are made to look for answers to "questions that practice never asks because it has no need to ask them."

  10. A mHealth Application for Chronic Wound Care: Findings of a User Trial

    Directory of Open Access Journals (Sweden)

    Marcia R. Friesen

    2013-11-01

    Full Text Available This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses’ paper-based charting and is positioned for integration with facility’s larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1 the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities, (2 data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3 tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application’s design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software’s telehealth capacities.

  11. Factors Associated With Volunteering Among Racial/Ethnic Groups: Findings From the California Health Interview Survey.

    Science.gov (United States)

    Johnson, Kimberly J; Lee, S Hannah

    2017-06-01

    The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.

  12. High prevalence of bronchiectasis in adults. Analysis of CT findings in a health screening program

    International Nuclear Information System (INIS)

    Kwak, Hyun-Jung; Moon, Ji-Yong; Choi, Vo-Won; Kim, Tae-Hyung; Sohn, Jang-Won; Yoon, Ho-Joo; Shin, Dong-Ho; Park, Sung-Soo; Kim, Sang-Heon

    2010-01-01

    Bronchiectasis is one of the common chronic respiratory diseases and associated with respiratory morbidity and mortality. However, neither its prevalence nor its etiology is well-defined. We aimed to estimate the prevalence and risk factors of bronchiectasis in adults. In a retrospective study, we analyzed radiologic findings on chest computed tomography (CT) images performed as part of a health-screening program. From January to December 2008, 1,409 (24.6%) of 5,727 participants in the screening program of a health promotion center at a university hospital underwent chest CT scans based on the subject's decision. Bronchiectasis was diagnosed, if there was abnormal bronchial dilatation in any area of both lungs on chest CT. Respiratory symptoms, smoking status, and past medical history were also analyzed to define clinical characteristics and risk factors of bronchiectasis. Of 1,409 patients (aged 23-86 years), who were screened for respiratory diseases using chest CT for one year in a health promotion center, 129 patients (9.1%) were diagnosed with bronchiectasis. The prevalence of bronchiectasis was higher in females than in males (11.5% vs. 7.9%, p=0.022) and increased with age. Respiratory symptoms were reported in 53.7% of subjects. Previous history of tuberculosis (TB) (odds ratio (OR) 4.61, 95% confidence interval (Cl) 2.39-8.88, p=0.001) and age (OR 2.49, 95% Cl 1.56-3.98, p=0.001) were significantly associated with bronchiectasis. This retrospective analysis of chest CT findings in health screening examinees revealed a very high prevalence of bronchiectasis in adults. Previous TB infection is one of the major causes of bronchiectasis. (author)

  13. Arsenic exposure and adverse health effects: A review of recent findings from arsenic and health studies in Matlab, Bangladesh

    Directory of Open Access Journals (Sweden)

    Mohammad Yunus

    2011-09-01

    Full Text Available The recent discovery of large-scale arsenic (As contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations.

  14. Arsenic exposure and adverse health effects: a review of recent findings from arsenic and health studies in Matlab, Bangladesh.

    Science.gov (United States)

    Yunus, Mohammad; Sohel, Nazmul; Hore, Samar Kumar; Rahman, Mahfuzar

    2011-09-01

    The recent discovery of large-scale arsenic (As) contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat) was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations. Copyright © 2011. Published by Elsevier B.V.

  15. Human-animal interaction as a social determinant of health: descriptive findings from the health and retirement study.

    Science.gov (United States)

    Mueller, Megan K; Gee, Nancy R; Bures, Regina M

    2018-03-09

    We focused on human-animal interaction (HAI) as an important aspect of social functioning at the individual level, framing this emerging field from a public health perspective. Using data from the Health and Retirement Study (HRS) 2012 HAI module, we describe the characteristics of pet ownership in a population of older adults, and examine the relation between pet ownership and multiple mental and physical health indicators such as health status, depression, and physical activity. Of the 1657 participants in our subsample, approximately half (51.5%) reported being pet owners; the majority owned dogs or cats, and most had only one pet. Pet ownership was significantly associated with a higher likelihood of ever having had depression, with pet owners being 1.89 times more likely to have experienced depression. However, pet ownership was not associated with having experienced depression within the last week. The findings from this study could indicate a relationship between pet ownership and depression, but it is impossible to determine the directionality of that relationship. It is possible that owning a pet may put a person at an increased risk of developing depression, or individuals who are at risk, or who have already developed depression, may acquire a pet as a way of managing their depressive symptoms. The findings of this study provide an initial step in contributing to our understanding of the relationship between companion animals and the social, physical, and mental well-being of the HRS study population. Future research should include measures of HAI in longitudinal, population-based surveys.

  16. The Children's Health Insurance Program Reauthorization Act Evaluation Findings on Children's Health Insurance Coverage in an Evolving Health Care Landscape.

    Science.gov (United States)

    Harrington, Mary E

    2015-01-01

    The Children's Health Insurance Program (CHIP) Reauthorization Act (CHIPRA) reauthorized CHIP through federal fiscal year 2019 and, together with provisions in the Affordable Care Act, federal funding for the program was extended through federal fiscal year 2015. Congressional action is required or federal funding for the program will end in September 2015. This supplement to Academic Pediatrics is intended to inform discussions about CHIP's future. Most of the new research presented comes from a large evaluation of CHIP mandated by Congress in the CHIPRA. Since CHIP started in 1997, millions of lower-income children have secured health insurance coverage and needed care, reducing the financial burdens and stress on their families. States made substantial progress in simplifying enrollment and retention. When implemented optimally, Express Lane Eligibility has the potential to help cover more of the millions of eligible children who remain uninsured. Children move frequently between Medicaid and CHIP, and many experienced a gap in coverage with this transition. CHIP enrollees had good access to care. For nearly every health care access, use, care, and cost measure examined, CHIP enrollees fared better than uninsured children. Access in CHIP was similar to private coverage for most measures, but financial burdens were substantially lower and access to weekend and nighttime care was not as good. The Affordable Care Act coverage options have the potential to reduce uninsured rates among children, but complex transition issues must first be resolved to ensure families have access to affordable coverage, leading many stakeholders to recommend funding for CHIP be continued. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  17. Improving the production of applied health research findings: insights from a qualitative study of operational research.

    Science.gov (United States)

    Crowe, Sonya; Turner, Simon; Utley, Martin; Fulop, Naomi J

    2017-09-08

    Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings. A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy. Semi-structured interviews (n = 20) were conducted with all members of the project's research team and advisory group (patient and health professional representatives and academics). These were augmented by participant (> 150 h) and non-participant (> 15 h) observations focusing on the process and experience of attempting to support knowledge production. Data were analysed thematically using QSR NVivo software. Operational research performed a knowledge mediation role shaped by a problem-focused approach and an intent to perform those tasks necessary to producing readily implementable knowledge but outwith the remit of other disciplinary strands of the project. Three characteristics of the role were found to support this: engaging and incorporating different perspectives to improve services by capturing a range of health professional and patient views alongside quantitative and qualitative research evidence; rendering data meaningful by creating and presenting evidence in forms that are accessible to and engage different audiences, enabling them to make sense of it for practical use; and maintaining perceived objectivity and rigour by establishing credibility, perceived neutrality and confidence in the robustness of the research in order to unite diverse professionals in thinking creatively about system-wide service improvement. Our study

  18. What do health workers in Timor-Leste want, know and do? Findings from a national health labour market survey.

    Science.gov (United States)

    Hou, Xiaohui; Witter, Sophie; Zaman, Rashid U; Engelhardt, Kay; Hafidz, Firdaus; Julia, Fernanda; Lemiere, Christophe; Sullivan, Eileen B; Saldanha, Estanislau; Palu, Toomas; Lievens, Tomas

    2016-11-18

    The objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, and to assess the skills, competence and performance (i.e. the 'know-do gap') of doctors working in Timor-Leste. This cross-sectional survey was implemented in all 13 districts of Timor-Leste in 2014. We surveyed 443 health workers, including 175 doctors, 150 nurses and 118 midwives (about 20% of the health workers in the country). We also observed 632 clinical consultations with doctors, including 442 direct clinical observations, and tested 190 vignettes. The study highlights some positive findings, including the gender balance of health workers overall, the concentration of doctors in rural areas, the high overall reported satisfaction of staff with their work and high motivation, the positive intention to stay in the public sector, the feeling of being well prepared by training for work, the relatively frequent and satisfactory supervisions, and the good attitudes towards patients as identified in observations and vignettes. However, some areas require more investigations and investments. The overall clinical performance of the doctors was very good in terms of attitude and moderate in regard to history taking, health education and treatment. However, the average physical examination performance score was low. Doctors performed better with simulated cases than the real cases in general, which means they have better knowledge and skills than they actually demonstrated. The factors that were significantly associated with the clinical performance of doctors were location of the health facility (urban doctors were better) and consultation time (cases with more consultation time were better). Regression analysis suggests that lack of knowledge was significantly associated with lack of performance, while lack of motivation and equipment were not significant. The survey provides essential information for workforce planning and for

  19. The Denver Aerosol Sources and Health (DASH) study: Overview and early findings

    Science.gov (United States)

    Vedal, S.; Hannigan, M. P.; Dutton, S. J.; Miller, S. L.; Milford, J. B.; Rabinovitch, N.; Kim, S.-Y.; Sheppard, L.

    Improved understanding of the sources of air pollution that are most harmful could aid in developing more effective measures for protecting human health. The Denver Aerosol Sources and Health (DASH) study was designed to identify the sources of ambient fine particulate matter (PM 2.5) that are most responsible for the adverse health effects of short-term exposure to PM 2.5. Daily 24-h PM 2.5 sampling began in July 2002 at a residential monitoring site in Denver, Colorado, using both Teflon and quartz filter samplers. Sampling is planned to continue through 2008. Chemical speciation is being carried out for mass, inorganic ionic compounds (sulfate, nitrate and ammonium), and carbonaceous components, including elemental carbon, organic carbon, temperature-resolved organic carbon fractions and a large array of organic compounds. In addition, water-soluble metals were measured daily for 12 months in 2003. A receptor-based source apportionment approach utilizing positive matrix factorization (PMF) will be used to identify PM 2.5 source contributions for each 24-h period. Based on a preliminary assessment using synthetic data, the proposed source apportionment should be able to identify many important sources on a daily basis, including secondary ammonium nitrate and ammonium sulfate, diesel vehicle exhaust, road dust, wood combustion and vegetative debris. Meat cooking, gasoline vehicle exhaust and natural gas combustion were more challenging for PMF to accurately identify due to high detection limits for certain organic molecular marker compounds. Measurements of these compounds are being improved and supplemented with additional organic molecular marker compounds. The health study will investigate associations between daily source contributions and an array of health endpoints, including daily mortality and hospitalizations and measures of asthma control in asthmatic children. Findings from the DASH study, in addition to being of interest to policymakers, by

  20. Counterintuitive findings from a qualitative study of mental health in English women's prisons.

    Science.gov (United States)

    Caulfield, Laura S

    2016-12-19

    Purpose Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women's mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues. Design/methodology/approach In-depth interviews were conducted with 43 women incarcerated in three English prisons and a thematic analysis of the data was conducted. Review of official prison records provided a form of data triangulation. Findings Analysis of the data revealed that while many women who experienced mental health issues in prison had experienced these issues in the past, a number of women reported first experiencing mental health and emotional problems only after entering prison. Although these problems often recede, this demonstrates the significant impact that entering prison can have upon the mental health of women. Unusually, the data highlighted many positive experiences of support within prison. However, there was some lack of consistency in the treatment and support offered to women. Originality/value The data presented here are in many ways more positive than previous research and - as opposed to much of the existing literature that simply states the prevalence women's issues in prison - provides insight into the lived experiences of women in prison. This paper documents how prison can present an opportunity for women to engage with treatment, but there is a need for a clearer understanding of women's needs and consistent and appropriate support.

  1. Educational success and adult health: findings from the Chicago longitudinal study.

    Science.gov (United States)

    Topitzes, James; Godes, Olga; Mersky, Joshua P; Ceglarek, Sudi; Reynolds, Arthur J

    2009-06-01

    Growing evidence indicates that education is associated with health, yet we lack knowledge about the specific educational experiences influencing health trajectories. This study examines the role school factors play in the emergence of poor young adult health outcomes for a low-income, minority sample. The following research questions are addressed. First, what are the education-based predictors of daily tobacco smoking, frequent substance use, depression, and no health insurance coverage? Second, do later-occurring school factors explain the association between earlier school measures and the outcomes and, if so, what pathways account for this mediation effect? Data were derived from the Chicago Longitudinal Study, an investigation of a cohort of 1,539 individuals, born around 1980, who attended kindergarten programs in the Chicago Public Schools. Participants were followed prospectively from early childhood through age 24, and study measures were created from various data sources and multiple assessment waves. Findings from probit hierarchical regressions with controls for early sociodemographic covariates indicated that elementary school socioemotional classroom adjustment and high school completion were significantly and negatively associated with all four study outcomes. Participation in the Chicago Child Parent Center preschool program predicted lower rates of both daily tobacco smoking and no health insurance coverage (p frustration tolerance was inversely associated with daily tobacco smoking and frequent drug use (p < .05). Also, negatively linked to frequent drug use was a high school measure of students' expectation to attend college (p < .01). In nearly all cases, later-occurring school factors fully mediated significant associations between earlier ones and the outcomes. Patterns of mediation were explored along with implications of results.

  2. Job dissatisfaction and the older worker: baseline findings from the Health and Employment After Fifty study.

    Science.gov (United States)

    D'Angelo, Stefania; Coggon, David; Harris, E Clare; Linaker, Cathy; Sayer, Avan Aihie; Gale, Catharine R; Evandrou, Maria; van Staa, Tjeerd; Cooper, Cyrus; Walker-Bone, Karen; Palmer, Keith T

    2016-08-01

    Demographic changes are requiring people to work longer. Labour force participation might be promoted by tackling sources of job dissatisfaction. We aimed to describe the epidemiology of job dissatisfaction in older British workers, to explore which perceptions of work contribute most importantly, and to assess possible impacts on health. Participants aged 50-64 years were recruited from 24 English general practices. At baseline, those currently in work (N=5437) reported on their demographic and employment circumstances, overall job satisfaction, perceptions of their work that might contribute to dissatisfaction, and their general health, mood and well-being. Associations of job dissatisfaction with risk factors and potential health outcomes were assessed cross-sectionally by logistic regression, and the potential contributions of different negative perceptions to overall dissatisfaction were summarised by population attributable fractions (PAFs). Job dissatisfaction was more common among men, below age 60 years, those living in London and the South East, in the more educated and in those working for larger employers. The main contributors to job dissatisfaction among employees were feeling unappreciated and/or lacking a sense of achievement (PAF 55-56%), while in the self-employed, job insecurity was the leading contributor (PAF 79%). Job dissatisfaction was associated with all of the adverse health outcomes examined (ORs of 3-5), as were most of the negative perceptions of work that contributed to overall dissatisfaction. Employment policies aimed at improving job satisfaction in older workers may benefit from focussing particularly on relationships in the workplace, fairness, job security and instilling a sense of achievement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Development of materials to support parents whose babies cry excessively: findings and health service implications.

    Science.gov (United States)

    Long, Jaqui; Powell, Charlotte; Bamber, Deborah; Garratt, Rosemary; Brown, Jayne; Dyson, Sue; James-Roberts, Ian St

    2018-01-10

    Aim To develop evidence-based materials which provide information and support for parents who are concerned about their baby's excessive crying. As well as meeting these parents' needs, the aim was to develop a package of materials suitable for use by the UK National Health Service (NHS). Parents report that around 20% of infants in Western countries cry excessively without an apparent reason during the first four months of age. Traditionally, research has focused on the crying and its causes. However, evidence is growing that how parents evaluate and respond to the crying needs to receive equal attention. This focus encompasses parental resources, vulnerabilities, well-being and mental health. At present, the UK NHS lacks a set of routine provisions to support parents who are concerned about their baby's excessive crying. The rationales, methods and findings from a study developing materials for this purpose are reported. Following a literature review, 20 parents whose babies previously cried excessively took part in focus groups or interviews. They provided reports on their experiences and the supports they would have liked when their baby was crying excessively. In addition, they identified their preferred delivery methods and devices for accessing information and rated four example support packages identified by the literature review. Findings During the period their baby cried excessively, most parents visited a health service professional and most considered these direct contacts to have provided helpful information and support. Websites were similarly popular. Telephones and tablets were the preferred means of accessing online information. Groups to meet other parents were considered an important additional resource by all the parents. Three package elements - a Surviving Crying website, a printed version of the website and a programme of Cognitive Behaviour Therapy-based support sessions delivered to parents by a qualified practitioner, were developed for

  4. Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative.

    Science.gov (United States)

    Arria, Amelia M; Jernigan, David H

    2018-03-01

    Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative's goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

  5. Perceptions of Personalized Medicine in an Academic Health System: Educational Findings.

    Science.gov (United States)

    Vorderstrasse, Allison; Katsanis, Sara Huston; Minear, Mollie A; Yang, Nancy; Rakhra-Burris, Tejinder; Reeves, Jason W; Cook-Deegan, Robert; Ginsburg, Geoffrey S; Ann Simmons, Leigh

    Prior reports demonstrate that personalized medicine implementation in clinical care is lacking. Given the program focus at Duke University on personalized medicine, we assessed health care providers' perspectives on their preparation and educational needs to effectively integrate personalized medicine tools and applications into their clinical practices. Data from 78 health care providers who participated in a larger study of personalized and precision medicine at Duke University were analyzed using Qualtrics (descriptive statistics). Individuals age 18 years and older were recruited for the larger study through broad email contacts across the university and health system. All participants completed an online 35-question survey that was developed, pilot-tested, and administered by a team of interdisciplinary researchers and clinicians at the Center for Applied Genomics and Precision Medicine. Overall, providers reported being ill-equipped to implement personalized medicine in clinical practice. Many respondents identified educational resources as critical for strengthening personalized medicine implementation in both research and clinical practice. Responses did not differ significantly between specialists and primary providers or by years since completion of the medical degree. Survey findings support prior calls for provider and patient education in personalized medicine. Respondents identified focus areas in training, education, and research for improving personalized medicine uptake. Given respondents' emphasis on educational needs, now may be an ideal time to address these needs in clinical training and public education programs.

  6. Main Memory

    NARCIS (Netherlands)

    P.A. Boncz (Peter); L. Liu (Lei); M. Tamer Özsu

    2008-01-01

    htmlabstractPrimary storage, presently known as main memory, is the largest memory directly accessible to the CPU in the prevalent Von Neumann model and stores both data and instructions (program code). The CPU continuously reads instructions stored there and executes them. It is also called Random

  7. Determination of antimicrobial susceptibility patterns in Staphylococcus aureus strains recovered from patients at two main health facilities in Kabul, Afghanistan.

    Science.gov (United States)

    Naimi, Haji Mohammad; Rasekh, Hamidullah; Noori, Ahmad Zia; Bahaduri, Mohammad Aman

    2017-11-29

    Staphylococcus aureus (S. aureus) is a major pathogen implicated in skin and soft tissue infections, abscess in deep organs, toxin mediated diseases, respiratory tract infections, urinary tract infections, post-surgical wound infections, meningitis and many other diseases. Irresponsible and over use of antibiotics has led to an increased presence of multidrug resistant organisms and especially methicillin resistant Staphylococcus aureus (MRSA) as a major public health concern in Afghanistan. As a result, there are many infections with many of them undiagnosed or improperly diagnosed. We aimed to establish a baseline of knowledge regarding the prevalence of MRSA in Kabul, Afghanistan, as well as S. aureus antimicrobial susceptibility to current available antimicrobials, while also determining those most effective to treat S. aureus infections. Samples were collected from patients at two main Health facilities in Kabul between September 2016 and February 2017. Antibiotic susceptibility profiles were determined by the disc diffusion method and studied using standard CLSI protocols. Out of 105 strains of S. aureus isolated from pus, urine, tracheal secretions, and blood, almost half (46; 43.8%) were methicillin-sensitive Staphylococcus aureus (MSSA) while 59 (56.2%) were Methicillin-resistant Staphylococcus aureus (MRSA). All strains were susceptible to vancomycin. In total, 100 (95.2%) strains were susceptible to rifampicin, 96 (91.4%) susceptible to clindamycin, 94 (89.5%) susceptible to imipenem, 83 (79.0%) susceptible to gentamicin, 81(77.1%) susceptible to doxycycline, 77 (77.1%) susceptible to amoxicillin + clavulanic acid, 78 (74.3%) susceptible to cefazolin, 71 (67.6%) susceptible to tobramycin, 68 (64.8%) susceptible to chloramphenicol, 60 (57.1%) were susceptible to trimethoprim-sulfamethoxazole, 47 (44.8%) susceptible to ciprofloxacin, 38 (36.2%) susceptible to azithromycin and erythromycin, 37 (35.2%) susceptible to ceftriaxone and 11 (10.5%) were

  8. Determining health personnel's application trends of new guidelines for preoperative fasting: findings from a survey.

    Science.gov (United States)

    Karadağ, Mevlüde; Pekin İşeri, Ozge

    2014-06-01

    For over a century, the discontinuation of oral food intake preoperatively after midnight has been routinely applied. Although routine fasting during the night before elective surgery has been abandoned by many modern centers, preoperative fasting after midnight continues as a routine practice. The purpose of this study was to determine trends in health personnel's application of new guidelines for preoperative fasting. The research sample of this descriptive study consisted of 73 nurses and physicians who were working in the surgical clinics during the time when the study was conducted and who agreed to participate in the study. The data of the study were collected using a questionnaire designed by the researchers. Of the health personnel included in the study group, 43.8% routinely kept adult patients fasting after midnight, 34.2% discontinued solid food intake 8 hours preoperatively, 5.5% discontinued solid food intake 6 hours preoperatively, and 34.2% discontinued the intake of clear and particulate liquids 4 to 8 hours preoperatively. Compliance of the American Society of Anesthesiologists' "2-4-6-8 rule" by health staff was very low. This study was carried out in a hospital and based on the statements of health staff. Therefore, the findings of the study are suggestive in nature and cannot be generalized. We recommend that the study should be conducted with larger sample groups and that actual preoperative fasting periods of the patients should be determined. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  9. An Overview of Turkish Healthcare System after Health Transformation Program: Main Successes, Performance Assessment, Further Challenges, and Policy Options

    Directory of Open Access Journals (Sweden)

    Kadir GÜRSOY

    2015-02-01

    Full Text Available Turkish healthcare system has been stated to show significant improvements regarding wider access to healthcare facilities, and the quality and efficiency through the introduction of Health Transformation Program launched in 2003. While the old system relied on differing provisions and financing and lacked behind many developed nations in terms of health outcomes, the new system achieved nearly universal coverage and many health outcomes enhanced significantly. Health expenditures rose to 5.4% of GDP in 2013 from 4.8% in 1998. Furthermore, Turkey provided both better financial protection for the poor against high health expenditures, and equity in access to health care across the population. However, Turkey still faces new challenges to catch other developed countries to have better health and further improve financial sustainability. To reach these targets, Turkey needs to further implement new policy options for reform such as combating informal economy, allocating more on health resources, designing incentive- based payment methods, adopting gate keeping system and referral chain, developing capacity to deploy health technology assessments in reimbursement decisions, and ensuring the hospital autonomy.

  10. Main and interactive effects of shiftwork, age and work stress on health in an Italian sample of healthcare workers

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Campanini, P; Sartori, S

    2008-01-01

    Among healthcare workers, shiftwork (mostly if nightwork is also included), ageing and work-related stress may be factors leading to impaired health. Such risk factors may also operate in interaction, resulting in an even increased harm for health. The present study aims at evaluating...... gastrointestinal disorders, poor work ability and job dissatisfaction. Work stress was the risk factor with the highest relevance for poor health. Ageing was associated with lower physical health. Few significant interactions were observed. Shiftwork with nights and high work stress significantly interacted...

  11. Main Memory

    OpenAIRE

    Boncz, Peter; Liu, Lei; Özsu, M.

    2008-01-01

    htmlabstractPrimary storage, presently known as main memory, is the largest memory directly accessible to the CPU in the prevalent Von Neumann model and stores both data and instructions (program code). The CPU continuously reads instructions stored there and executes them. It is also called Random Access Memory (RAM), to indicate that load/store instructions can access data at any location at the same cost, is usually implemented using DRAM chips, which are connected to the CPU and other per...

  12. Services to patients with dual diagnoses: findings from Washington's mental health service system.

    Science.gov (United States)

    Ouimette, Paige; Jemelka, Ron; Hall, Judy; Brimner, Karl; Krupski, Antoinette; Stark, Kenneth

    2007-01-01

    This study examined how Washington State's (WA) mental health treatment system provided services to patients with substance use disorders or dual diagnoses at several stages of care: crisis commitment, hospitalization, and outpatient treatment. A total of 30 key informants from urban and rural areas were surveyed between February and July 2004 using semi-structured interviews. Key informants represented direct service providers to chief operating officers. Themes, consensus, and disagreements were summarized. Results indicated that best practices are not consistently implemented and administrative and provider barriers hinder provision of more effective care. Findings highlight that work on how to best implement evidence-based practices is critical to improving care of dual diagnosis patients. Limitations of the study are noted as well as future research directions.

  13. Relationship between low back pain, disability, MR imaging findings and health care provider

    Energy Technology Data Exchange (ETDEWEB)

    Arana, Estanislao; Molla, Enrique; Costa, Salvador; Montijano, Ruben [Clinica Quiron, Department of Radiology, Valencia (Spain); Marti-Bonmati, Luis [Clinica Quiron, Department of Radiology, Valencia (Spain); Hospital Universitario Dr. Peset, Department of Radiology, Valencia (Spain); Vega, Maria [Hospital Universitario Dr. Peset, Department of Radiology, Valencia (Spain); Bautista, Daniel [Hospital Universitario Dr. Peset, Department of Preventive Medicine, Valencia (Spain)

    2006-09-15

    To determine the association between the self-report of pain and disability and findings on lumbar MR images, and to compare two different health care providers in Spanish patients with low back pain (LBP). Cross-sectional A total of 278 patients, 137 men and 141 women aged 44{+-}14 years submitted with low back pain (LBP) were studied. One hundred and nine patients were from the National Health System (NHS) and 169 from private practice. Patients with previous discitis, surgery, neoplasm or traumatic episodes were excluded. Every patient completed a disability questionnaire with six core items, providing a score of disability from 2 to 28. All patients had sagittal spin-echo T1 and turbo spin-echo T2, axial proton-density and MR myelography weighted images. MR images of the two most affected disc levels were read, offering an MR imaging score from 0 to 30. Patients with a combination of LBP and sciatica showed the highest levels of disability (p=0.002). MR imaging scores only correlated with pain interference with normal work (p=0.04), but not with other disability questions. Patients from the NHS showed greater disability scores than private ones (p=0.001) and higher MR imaging scores (p=0.01). In patients with LBP, MR imaging only correlates with pain interference with work but not with other disability questions. Differences are found between private and NHS patients, the latter being more physically affected. (orig.)

  14. Blended learning on family planning policy requirements: key findings and implications for health professionals.

    Science.gov (United States)

    Limaye, Rupali J; Ahmed, Naheed; Ohkubo, Saori; Ballard, Anne

    2018-04-01

    To address unmet needs for family planning and advance women's rights, US federal foreign aid recipients must ensure compliance with the family planning legislative and policy requirements. Because many health providers work in rural and remote settings, blended learning, which combines in-person and online experiences, is a promising approach for strengthening their compliance knowledge. This cross-sectional study examined the effect of blended learning that included three components (online course, in-person training and conference call) on retention of family planning compliance knowledge. A total of 660 learners from 44 countries completed the online survey (8% response rate). Study participants were asked about their knowledge of family planning compliance and suggestions to improve their learning experiences. Knowledge retention was higher in the group that utilised all three learning approaches compared with the online course plus conference call group (Pblended learning training resulted in the highest gains in knowledge retention compared with online-only learning. These findings suggest that blended learning and repeat online trainings are critical to ensuring health professionals are aware of family planning compliance regulations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Predictors of Dental Care Use: Findings from the National Longitudinal Study of Adolescent Health

    Science.gov (United States)

    Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I.; Visotcky, Alexis (Dye); Szabo, Aniko

    2013-01-01

    Objective To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Data Source The National Longitudinal Study of Adolescent Health from Waves I (1994-95), II (1996), III (2001-2002) and IV (2007-2008). Study Design This is a retrospective, observational study of adolescents' transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Principal Findings Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and thereafter remained flat. Whites and Asians had a 10-20 percentage points higher proportion of dental service utilization at most ages compared to Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization with OR= 10.7, 2.4 and 1.5 at the 1-year, 7-year and 13-year follow-ups respectively. These effects decreased when adjusted for current income, insurance and education. Compared to Whites, Blacks were consistently less likely to report any dental examination. Conclusion Dental service utilization was highest in adolescents. Gender, education, health insurance and income in young adulthood were significant predictors of reporting a dental examination. Blacks had lower odds of reporting a dental examination either as adolescents or as young adults. PMID:23850156

  16. Measuring health lifestyles in a comparative analysis: theoretical issues and empirical findings.

    Science.gov (United States)

    Abel, T

    1991-01-01

    The concept of lifestyle bears great potential for research in medical sociology. Yet, weaknesses in current methods have restrained lifestyle research from realizing its full potentials. The present focus is on the links between theoretical conceptions and their empirical application. The paper divides into two parts. The first part provides a discussion of basic theoretical and methodological issues. In particular selected lines of thought from Max Weber are presented and their usefulness in providing a theoretical frame of reference for health lifestyle research is outlined. Next, a theory guided definition of the subject matter is introduced and basic problems in empirical applications of theoretical lifestyle concepts are discussed. In its second part the paper presents findings from comparative lifestyle analyses. Data from the U.S. and West Germany are utilized to explore issues of measurement equivalence and theoretical validity. Factor analyses indicate high conceptual equivalence for new measures of health lifestyle dimensions in both the U.S. and West Germany. Divisive cluster analyses detect three distinct lifestyle groups in both nations. Implications for future lifestyle research are discussed.

  17. Relationship between low back pain, disability, MR imaging findings and health care provider

    International Nuclear Information System (INIS)

    Arana, Estanislao; Molla, Enrique; Costa, Salvador; Montijano, Ruben; Marti-Bonmati, Luis; Vega, Maria; Bautista, Daniel

    2006-01-01

    To determine the association between the self-report of pain and disability and findings on lumbar MR images, and to compare two different health care providers in Spanish patients with low back pain (LBP). Cross-sectional A total of 278 patients, 137 men and 141 women aged 44±14 years submitted with low back pain (LBP) were studied. One hundred and nine patients were from the National Health System (NHS) and 169 from private practice. Patients with previous discitis, surgery, neoplasm or traumatic episodes were excluded. Every patient completed a disability questionnaire with six core items, providing a score of disability from 2 to 28. All patients had sagittal spin-echo T1 and turbo spin-echo T2, axial proton-density and MR myelography weighted images. MR images of the two most affected disc levels were read, offering an MR imaging score from 0 to 30. Patients with a combination of LBP and sciatica showed the highest levels of disability (p=0.002). MR imaging scores only correlated with pain interference with normal work (p=0.04), but not with other disability questions. Patients from the NHS showed greater disability scores than private ones (p=0.001) and higher MR imaging scores (p=0.01). In patients with LBP, MR imaging only correlates with pain interference with work but not with other disability questions. Differences are found between private and NHS patients, the latter being more physically affected. (orig.)

  18. Finding joy in poor health: The leisure-scapes of chronic illness.

    Science.gov (United States)

    McQuoid, Julia

    2017-06-01

    Globally, increasing numbers of people face the challenge of enjoying life while living with long-term illness. Little research addresses leisure participation for people with chronic illness despite its links with mental and physical health and self-rated quality of life. I use a space-time geographical approach to explore experiences with leisure in everyday life for 26 individuals with chronic kidney disease (CKD) in Australia. I examine ways in which the spatial and temporal characteristics of illness management and symptoms shape where, when, and how participants can enjoy leisure, focusing on: 1) logistical conflicts between illness and leisure; 2) rhythmic interferences with the force of habit in skilful leisure performance; and 3) absorbing experiences of encounter with self and place through leisure. Data were collected from 2013 to 2014. Participants kept diaries over two sample days and then participated in semi-structured interviews. Findings show that the voluntary nature of leisure offered participants important benefits in coping with and managing illness over the long-term, including opportunities to experience greater sense of control, an alternative experience of one's body to the 'sick body', and knowledge creation that supports adaptation to the uncertainties of illness trajectories. The ability to engage in meaningful leisure was constrained by the shaping forces of illness symptoms and management on participants' leisure-scapes. Illness treatment regimens should therefore be adapted to better accommodate leisure participation for chronically ill patients, and leisure should be explicitly incorporated into illness management plans negotiated between patients and health practitioners. Finally, greater understanding of the transformative capacity of habit in activities of experimentation and play may have wider-reaching implications for leisure's potential applications in public health. Leisure should be taken seriously as a vehicle for enhancing

  19. Finding joy in poor health: The leisure-scapes of chronic illness

    Science.gov (United States)

    2017-01-01

    Globally, increasing numbers of people face the challenge of enjoying life while living with long-term illness. Little research addresses leisure participation for people with chronic illness despite its links with mental and physical health and self-rated quality of life. I use a space-time geographical approach to explore experiences with leisure in everyday life for 26 individuals with chronic kidney disease (CKD) in Australia. I examine ways in which the spatial and temporal characteristics of illness management and symptoms shape where, when, and how participants can enjoy leisure, focusing on: 1) logistical conflicts between illness and leisure; 2) rhythmic interferences with the force of habit in skilful leisure performance; and 3) absorbing experiences of encounter with self and place through leisure. Data were collected from 2013 to 2014. Participants kept diaries over two sample days and then participated in semi-structured interviews. Findings show that the voluntary nature of leisure offered participants important benefits in coping with and managing illness over the long-term, including opportunities to experience greater sense of control, an alternative experience of one’s body to the ‘sick body’, and knowledge creation that supports adaptation to the uncertainties of illness trajectories. The ability to engage in meaningful leisure was constrained by the shaping forces of illness symptoms and management on participants’ leisure-scapes. Illness treatment regimens should therefore be adapted to better accommodate leisure participation for chronically ill patients, and leisure should be explicitly incorporated into illness management plans negotiated between patients and health practitioners. Finally, greater understanding of the transformative capacity of habit in activities of experimentation and play may have wider-reaching implications for leisure’s potential applications in public health. Leisure should be taken seriously as a vehicle for

  20. Modelling the relationship between obesity and mental health in children and adolescents: findings from the Health Survey for England 2007

    Directory of Open Access Journals (Sweden)

    Summerbell Carolyn D

    2011-10-01

    Full Text Available Abstract A number of studies have reported significant associations between obesity and poor psychological wellbeing in children but findings have been inconsistent. Methods: This study utilised data from 3,898 children aged 5-16 years obtained from the Health Survey for England 2007. Information was available on Body Mass Index (BMI, parental ratings of child emotional and behavioural health (Strengths and Difficulties Questionnaire, self-reported physical activity levels and sociodemographic variables. A multilevel modelling approach was used to allow for the clustering of children within households. Results: Curvilinear relationships between both internalising (emotional and externalising (behavioural symptoms and adjusted BMI were observed. After adjusting for potential confounders the relationships between obesity and psychological adjustment (reported externalising and internalising symptoms remained statistically significant. Being overweight, rather than obese, had no impact on overall reported mental health. 17% of children with obesity were above the suggested screening threshold for emotional problems, compared to 9% of non-obese children. Allowing for clustering and potential confounding variables children classified as obese had an odds ratio (OR of 2.13 (95% CI 1.39 to 3.26 for being above the screening threshold for an emotional disorder compared to non-obese young people. No cross-level interactions between household income and the relationships between obesity and internalising or externalising symptoms were observed. Conclusions: In this large, representative, UK-based community sample a curvilinear association with emotional wellbeing was observed for adjusted BMI suggesting the possibility of a threshold effect. Further research could focus on exploring causal relationships and developing targeted interventions.

  1. Investigation of natural levels of radon-222 in groundwater in Maine for assessment of related health effects

    International Nuclear Information System (INIS)

    Hess, C.T.; Casparius, R.E.; Norton, S.A.; Brutsaert, W.F.

    1980-01-01

    We have used an inexpensive radon ( 222 Rn) measurement method using liquid scintillation counting to remeasure potable water from 10 sites near Raymond, Maine, to determine the accuracy and reproducibility of earlier measurements. Duplication or triplication of samples shows a high degree of reproducibility for the liquid scintillation method. A hypothesis emerged from analysis of the measured values of 222 Rn near Raymond, Maine, that high values (50,000 to 200,000 pCi/liter) are associated with granite. This was shown to be correct for several large areas of granite such as the Sebago, Lucern, Waldo, and Waldoboro granites. The presence of high 222 Rn concentrations in granite areas hundreds of kilometers from the Raymond area shows that the high 222 Rn levels in water are a statewide and perhaps a regional problem rather than a western Maine problem

  2. Understanding Health Workers' Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment.

    Science.gov (United States)

    Smitz, Marc-Francois; Witter, Sophie; Lemiere, Christophe; Eozenou, Patrick Hoang-Vu; Lievens, Tomas; Zaman, Rashid U; Engelhardt, Kay; Hou, Xiaohui

    2016-01-01

    Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing. One of the main findings of the study is the relative lack of importance of wages for doctors, which could be linked to high intrinsic motivation, perceptions of having an already highly paid job (relative to local conditions), and/or being in a relatively early stage of their career for most respondents. Professional development provides the highest satisfaction with jobs, followed by the working conditions. Doctors with less experience, males and the unmarried are more flexible about location. For nurses and midwives, skill upgrading emerged as the most cost effective method. The study is the first of its kind conducted in Timor-Leste. It provides policy-relevant information to balance financial and non-financial incentives for different cadres and profiles of staff. It also augments a thin literature on the preferences of working doctors (as opposed to medical students) in low and middle income countries and provides insights into the ability to instil motivation to work in rural areas, which may be influenced by rural recruitment and Cuban-style training, with its emphasis on community service.

  3. Finding the moral heart of treatment: mental health care in a French prison.

    Science.gov (United States)

    Fernandez, Fabrice; Lézé, Samuel

    2011-05-01

    Morality is one of the most important elements of social actions, specifically in medical settings. Unfortunately, in social science, morality is often undertheorized and can lead to moralism. The aim of the paper is to test the "moral economy theory" which highlights the link between some local moral evaluations and a political context. We focus on "treatment" as therapeutic tool and as moral regulation of patients in a French remand centre. On the basis of an ethnography of forms of care for prisoners (2009-2010), and semi-directed interviews with working mental health professionals (n = 10), we analyse their engagement and their moral expectations of the prisoners under their care. Firstly, we show how prisoners are selected and then converted into patients deserving of attention (expectations of honesty, sincerity and compliance). Secondly, we show how these patients are divided into three main intervention categories, in which the treatment is both therapeutic and moral (expectations of responsibility, recognition of guilt, and self-esteem). Finally, we discuss these moral criteria within a new moral economy of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health

    Directory of Open Access Journals (Sweden)

    Alice Ravera

    2016-06-01

    Full Text Available The increasing burden of cardiovascular disease (CVD despite the progress in management entails the need of more effective preventive and curative strategies. As dietary-associated risk is the most important behavioral factor influencing global health, it appears the best target in the challenge against CVD. Although for many years, since the formulation of the cholesterol hypothesis, a nutrient-based approach was attempted for CVD prevention and treatment, in recent years a dietary-based approach resulted more effective in reducing cardiovascular risk worldwide. After the publication of randomized trials on the remarkable effects of the Mediterranean diet and the Dietary Approach to Stop Hypertension (DASH diet on CVD, new efforts were put on research about the effects of complex dietary interventions on CVD. The purpose of this paper is to review the evidence on dietary interventions in the prevention and disease modification of CVD, focusing on coronary artery disease and heart failure, the main disease responsible for the enormous toll taken by CVD worldwide.

  5. Inequalities in health status among rural residents: EQ-5D findings from household survey China.

    Science.gov (United States)

    Li, Haitao; Wei, Xiaolin; Ma, Aixia; Chung, Roger Y

    2014-05-19

    This study analyzed inequalities in health status among different socioeconomic and demographic rural residents covered by the New Rural Cooperative Medical System in China. A cross-sectional study was conducted in Lian Yungang City, China. A total of 337 respondents, who were selected by using a multistage stratified systematic random sampling method, completed the surveys. A questionnaire consisting of EQ-5D and demographic and socioeconomic information was adopted for data collection, and was administered by face-to-face interviews. Multiple regression models were employed to examine the differences in the Visual Analogue Scale (VAS) score and the EQ-5D dimensions. Compared with those with lower education attainment, the respondents with higher education levels tended to report a higher VAS score (β = 2.666, 95% CI: 0.978 to 6.310), and were less likely to suffer from pain/discomfort (OR = 3.968; 95% CI: 1.447 to 10.880). The singles were more likely than the married to report moderate or extreme problems in usual activities (OR = 4.583; 95% CI: 1.188 to 17.676) and mobility (OR = 10.666; 95% CI: 2.464 to 6.171). However, no statistically significant differences were identified between the respondents with different income levels in the VAS score and EQ-5D dimensions. This study suggests that the singles and the people with lower education levels are high-risk groups for poorer health status in the Chinese rural population. The findings from this study warrant further investigation.

  6. Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey.

    Science.gov (United States)

    Joscelyne, Amy; Knuckey, Sarah; Satterthwaite, Margaret L; Bryant, Richard A; Li, Meng; Qian, Meng; Brown, Adam D

    2015-01-01

    Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.

  7. Prediabetes, undiagnosed diabetes, and diabetes among Mexican adults: findings from the Mexican Health and Aging Study.

    Science.gov (United States)

    Kumar, Amit; Wong, Rebeca; Ottenbacher, Kenneth J; Al Snih, Soham

    2016-03-01

    The purpose of the study was to examine the prevalence and determinants of prediabetes, undiagnosed diabetes, and diabetes among Mexican adults from a subsample of the Mexican Health and Aging Study. We examined 2012 participants from a subsample of the Mexican Health and Aging Study. Measures included sociodemographic characteristics, body mass index, central obesity, medical conditions, cholesterol, high-density lipoprotein cholesterol, hemoglobin A1c, and vitamin D. Logistic regression was performed to identify factors associated with prediabetes, undiagnosed diabetes, and self-reported diabetes. Prevalence of prediabetes, undiagnosed, and self-reported diabetes in this cohort was 44.2%, 18.0%, and 21.4%, respectively. Participants with high waist-hip ratio (1.61, 95% confidence interval [CI] = 1.05-2.45) and high cholesterol (1.85, 95% CI = 1.36-2.51) had higher odds of prediabetes. Overweight (1.68, 95% CI = 1.07-2.64), obesity (2.38, 95% CI = 1.41-4.02), and high waist circumference (1.60, 95% CI = 1.06-2.40) were significantly associated with higher odds of having undiagnosed diabetes. Those residing in a Mexican state with high U.S. migration had lower odds of prediabetes (0.61, 95% CI = 0.45-0.82) and undiagnosed diabetes (0.53, 95% CI = 0.41-0.70). Those engaged in regular physical activity had lower odds of undiagnosed diabetes (0.74, 95% CI = 0.57-0.97). There is a high prevalence of prediabetes and undiagnosed diabetes among Mexican adults in this subsample. Findings suggest the need for resources to prevent, identify, and treat persons with prediabetes and undiagnosed diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey.

    Directory of Open Access Journals (Sweden)

    Amy Joscelyne

    Full Text Available Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD, resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C and depression was measured with the Patient History Questionnaire-9 (PHQ-9. These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.

  9. Vitamin C and Heart Health: A Review Based on Findings from Epidemiologic Studies

    Directory of Open Access Journals (Sweden)

    Melissa A. Moser

    2016-08-01

    Full Text Available Vitamin C is a powerful dietary antioxidant that has received considerable attention in the literature related to its possible role in heart health. Although classical vitamin C deficiency, marked by scurvy, is rare in most parts of the world, some research has shown variable heart disease risks depending on plasma vitamin C concentration, even within the normal range. Furthermore, other studies have suggested possible heart-related benefits to vitamin C taken in doses beyond the minimal amounts required to prevent classically defined deficiency. The objective of this review is to systematically review the findings of existing epidemiologic research on vitamin C and its potential role in cardiovascular disease (CVD. It is well established that vitamin C inhibits oxidation of LDL-protein, thereby reducing atherosclerosis, but the cardiovascular outcomes related to this action and other actions of vitamin C are not fully understood. Randomized controlled trials as well as observational cohort studies have investigated this topic with varying results. Vitamin C has been linked in some work to improvements in lipid profiles, arterial stiffness, and endothelial function. However, other studies have failed to confirm these results, and observational cohort studies are varied in their findings on the vitamin’s effect on CVD risk and mortality. Overall, current research suggests that vitamin C deficiency is associated with a higher risk of mortality from CVD and that vitamin C may slightly improve endothelial function and lipid profiles in some groups, especially those with low plasma vitamin C levels. However, the current literature provides little support for the widespread use of vitamin C supplementation to reduce CVD risk or mortality.

  10. Beliefs about tobacco, health, and addiction among adults in Cambodia: findings from a national survey.

    Science.gov (United States)

    Yel, Daravuth; Bui, Anthony; Job, Jayakaran S; Knutsen, Synnove; Singh, Pramil N

    2013-09-01

    There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n=13,988) of all provinces of Cambodia, we found that (1) 88-93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86-93% believe that the Wat (temple) should be a smoke-free area; (3) 93-95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.

  11. Do Dutch workers seek and find information on occupational safety and health?

    Science.gov (United States)

    Rhebergen, Martijn D F; Lenderink, Annet F; van Dijk, Frank J H; Hulshof, Carel T J

    2012-03-01

    Currently, little is known about workers' occupational safety and health (OSH) information-seeking behavior. We assessed whether Dutch workers have (OSH) questions, what motivates them to seek information or advice to solve these questions, and whether workers actually find the information they are looking for. A random sample of 888 workers from a large business panel were sent an online questionnaire. In total, 535 workers, likely parallel to the Dutch working population, returned the questionnaire (response rate 60%). In the last year, 380 of the 535 respondents (71%) had at least one OSH question. In total, 159 of the 380 respondents (42%) with an OSH question actively searched for information or advice. In a logistic regression analysis, three factors were identified to influence workers' information seeking: cognitions about personal benefits or costs of solving the question (OR = 2.8, 95% CI: 1.8-4.5), emotions that accompany the question (OR = 1.8, 95% CI: 1.1-3.0), and encouragement by the social environment (OR = 1.8, 95% CI: 1.0-3.0). In total, 50% of the respondents seeking information indicated they could not find (all) the information they sought. The barrier most often mentioned (47%) was the poor applicability of the information. Although most workers have OSH questions, only 40% seek information or advice to answer their questions. Moreover, many OSH questions remain unanswered by common information facilities. This study provides input on how to develop campaigns and new facilities that may induce workers to seek information and that offer more applicable information. Copyright © 2011 Wiley Periodicals, Inc.

  12. Findings from non-participant observational data concerning health promoting nursing practice in the acute hospital setting focusing on generalist nurses.

    Science.gov (United States)

    Casey, Dympna

    2007-03-01

    This paper reports on the non-participant observational findings from a study, which examined hospital-based nurses' health promoting nursing practice in an acute setting. Nurses are considered to have a key role in health promotion. However, the development of the role of the generalist hospital-based nurse in health promotion has been slow and is not well-understood. The conceptual framework used was based on the Ottawa Charter (WHO 1986). A single qualitative embedded case study, employing data source and methodological triangulation was used. A framework for identifying nurse's use of health promotion methods was developed and used to collect non-participant observations on a purposive sample of eight nurses working on an acute hospital ward. Following the observations a semi structured one-to-one interview was conducted with each observed nurse. One randomly selected patient that the observed nurse had cared for during the observations was also interviewed. Qualitative data analysis based on the work of Miles and Huberman was employed. Two categories were identified 'health promotion strategies and content' and 'patient participation'. The findings indicated that, overall, the strategies used by nurses to promote health were prescriptive and individualistic. The main strategy observed was information giving and the content was 'preparatory information'. Predominantly, nurses practised traditional health education. Overall, patient participation was limited to minor personal aspects of care as nurses focused on the routine and getting the tasks completed. There was no evidence of a ward culture which valued health promotion. Ward managers are key in creating a culture for health promotion. A review of the methods of organizing nursing care is warranted. Nursing programmes must highlight health promotion as integral to practice and emphasis the socio-political dimensions of health promotion.

  13. Finding a Place for Health in the Schooling Process: A Challenge for Education.

    Science.gov (United States)

    Ridge, Damien; Northfield, Jeff; St. Leger, Lawrence; Marshall, Bernie; Sheehan, Margaret; Maher, Shelley

    2002-01-01

    Evaluated outcomes in selected Australian schools of an intervention project, Health Promoting Schools (promoted by the World Health Organization). Found that studied schools moved beyond oppositional constructions of health and education towards approaching health as an element of effective schooling. (EV)

  14. Emotion regulation and mental health: recent findings, current challenges, and future directions.

    Science.gov (United States)

    Berking, Matthias; Wupperman, Peggilee

    2012-03-01

    In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research. Deficits in emotion regulation appear to be relevant to the development, maintenance, and treatment of various forms of psychopathology. Increasing evidence demonstrates that deficits in the ability to adaptively cope with challenging emotions are related to depression, borderline personality disorder, substance-use disorders, eating disorders, somatoform disorders, and a variety of other psychopathological symptoms. Unfortunately, studies differ with regard to the conceptualization and assessment of emotion regulation, thus limiting the ability to compare findings across studies. Future research should systematically work to use comparable methods in order to clarify the following: which individuals have; what kinds of emotion regulation difficulties with; which types of emotions; and what interventions are most effective in alleviating these difficulties. Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.

  15. Bronchiectasis: correlation of high-resolution CT findings with health-related quality of life

    Energy Technology Data Exchange (ETDEWEB)

    Eshed, I. [Department of Diagnostic Radiology, E. Wolfson Medical Center, Holon (Israel)]. E-mail: iriseshed@gmail.com; Minski, I. [Department of Diagnostic Radiology, E. Wolfson Medical Center, Holon (Israel); Katz, R. [Department of Diagnostic Radiology, E. Wolfson Medical Center, Holon (Israel); Jones, P.W. [Department of Respiratory Medicine, St George' s Hospital Medical School, University of London (United Kingdom); Priel, I.E. [Department of Pulmonary Medicine, E. Wolfson Medical Center, Holon, Israel, Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University (Israel)

    2007-02-15

    Aim: To evaluate the relationship between the severity of bronchiectatic diseases, as evident on high-resolution computed tomography (HRCT) and the patient's quality of life measured using the St George's Respiratory Questionnaire (SGRQ). Methods and materials: Forty-six patients (25 women, 21 men, mean age: 63 years) with bronchiectatic disease as evident on recent HRCT examinations were recruited. Each patient completed the SGRQ and underwent respiratory function tests. HRCT findings were blindly and independently scored by two radiologists, using the modified Bhalla scoring system. The relationships between HRCT scores, SGRQ scores and pulmonary function tests were evaluated. Results: The patients' total CT score did not correlate with the SGRQ scores. However, patients with more advanced disease on HRCT, significantly differed in their SGRQ scores from patients with milder bronchiectatic disease. A significant correlation was found between the CT scores for the middle and distal lung zones and the activity, impacts and total SGRQ scores. No correlation was found between CT scores and respiratory function test indices. However, a significant correlation was found between the SGRQ scores and most of the respiratory function test indices. Conclusion: A correlation between the severity of bronchiectatic disease as expressed in HRCT and the health-related quality of life exists in patients with a more severe bronchiectatic disease but not in patients with mild disease. Such correlation depends on the location of the bronchiectasis in the pulmonary tree.

  16. Public health impacts of city policies to reduce climate change: Findings from the URGENCHE EU-China project

    NARCIS (Netherlands)

    Sabel, C.E.; Hiscock, R.; Asikainen, A.; Bi, J.; Depledge, M.; Van Den Elshout, S.; Friedrich, R.; Huang, G.; Hurley, F.; Jantunen, M.; Karakitsios, S.P.; Keuken, M.; Kingham, S.; Kontoroupis, P.; Kuenzli, N.; Liu, M.; Martuzzi, M.; Morton, K.; Mudu, P.; Niittynen, M.; Perez, L.; Sarigiannis, D.; Stahl-Timmins, W.; Tobollik, M.; Tuomisto, J.; Willers, S.

    2016-01-01

    Background: Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments. Methods: Five European and two Chinese city

  17. The main indicators of the health of children and adolescents in residential zone of the facility for disposal of rocket engines

    Directory of Open Access Journals (Sweden)

    Tarakanova S.Y.

    2014-12-01

    39.5%. The main cause of morbidity in children is diseases of the nervous system and mental disorders, and congenital anomalies. Conclusion. Operation of installations for the disposal of rocket engines solid fuel according to the official reporting forms medical institutions has no effect on child health.

  18. Health in All Social Work Programs: Findings From a US National Analysis

    Science.gov (United States)

    Wachman, Madeline K.; Marshall, Jamie W.; Backman, Allison R.; Harrington, Calla B.; Schultz, Neena S.; Ouimet, Kaitlyn J.

    2017-01-01

    Objectives. To establish a baseline of health content in 4 domains of US social work education—baccalaureate, master’s, doctoral, and continuing education programs—and to introduce the Social Work Health Impact Model, illustrating social work’s multifaceted health services, from clinical to wide-lens population health approaches. Methods. We analyzed US social work programs’ Web site content to determine amount and types of health content in mission statements, courses, and specializations. Coding criterion determined if content was (1) health or health-related (HHR) and (2) had wide-lens health (WLH) emphasis. A second iteration categorized HHR and WLH courses into health topics. Results. We reviewed 4831 courses. We found broad HHR content in baccalaureate, master’s, and continuing education curricula; doctoral programs had limited health content. We identified minimal WLH content across all domains. Topical analysis indicated that more than 50% of courses concentrated on 3 areas: mental and behavioral health, abuse and violence, and substance use and addictions. Conclusions. As a core health profession, social work must strengthen its health and wide-lens content to better prepare graduates for integrated practice and collaboration in the changing health environment. PMID:29236538

  19. Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey.

    Science.gov (United States)

    Hossain, Mohammad Jahangir; Biswas, Animesh; Mashreky, Saidur Rahman; Rahman, Fazlur; Rahman, Aminur

    2017-01-01

    Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh. Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.   Results:   Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39). In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94) or less. Only 25.5% of incidences were reported to the police station. Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh.

  20. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

    Directory of Open Access Journals (Sweden)

    Alexander Jeffery A

    2009-08-01

    Full Text Available Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality, four constructs were identified related to outer setting (e.g., patient needs and resources, 12 constructs were identified related to inner setting (e.g., culture

  1. The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda

    OpenAIRE

    Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

    2017-01-01

    Background Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored...

  2. Exploration of barriers and facilitators to publishing local public health findings: A mixed methods protocol

    OpenAIRE

    Smith, Selina A.; Webb, Nancy C.; Blumenthal, Daniel S.; Willcox, Bobbie; Ballance, Darra; Kinard, Faith; Gates, Madison L.

    2016-01-01

    Background Worldwide, the US accounts for a large proportion of journals related to public health. Although the American Public Health Association (APHA) includes 54 affiliated regional and state associations, little is known about their capacity to support public health scholarship. The aim of this study is to assess barriers and facilitators to operation of state journals for the dissemination of local public health research and practices. Methods A mixed methods approach will be used to co...

  3. Sexual orientation and mental and physical health status: findings from a Dutch population survey.

    NARCIS (Netherlands)

    Sandfort, T.G.M.; Bakker, F.; Schellevis, F.G.; Vanwesenbeeck, I.

    2006-01-01

    OBJECTIVES: We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population. METHODS: Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001

  4. Quantifying Collaboration Using Himmelman's Strategies for Working Together: Findings from the Tennessee Coordinated School Health Program

    Science.gov (United States)

    Quinn, Megan A; Southerland, Jodi L.; Richards, Kasie; Slawson, Deborah L; Behringer, Bruce; Johns-Womack, Rebecca; Smith, Sara

    2016-01-01

    Purpose: Coordinated school health programs (CSHPs), a type of health promoting school (HPS) program adopted by Canada and the USA, were developed to provide a comprehensive approach to school health in the USA. Community partnerships are central to CSHP and HPS efforts, yet the quality of collaboration efforts is rarely assessed. The purpose of…

  5. A bulletin on survey findings of China's national population and reproductive health in 1997.

    Science.gov (United States)

    Zhu, H

    1998-08-01

    This article presents findings from the 1997 State Family Planning Commission's KAP survey in China. The aim was to assess reproductive health and contraception and the future needs for family planning management. The national sample included 1041 sampling points in 337 counties among 186,089 registered persons in the first demographic stage and 15,213 persons in the second in-depth KAP stage of the survey. The average age at first marriage of women was 1.5 years higher in 1997 than in 1990. The birthrate declined, and fertility remained stable at below replacement levels. Contraceptive usage among women of childbearing ages was 83.4%. 9.2% relied on male sterilization, 40% relied on female sterilization, 43.4% used IUDs, and 4.1% used condoms. 25.5% of married reproductive age women had an unwanted pregnancy due to contraceptive failure. 62.5% of women of childbearing age received contraceptives free of charge. 28.6% received contraceptive supplies from retail shops. 39.1% who had a contraceptive operation had access to pre-operative counseling, and 50.9% received post-operative counseling. 23.5% had follow-up visits. The average age of menarche was 15.2 years. The average age of menopause was 44.8 years. Gynecological discomfort increased with age. 63% consulted doctors. 58.5% fully breast-fed for over 6 months. 57.3% had knowledge of sexually transmitted diseases, and 63.5% had heard of AIDS. 75% were happy with their sexual lives. 7.8% nationally had received at least one kind of economic assistance or skill training, of whom 50.6% had access to loans or poverty alleviation funds.

  6. The World Health Organization fetal growth charts: concept, findings, interpretation, and application.

    Science.gov (United States)

    Kiserud, Torvid; Benachi, Alexandra; Hecher, Kurt; Perez, Rogelio González; Carvalho, José; Piaggio, Gilda; Platt, Lawrence D

    2018-02-01

    weight was strongest on the lowest percentiles and smallest on the highest percentiles for estimated fetal weight. (3) When adjustment was made for maternal covariates, there was still a significant effect of country as covariate that indicated that ethnic, cultural, and geographic variation play a role. (4) Variation between populations was not restricted to fetal size because there were also differences in growth trajectories. (5) The wide physiologic ranges, as illustrated by the 5th-95th percentile for estimated fetal weight being 2205-3538 g at 37 weeks gestation, signify that human fetal growth under optimized maternal conditions is not uniform. Rather, it has a remarkable variation that largely is unexplained by commonly known factors. We suggest this variation could be part of our common biologic strategy that makes human evolution extremely successful. The World Health Organization fetal growth charts are intended to be used internationally based on low-risk pregnancies from populations in Africa, Asia, Europe, and South America. We consider it prudent to test and monitor whether the growth charts' performance meets the local needs, because refinements are possible by a change in cut-offs or customization for fetal sex, maternal factors, and populations. In the same line, the study finding of variations emphasizes the need for carefully adjusted growth charts that reflect optimal local growth when public health issues are addressed. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Preparing for construction and operation of geological repositories - Challenges to the regulator and the implementer. Main findings of a joint RF/IGSC workshop Held in Issy-les-Moulineaux, France. 23-25 January 2012

    International Nuclear Information System (INIS)

    Raimbault, Philippe; Kwong, Gloria; Pescatore, Claudio; Arens, Georg; Roehlig, Klaus-Juergen

    2012-01-01

    A key challenge for some national radioactive waste management programmes and an important learning opportunity for many others will be the licensing of the construction and operation of the first deep geological repositories for high level waste and spent fuel over the next decade. This document describes the main findings of the international workshop on this topic organised jointly by the Regulators' Forum (RF) and the Integration Group for the Safety Case (IGSC) of the NEA/RWMC. The main objective of the workshop was to identify, and share experience on, the challenges that implementers and regulators are facing or will face when preparing for the license for the implementation of a deep geological repository. Additional objectives were to: listen to viewpoints from representatives of governments and local communities, increase awareness of the actual challenges/issues and of the state of the art in dealing with them, identify areas of commonalities and differences amongst parties and explanation of the different views, create a record of the current thinking, inform future work at the international level. The first session introduced the workshop, its aims, the challenges to be faced and the expected achievements. The following sessions were divided into three parts: presentations, in plenary, of national case studies from both the regulators' and implementers' viewpoints and focusing on issues and practices in construction and operation of geological disposal facilities; round table discussions led by a moderator and recorded by a round-table spoke-person; presentation by spoke-persons in plenary followed by wrap up of the session by the session Rapporteur. The main findings concerned licensing regimes, challenges for construction (implementer), challenges for construction (regulator), challenges for operation (implementer and regulator), optimisation

  8. Main achievements of the World Organisation for Animal Health/United Nations Food and Agriculture Organization network on animal influenza.

    Science.gov (United States)

    Dauphin, Gwenaelle; Hamilton, Keith; Kim, L Mia; Choudhury, Bhudipa; Capua, Ilaria; Edwards, Steve

    2010-03-01

    The World Organisation for Animal Health (OIE)/United Nations Food and Agriculture Organization (FAO) joint network of expertise on animal influenza (OFFLU) includes all ten OIE/FAO reference laboratories and collaborating centers for avian influenza, other diagnostic laboratories, research and academic institutions, and experts in the fields of virology, epidemiology, vaccinology, and molecular biology. OFFLU has made significant progress in improving its infrastructure, in identifying and addressing technical gaps, and in establishing associations among leading veterinary institutions. Interaction with the World Health Organization (WHO) Global Influenza Program is also critical, and mechanisms for permanent interaction are being developed. OFFLU played a key role in the WHO/OIE/FAO Joint Technical Consultation held in Verona (October 7-9, 2008), which provided an opportunity to highlight and share knowledge and identify potential gaps regarding issues at the human-animal interface for avian influenza. OFFLU experts also contributed to the working group for the Unified Nomenclature System for H5N1 influenza viruses based on hemagglutinin gene phylogeny (WHO/OIE/FAO, H5N1 Evolution Working Group, Towards a unified nomenclature system for highly pathogenic avian influenza virus (H5N1) in Emerging Infectious Diseases 14:el, 2008). OFFLU technical activities, led by expert scientists from OIE/FAO reference institutions and coordinated by OIE and FAO focal points, have been prioritized to include commercial diagnostic kit evaluation, applied epidemiology, biosafety, vaccination, proficiency testing, development of standardized reference materials for sera and RNA, and issues at the human-animal interface. The progress to date and future plans for these groups will be presented. OFFLU is also involved in two national projects implemented by FAO in Indonesia and Egypt that seek to establish sustainable mechanisms for monitoring virus circulation, including viral

  9. Consumer Attitudes and Perceptions on mHealth Privacy and Security: Findings From a Mixed-Methods Study.

    Science.gov (United States)

    Atienza, Audie A; Zarcadoolas, Christina; Vaughon, Wendy; Hughes, Penelope; Patel, Vaishali; Chou, Wen-Ying Sylvia; Pritts, Joy

    2015-01-01

    This study examined consumers' attitudes and perceptions regarding mobile health (mHealth) technology use in health care. Twenty-four focus groups with 256 participants were conducted in 5 geographically diverse locations. Participants were also diverse in age, education, race/ethnicity, gender, and rural versus urban settings. Several key themes emerged from the focus groups. Findings suggest that consumer attitudes regarding mHealth privacy/security are highly contextualized, with concerns depending on the type of information being communicated, where and when the information is being accessed, who is accessing or seeing the information, and for what reasons. Consumers frequently considered the tradeoffs between the privacy/security of using mHealth technologies and the potential benefits. Having control over mHealth privacy/security features and trust in providers were important issues for consumers. Overall, this study found significant diversity in attitudes regarding mHealth privacy/security both within and between traditional demographic groups. Thus, to address consumers' concerns regarding mHealth privacy and security, a one-size-fits-all approach may not be adequate. Health care providers and technology developers should consider tailoring mHealth technology according to how various types of information are communicated in the health care setting, as well as according to the comfort, skills, and concerns individuals may have with mHealth technology.

  10. Life Stress and Health: A Review of Conceptual Issues and Recent Findings

    OpenAIRE

    Slavich, George M.

    2016-01-01

    Life stress is a central construct in many models of human health and disease. The present article reviews research on stress and health, with a focus on (a) how life stress has been conceptualized and measured over time, (b) recent evidence linking stress and disease, and (c) mechanisms that might underlie these effects. Emerging from this body of work is evidence that stress is involved in the development, maintenance, or exacerbation of several mental and physical health conditions, includ...

  11. Estimation of exposed radiation dose in radiography of the chest. Mainly on the dose at health examination on automobiles

    International Nuclear Information System (INIS)

    Suzuki, Shoichi; Oda, Akiko; Ohkura, Masaki

    1998-01-01

    The exposure doses in radiography and photofluorography of the chest at health examination on automobiles were estimated and compared with those using other hospital equipments. The tube voltage, effective energy and half value layer under ordinary conditions for radiography and fluorography were measured by KYOKKO model 100 X-ray analyzer and output pulse shape was confirmed by the fluorometer (TOREKEY-1001 C). The dose at the body surface was measured by the ionization chambers (VICTOREEN RADCON 500 and 30-330) which had been equipped in the WAC chest phantom (JIS Z 4915, Kyoto Kagaku). Nine automobiles of 3 facilities were used, of which X-ray generating apparatuses of either condenser or inverter type were manufactured by Hitachi (5 machines), Toshiba (1) and Shimadzu (3). The examined apparatuses not for the automobile were Toshiba-20 and Hitachi SIRIUS-100 portable ones and Hitachi DH-1520 TM high-voltage one. The effective energy was found dependent on the tube voltage (100-130 kV) and X-ray generating system (35.1-54.37 keV in the condenser type and 41.1-43.9 keV in the inverter type). Pulse shape analysis revealed that the pulse height and area under the pulse height-time curve were larger in the inverter system. The mean doses in photofluorography and radiography on automobiles were 0.525 and 0.297 mGy, respectively. The mean dose of 0.61 mGy in radiography at home with the portable apparatus was the highest even when compared with that of 0.525 mGy for fluorography on the automobile. Thus, the inverter system on the car can guarantee the level of 0.4 mGy defined by IAEA guideline (Safety series No. 115, 1996). (K.H.)

  12. Situating mental health work in place: Qualitative findings from interviews with Veterans in Southeastern Louisiana and Northern California.

    Science.gov (United States)

    Abraham, Traci H; Koenig, Christopher J; Zamora, Kara; Hill, Coleen; Uddo, Madeline; Kelly, Adam P; Hamilton, Michelle F; Curran, Geoffrey M; Pyne, Jeffrey M; Seal, Karen H

    2017-09-01

    Most chronic illness management occurs outside clinics and hospitals, in the everyday lives of individuals. We use data from semi-structured interviews with 37 veterans from Southeastern Louisiana and Northern California to illustrate how "health work" for mental health concerns are shaped by place. Using health work as an orienting concept for analysis, we discerned variation between the two study sites in how Veterans used interacting with the natural environment, cultivating time alone, and religious practice to manage their mental health and well-being. Through these findings, we advocate for a situated notion of health work that is mindful of how health-related behaviors are shaped by place and the attributes that constitute place. Published by Elsevier Ltd.

  13. Is Social Capital a Determinant of Oral Health among Older Adults? Findings from the English Longitudinal Study of Ageing

    Science.gov (United States)

    Rouxel, Patrick; Tsakos, Georgios; Demakakos, Panayotes; Zaninotto, Paola; Chandola, Tarani; Watt, Richard Geddie

    2015-01-01

    There are a number of studies linking social capital to oral health among older adults, although the evidence base mainly relies on cross-sectional study designs. The possibility of reverse causality is seldom discussed, even though oral health problems could potentially lead to lower social participation. Furthermore, few studies clearly distinguish between the effects of different dimensions of social capital on oral health. The objective of the study was to examine the longitudinal associations between individual social capital and oral health among older adults. We analyzed longitudinal data from the 3rd and 5th waves of the English Longitudinal Study of Ageing (ELSA). Structural social capital was operationalized using measures of social participation, and volunteering. Number of close ties and perceived emotional support comprised the functional dimension of social capital. Oral health measures were having no natural teeth (edentate vs. dentate), self-rated oral health and oral health-related quality of life. Time-lag and autoregressive models were used to explore the longitudinal associations between social capital and oral health. We imputed all missing data, using multivariate imputation by chained equations. We found evidence of bi-directional longitudinal associations between self-rated oral health, volunteering and functional social capital. Functional social capital was a strong predictor of change in oral health-related quality of life – the adjusted odds ratio of reporting poor oral health-related quality of life was 1.75 (1.33–2.30) for older adults with low vs. high social support. However in the reverse direction, poor oral health-related quality of life was not associated with changes in social capital. This suggests that oral health may not be a determinant of social capital. In conclusion, social capital may be a determinant of subjective oral health among older adults rather than edentulousness, despite many cross-sectional studies on the

  14. Investing in mental health and well-being: findings from the DataPrev project

    Science.gov (United States)

    Mcdaid, David; Park, A-La

    2011-01-01

    A systematic review was conducted to determine the extent to which an economic case has been made in high-income countries for investment in interventions to promote mental health and well-being. We focused on areas of interest to the DataPrev project: early years and parenting interventions, actions set in schools and workplaces and measures targeted at older people. Economic evaluations had to have some focus on promotion of mental health and well-being and/or primary prevention of poor mental health through health-related means. Studies preventing exacerbations in existing mental health problems were excluded, with the exception of support for parents with mental health problems, which might indirectly affect the mental health of their children. Overall 47 studies were identified. There was considerable variability in their quality, with a variety of outcome measures and different perspectives: societal, public purse, employer or health system used, making policy comparisons difficult. Caution must therefore be exercised in interpreting results, but the case for investment in parenting and health visitor-related programmes appears most strong, especially when impacts beyond the health sector are taken into account. In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects (largely in the USA) was reported, while group-based exercise and psychosocial interventions are of potential benefit to older people. Many gaps remain; a key first step would be to make more use of the existence evidence base on effectiveness and model mid- to long-term costs and benefits of action in different contexts and settings. PMID:22079932

  15. Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

    Science.gov (United States)

    Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

    To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

  16. Finding Sustainability: University-community collaborations focused on arts in health

    Directory of Open Access Journals (Sweden)

    Mike White

    2011-11-01

    Full Text Available This article describes a number of community-based arts in health projects in schools and disadvantaged communities in Northern England that connect with the interdisciplinary research interests of the Centre for Medical Humanities at Durham University (www.dur.ac.uk/cmh. It examines issues about what makes for sustainability in both practice and research of arts in health when operating from a university base and stresses the importance of relationship-based work in health promotion interventions in communities. It attempts to set arts development work in the policy context of how community health has been addressed over the last decade. It provides both practical and metaphorical illustrations of how community cohesion and emotional literacy can be developed and recognised in schools and communities when supported by ethnographic research that is underpinned by theories of social capital, resilience and participatory arts practice. The significance that the artwork can attain as a social gift, with a special meaning for its creators, is examined from an anthropological perspective. Looking historically and comparatively at some longitudinal projects in community-based arts in health, the article assesses what makes for both success and failure in practice, and looks particularly at the significance of the arts in helping to deliver strategies for improving child health and education. In a strategic development context, explanation is given of several strands of university-community collaboration in arts in health, with interlinked project examples drawn from Tyneside and West Yorkshire. Finally, the article looks at the prospects for sustaining arts in health within the coming transfer of the public health function to local government. Keywords Sustainability, arts in community health, resilience, child mental health, social capital

  17. Findings from a prospective cohort study evaluating the effects of International Health Advisors’ work on recently settled migrants’ health

    Directory of Open Access Journals (Sweden)

    Susanne Sundell Lecerof

    2017-04-01

    Full Text Available Abstract Background Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b determine the moderating role of educational level and social capital; and c critically discuss the outcomes and suggest implications for health promotion practice. Methods The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02–5.22, after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24–0.92. No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the

  18. Findings from a prospective cohort study evaluating the effects of International Health Advisors' work on recently settled migrants' health.

    Science.gov (United States)

    Lecerof, Susanne Sundell; Stafström, Martin; Emmelin, Maria; Westerling, Ragnar; Östergen, Per-Olof

    2017-04-28

    Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants' self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and

  19. Can microcredit help improve the health of poor women? Some findings from a cross-sectional study in Kerala, India.

    Science.gov (United States)

    Mohindra, Ks; Haddad, Slim; Narayana, D

    2008-01-10

    This study examines associations between female participation in a microcredit program in India, known as self help groups (SHGs), and women's health in the south Indian state of Kerala. Because SHGs do not have a formal health program, this provides a unique opportunity to assess whether SHG participation influences women's health via the social determinants of health. This cross-sectional study used special survey data collected in 2003 from one Panchayat (territorial decentralized unit). Information was collected on women's characteristics, health determinants (exclusion to health care, exposure to health risks, decision-making agency), and health achievements (self assessed health, markers of mental health). The study sample included 928 non elderly poor women. The primary finding is that compared to non-participants living in a household without a SHG member, the odds of facing exclusion is significantly lower among early joiners, women who were members for more than 2 years (OR = 0.58, CI = 0.41-0.80), late joiners, members for 2 years and less (OR = 0.60, CI = 0.39-0.94), and non-participants who live in a household with a SHG member (OR = 0.53, CI = 0.32-0.90). We also found that after controlling for key women's characteristics, early joiners of a SHG are less likely to report emotional stress and poor life satisfaction compared to non-members (OR = 0.52, CI = 0.30-0.93; OR = 0.32, CI = 0.14-0.71). No associations were found between SHG participation and self assessed health or exposure to health risks. The relationship between SHG participation and decision-making agency is unclear. Microcredit is not a panacea, but could help to improve the health of poor women by addressing certain issues relevant to the context. In Kerala, SHG participation can help protect poor women against exclusion to health care and possibly aid in promoting their mental health.

  20. Health Education Video Games for Children and Adolescents: Theory, Design, and Research Findings.

    Science.gov (United States)

    Lieberman, Debra A.

    This study examined whether video games could be effective health education and therapeutic interventions for children and adolescents with diabetes. KIDZ Health Software developed a game about diabetes self-management, and tested its effectiveness for children with diabetes. The Packy and Marlon Super Nintendo video game promotes fun,…

  1. Health-Promoting Changes with Children as Agents: Findings from a Multiple Case Study Research

    Science.gov (United States)

    Simovska, Venka; Carlsson, Monica

    2012-01-01

    Purpose: With the aim of contributing to the evidence base on school-based health promotion, the authors discuss the outcomes and processes of a European intervention project aiming to prevent obesity among children (4-16 years) and promote their health and well-being, titled "Shape Up: a school-community approach to influencing determinants…

  2. Life Stress and Health: A Review of Conceptual Issues and Recent Findings

    Science.gov (United States)

    Slavich, George M.

    2016-01-01

    Life stress is a central construct in many models of human health and disease. The present article reviews research on stress and health, with a focus on (a) how life stress has been conceptualized and measured over time, (b) recent evidence linking stress and disease, and (c) mechanisms that might underlie these effects. Emerging from this body…

  3. Training of Home Health Aides and Nurse Aides: Findings from National Data

    Science.gov (United States)

    Sengupta, Manisha; Ejaz, Farida K.; Harris-Kojetin, Lauren D.

    2012-01-01

    Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 home health aides (HHAs) from the National Home Health Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the…

  4. Student Support for Reproductive Health Education in Middle Schools: Findings from Lebanon

    Science.gov (United States)

    Mouhanna, Farah; DeJong, Jocelyn; Afifi, Rima; Asmar, Khalil; Nazha, Bassel; Zurayk, Huda

    2017-01-01

    Reproductive health education (RHE) programmes in schools are a well-recognised means of helping young people make informed decisions relating to their sexual health and well-being. Very little research however has investigated attitudes towards such programmes among students in the Arab world. A national HIV education curriculum was developed in…

  5. Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Smith, Samuel G; Jackson, Sarah E; Kobayashi, Lindsay C; Steptoe, Andrew

    2018-02-01

    To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. A rural virtual health sciences library project: research findings with implications for next generation library services*

    OpenAIRE

    Richwine, Margaret (Peggy); McGowan, Julie J.

    2001-01-01

    Purpose: The Shared Hospital Electronic Library of Southern Indiana (SHELSI) research project was designed to determine whether access to a virtual health sciences library and training in its use would support medical decision making in rural southern Indiana and achieve the same level of impact seen by targeted information services provided by health sciences librarians in urban hospitals.

  7. Adolescent binge drinking and risky health behaviours: findings from northern Russia.

    Science.gov (United States)

    Stickley, Andrew; Koyanagi, Ai; Koposov, Roman; Razvodovsky, Yury; Ruchkin, Vladislav

    2013-12-15

    Some evidence suggests that in recent years the prevalence of heavy drinking has increased among Russian adolescents. However, as yet, little is known about either heavy alcohol consumption or its relationship with other adolescent health risk behaviours in Russia. The aim of this study therefore was to investigate the association between binge drinking and health risk behaviours among adolescents in Russia. Data were drawn from the Social and Health Assessment (SAHA), a survey carried out in Arkhangelsk, Russia in 2003. Information was obtained from a representative sample of 2868 adolescents aged 13-17 regarding the prevalence and frequency of binge drinking (five or more drinks in a row in a couple of hours) and different forms of substance use, risky sexual behaviour and violent behaviour. Logistic regression analysis was used to examine the association between binge drinking and adolescent involvement in various health risk behaviours. Adolescent binge drinking was associated with the occurrence of every type of health risk behaviour - with the sole exception of non-condom use during last sex. In addition, there was a strong association between the number of days on which binge drinking occurred and the prevalence of many health risk behaviours. Binge drinking is associated with a variety of health risk behaviours among adolescents in Russia. Public health interventions such as reducing the affordability and accessibility of alcohol are now needed to reduce binge drinking and its harmful effects on adolescent well-being. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Sociocultural contexts and worker safety and health: findings of a study with Chinese immigrant restaurant workers.

    Science.gov (United States)

    Tsai, Jenny; Bruck, Annie

    2009-02-01

    More immigrants are seeking employment in restaurants. Drawing data from an ethnographic study, this article discusses what and how sociocultural contexts shape the safety and health of immigrant restaurant workers. Eighteen Chinese immigrants from China, Hong Kong, and Taiwan participated in the study. Data generation methods included a questionnaire, individual and focus group interviews, and participant observations. Ethnographic analysis revealed that immigration mechanisms, demands of English proficiency for employment, and existence of networks and ethnic communities shaped the participants' employment choices. Working hours and schedules, interpersonal relationships at work, job design and training, occupational safety and health training, and national events and economy further influenced the participants' occupational experiences and well-being. Issues were noted with job security, mental health, family relationships, and risks for occupational injuries and illnesses. Implications for occupational health nursing research and practice to reduce immigrant workers' vulnerability to poor safety and health outcomes conclude this article.

  9. Improving Nutritional Health of the Public through Social Change: Finding Our Roles in Collective Action.

    Science.gov (United States)

    Raine, Kim D

    2014-09-01

    Improving the nutritional health of the public continues to be a major challenge. Our mission of advancing health through food and nutrition has become increasingly complex, particularly as food environments shape the availability, affordability, and social acceptability of food and nutrition "choices". Promoting nutritional health requires that dietitians expand our knowledge in understanding the determinants of healthy eating and of social change strategies that advocates for and acts on improving food environments. While no single strategy can solve the challenges of public health nutrition, we can each identify unique strengths and opportunities. If we practice in complementary ways, using those strengths for collective action will make us stronger together toward social change supporting improved nutritional health of the public.

  10. Environmental health indicators of climate change for the United States: findings from the State Environmental Health Indicator Collaborative.

    Science.gov (United States)

    English, Paul B; Sinclair, Amber H; Ross, Zev; Anderson, Henry; Boothe, Vicki; Davis, Christine; Ebi, Kristie; Kagey, Betsy; Malecki, Kristen; Shultz, Rebecca; Simms, Erin

    2009-11-01

    To develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions. We conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature. Sources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level. We present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change. A review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.

  11. Is poor mental health a risk factor for retirement? Findings from a longitudinal population survey.

    Science.gov (United States)

    Olesen, Sarah C; Butterworth, Peter; Rodgers, Bryan

    2012-05-01

    Poor mental health may influence people's decisions about, and ability to, keep working into later adulthood. The identification of factors that drive retirement provides valuable information for policymakers attempting to mitigate the effects of population ageing. This study examined whether mental health predicts subsequent retirement in a general population sample, and whether this association varied with the timing of retirement. Longitudinal data from 2,803 people aged 45-75 years were drawn from five waves of the Household Income and Labour Dynamics in Australia (HILDA) survey. Discrete-time survival analyses were used to estimate the association between mental health and retirement. Mental health was measured using the Mental Health Index (MHI-5). The relative influences of other health, social, financial, and work-related predictors of retirement were considered to determine the unique contribution of mental health to retirement behaviour. Poor mental health was associated with higher rates of retirement in men (hazard rate ratio, HRR 1.19, 95% CI 1.01-1.29), and workforce exit more generally in women (HRR 1.14, 95% CI 1.07-1.22). These associations varied with the timing of retirement and were driven by early retirees specifically. Physical functioning, income, social activity, job conditions (including job stress for women and job control for men), and aspects of job satisfaction also predicted subsequent retirement. Poor mental and physical health predict workforce departure in mid-to-late adulthood, particularly early retirement. Strategies to accommodate health conditions in the workplace may reduce rates of early retirement and encourage people to remain at work into later adulthood.

  12. Time for an Adolescent Health Surveillance System in Saudi Arabia: Findings From "Jeeluna".

    Science.gov (United States)

    AlBuhairan, Fadia S; Tamim, Hani; Al Dubayee, Mohammad; AlDhukair, Shahla; Al Shehri, Sulieman; Tamimi, Waleed; El Bcheraoui, Charbel; Magzoub, Mohi Eldin; de Vries, Nanne; Al Alwan, Ibrahim

    2015-09-01

    With the increasing burden of noncommunicable disease, adolescence is viewed as an opportune time to prevent the onset of certain behaviors and promote healthy states. Although adolescents comprise a considerable portion of Saudi Arabia's population, they have received insufficient attention and indicators of their health status, as a first step in a prevention cycle are unavailable. This study was carried out with the aim of identifying the health risk behaviors and health status of adolescents in Saudi Arabia. This cross-sectional, school-based study was carried out in all 13 regions of Saudi Arabia. Through multistage, cluster, random sampling, intermediate, and secondary school students were invited to participate. Data were collected by means of a self-administered questionnaire addressing health risk behaviors and health status, clinical anthropometric measurements, and laboratory investigations. A total of 12,575 adolescents participated. Various health risk behaviors, including dietary and sedentary behaviors, lack of safety measures, tobacco use, bullying, and violence were highly prevalent. Twenty-eight percent of adolescents reported having a chronic health condition, 14.3% reported having symptoms suggestive of depression, 30.0% were overweight/obese, and 95.6% were vitamin D deficient. Behaviors and conditions known to persist into adulthood and result in morbidity and premature mortality are prevalent among adolescents in Saudi Arabia. Preventive measures and local health policies are urgently needed and can impact adolescents and future adults. Establishing adolescent health surveillance is necessary to monitor trends and impacts of such measures. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Stakeholder analysis of the Programme for Improving Mental health carE (PRIME): baseline findings.

    Science.gov (United States)

    Makan, Amit; Fekadu, Abebaw; Murhar, Vaibhav; Luitel, Nagendra; Kathree, Tasneem; Ssebunya, Joshua; Lund, Crick

    2015-01-01

    The knowledge generated from evidence-based interventions in mental health systems research is seldom translated into policy and practice in low and middle-income countries (LMIC). Stakeholder analysis is a potentially useful tool in health policy and systems research to improve understanding of policy stakeholders and increase the likelihood of knowledge translation into policy and practice. The aim of this study was to conduct stakeholder analyses in the five countries participating in the Programme for Improving Mental health carE (PRIME); evaluate a template used for cross-country comparison of stakeholder analyses; and assess the utility of stakeholder analysis for future use in mental health policy and systems research in LMIC. Using an adapted stakeholder analysis instrument, PRIME country teams in Ethiopia, India, Nepal, South Africa and Uganda identified and characterised stakeholders in relation to the proposed action: scaling-up mental health services. Qualitative content analysis was conducted for stakeholder groups across countries, and a force field analysis was applied to the data. Stakeholder analysis of PRIME has identified policy makers (WHO, Ministries of Health, non-health sector Ministries and Parliament), donors (DFID UK, DFID country offices and other donor agencies), mental health specialists, the media (national and district) and universities as the most powerful, and most supportive actors for scaling up mental health care in the respective PRIME countries. Force field analysis provided a means of evaluating cross-country stakeholder power and positions, particularly for prioritising potential stakeholder engagement in the programme. Stakeholder analysis has been helpful as a research uptake management tool to identify targeted and acceptable strategies for stimulating the demand for research amongst knowledge users, including policymakers and practitioners. Implementing these strategies amongst stakeholders at a country level will

  14. All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.

    Science.gov (United States)

    Jensen, Roxanne E; Snyder, Claire F; Basch, Ethan; Frank, Lori; Wu, Albert W

    2016-11-01

    In recent years, patient-reported outcomes have become increasingly collected and integrated into electronic health records. However, there are few cross-cutting recommendations and limited guidance available in this rapidly developing research area. Our goal is to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on this topic and a summary of actions that followed from the workshop, and present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use. These findings provide actionable guidance across research and practice settings to promote and sustain widespread adoption of patient-reported outcomes across patient populations, healthcare settings and electronic health record systems.

  15. Major Findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700.

    Science.gov (United States)

    Fogel, Robert W; Grotte, Nathaniel

    2011-12-01

    This paper discusses findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700 (Cambridge University Press) The book is built on the authors' work with 300 years of height and nutrition data and discusses their findings in the context of technophysio evolution, a uniquely modern form of rapid physiological development, the result of humanity's ability to control its environment and create technological innovations to adapt to it.

  16. Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

    Science.gov (United States)

    Nuti, Sabina

    2017-01-01

    Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

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

    Science.gov (United States)

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

    2011-12-01

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

  18. Oral Health Status of Older Adults in Sweden Receiving Elder Care: Findings From Nursing Assessments.

    Science.gov (United States)

    Johansson, Isabelle; Jansson, Henrik; Lindmark, Ulrika

    2016-01-01

    Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life. The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care. Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care. Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.

  19. The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda.

    Science.gov (United States)

    Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

    2017-12-19

    Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored the relationship between caregiver depression and adolescent mental health in two refugee settlements, Kiryandongo and Adjumani, in Uganda. Adolescents between 13 and 17 and their caregivers participated in a household survey, which included measures of adolescent anxiety and depression, and caregiver depression. Analysis was conducted using multiple logistic regression models, and results were reported for the full sample and for each site separately. In Kiryandongo, a one-unit increase in a caregiver's depression score tripled the odds that the adolescent would have high levels of anxiety symptoms (AOR: 3.0, 95% CI: 1.4, 6.1), while in Adjumani, caregiver depression did not remain significant in the final model. Caregiver depression, gender and exposure to violence were all associated with higher symptoms of adolescent depression in both sites and the full sample, for example, a one unit increase in caregiver depression more than tripled the odds of higher levels of symptoms of adolescent depression (AOR: 3.6, 95% CI: 2.0, 6.2). Caregiver depression is a consistently significantly associated with adverse mental health outcomes for adolescents in this study. Adolescent well-being is significantly affected by caregiver mental health in this refugee context. Child protection interventions in humanitarian contexts do not adequately address the influence of caregivers' mental health, and there are opportunities to integrate child protection programming with prevention and treatment of

  20. The prevalence of depression and associated factors in Ethiopia: findings from the National Health Survey

    Directory of Open Access Journals (Sweden)

    Hailemariam Solomon

    2012-10-01

    Full Text Available Abstract Background Integrating mental health into primarily health care and studying risk for mental health particularly depression needs assessment of different factors including those that impede diagnosis and treatment of mental disorders. But so far the numbers of literature for local context to analyze risk factors for depression and its treatment are scare. The objective of this study was to assess risk factors and health service attendance for depression among adults, in Ethiopia. Methods For this analysis, data from the Ethiopian National health survey was used. The Ethiopian national health survey studied 4,925 adults aged 18 years and older to obtain among other things, data on depression episodes, socio-demographic, chronic diseases, life style factors and treatment receiving for depression episodes in the past twelve months using questionnaire from world health organization (WHO. Prevalence of Depression in respondents based on ICD-10 criteria was estimated and logistic regression analysis was used to identify risk factors for depression and treatment receiving. Results The prevalence of depressive episode was 9.1% (95% CI: 8.39-9.90. In a Univariate analysis, residence, age, marital status, educational status, number of diagnosed chronic non communicable diseases (heart diseases, diabetic mellitus and arthritis and alcohol drinking status were associated with depression. After full adjustment for possible confounding, odds ratios for depression were significantly higher only for older age, divorced and widowed, number of diagnosed chronic non communicable diseases and alcohol drinking status. The proportion of attending health service among those with depression episodes was 22.9%. After full control for all socio-demographic variables the only predictor variable was educational status, being in grade 5–8 had a higher odds (OR=2.6, 95% CI: 1.23-5.43 and 9–12 grade (OR=1.8 95% CI: 1.45-6.12 of attending service for depressive

  1. Factors affecting Latina immigrants' perceptions of maternal health care: findings from a qualitative study.

    Science.gov (United States)

    Gurman, Tilly A; Becker, Davida

    2008-05-01

    Due to the influx of Latino immigration in the United States, health care services are faced with the challenge of meeting the needs of this growing population. In this qualitative study, we explored Latina immigrants' experiences with maternal health care services. We found that despite enduring language barriers and problems, Spanish-speaking women expressed satisfaction with their care. Factors influencing women's perceptions of care included sociocultural norms (respeto, personalismo, and familismo), previous experiences with care in their countries of origin, having healthy babies, and knowledge about entitlement to interpreter services. We offer recommendations for public health practice and research.

  2. Building Capacity for Workplace Health Promotion: Findings From the Work@Health® Train-the-Trainer Program

    Science.gov (United States)

    Lang, Jason; Cluff, Laurie; Rineer, Jennifer; Brown, Darigg; Jones-Jack, Nkenge

    2017-01-01

    Small- and mid-sized employers are less likely to have expertise, capacity, or resources to implement workplace health promotion programs, compared with large employers. In response, the Centers for Disease Control and Prevention developed the Work@Health® employer training program to determine the best way to deliver skill-based training to employers of all sizes. The core curriculum was designed to increase employers’ knowledge of the design, implementation, and evaluation of workplace health strategies. The first arm of the program was direct employer training. In this article, we describe the results of the second arm—the program’s train-the-trainer (T3) component, which was designed to prepare new certified trainers to provide core workplace health training to other employers. Of the 103 participants who began the T3 program, 87 fully completed it and delivered the Work@Health core training to 233 other employers. Key indicators of T3 participants’ knowledge and attitudes significantly improved after training. The curriculum delivered through the T3 model has the potential to increase the health promotion capacity of employers across the nation, as well as organizations that work with employers, such as health departments and business coalitions. PMID:28829622

  3. Expert and Advocacy Group Consensus Findings on the Horizon of Public Health Genetic Testing

    Directory of Open Access Journals (Sweden)

    Stephen M. Modell

    2016-01-01

    Full Text Available Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC, familial hypercholesterolemia (FH, and Lynch syndrome (LS. Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional

  4. Prevalence and predictors of mental health distress post-Katrina: findings from the Gulf Coast Child and Family Health Study.

    Science.gov (United States)

    Abramson, David; Stehling-Ariza, Tasha; Garfield, Richard; Redlener, Irwin

    2008-06-01

    Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting. A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted: a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability. More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health. Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes

  5. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    Science.gov (United States)

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  6. What does primary health care cost and can we afford to find out ...

    African Journals Online (AJOL)

    Accurate information on the costs of providing priInary health care (PHC) ... if the Government's stated commitment to an adequate PHC system is to be realised. ... to generate accurate cost accounting information is a serious shortcoIDing.

  7. Counterintuitive findings from a qualitative study of mental health in English women’s prisons

    OpenAIRE

    Caulfield, L.S

    2016-01-01

    Purpose:- Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women’s mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues.\\ud \\ud Desi...

  8. Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey.

    Science.gov (United States)

    Serrano, Katrina J; Yu, Mandi; Riley, William T; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A

    2016-01-01

    The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients' willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68-7.81), general health tips (OR = 2.03; 95% CI, 1.74-2.38), medication reminders (OR = 2.73; 95% CI, 2.35-3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62-1.92), vital signs (OR = 1.63; 95% CI, 1.48-1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24-1.58), and symptoms (OR = 1.62; 95% CI, 1.46-1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. © 2016 Annals of Family Medicine, Inc.

  9. The 2015 National Canadian Homeless Youth Survey: Mental Health and Addiction Findings.

    Science.gov (United States)

    Kidd, Sean A; Gaetz, Stephen; O'Grady, Bill

    2017-07-01

    This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population. This study reports mental health-related data from the 2015 "Leaving Home" national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators. Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]). This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.

  10. A rural virtual health sciences library project: research findings with implications for next generation library services.

    Science.gov (United States)

    Richwine, M P; McGowan, J J

    2001-01-01

    The Shared Hospital Electronic Library of Southern Indiana (SHELSI) research project was designed to determine whether access to a virtual health sciences library and training in its use would support medical decision making in rural southern Indiana and achieve the same level of impact seen by targeted information services provided by health sciences librarians in urban hospitals. Based on the results of a needs assessment, a virtual medical library was created; various levels of training were provided. Virtual library users were asked to complete a Likert-type survey, which included questions on intent of use and impact of use. At the conclusion of the project period, structured interviews were conducted. Impact of the virtual health sciences library showed a strong correlation with the impact of information provided by health sciences librarians. Both interventions resulted in avoidance of adverse health events. Data collected from the structured interviews confirmed the perceived value of the virtual library. While librarians continue to hold a strong position in supporting information access for health care providers, their roles in the information age must begin to move away from providing information toward selecting and organizing knowledge resources and instruction in their use.

  11. A rural virtual health sciences library project: research findings with implications for next generation library services*

    Science.gov (United States)

    Richwine, Margaret (Peggy); McGowan, Julie J.

    2001-01-01

    Purpose: The Shared Hospital Electronic Library of Southern Indiana (SHELSI) research project was designed to determine whether access to a virtual health sciences library and training in its use would support medical decision making in rural southern Indiana and achieve the same level of impact seen by targeted information services provided by health sciences librarians in urban hospitals. Methods: Based on the results of a needs assessment, a virtual medical library was created; various levels of training were provided. Virtual library users were asked to complete a Likert-type survey, which included questions on intent of use and impact of use. At the conclusion of the project period, structured interviews were conducted. Results: Impact of the virtual health sciences library showed a strong correlation with the impact of information provided by health sciences librarians. Both interventions resulted in avoidance of adverse health events. Data collected from the structured interviews confirmed the perceived value of the virtual library. Conclusion: While librarians continue to hold a strong position in supporting information access for health care providers, their roles in the information age must begin to move away from providing information toward selecting and organizing knowledge resources and instruction in their use. PMID:11209799

  12. Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

    Science.gov (United States)

    Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

    2006-06-01

    To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

  13. Advances in public health accreditation readiness and quality improvement: evaluation findings from the National Public Health Improvement Initiative.

    Science.gov (United States)

    McLees, Anita W; Thomas, Craig W; Nawaz, Saira; Young, Andrea C; Rider, Nikki; Davis, Mary

    2014-01-01

    Continuous quality improvement is a central tenet of the Public Health Accreditation Board's (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Evaluate the extent to which NPHII awardees have achieved program goals. NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. NPHII performance improvement managers or principal investigators. Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. NPHII appears to be supporting awardees' initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

  14. Preparing master-level mental health nurses to work within a wellness paradigm: Findings from the eMenthe project.

    Science.gov (United States)

    Doyle, Louise; Ellilä, Heikki; Jormfeldt, Henrika; Lahti, Mari; Higgins, Agnes; Keogh, Brian; Meade, Oonagh; Sitvast, Jan; Skärsäter, Ingela; Stickley, Theo; Kilkku, Nina

    2018-04-01

    Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship. © 2017 Australian College of Mental Health Nurses Inc.

  15. ReliefSeq: a gene-wise adaptive-K nearest-neighbor feature selection tool for finding gene-gene interactions and main effects in mRNA-Seq gene expression data.

    Directory of Open Access Journals (Sweden)

    Brett A McKinney

    Full Text Available Relief-F is a nonparametric, nearest-neighbor machine learning method that has been successfully used to identify relevant variables that may interact in complex multivariate models to explain phenotypic variation. While several tools have been developed for assessing differential expression in sequence-based transcriptomics, the detection of statistical interactions between transcripts has received less attention in the area of RNA-seq analysis. We describe a new extension and assessment of Relief-F for feature selection in RNA-seq data. The ReliefSeq implementation adapts the number of nearest neighbors (k for each gene to optimize the Relief-F test statistics (importance scores for finding both main effects and interactions. We compare this gene-wise adaptive-k (gwak Relief-F method with standard RNA-seq feature selection tools, such as DESeq and edgeR, and with the popular machine learning method Random Forests. We demonstrate performance on a panel of simulated data that have a range of distributional properties reflected in real mRNA-seq data including multiple transcripts with varying sizes of main effects and interaction effects. For simulated main effects, gwak-Relief-F feature selection performs comparably to standard tools DESeq and edgeR for ranking relevant transcripts. For gene-gene interactions, gwak-Relief-F outperforms all comparison methods at ranking relevant genes in all but the highest fold change/highest signal situations where it performs similarly. The gwak-Relief-F algorithm outperforms Random Forests for detecting relevant genes in all simulation experiments. In addition, Relief-F is comparable to the other methods based on computational time. We also apply ReliefSeq to an RNA-Seq study of smallpox vaccine to identify gene expression changes between vaccinia virus-stimulated and unstimulated samples. ReliefSeq is an attractive tool for inclusion in the suite of tools used for analysis of mRNA-Seq data; it has power to

  16. Using the Internet for Health-Related Activities: Findings From a National Probability Sample

    Science.gov (United States)

    Saperstein, Sandra L; Pleis, John

    2009-01-01

    Background eHealth tools on the Internet have the potential to help people manage their health and health care. However, little is known about the distribution and use of different kinds of eHealth tools across the population or within population subgroups. Objective The purpose of this study was to examine the prevalence and predictors of participation in specific online health-related activities. Methods A secondary data analysis of the National Cancer Institute’s Health Information National Trends Survey (HINTS) 2005 was conducted to study three online behaviors among Internet users (n = 3244): searching for health information for oneself, participating in a support group for those with similar health or medical conditions, and purchasing medicine or vitamins. Results A total of 58% of Internet users reported searching for health information for themselves, 3.8% used online support groups, and 12.8% bought medicine or vitamins online in the past year. Multivariate analysis found that those seeking health information were more likely to be women (OR = 2.23, 95% CI = 1.60, 3.09), have cable or satellite Internet connections (OR = 1.73, 95% CI = 1.22, 2.45) or DSL connections (OR = 1.94, 95% CI = 1.36, 2.76), have Internet access from work (OR = 2.43, 95% CI = 1.27, 4.67) or from home and work (OR = 1.73, 95% CI = 1.31, 2.30), and report more hours of weekday Internet use (OR = 4.12, 95% CI = 2.41, 7.07). Those with a high school education or less (OR = 0.44, 95% CI = 0.31, 0.63) and those with some college (OR = 0.66, 95% CI = 0.49, 0.89) were less likely to search for health information. Online support groups were more likely to be used by those with “fair” health (OR = 3.28, 95% CI = 1.21, 8.92) and “poor” health (OR = 5.98, 95% CI = 1.49, 24.07) and those with lower incomes (OR = 2.64, 95% CI = 1.09, 6.41) and less likely to be used by those with Internet access both at home and work (OR = 0.56, 95% CI = 0.35, 0.90). Those who were age 35-49 (OR = 2

  17. Client satisfaction in a faith-based health network: findings from a survey in Uganda.

    Science.gov (United States)

    Shumba, Constance Sibongile; Kabali, Kenneth; Miyonga, Jonathan; Mugadu, Jairus; Lakidi, Luke; Kerchan, Patrick; Tumwesigye, Tonny

    2017-09-01

    Client satisfaction surveys are important in evaluating quality of the healthcare processes and contribute to health service improvements by assisting health program managers to develop appropriate strategies. The goal of this study was to assess clients' level of satisfaction with services provided by private-not-for-profit member health facilities affiliated to Uganda Protestant Medical Bureau. This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27th April and 14th July 2014 among 927 clients. The tool measured ten dimensions of the care-seeking experience namely; health facility access; waiting time; health providers; support staff; rights; payments; facilities and environment; consent; confidentiality; and the overall care seeking experience. Logistic regression was utilised for multivariate analysis. Overall client satisfaction was found to be high within the UPMB network (84.2%). Most of the client satisfaction dimensions were rated above 70% except payments and rights. There was evidence of association with marital status; single/never married were 3.05 times more likely to be dissatisfied compared to widowed. Clients attending HCIII were less likely to be dissatisfied compared to those attending HCII (OR=0.51, 95% CI: 0.25-1.05). Post-secondary education (OR=1.79; 95% CI 1.01-3.17), being formally employed (OR=2.78, 95% CI: 0.91-8.48) or unemployed (OR=3.34, 95% CI: 1.00-11.17), attendance at a hospital (OR=2.15, 95% CI: 1.36- 3.41) were also associated with high dissatisfaction levels with payments. This study found a high level of satisfaction with services in the UPMB network but recorded low client satisfaction with the dimensions of rights and payments. Health workers should take time to explain rights and entitlement as well as charges levied to clients.

  18. Is Development Assistance for Health fungible? Findings from a mixed methods case study in Tanzania.

    Science.gov (United States)

    Martínez Álvarez, Melisa; Borghi, Josephine; Acharya, Arnab; Vassall, Anna

    2016-06-01

    The amount of Development Assistance for Health (DAH) available to low- and middle-income countries has increased exponentially over the past decade. However, there are concerns that DAH increases have not resulted in increased spending on health at the country level. This is because DAH may be fungible, resulting from the recipient government decreasing its contribution to the health sector as a result of external funding. The aim of this research is to assess whether DAH funds in Tanzania are fungible, by exploring government substitution of its own resources across sectors and within the health sector. A database containing 28140 projects of DAH expenditure between 2000 and 2010 was compiled from the Organisation for Economic Co-operation and Development's Creditor Reporting System (OECD-CRS) and AidData databases. Government health expenditure data for the same period were obtained from the Government of Tanzania, World Bank, public expenditure reviews and budget speeches and analysed to assess the degree of government substitution. 22 semi-structured interviews were conducted with Development Partners (DPs), government and non-government stakeholders between April and June 2012 to explore stakeholder perceptions of fungibility. We found some evidence of substitution of government funds at the health sector and sub-sector levels and two mechanisms through which it takes place: the resource allocation process and macro-economic factors. We found fungibility of external funds may not necessarily be detrimental to Tanzania's development (as evidence suggests the funds displaced may be reallocated to education) and the mechanisms used by DPs to prevent substitution were largely ineffective. We recommend DPs engage more effectively in the priority-setting process, not just with the Ministry of Health and Social Welfare (MoHSW), but also with the Ministry of Finance, to agree on priorities and mutual funding responsibilities at a macroeconomic level. We also call for

  19. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013.

    Science.gov (United States)

    Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Marques, Aline Pinto; Almeida, Wanessa da Silva de; Montilla, Dalia Elena Romero

    2016-11-17

    The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies

  20. Home and Health in the Third Age — Methodological Background and Descriptive Findings

    Directory of Open Access Journals (Sweden)

    Maya Kylén

    2014-07-01

    Full Text Available Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.

  1. Beyond Meatless, the Health Effects of Vegan Diets: Findings from the Adventist Cohorts

    Directory of Open Access Journals (Sweden)

    Lap Tai Le

    2014-05-01

    Full Text Available Vegetarians, those who avoid meat, and vegans, additionally avoiding dairy and eggs, represent 5% and 2%, respectively, of the US population. The aim of this review is to assess the effects of vegetarian diets, particularly strict vegetarian diets (i.e., vegans on health and disease outcomes. We summarized available evidence from three prospective cohorts of Adventists in North America: Adventist Mortality Study, Adventist Health Study, and Adventist Health Study-2. Non-vegetarian diets were compared to vegetarian dietary patterns (i.e., vegan and lacto-ovo-vegetarian on selected health outcomes. Vegetarian diets confer protection against cardiovascular diseases, cardiometabolic risk factors, some cancers and total mortality. Compared to lacto-ovo-vegetarian diets, vegan diets seem to offer additional protection for obesity, hypertension, type-2 diabetes, and cardiovascular mortality. Males experience greater health benefits than females. Limited prospective data is available on vegetarian diets and body weight change. Large randomized intervention trials on the effects of vegetarian diet patterns on neurological and cognitive functions, obesity, diabetes, and other cardiovascular outcomes are warranted to make meaningful recommendations.

  2. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts.

    Science.gov (United States)

    Le, Lap Tai; Sabaté, Joan

    2014-05-27

    Vegetarians, those who avoid meat, and vegans, additionally avoiding dairy and eggs, represent 5% and 2%, respectively, of the US population. The aim of this review is to assess the effects of vegetarian diets, particularly strict vegetarian diets (i.e., vegans) on health and disease outcomes. We summarized available evidence from three prospective cohorts of Adventists in North America: Adventist Mortality Study, Adventist Health Study, and Adventist Health Study-2. Non-vegetarian diets were compared to vegetarian dietary patterns (i.e., vegan and lacto-ovo-vegetarian) on selected health outcomes. Vegetarian diets confer protection against cardiovascular diseases, cardiometabolic risk factors, some cancers and total mortality. Compared to lacto-ovo-vegetarian diets, vegan diets seem to offer additional protection for obesity, hypertension, type-2 diabetes, and cardiovascular mortality. Males experience greater health benefits than females. Limited prospective data is available on vegetarian diets and body weight change. Large randomized intervention trials on the effects of vegetarian diet patterns on neurological and cognitive functions, obesity, diabetes, and other cardiovascular outcomes are warranted to make meaningful recommendations.

  3. Home and Health in the Third Age — Methodological Background and Descriptive Findings

    Science.gov (United States)

    Kylén, Maya; Ekström, Henrik; Haak, Maria; Elmståhl, Sölve; Iwarsson, Susanne

    2014-01-01

    Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens. PMID:25019267

  4. Revenue sources for essential services in Florida: findings and implications for organizing and funding public health.

    Science.gov (United States)

    Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David

    2013-01-01

    The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.

  5. Barriers to participation in mental health research: findings from the Genetics and Psychosis (GAP) Study.

    Science.gov (United States)

    Woodall, Anna; Howard, Louise; Morgan, Craig

    2011-01-01

    The aim of this study was to investigate why people with a first episode of psychosis choose or decline to participate in mental health research, using a qualitative study design. Participants were recruited via referrals from the Genetics and Psychosis (GAP) study. A total of 26 individuals with a first-episode of psychosis (nine of whom declined participation in the GAP study and 17 who participated) were individually interviewed and asked about their attitudes towards mental health research participation. Thematic analysis of interview transcripts was used to determine dominant themes and sub-themes on what constituted barriers and facilitators to participation. Reasons for research participation identified included a desire to help others, curiosity, and positive experiences with clinicians. Decisions to participate or not were also influenced by practical issues, including the timing of the approach, researchers' communication skills and whether individuals had concerns that it may be potentially harmful to their health. Other barriers to participation included patients' conceptualizations of mental health problems and the influence of other inpatients. Information on barriers and facilitators to recruitment in mental health research could inform recruitment strategies, thereby maximizing recruitment rates and minimizing the risk of selection biases.

  6. Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand.

    Science.gov (United States)

    Came, H; Doole, C; McKenna, B; McCreanor, T

    2018-02-01

    Public institutions within New Zealand have long been accused of mono-culturalism and institutional racism. This study sought to identify inconsistencies and bias by comparing government funded contracting processes for Māori public health providers (n = 60) with those of generic providers (n = 90). Qualitative and quantitative data were collected (November 2014-May 2015), through a nationwide telephone survey of public health providers, achieving a 75% response rate. Descriptive statistical analyses were applied to quantitative responses and an inductive approach was taken to analyse data from open-ended responses in the survey domains of relationships with portfolio contract managers, contracting and funding. The quantitative data showed four sites of statistically significant variation: length of contracts, intensity of monitoring, compliance costs and frequency of auditing. Non-significant data involved access to discretionary funding and cost of living adjustments, the frequency of monitoring, access to Crown (government) funders and representation on advisory groups. The qualitative material showed disparate provider experiences, dependent on individual portfolio managers, with nuanced differences between generic and Māori providers' experiences. This study showed that monitoring government performance through a nationwide survey was an innovative way to identify sites of institutional racism. In a policy context where health equity is a key directive to the health sector, this study suggests there is scope for New Zealand health funders to improve their contracting practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children's Health Study.

    Science.gov (United States)

    Chen, Zhanghua; Salam, Muhammad T; Eckel, Sandrah P; Breton, Carrie V; Gilliland, Frank D

    2015-01-01

    Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children's Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children's health while control measures are being implemented.

  8. National findings regarding health IT use and participation in health care delivery reform programs among office-based physicians.

    Science.gov (United States)

    Heisey-Grove, Dawn; Patel, Vaishali

    2017-01-01

    Our objective was to characterize physicians' participation in delivery and payment reform programs over time and describe how participants in these programs were using health information technology (IT) to coordinate care, engage patients, manage patient populations, and improve quality. A nationally representative cohort of physicians was surveyed in 2012 (unweighted N = 2567) and 2013 (unweighted N = 2399). Regression analyses used those survey responses to identify associations between health IT use and participation in and attrition from patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and pay-for-performance programs (P4Ps). In 2013, 45% of physicians participated in PCMHs, ACOs, or P4Ps. While participation in each program increased (P payment reform programs increased between 2012 and 2013. Participating physicians were more likely to use health IT. There was significant attrition from and switching between PCMHs, ACOs, and P4Ps. This work provides the basis for understanding physician participation in and attrition from delivery and payment reform programs, as well as how health IT was used to support those programs. Understanding health IT use by program participants may help to identify factors enabling a smooth transition to alternative payment models. Published by Oxford University Press on behalf of the American Medical Informatics Association 2016. This work is written by US Government employees and is in the public domain in the United States.

  9. The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments Study: Feasibility and Findings

    Directory of Open Access Journals (Sweden)

    Kerry Stephen Kuehl

    2014-05-01

    Full Text Available This randomized prospective trial aimed to assess the feasibility and efficacy of a team-based worksite health and safety intervention for law enforcement personnel. Four-hundred and eight subjects were enrolled and half were randomized to meet participants met for weekly, peer-led sessions delivered from a scripted team-based health and safety curriculum. Curriculum addressed: exercise, nutrition, stress, sleep, body weight, injury, and other unhealthy lifestyle behaviours such as smoking and heavy alcohol use. Health and safety questionnaires administered before and after the intervention found significant improvements for increased fruit and vegetable consumption, overall healthy eating, increased sleep quantity and sleep quality, and reduced personal stress.

  10. HPV vaccine hesitancy: findings from a statewide survey of health care providers.

    Science.gov (United States)

    McRee, Annie-Laurie; Gilkey, Melissa B; Dempsey, Amanda F

    2014-01-01

    Health care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy. A statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013. Only 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  11. Health risk behaviours of Palestinian youth: findings from a representative survey.

    Science.gov (United States)

    Glick, Peter; Al-Khammash, Umaiyeh; Shaheen, Mohammed; Brown, Ryan; Goutam, Prodyumna; Karam, Rita; Linnemayr, Sebastian; Massad, Salwa

    2018-05-03

    There is little systematic information about health risk behaviours among youth in Middle Eastern countries, leaving public health authorities unprepared to deal with emerging public health threats at a time of major social change. The Palestinian Youth Health Risk study investigates patterns of risk behaviours among Palestinian youth, their perceptions of the risks and benefits of such behaviours, and the relationship of exposure to violence with mental health and engagement in risk behaviours. We conducted a representative survey among 2500 individuals aged 15-24 years in the West Bank and East Jerusalem, permitting reliable comparison across sex and rural-urban divisions. A stratified 2-stage random sample was drawn from the 2007 population census, with strata formed by crossing the 12 governorates with urban, rural and refugee camp locations. Within strata, 208 survey clusters were sampled with probability proportional to size. Within each cluster, 14 households with youth of the appropriate age were sampled. Among youth aged 20-24 years, 22.4% of males and 11.6% of females reported trying alcohol; 10.5% of males and 4.3% of females reported trying drugs. Almost one quarter of unmarried youth aged 20-24 years reported any sexual experience. Tobacco use is high, even among younger youth (45.4% of males and 21.2% of females aged 15-19 smoke). Risk behaviours are higher among males, older youth and in urban areas and refugee camps. While smoking is of particular concern, prevention outreach for all behaviours should be directed at subgroups and areas identified as highest risk. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  12. Workgroup report: Drinking-water nitrate and health - Recent findings and research needs

    Science.gov (United States)

    Ward, M.H.; deKok, T.M.; Levallois, P.; Brender, J.; Gulis, G.; Nolan, B.T.; VanDerslice, J.

    2005-01-01

    Human alteration of the nitrogen cycle has resulted in steadily accumulating nitrate in our water resources. The U.S. maximum contaminant level and World Health Organization guidelines for nitrate in drinking water were promulgated to protect infants from developing methemoglobinemia, an acute condition. Some scientists have recently suggested that the regulatory limit for nitrate is overly conservative; however, they have not thoroughly considered chronic health outcomes. In August 2004, a symposium on drinking-water nitrate and health was held at the International Society for Environmental Epidemiology meeting to evaluate nitrate exposures and associated health effects in relation to the current regulatory limit. The contribution of drinking-water nitrate toward endogenous formation of N-nitroso compounds was evaluated with a focus toward identifying subpopulations with increased rates of nitrosation. Adverse health effects may be the result of a complex interaction of the amount of nitrate ingested, the concomitant ingestion of nitrosation cofactors and precursors, and specific medical conditions that increase nitrosation. Workshop participants concluded that more experimental studies are needed and that a particularly fruitful approach may be to conduct epidemiologic studies among susceptible subgroups with increased endogenous nitrosation. The few epidemiologic studies that have evaluated intake of nitrosation precursors and/or nitrosation inhibitors have observed elevated risks for colon cancer and neural tube defects associated with drinking-water nitrate concentrations below the regulatory limit. The role of drinking-water nitrate exposure as a risk factor for specific cancers, reproductive outcomes, and other chronic health effects must be studied more thoroughly before changes to the regulatory level for nitrate in drinking water can be considered.

  13. Who is food-insecure in California? Findings from the California Women's Health Survey, 2004.

    Science.gov (United States)

    Kaiser, Lucia; Baumrind, Nikki; Dumbauld, Sheila

    2007-06-01

    To identify factors associated with food insecurity in California women. The California Women's Health Survey is an ongoing annual telephone survey that collects data about health-related attitudes and behaviours from a randomly selected sample of women. Food insecurity of the women was measured by a 6-item subset of the Food Security Module. Statistical procedures included chi-square tests, t-tests, logistic regression analysis and analysis of covariance. California, USA. Four thousand and thirty-seven women (18 years or older). Prevalence of food insecurity was 25.7%. After controlling for income, factors associated with greater food insecurity were Hispanic or Black race/ethnicity; less than a 12th grade education; being unmarried; less than 55 years old; being Spanish-speaking; having spent less than half of one's life in the USA; sadness/depression; feeling overwhelmed; poor physical/mental health interfering with activities; and fair to poor general health. Among Food Stamp Program (FSP) participants, 71% were food-insecure. Among FSP-eligible women who had not applied for the programme, the prevalence of food insecurity was lower among women responding that they did not need food stamps than in women giving other reasons for not applying (23.9% vs. 66.9%, P < 0.001). Factors associated with food insecurity in FSP recipients included being unable to make food stamps last for 30 days, feeling overwhelmed, and having a birthplace in Mexico or Central America. Along with several socio-economic variables, poor physical and mental health is associated with food insecurity. Whether food insecurity is a cause or effect of poor health remains in question.

  14. The importance of regional availability of health care for old age survival - Findings from German reunification

    DEFF Research Database (Denmark)

    Vogt, Tobias C.; Vaupel, James W

    2015-01-01

    BACKGROUND: This article investigates the importance of regional health care availability for old age survival. Using German reunification as a natural experiment, we show that spatial variation in health care in East Germany considerably influenced the convergence of East German life expectancy...... toward West German levels. METHOD: We apply cause-deleted life tables and continuous mortality decomposition for the years 1982-2007 to show how reductions in circulatory mortality among the elderly affected the East German catch-up in life expectancy. RESULTS: Improvements in remaining life expectancy...

  15. Establishing a health demographic surveillance site in Bhaktapur district, Nepal: initial experiences and findings

    Directory of Open Access Journals (Sweden)

    Aryal Umesh

    2012-09-01

    Full Text Available Abstract Background A health demographic surveillance system (HDSS provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal. Results We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%; headache, vertigo and dizziness (16.7%; bone and joint pain (14.4%; gastrointestinal problems (13.9%; heart disease, including hypertension (8.8%; accidents and injuries (2.9%; and diabetes mellitus (2.6%. The prevalence of non-communicable disease (NCD was 4.3% (95% CI: 3.83; 4.86 among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD. Conclusion Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns.

  16. Male mental health problems, psychopathy, and personality traits: key findings from the first 14 years of the Pittsburgh Youth Study.

    Science.gov (United States)

    Loeber, R; Farrington, D P; Stouthamer-Loeber, M; Moffitt, T E; Caspi, A; Lynam, D

    2001-12-01

    This paper reviews key findings on juvenile mental health problems in boys, psychopathy, and personality traits, obtained in the first 14 years of studies using data from the Pittsburgh Youth Study. This is a study of 3 samples, each of about 500 boys initially randomly drawn from boys in the 1st, 4th, and 7th grades of public schools in Pittsburgh. The boys have been followed regularly, initially each half year, and later at yearly intervals. Currently, the oldest boys are about 25 years old, whereas the youngest boys are about 19. Findings are presented on the prevalence and interrelation of disruptive behaviors, ADHD, and depressed mood. Results concerning risk factors for these outcomes are reviewed. Psychological factors such as psychopathy, impulsivity, and personality are described. The paper closes with findings on service delivery of boys with mental health problems.

  17. Alternative Health Care Practitioners in a Chinese American Community: A Preliminary Report of Findings.

    Science.gov (United States)

    Kao, Jessica Ching-Yi

    This paper provides a brief review of the literature on traditional Chinese medicine in both China and the United States and presents observations from a preliminary study of Chinese practitioners in the Chinatown section of Los Angeles, California. The dualistic health care system in Chinese culture is described as comprising both scholarly and…

  18. What does pritnary health care cost and can we afford to find out?

    African Journals Online (AJOL)

    cost infonnation is a critical management tool for both public and private sector providers. Without ... COSt infonnation is also vital if appropriate user charges are to be levied.2. Effons to generate accurate cost accounting informa- tion are obviously the primary responsibility of health planners and managers, who require this ...

  19. Towards enhanced emotional interactions with older persons: findings from a nursing intervention in home health care.

    NARCIS (Netherlands)

    Veenvliet, C.; Eide, H.; Lange, M.A. de; Dulmen, S. van

    2016-01-01

    Background. Living at home with a physical condition that requires assistance places high emotional burden on older persons that needs to be attended to by nurses. However, nurses in home health care have previously been found to communicate primarily in an instrumental way. This increases the risk

  20. Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

    Science.gov (United States)

    Eskelinen, Saana; Sailas, Eila; Joutsenniemi, Kaisla; Holi, Matti; Koskela, Tuomas H; Suvisaari, Jaana

    2017-08-01

    Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

  1. Client satisfaction in a faith-based health network: findings from a ...

    African Journals Online (AJOL)

    2014-07-14

    Jul 14, 2014 ... is likely to be high and this will have a positive impact on the health seeking .... tional Council for Science and Technology (SS3823). Participants were .... or unemployed (OR=3.34), attendance at a hospital. (OR=2.15) were ...

  2. Evidence-Based Mental Health Practices with Children Self-Efficacy Scale: Development and Preliminary Findings

    Science.gov (United States)

    McMeel, Lorri S.; Leathers, Sonya J.; Strand, Tonya C.

    2017-01-01

    This article reviews existing measures related to evidence-based practices with children and self-efficacy and describes the development and psychometric properties of the Evidence-Based Mental Health Practices With Children Efficacy Scale. This scale was developed to assess students' and clinicians' self-efficacy in their abilities to use…

  3. Does worker participation improve health and safety? Findings from the Netherlands

    NARCIS (Netherlands)

    Popma, J.R.

    2009-01-01

    Worker participation, both at a sectoral and organisational level, has been assigned a prominent role in Dutch occupational safety and health (OSH) policy since the 1980s. This emphasis on worker participation stems from the belief that such participation may enhance the effectiveness of OSH policy

  4. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  5. Connecting Students to Mental Health Care: Pilot Findings from an Engagement Program for School Nurses

    Science.gov (United States)

    Kim, Rachel E.; Becker, Kimberly D.; Stephan, Sharon H.; Hakimian, Serop; Apocada, Dee; Escudero, Pia V.; Chorpita, Bruce F.

    2015-01-01

    Schools function as the major provider of mental health services (MHS) for youth, but can struggle with engaging them in services. School nurses are well-positioned to facilitate referrals for MHS. This pilot study examined the feasibility, acceptability, and preliminary efficacy of an engagement protocol (EP) designed to enhance school nurses'…

  6. Life Stress and Health: A Review of Conceptual Issues and Recent Findings.

    Science.gov (United States)

    Slavich, George M

    2016-10-01

    Life stress is a central construct in many models of human health and disease. The present article reviews research on stress and health, with a focus on (a) how life stress has been conceptualized and measured over time, (b) recent evidence linking stress and disease, and (c) mechanisms that might underlie these effects. Emerging from this body of work is evidence that stress is involved in the development, maintenance, or exacerbation of several mental and physical health conditions, including asthma, rheumatoid arthritis, anxiety disorders, depression, cardiovascular disease, chronic pain, human immunodeficiency virus/AIDS, stroke, and certain types of cancer. Stress has also been implicated in accelerated biological aging and premature mortality. These effects have been studied most commonly using self-report checklist measures of life stress exposure, although interview-based approaches provide a more comprehensive assessment of individuals' exposure to stress. Most recently, online systems like the Stress and Adversity Inventory (STRAIN) have been developed for assessing lifetime stress exposure, and such systems may provide important new information to help advance our understanding of how stressors occurring over the life course get embedded in the brain and body to affect lifespan health.

  7. Usefulness of systematic review search strategies in finding child health systematic reviews in MEDLINE

    NARCIS (Netherlands)

    Boluyt, Nicole; Tjosvold, Lisa; Lefebvre, Carol; Klassen, Terry P.; Offringa, Martin

    2008-01-01

    OBJECTIVE: To determine the sensitivity and precision of existing search strategies for retrieving child health systematic reviews in MEDLINE using PubMed. DESIGN: Filter (diagnostic) accuracy study. We identified existing search strategies for systematic reviews, combined them with a filter that

  8. Corporate characteristics and worksite health promotion programs: survey findings from Fortune 500 companies.

    Science.gov (United States)

    Hollander, R B; Lengermann, J J

    1988-01-01

    A study was carried out to assess the nature and extent of worksite health promotion programs in Fortune 500 companies. Growth and interest in worksite health promotion continues at a remarkable rate. Fortune 500 firms are a good barometer of the state of the art of programs in work settings because these companies have large numbers of employees, an interest in cost savings, and expertise to invest in innovative efforts. Data collection consisted of questionnaires sent to the medical officer or Chief Executive Officer of all companies appearing on the 1984 Fortune 500 list. The following issues were addressed: whether companies offered worksite programs; what health promotion activities were provided in their programs; whether organizations had plans to start up or expand programs; what organizational support existed for programs (i.e. who pays, on whose time employees participate, when activities are offered, and what types of personnel are hired to staff programs); and whether these companies applied needs assessments, evaluation and cost analysis in their programs. Differences in these characteristics were examined in relation to the organizational variables of size (number of employees), Fortune 500 rank and type of industry (low-technology versus high-technology). The response rate for the survey was 49.4% (n = 247). Results of the study indicate a high level of health promotion activity in Fortune 500 firms. Out of the total group of respondents, two-thirds (n = 164) report having worksite programs and two-thirds of organizations with programs have plans to expand their health promotion offerings. One-third of responding organizations without programs planned to initiate them. The health promotion activities provided are numerous and varied, and within units that have programs rates of employee eligibility are reported to be high. However, the participation rates reported are appreciably lower. It is of special interest that, in general, the higher ranked

  9. Disconnects in pedagogy and practice in community health nursing clinical experiences: Qualitative findings of a mixed method study.

    Science.gov (United States)

    Pijl-Zieber, Em M; Barton, Sylvia; Awosoga, Olu; Konkin, Jill

    2015-10-01

    Many baccalaureate schools of nursing are using non-traditional placements for undergraduate community health clinical rotations. These placements occur at agencies not organizationally affiliated with the health care system and they typically do not employ registered nurses (RNs). In this paper, we describe the qualitative findings of a mixed method study that explored these gaps as they relate to pre-registration nursing students' preparation for community health roles. While non-traditional community health placements offer unique opportunities for learning through carefully crafted service learning pedagogy, these placements also present challenges for student preparation for practice in community health roles. The theory-practice gap and the gap between the expected and actual performance of new graduates are accentuated through the use of non-traditional community clinical experiences. These gaps are not necessarily due to poor pedagogy, but rather due to the perceptions and values of the stakeholders involved: nursing students, community health nursing faculty, and community health nurses. New ways must be developed between academe and community health practice areas to provide students with opportunities to develop competence for practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Personality trait level and change as predictors of health outcomes: findings from a national study of Americans (MIDUS).

    Science.gov (United States)

    Turiano, Nicholas A; Pitzer, Lindsay; Armour, Cherie; Karlamangla, Arun; Ryff, Carol D; Mroczek, Daniel K

    2012-01-01

    Personality traits predict numerous health outcomes, but previous studies have rarely used personality change to predict health. The current investigation utilized a large national sample of 3,990 participants from the Midlife in the U.S. study (MIDUS) to examine if both personality trait level and personality change longitudinally predict 3 different health outcomes (i.e., self-rated physical health, self-reported blood pressure, and number of days limited at work or home due to physical health reasons) over a 10-year span. Each of the Big Five traits, except openness, predicted self-rated health. Change in agreeableness, conscientiousness, and extraversion also predicted self-rated health. Trait levels of conscientiousness and neuroticism level predicted self-reported blood pressure. All trait levels except agreeableness predicted number of work days limited. Only change in conscientiousness predicted the number of work days limited. Findings demonstrate that a full understanding of the link between personality and health requires consideration of trait change as well as trait level.

  11. Sex Education, First Sex and Sexual Health Outcomes in Adulthood: Findings from a Nationally Representative Sexual Health Survey

    Science.gov (United States)

    Bourke, Ashling; Boduszek, Daniel; Kelleher, Caroline; McBride, Orla; Morgan, Karen

    2014-01-01

    This study investigated the relationship between school sex education and sexual health behaviours at first sex and later in adulthood, using nationally representative data. Respondents were adults from the 2010 Irish Contraception and Crisis Pregnancy Survey, a cross-sectional survey designed to assess knowledge, attitudes and behaviours relating…

  12. How to optimize tuberculosis case finding: explorations for Indonesia with a health system model

    NARCIS (Netherlands)

    R.A. Ahmad (Riris); Y. Mahendradhata (Yodi); J. Cunningham (Jane); A. Utarini (Adi); S.J. de Vlas (Sake)

    2009-01-01

    textabstractBACKGROUND: A mathematical model was designed to explore the impact of three strategies for better tuberculosis case finding. Strategies included: (1) reducing the number of tuberculosis patients who do not seek care; (2) reducing diagnostic delay; and (3) engaging non-DOTS providers in

  13. Evaluation of Self-Ratings for Health Information Behaviour Skills Requires More Heterogeneous Sample, but Finds that Public Library Print Collections and Health Information Literacy of Librarians Needs Improvement

    Directory of Open Access Journals (Sweden)

    Carol Perryman

    2016-03-01

    Full Text Available Objective – To understand public library users’ perceptions of ability to locate, evaluate, and use health information; to identify barriers experienced in finding and using health information; and to compare self-ratings of skills to an administered instrument. Design – Mixed methods. Setting – Main library and two branches of one public library system in Florida. Subjects – 20 adult library users purposively selected from 131 voluntary respondents to a previously conducted survey (Yi, 2014 based on age range, ethnicity, gender, and educational level. Of the 20, 13 were female; 11 White, 8 Black, 1 Native American; most had attained college or graduate school education levels (9 each, with 2 having graduated from high school. 15 respondents were aged 45 or older. Methods – Intensive interviews conducted between April and May 2011 used critical incident technique to inquire about a recalled health situation. Participants responded to questions about skill self-appraisal, health situation severity, information seeking and assessment behaviour, use of information, barriers, and outcome. Responses were compared to results of the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA test, administered to participants. Main Results – On a scale of 100, participants’ S-TOFHLA scores measured at high levels of proficiency, with 90% rating 90 points or above. Self-ratings of ability to find health information related to recalled need were ”excellent” (12 participants or “good” (8 participants. Fourteen participants did not seek library assistance; 12 began their search on the Internet, 5 searched the library catalogue, and 3 reported going directly to the collection. Resource preferences were discussed, although no frequency descriptions were provided. 90% of participants self-rated their ability to evaluate the quality of health information as “good” or “excellent.” Participants selected authority

  14. [Health impact assessment of policies for municipal solid waste management: findings of the SESPIR Project].

    Science.gov (United States)

    Ranzi, Andrea; Ancona, Carla; Angelini, Paola; Badaloni, Chiara; Cernigliaro, Achille; Chiusolo, Monica; Parmagnani, Federica; Pizzuti, Renato; Scondotto, Salvatore; Cadum, Ennio; Forastiere, Francesco; Lauriola, Paolo

    2014-01-01

    The SESPIR Project (Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants) assessed the impact on health of residents nearby incinerators, landfills and mechanical biological treatment plants in five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily). The assessment procedure took into account the available knowledge on health effects of waste disposal facilities. Analyses were related to three different scenarios: a Baseline scenario, referred to plants active in 2008-2009; the regional future scenario, with plants expected in the waste regional plans; a virtuous scenario (Green 2020), based on a policy management of municipal solid waste (MSW) through the reduction of production and an intense recovery policy. Facing with a total population of around 24 million for the 5 regions, the residents nearby the plants were more than 380,000 people at Baseline. Such a population is reduced to approximately 330.000 inhabitants and 170.000 inhabitants in the regional and Green 2020 scenarios, respectively. The health impact was assessed for the period 2008-2040. At Baseline, 1-2 cases per year of cancer attributable to MSW plants were estimated, as well as 26 cases per year of adverse pregnancy outcomes (including low birth weight and birth defects), 102 persons with respiratory symptoms, and about a thousand affected from annoyance caused by odours. These annual estimates are translated into 2,725 years of life with disability (DALYs) estimated for the entire period. The DALYs are reduced by approximately 20% and 80% in the two future scenarios. Even in these cases, health impact is given by the greater effects on pregnancy and the annoyance associated with the odours of plants. In spite of the limitations due to the inevitable assumptions required by the present exercise, the proposed methodology is suitable for a first approach to assess different policies that can be adopted in regional planning in

  15. Highlights of the Russian health studies program and updated research findings

    International Nuclear Information System (INIS)

    Fountos, Barrett N.

    2017-01-01

    Recognized for conducting cutting-edge science in the field of radiation health effects research, the Department of Energy's (DOE) Russian Health Studies Program has continued to generate excitement and enthusiasm throughout its 23-year mission to assess worker and public health risks from radiation exposure resulting from nuclear weapons production activities in the former Soviet Union. The three goals of the Program are to: (1) clarify the relationship between health effects and chronic, low-to-medium dose radiation exposure; (2) estimate the cancer risks from exposure to gamma, neutron, and alpha radiation; and (3) provide information to the national and international organizations that determine radiation protection standards and practices. Research sponsored by DOE's Russian Health Studies Program is conducted under the authority of the Joint Coordinating Committee for Radiation Effects Research (JCCRER), a bi-national committee representing Federal agencies in the United States and the Russian Federation. Signed in 1994, the JCCRER Agreement established the legal basis for the collaborative research between USA and Russian scientists to determine the risks associated with working at or living near Russian former nuclear weapons production sites. The products of the Program are peer-reviewed publications on cancer risk estimates from worker and community exposure to ionizing radiation following the production of nuclear weapons in Russia. The scientific return on investment has been substantial. Through 31 December 2015, JCCRER researchers have published 299 peer-reviewed publications. To date, the research has focused on the Mayak Production Association (Mayak) in Ozersk, Russia, which is the site of the first Soviet nuclear weapons production facility, and people in surrounding communities along the Techa River. There are five current projects in the Russian Health Studies Program: two radiation epidemiology studies; two historical dose reconstruction

  16. Savings needed to fund health insurance and health care expenses in retirement: findings from a simulation model.

    Science.gov (United States)

    Fronstin, Paul; Salisbury, Dallas; VanDerhei, Jack

    2008-05-01

    MODELING RETIREE HEALTH COSTS: This Issue Brief examines the uncertainty of health care expenses in retirement by using a Monte Carlo simulation model to estimate the amount of savings needed to cover health insurance premiums and out-of-pocket health care expenses. This type of simulation is able to account for the uncertainty related to individual mortality and rates of return, and computes the present value of the savings needed to cover health insurance premiums and out-of-pocket expenses in retirement. These observations were used to determine asset targets for having adequate savings to cover retiree health costs 50, 75, and 90 percent of the time. NOT ENOUGH SAVINGS: Many individuals will need more money than the amounts reported in this Issue Brief because this analysis does not factor in the savings needed to cover long-term care expenses, nor does it take into account the fact that many individuals retire prior to becoming eligible for Medicare. However, some workers will need to save less than what is reported if they keep working in retirement and receive health benefits as active workers. WHO HAS RETIREE HEALTH BENEFITS BEYOND MEDICARE?: About 12 percent of private-sector employers report offering any Medicare supplemental health insurance. This increases to about 40 percent among large employers. Overall, nearly 22 percent of retirees age 65 and older had retiree health benefits in 2005 to supplement Medicare coverage. As recently as 2006, 53 percent of retirees age 65 and older were covered by Medicare Part D, 24 percent had outpatient prescription drug coverage through an employment-based plan. Only 10 percent had no prescription drug coverage. INDIVIDUALLY PURCHASED MEDICARE SUPPLEMENTS, 2008: Among those who purchase Medigap and Medicare Part D prescription drug coverage at age 65 in 2008, men would need between $79,000 and $159,000 with median prescription drug expenses (50th percentile and 90th percentiles, respectively), and between $156

  17. Domestic violence in consanguineous marriages - findings from Pakistan Demographic and Health Survey 2012-13.

    Science.gov (United States)

    Shaikh, Masood Ali

    2016-10-01

    Domestic violence is a pandemic and estimated to affect one in three women globally, in their lifetime. Marriages within blood relations in Pakistan are common. In this study a secondary analysis of Pakistan Demographic and Health Survey 2012-13 was done to study the prevalence and profile of domestic violence in the context of consanguineous marriages in Pakistan. Almost 65% of women had some kind of blood relationship with their husbands. Women having a blood relationship with husbands were more likely to report having ever been subjected to marital control behaviours, emotional and physical violence by their husbands, compared to ones without such relationship. However, these associations fail to reach statistical significance; underscoring the ubiquitous nature of marital control and violence. More effective public health education campaigns for just and equal treatment of wives by their husbands to speedily curb the scourge of domestic violence in the country are needed.

  18. Association between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa

    2015-01-01

    Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. The Chicago Health and Aging Project (CHAP) cohort is a population-based study (n = 4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes [22.4 vs. 10.7% (WHO), 50.7 vs. 40.0% (AHA) and 47.7 vs. 33.5% (IDF)]. After adjusting for potential confounding factors, elder abuse was associated with an increased risk for metabolic syndromes according to WHO [OR, 3.95 (2.86-5.47)], AHA [OR, 2.03 (1.56-2.64)] and IDF [OR, 2.55 (1.97-3.29)] criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics but not by health-related or psychosocial factors. Elder abuse is associated with an increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease.

  19. The Role of Mental Health Disease in Potentially Preventable Hospitalizations: Findings From a Large State.

    Science.gov (United States)

    Medford-Davis, Laura N; Shah, Rohan; Kennedy, Danielle; Becker, Emilie

    2018-01-01

    Preventable hospitalizations are markers of potentially low-value care. Addressing the problem requires understanding their contributing factors. The objective of this study is to determine the correlation between specific mental health diseases and each potentially preventable hospitalization as defined by the Agency for Healthcare Research and Quality. The Texas Inpatient Public Use Data File, an administrative database of all Texas hospital admissions, identified 7,351,476 adult acute care hospitalizations between 2005 and 2008. A hierarchical multivariable logistic regression model clustered by admitting hospital adjusted for patient and hospital factors and admission date. A total of 945,280 (12.9%) hospitalizations were potentially preventable, generating $6.3 billion in charges and 1.2 million hospital days per year. Mental health diseases [odds ratio (OR), 1.25; 95% confidence interval (CI), 1.22-1.27] and substance use disorders (OR, 1.13; 95% CI, 1.12-1.13) both increased odds that a hospitalization was potentially preventable. However, each mental health disease varied from increasing or decreasing the odds of potentially preventable hospitalization depending on which of the 12 preventable hospitalization diagnoses were examined. Older age (OR, 3.69; 95% CI, 3.66-3.72 for age above 75 years compared with 18-44 y), black race (OR 1.44; 95% CI, 1.43-1.45 compared to white), being uninsured (OR 1.52; 95% CI, 1.51-1.54) or dual-eligible for both Medicare and Medicaid (OR, 1.23; 95% CI, 1.22-1.24) compared with privately insured, and living in a low-income area (OR, 1.20; 95% CI, 1.17-1.23 for lowest income quartile compared with highest) were other patient factors associated with potentially preventable hospitalizations. Better coordination of preventative care for mental health disease may decrease potentially preventable hospitalizations.

  20. Exposure-response functions for health effects of air pollutants based on epidemiological findings

    Energy Technology Data Exchange (ETDEWEB)

    Aunan, K

    1995-10-01

    The objective of this report is to provide exposure-response functions for health effects and air pollution, which can be used in cost-effectiveness analyses of abatement measures. When cost-effective abatement strategies for air pollution are analyzed, and when air quality standards are set, it is important to have quantitative knowledge about health damage. In spite of their shortcomings, epidemiological studies provide a sound basis for exposure-response functions because they involve a random cross section of the population. In this report the exposure-response functions apply to the relation between air pollutant concentrations and relative effect frequencies, and involve the following health effect end-points: acute and chronic respiratory symptoms in children and adults, asthma episodes in children and adults, eye irritations, headache, lung damage in children, excess mortality, lung cancer incidence. The effects are attributed to one indicator component, which in many cases is particles, but for some effects NO{sub 2}, SO{sub 2}, O{sub 3}, or CO. A calculation procedure is suggested which makes it possible to estimate excess annual symptom-days for short-term effects using the annual average concentration. 103 refs., 1 table

  1. Big data - smart health strategies. Findings from the yearbook 2014 special theme.

    Science.gov (United States)

    Koutkias, V; Thiessard, F

    2014-08-15

    To select best papers published in 2013 in the field of big data and smart health strategies, and summarize outstanding research efforts. A systematic search was performed using two major bibliographic databases for relevant journal papers. The references obtained were reviewed in a two-stage process, starting with a blinded review performed by the two section editors, and followed by a peer review process operated by external reviewers recognized as experts in the field. The complete review process selected four best papers, illustrating various aspects of the special theme, among them: (a) using large volumes of unstructured data and, specifically, clinical notes from Electronic Health Records (EHRs) for pharmacovigilance; (b) knowledge discovery via querying large volumes of complex (both structured and unstructured) biological data using big data technologies and relevant tools; (c) methodologies for applying cloud computing and big data technologies in the field of genomics, and (d) system architectures enabling high-performance access to and processing of large datasets extracted from EHRs. The potential of big data in biomedicine has been pinpointed in various viewpoint papers and editorials. The review of current scientific literature illustrated a variety of interesting methods and applications in the field, but still the promises exceed the current outcomes. As we are getting closer towards a solid foundation with respect to common understanding of relevant concepts and technical aspects, and the use of standardized technologies and tools, we can anticipate to reach the potential that big data offer for personalized medicine and smart health strategies in the near future.

  2. Evidence-based Practice. Findings from the Section on Education and Consumer Health Informatics.

    Science.gov (United States)

    Staccini, P; Douali, N

    2013-01-01

    To provide an overview of outstanding current research conducted in Education and Consumer Informatics. Synopsis of the articles on education and consumer health informatics published in 2012 and selected for the IMIA Yearbook of Medical Informatics 2013. Architecture of monitoring or telehealth information systems for patients with chronic disease must include wireless devices to aid in the collection of personal data. Data acquisition technologies have an impact on patients' willingness to participate in telehealth programmes. Patients are more likely to prefer mobile applications over web-based applications. Social media is widely used by clinicians. Especially younger clinicians use it for personal purposes and for reference materials retrieval. Questions remain on optimal training requirements and on the effects on clinician behavior and on patient outcomes. A high level of e-Health literacy by patients will promote increased adoption and utilization of personal health records. The selected articles highlight the need for training of clinicians to become aware of existing telehealth systems, in order to correctly inform and guide patients to take part in telehealth systems and adopt personal healthcare records (PHR).

  3. Te Rau Hinengaro: the New Zealand Mental Health Survey: overview of methods and findings.

    Science.gov (United States)

    Wells, J Elisabeth; Oakley Browne, Mark A; Scott, Kate M; McGee, Magnus A; Baxter, Joanne; Kokaua, Jesse

    2006-10-01

    To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment. A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months. The response rate was 73.3%. There were 12,992 participants (2,595 Māori and 2,236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need. Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those

  4. A mHealth cardiac rehabilitation exercise intervention: findings from content development studies

    Directory of Open Access Journals (Sweden)

    Pfaeffli Leila

    2012-05-01

    Full Text Available Abstract Background Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based cardiac rehabilitation (CR exercise intervention. Methods An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial. Results 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41 of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85% stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60% showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to

  5. Partnership capacity for community health improvement plan implementation: findings from a social network analysis.

    Science.gov (United States)

    McCullough, J Mac; Eisen-Cohen, Eileen; Salas, S Bianca

    2016-07-13

    Many health departments collaborate with community organizations on community health improvement processes. While a number of resources exist to plan and implement a community health improvement plan (CHIP), little empirical evidence exists on how to leverage and expand partnerships when implementing a CHIP. The purpose of this study was to identify characteristics of the network involved in implementing the CHIP in one large community. The aims of this analysis are to: 1) identify essential network partners (and thereby highlight potential network gaps), 2) gauge current levels of partner involvement, 3) understand and effectively leverage network resources, and 4) enable a data-driven approach for future collaborative network improvements. We collected primary data via survey from n = 41 organizations involved in the Health Improvement Partnership of Maricopa County (HIPMC), in Arizona. Using the previously validated Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) tool, organizations provided information on existing ties with other coalition members, including frequency and depth of partnership and eight categories of perceived value/trust of each current partner organization. The coalition's overall network had a density score of 30 %, degree centralization score of 73 %, and trust score of 81 %. Network maps are presented to identify existing relationships between HIPMC members according to partnership frequency and intensity, duration of involvement in the coalition, and self-reported contributions to the coalition. Overall, number of ties and other partnership measures were positively correlated with an organization's perceived value and trustworthiness as rated by other coalition members. Our study presents a novel use of social network analysis methods to evaluate the coalition of organizations involved in implementing a CHIP in an urban community. The large coalition had relatively low network density but high

  6. Can microcredit help improve the health of poor women? Some findings from a cross-sectional study in Kerala, India

    Directory of Open Access Journals (Sweden)

    Haddad Slim

    2008-01-01

    Full Text Available Abstract Background This study examines associations between female participation in a microcredit program in India, known as self help groups (SHGs, and women's health in the south Indian state of Kerala. Because SHGs do not have a formal health program, this provides a unique opportunity to assess whether SHG participation influences women's health via the social determinants of health. Methods This cross-sectional study used special survey data collected in 2003 from one Panchayat (territorial decentralized unit. Information was collected on women's characteristics, health determinants (exclusion to health care, exposure to health risks, decision-making agency, and health achievements (self assessed health, markers of mental health. The study sample included 928 non elderly poor women. Results The primary finding is that compared to non-participants living in a household without a SHG member, the odds of facing exclusion is significantly lower among early joiners, women who were members for more than 2 years (OR = 0.58, CI = 0.41–0.80, late joiners, members for 2 years and less (OR = 0.60, CI = 0.39–0.94, and non-participants who live in a household with a SHG member (OR = 0.53, CI = 0.32–0.90. We also found that after controlling for key women's characteristics, early joiners of a SHG are less likely to report emotional stress and poor life satisfaction compared to non-members (OR = 0.52, CI = 0.30–0.93; OR = 0.32, CI = 0.14–0.71. No associations were found between SHG participation and self assessed health or exposure to health risks. The relationship between SHG participation and decision-making agency is unclear. Conclusion Microcredit is not a panacea, but could help to improve the health of poor women by addressing certain issues relevant to the context. In Kerala, SHG participation can help protect poor women against exclusion to health care and possibly aid in promoting their mental health.

  7. Educational Health Disparities in Cardiovascular Disease Risk Factors: Findings from Jamaica Health and Lifestyle Survey 2007–2008

    Directory of Open Access Journals (Sweden)

    Trevor S. Ferguson

    2017-05-01

    Full Text Available ObjectivesSocioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity, among Jamaican adults.MethodsWe analyzed data from the Jamaica Health and Lifestyle Survey 2007–2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates.ResultsThe sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p < 0.05 for each group. Prevalence ratios for diabetes among men ranged from 3.3 to 3.5 but were not statistically significant. Age-specific prevalence of hypertension was generally higher among the less educated women, with statistically significant prevalence differences ranging from 6.0 to 45.6 percentage points and prevalence ratios ranging from 2.5 to 4.3. Similarly, estimates for obesity and hypercholesterolemia suggested that prevalence was higher among the less educated younger women (25–39 years and among more educated older

  8. Burden of poor oral health in older age: findings from a population-based study of older British men.

    Science.gov (United States)

    Ramsay, S E; Whincup, P H; Watt, R G; Tsakos, G; Papacosta, A O; Lennon, L T; Wannamethee, S G

    2015-12-29

    Evidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men. Cross-sectional study. A representative sample of men aged 71-92 years in 2010-2012 from the British Regional Heart Study, initially recruited in 1978-1980 from general practices across Britain. Physical examination among 1660 men included the number of teeth, and periodontal disease in index teeth in each sextant (loss of attachment, periodontal pocket, gingival bleeding). Postal questionnaires (completed by 2147 men including all participants who were clinically examined) included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience. Among 1660 men clinically examined, 338 (20%) were edentulous and a further 728 (43%) had 5.5 mm) affecting 1-20% of sites while 303 (24%) had >20% sites affected. The prevalence of gingival bleeding was 16%. Among 2147 men who returned postal questionnaires, 35% reported fair/poor oral health; 11% reported difficulty eating due to oral health problems. 31% reported 1-2 symptoms of dry mouth and 20% reported 3-5 symptoms of dry mouth. The prevalence of edentulism, loss of attachment, or fair/poor self-rated oral health was greater in those from manual social class. These findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Psychological resources as mediators of the association between social class and health: comparative findings from Japan and the USA.

    Science.gov (United States)

    Kan, Chiemi; Kawakami, Norito; Karasawa, Mayumi; Love, Gayle Dienberg; Coe, Christopher L; Miyamoto, Yuri; Ryff, Carol D; Kitayama, Shinobu; Curhan, Katherine B; Markus, Hazel Rose

    2014-02-01

    Recently, researchers have proposed that psychological resources might be key concept in explaining the association between social class and health. However, empirical examinations of the extent to which psychological resources to social class in health are still few. This study investigated mediating effects of selected psychological resources (sense of control, self-esteem, optimism, and neuroticism) on the association of social class [education and subjective social status (SSS)] with current health status (self-rated health and the number of chronic conditions). This sample consisted of 1,805 Americans (818 males and 987 females) from the Midlife in the United States (MIDUS) survey, 2004-2006 and 1,027 Japanese (505 males and 522 females) from the Midlife in Japan (MIDJA) survey in Tokyo, Japan, 2008-2010. Information on social class, psychological resources, and health status was obtained using telephone interviews or written questionnaires. A mediation analysis was conducted separately for males and females in Japan and the USA. Neuroticism significantly mediated the association of education and SSS with self-rated health and chronic conditions among males and females in both countries, with one exception (not for chronic conditions among Japanese females). Sense of control significantly mediated the association of education and SSS with self-rated health among males and females in both countries. As hypothesized, self-esteem significantly mediated almost all of the associations of education and SSS with self-rated health and chronic conditions among men and women in the USA, but very few such associations in Japan. Optimism significantly mediated most associations of social class and health status in both countries, but only among females. Overall, the findings underscore important culture- and gender specificity in the ways in which psychosocial resources mediate the links between social class and health.

  10. Perceived reciprocity in social exchange and health functioning in early old age: prospective findings from the GAZEL study.

    Science.gov (United States)

    Wahrendorf, Morten; Ribet, Celine; Zins, Marie; Goldberg, Marcel; Siegrist, Johannes

    2010-05-01

    To assess prospectively the effects of perceived non-reciprocity of exchange in three different types of social engagement on health functioning in early old age. In the frame of the prospective French GAZEL cohort study, data on reciprocity in three types of role-related social engagement (principal regular activity in everyday life, marital role relationship, trusting relationships in civic life) were collected from 8679 men and 2742 women (mean age: 60.4 years) in 2005. Two years later, health functioning was assessed using the SF-36 mental and physical component scores, as well as self-perceived health. Multivariate regressions were calculated, controlling for important confounders including baseline self-perceived health. Consistent effects of perceived non-reciprocity in all three types of social exchange on mental and physical health functioning were observed. After adjustment for relevant confounders including baseline self-perceived, health effects were attenuated, but largely remained significant. Findings underline the importance of the quality of social exchange (reciprocity vs. non-reciprocity) for health functioning in early old age.

  11. Predicting continuance-findings from a longitudinal study of older adults using an eHealth newsletter.

    Science.gov (United States)

    Forquer, Heather A; Christensen, John L; Tan, Andy S L

    2014-01-01

    While eHealth technologies are promisingly efficient and widespread, theoretical frameworks capable of predicting long-term use, termed continuance, are lacking. Attempts to extend prominent information technology (IT) theories to the area of eHealth have been limited by small sample sizes, cross-sectional designs, self-reported as opposed to actual use measures, and a focus on technology adoption rather than continuance. To address these gaps in the literature, this analysis includes empirical evidence of actual use of an eHealth technology over the course of one year. This large (n = 4,570) longitudinal study focuses on older adults, a population with many health needs and among whom eHealth use may be particularly important. With three measurement points over the course of a year, this study examined the effects of utilitarian and hedonic beliefs on the continued use of an eHealth newsletter using constructs from IT adoption and continuance theories. Additional analyses compared the relative strength of intentions compared to earlier use in predicting later use. Usage intention was strongly predicted by both hedonic beliefs and utilitarian beliefs. In addition, utilitarian beliefs had both direct effects on intention and indirect effects, mediated by hedonic beliefs. While intention predicted subsequent use, earlier use was a significantly stronger predictor of use than intention. These findings make a theoretical contribution to an emerging literature by shedding light on the complex interplay of reasoned action and automaticity in the context of eHealth continuance.

  12. Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology.

    Science.gov (United States)

    van Exel, Job; Baker, Rachel; Mason, Helen; Donaldson, Cam; Brouwer, Werner

    2015-02-01

    Resources available to the health care sector are finite and typically insufficient to fulfil all the demands for health care in the population. Decisions must be made about which treatments to provide. Relatively little is known about the views of the general public regarding the principles that should guide such decisions. We present the findings of a Q methodology study designed to elicit the shared views in the general public across ten countries regarding the appropriate principles for prioritising health care resources. In 2010, 294 respondents rank ordered a set of cards and the results of these were subject to by-person factor analysis to identify common patterns in sorting. Five distinct viewpoints were identified, (I) "Egalitarianism, entitlement and equality of access"; (II) "Severity and the magnitude of health gains"; (III) "Fair innings, young people and maximising health benefits"; (IV) "The intrinsic value of life and healthy living"; (V) "Quality of life is more important than simply staying alive". Given the plurality of views on the principles for health care priority setting, no single equity principle can be used to underpin health care priority setting. Hence, the process of decision making becomes more important, in which, arguably, these multiple perspectives in society should be somehow reflected. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Witness for Wellness: preliminary findings from a community-academic participatory research mental health initiative.

    Science.gov (United States)

    Bluthenthal, Ricky N; Jones, Loretta; Fackler-Lowrie, Nicole; Ellison, Marcia; Booker, Theodore; Jones, Felica; McDaniel, Sharon; Moini, Moraya; Williams, Kamau R; Klap, Ruth; Koegel, Paul; Wells, Kenneth B

    2006-01-01

    Quality improvement programs promoting depression screening and appropriate treatment can significantly reduce racial and ethnic disparities in mental-health care and outcomes. However, promoting the adoption of quality-improvement strategies requires more than the simple knowledge of their potential benefits. To better understand depression issues in racial and ethnic minority communities and to discover, refine, and promote the adoption of evidence-based interventions in these communities, a collaborative academic-community participatory partnership was developed and introduced through a community-based depression conference. This partnership was based on the community-influenced model used by Healthy African-American Families, a community-based agency in south Los Angeles, and the Partners in Care model developed at the UCLA/RAND NIMH Health Services Research Center. The integrated model is described in this paper as well as the activities and preliminary results based on multimethod program evaluation techniques. We found that combining the two models was feasible. Significant improvements in depression identification, knowledge about treatment options, and availability of treatment providers were observed among conference participants. In addition, the conference reinforced in the participants the importance of community mobilization for addressing depression and mental health issues in the community. Although the project is relatively new and ongoing, already substantial gains in community activities in the area of depression have been observed. In addition, new applications of this integrated model are underway in the areas of diabetes and substance abuse. Continued monitoring of this project should help refine the model as well as assist in the identification of process and outcome measures for such efforts.

  14. Health services needs of older persons: emerging findings from Tarakan City, East Kalimantan

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    Rina K. Kusumaratna

    2011-12-01

    Full Text Available As older persons are steadily increasing in number and there are no specialized comprehensive healthcare services for older persons in Indonesia, including East Kalimantan, the aim of the present study was to determine the extent of the problems facing healthcare staff and officials in Tarakan City, East Kalimantan, in providing comprehensive healthcare services attuned to the needs of older persons.This study was a qualitative interview-based survey with focus group discussions, involving heads and healthcare officials of seven puskesmas in Tarakan City, East Kalimantan district, with the addition of a number of district health planning officials. The results revealed a difference between daily hospital referral rate of older persons by puskesmas staff and actual daily hospital admission rate for the referrals. None of the consulted healthcare staff had any speciality education in geriatrics or older persons health. The older persons most frequently presented to the hospital with hypertension, diabetes, and myocardial insufficiency. On the other hand, at the health centers the presenting conditions were hypertension, gastroenteritis, rheumatism, sleep disorders, and upper respiratory tract infections. Improved access to healthcare for older persons should be achieved by improving knowledge and skills of human resources, including communication skills, and of supporting healthcare service infrastructure at puskesmas, specifically oriented towards the needs of and designed for use by older persons, such as ramps for wheelchairs, and handrails in corridors. Local governments should strengthen the appropriate service delivery to older persons, and provide support for the maintenance, sustainability and strengthening of community-based care for older persons.

  15. Health service needs of older persons: emerging findings from Tarakan City, East Kalimantan

    Directory of Open Access Journals (Sweden)

    Rina K. Kusumaratna

    2016-02-01

    Full Text Available As older persons are steadily increasing in number and there are no specialized comprehensive healthcare services for older persons in Indonesia, including East Kalimantan, the aim of the present study was to determine the extent of the problems facing healthcare staff and officials in Tarakan City, East Kalimantan, in providing comprehensive healthcare services attuned to the needs of older persons.This study was a qualitative interview-based survey with focus group discussions, involving heads and healthcare officials of seven puskesmas in Tarakan City, East Kalimantan district, with the addition of a number of district health planning officials. The results revealed a difference between daily hospital referral rate of older persons by puskesmas staff and actual daily hospital admission rate for the referrals. None of the consulted healthcare staff had any speciality education in geriatrics or older persons health. The older persons most frequently presented to the hospital with hypertension, diabetes, and myocardial insufficiency. On the other hand, at the health centers the presenting conditions were hypertension, gastroenteritis, rheumatism, sleep disorders, and upper respiratory tract infections. Improved access to healthcare for older persons should be achieved by improving knowledge and skills of human resources, including communication skills, and of supporting healthcare service infrastructure at puskesmas, specifically oriented towards the needs of and designed for use by older persons, such as ramps for wheelchairs, and handrails in corridors. Local governments should strengthen the appropriate service delivery to older persons, and provide support for the maintenance, sustainability and strengthening of community-based care for older persons.

  16. Achieving organizational change: findings from a case study of health promoting hospitals in Taiwan.

    Science.gov (United States)

    Lee, Chiachi Bonnie; Chen, Michael S; Powell, Michael; Chu, Cordia Ming-Yeuk

    2014-06-01

    The Taiwanese Network of Health Promoting Hospitals (HPH) has been in place since 2006 and developing rapidly. The criticism of inadequate evaluation of the HPH approach taken elsewhere also holds true for the Taiwan HPH Network. Organizational change is a key to sustainable and effective health promotion, and it is also an important aspect in the European HPH movement. Therefore, this study aims to evaluate changes in organizational capacity for the implementation of HPH in Taiwan. All 55 HPH coordinators were invited to participate in the study, and 52 of them completed the questionnaires. The survey covered seven dimensions of HPH organizational capacity, and a total score of each dimension was calculated and converted to a figure on a scale of 10. This study has shown that HPH made a positive impact on HP hospitals in Taiwan regarding organizational change in capacity building for HPH. Leadership, organization culture and mission and strategy received the top three highest mean scores (8.19 ± 1.25, 8.08 ± 1.39, 7.99 ± 1.42), while staff participation received the lowest score (7.62 ± 1.26). The high level of organizational change was associated with the high satisfaction levels of organizational support from the viewpoint of the HPH coordinators. Based on a cluster analysis, a majority of the HP hospitals in Taiwan seemed to have adopted the addition model in putting the HPH initiative into practice; a few hospitals appeared to have accepted HPH initiative well through the integration model. These results presented evidence that HPH contributed to organizational capacity building of hospitals for health promotion.

  17. Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review

    Directory of Open Access Journals (Sweden)

    Asha S. George

    2016-11-01

    Full Text Available Abstract Background Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs. Methods We searched for journal articles published between 2000 and 2012 related to the concepts of “community”, “capability/participation”, “health systems research” and “LMIC.” We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. Results When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community

  18. Milk Donation Awareness of Parents, Health Workers and Lactation Consultants: Survey Findings

    OpenAIRE

    Olga L. Lukoyanova; Tatyana E. Borovik; Irina A. Belyaeva; Leyla S. Namazova-Baranova; Galina V. Yatsyk; Elena V. Shepkina; Ulyana M. Lebedeva; Vladimir I. Phurtsev; Yakov Ya. Yakovlev; Lyudmila N. Sophronova; Liliana A. Dautova; Olga V. Nodvikova; Anna L. Karpova; Nonna V. Klyueva

    2016-01-01

    Background. Today, in Russia there is no practice of using donor milk in hospitals, while abroad it is a common technique of caring for premature and low-weight infants.Objective: Our aim was to study the milk donation awareness of parents of children under the age of 1, health workers and lactation consultants.Methods. A sample survey was carried out.Results. The study involved 2,332 respondents from 13 medical institutions in 11 cities and towns located in 6 federal districts of the Russian...

  19. Food poverty and health among schoolchildren in Ireland: findings from the Health Behaviour in School-aged Children (HBSC) study.

    Science.gov (United States)

    Molcho, Michal; Gabhainn, Saoirse Nic; Kelly, Colette; Friel, Sharon; Kelleher, Cecily

    2007-04-01

    To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren. Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland. A total of 8424 schoolchildren (aged 10-17 years) from 176 schools, with an 83% response rate from children. Food poverty was found to be similarly distributed among the three social classes (15.3% in the lower social classes, 15.9% in the middle social classes and 14.8% in the higher social classes). It was also found that schoolchildren reporting food poverty are less likely to eat fruits, vegetables and brown bread, odds ratio (OR) from 0.66 (95% confidence interval (CI) 0.45-0.87) to 0.81 (95% CI 0.63-0.99); more likely to eat crisps, fried potatoes and hamburgers, OR from 1.20 (95% CI 1.00-1.40) to 1.62 (95% CI 1.39-1.85); and more likely to miss breakfast on weekdays, OR from 1.29 (95% CI 0.33-1.59) to 1.72 (95% CI 1.50-1.95). The risk of somatic and mental symptoms is also increased, OR from 1.48 (95% CI 1.18-1.78) to 2.57 (95% CI 2.33-2.81); as are negative health perceptions, OR from 0.63 (95% CI 0.43-0.83) to 0.52 (95% CI 0.28-0.76) and measures of life dissatisfaction, OR from 1.88 (95% CI 1.64-2.12) to 2.25 (95% CI 2.05-2.45). Similar results were found for life dissatisfaction in an international comparison of 32 countries. All analyses were adjusted for age and social class. Food poverty in schoolchildren is not restricted to those from lower social class families, is associated with a substantial risk to physical and mental health and well-being, and requires the increased attention of policy makers and practitioners.

  20. Dental caries in Uruguayan adults and elders: findings from the first Uruguayan National Oral Health Survey.

    Science.gov (United States)

    Álvarez, Licet; Liberman, Judith; Abreu, Soledad; Mangarelli, Carolina; Correa, Marcos B; Demarco, Flávio Fernando; Lorenzo, Susana; Nascimento, Gustavo G

    2015-08-01

    This study aimed to assess dental caries status and associated factors in Uruguayan adults and elders using data from the first Uruguayan National Oral Health Survey. Data were representative of the country as a whole. Socio-demographic information was collected with a closed questionnaire. Dental caries was assessed by clinical examination using the DMFT index. The final sample consisted of 769 participants. Mean DMFT was 15.20 and 24.12 for the 35-44 and 65-74-year age groups, respectively. Mean number of decayed teeth was 1.70 in adults and 0.66 in elders. Multivariate analyses showed higher prevalence of dental caries associated with age 65-74 years, low socioeconomic status, use of public dental services, presence of gingivitis; for decayed teeth, age 35-44 years, low socioeconomic status, use of public dental services, infrequent tooth brushing, need for oral health care, and presence of root caries showed higher severity. Uruguayan adults and elders from disadvantaged backgrounds concentrated a heavier burden of dental caries.

  1. Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam.

    Science.gov (United States)

    Salmon, Sharon; McLaws, Mary-Louise

    2015-10-01

    It is accepted by hospital clinical governance that every clinician's "duty of care" includes hand hygiene, yet globally, health care workers (HCWs) continue to struggle with compliance. Focus group discussions were conducted to explore HCWs' barriers to hand hygiene in Vietnam. Twelve focus group discussions were conducted with HCWs from 6 public hospitals across Hanoi, Vietnam. Discussions included participants' experiences with and perceptions concerning hand hygiene. Tape recordings were transcribed verbatim and then translated into English. Thematic analysis was conducted by 2 investigators. Expressed frustration with high workload, limited access to hand hygiene solutions, and complicated guidelines that are difficult to interpret in overcrowded settings were considered by participants to be bona fide reasons for noncompliance. No participant acknowledged hand hygiene as a duty of care practice for her or his patients. Justification for noncompliance was the observation that visitors did not perform hand hygiene. HCWs did acknowledge a personal duty of care when hand hygiene was perceived to benefit her or his own health, and then neither workload or environmental challenges influenced compliance. Limited resources in Vietnam are amplified by overcrowded conditions and dual bed occupancy. Yet without a systematic systemic duty of care to patient safety, changes to guidelines and resources might not immediately improve compliance. Thus, introducing routine hand hygiene must start with education programs focusing on duty of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Finding Resolution for the Responsible Transparency of Economic Models in Health and Medicine.

    Science.gov (United States)

    Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

    2017-11-01

    The Second Panel on Cost-Effectiveness in Health and Medicine recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses has a number of questions unanswered with respect to the implementation of transparent, open source code interface for economic models. The possibility of making economic model source code could be positive and progressive for the field; however, several unintended consequences of this system should be first considered before complete implementation of this model. First, there is the concern regarding intellectual property rights that modelers have to their analyses. Second, the open source code could make analyses more accessible to inexperienced modelers, leading to inaccurate or misinterpreted results. We propose several resolutions to these concerns. The field should establish a licensing system of open source code such that the model originators maintain control of the code use and grant permissions to other investigators who wish to use it. The field should also be more forthcoming towards the teaching of cost-effectiveness analysis in medical and health services education so that providers and other professionals are familiar with economic modeling and able to conduct analyses with open source code. These types of unintended consequences need to be fully considered before the field's preparedness to move forward into an era of model transparency with open source code.

  3. Internet interventions for mental health and addictions: current findings and future directions.

    Science.gov (United States)

    Cunningham, John A; Gulliver, Amelia; Farrer, Lou; Bennett, Kylie; Carron-Arthur, Bradley

    2014-12-01

    Over the last several years, there has been a substantial increase in the number of publications reporting on Internet interventions for mental health and addictions. This paper provides a summary of the recent research on Internet interventions for the most common mental health and addictions concerns-depression, anxiety, alcohol and smoking. There is considerable evidence for the effectiveness of Internet-based interventions targeting depression, anxiety disorders, alcohol use and smoking. Small to moderate effect sizes have been reported for interventions targeting depression, anxiety and alcohol use, and smoking interventions have shown large effects. The addition of human support to depression and anxiety interventions has generally resulted in larger treatments effects, but this trend has not been observed in trials of interventions targeting alcohol use. There is some evidence that online interventions can be as effective as face-to-face therapies, at least for anxiety disorders. Despite a proliferation of research activity in this area, gaps in knowledge remain. Future research should focus on the development and evaluation of interventions for different platforms (e.g. smartphone applications), examining the long-term impacts of these interventions, determining active intervention components and identifying methods for enhancing tailoring and engagement. Careful consideration should be given to the ongoing technical and clinical expertise required to ensure that Internet interventions are delivered safely and professionally in a rapidly changing technology environment.

  4. Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

    Science.gov (United States)

    Vogel, J P; Souza, J P; Mori, R; Morisaki, N; Lumbiganon, P; Laopaiboon, M; Ortiz-Panozo, E; Hernandez, B; Pérez-Cuevas, R; Roy, M; Mittal, S; Cecatti, J G; Tunçalp, Ö; Gülmezoglu, A M

    2014-03-01

    We aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications. Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS). A total of 359 participating facilities in 29 countries. A total of 308 392 singleton deliveries. We reported on perinatal indicators and determined risks of perinatal death in the presence of severe maternal complications (haemorrhagic, infectious, and hypertensive disorders, and other medical conditions). Fresh and macerated LFDs (defined as stillbirths ≥ 1000 g and/or ≥28 weeks of gestation) and ENDs. The LFD rate was 17.7 per 1000 births; 64.8% were fresh stillbirths. The END rate was 8.4 per 1000 liveborns; 67.1% occurred by day 3 of life. Maternal complications were present in 22.9, 27.7, and 21.2% [corrected] of macerated LFDs, fresh LFDs, and ENDs, respectively. The risks of all three perinatal mortality outcomes were significantly increased with placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, and severe anaemia. Preventing intrapartum-related perinatal deaths requires a comprehensive approach to quality intrapartum care, beyond the provision of caesarean section. Early identification and management of women with complications could improve maternal and perinatal outcomes. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  5. UK health performance: findings of the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Murray, Christopher J L; Richards, Michael A; Newton, John N; Fenton, Kevin A; Anderson, H Ross; Atkinson, Charles; Bennett, Derrick; Bernabé, Eduardo; Blencowe, Hannah; Bourne, Rupert; Braithwaite, Tasanee; Brayne, Carol; Bruce, Nigel G; Brugha, Traolach S; Burney, Peter; Dherani, Mukesh; Dolk, Helen; Edmond, Karen; Ezzati, Majid; Flaxman, Abraham D; Fleming, Tom D; Freedman, Greg; Gunnell, David; Hay, Roderick J; Hutchings, Sally J; Ohno, Summer Lockett; Lozano, Rafael; Lyons, Ronan A; Marcenes, Wagner; Naghavi, Mohsen; Newton, Charles R; Pearce, Neil; Pope, Dan; Rushton, Lesley; Salomon, Joshua A; Shibuya, Kenji; Vos, Theo; Wang, Haidong; Williams, Hywel C; Woolf, Anthony D; Lopez, Alan D; Davis, Adrian

    2013-03-23

    The UK has had universal free health care and public health programmes for more than six decades. Several policy initiatives and structural reforms of the health system have been undertaken. Health expenditure has increased substantially since 1990, albeit from relatively low levels compared with other countries. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to examine the patterns of health loss in the UK, the leading preventable risks that explain some of these patterns, and how UK outcomes compare with a set of comparable countries in the European Union and elsewhere in 1990 and 2010. We used results of GBD 2010 for 1990 and 2010 for the UK and 18 other comparator nations (the original 15 members of the European Union, Australia, Canada, Norway, and the USA; henceforth EU15+). We present analyses of trends and relative performance for mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE). We present results for 259 diseases and injuries and for 67 risk factors or clusters of risk factors relevant to the UK. We assessed the UK's rank for age-standardised YLLs and DALYs for their leading causes compared with EU15+ in 1990 and 2010. We estimated 95% uncertainty intervals (UIs) for all measures. For both mortality and disability, overall health has improved substantially in absolute terms in the UK from 1990 to 2010. Life expectancy in the UK increased by 4·2 years (95% UI 4·2-4·3) from 1990 to 2010. However, the UK performed significantly worse than the EU15+ for age-standardised death rates, age-standardised YLL rates, and life expectancy in 1990, and its relative position had worsened by 2010. Although in most age groups, there have been reductions in age-specific mortality, for men aged 30-34 years, mortality rates have hardly changed (reduction of 3·7%, 95% UI 2·7-4·9). In terms of premature

  6. Low control beliefs in relation to school dropout and poor health: findings from the SIODO case-control study.

    Science.gov (United States)

    Bosma, Hans; Theunissen, Marie-José; Verdonk, Petra; Feron, Frans

    2014-11-28

    There is cumulating evidence that health is compromised through adverse socioeconomic conditions negatively affecting how people think, feel, and behave. Low control beliefs might be a key mechanism. The reversed possibility that low control beliefs might set people on a pathway towards adverse socioeconomic and health-related outcomes is much less examined. A case-control design was used, consisting of 330 cases who dropped out of school in the 2010-2011 school year and 330 controls who still attended school at the end of that year. The respondents, aged between 18 and 23, came from Eindhoven and surrounding areas in the south-east of The Netherlands. A questionnaire asked for current health status, recalled socioeconomic and social background, and recalled control beliefs (mastery and general self-efficacy). Logistic regression analyses were used. Recalls of low mastery and low self-efficacy were strongly related to both dropout and less than good health. Low socioeconomic background was also associated to odds of dropout, but did not confound or moderate the associations of low control beliefs with dropout and health. Odds ratios of dropout and less than good health indicated at least twice the odds of a poor outcome with recalls of low control beliefs. Independent of the socioeconomic background, low control beliefs are related to heightened odds of both poor health and school dropout. Individual differences in control beliefs might thus be as fundamental as socioeconomic conditions in generating life-course socioeconomic and health-related pathways. Although the findings should first be cross-validated in prospective studies, public health professionals working with youth might already start considering early interventions in youth with all too fatalistic and powerless mind-sets.

  7. Health-related job loss: findings from a community-based survey.

    Science.gov (United States)

    Solomon, Christine; Poole, Jason; Palmer, Keith T; Coggon, David

    2007-03-01

    To explore the frequency, nature, determinants and outcome of health-related job loss (HRJL) in men sampled from the general population of three rural areas. Data on lifetime occupational history, including any HRJL, were obtained as part of a postal survey of men aged 24-70 years in three rural areas of England and Wales. Incidence rates were calculated for first health-related loss of a job that had been held for >or=1 year. Associations with risk factors were examined by Poisson regression, and by application of conditional logistic regression in a nested case-control study. HRJL was reported by 1408 (13%) of the 10 559 men who had held long-term jobs. The incidence rose steeply with age for cardiorespiratory and neurological disorders, but for accidents and poisoning the trend was, if anything, in the reverse direction. An increase in incidence over time was most marked for musculoskeletal disorders and mental illness, and much less prominent for cardiorespiratory and neurological disease. In comparison with other occupations, the risk was lower in agricultural workers (odds ratio (OR) 0.6, 95% CI 0.5 to 0.8), and higher in policemen (OR 2.4, 95% CI 1.6 to 3.7) and teachers (OR 2.0, 95% CI 1.5 to 2.7), this differential being even greater for HRJL caused by mental illness. Risk was also increased in employees relative to the self-employed (OR 2.0, 95% CI 1.7 to 2.3). Shift work was associated with a higher incidence of job loss caused by mental illness (OR 1.5, 95%CI 1.1-2.2), and heavy lifting with HRJL caused by musculoskeletal disorders (OR 2.6, 95% CI 2.0 to 3.5). After HRJL, 61% of subjects had subsequently obtained further long-term employment, usually within 1 year. In the population studied, HRJL has become increasingly common, especially in relation to musculoskeletal disorders and mental illness. In addition to being associated with ergonomic stresses in the workplace, it may be importantly influenced by cultural and economic factors. Future research

  8. Assessing health-related resiliency in HIV+ Latin women: Preliminary psychometric findings.

    Directory of Open Access Journals (Sweden)

    Gladys J Jimenez-Torres

    Full Text Available HIV-associated vulnerabilities-especially those linked to psychological issues-and limited mental health-treatment resources have the potential to adversely affect the health statuses of individuals. The concept of resilience has been introduced in the literature to shift the emphasis from vulnerability to protective factors. Resilience, however, is an evolving construct and is measured in various ways, though rarely among underserved, minority populations. Herein, we present the preliminary psychometric properties of a sample of HIV-seropositive Puerto Rican women, measured using a newly developed health-related resilience scale.The Resilience Scales for Children and Adolescents, an instrument with solid test construction properties, acted as a model in the development (in both English and Spanish of the HRRS, providing the same dimensions and most of the same subscales. The present sample was nested within the Hispanic-Latino longitudinal cohort of women (HLLC, that is part of the NeuroAIDS Research Program at the University of Puerto Rico (UPR, Medical Sciences Campus (MSC. Forty-five consecutively recruited, HIV+ women from the HLLC completed a demographic survey, the HRRS, and the Beck Depression Inventory-I, Spanish version.The results demonstrate excellent overall internal consistency for the total HRRS score (α = 0.95. Each of the dimensional scores also evidenced acceptable internal consistency (α ≥ 0.88. All the dimensional and subscale content validity indices were above the 0.42 cut-off. Analysis revealed a significant negative correlation between the HRRS total score and BDI-I-S (r(45 = -0.453, p < 0.003.Albeit preliminary in nature, the present study provides support for the HRRS as a measure to assess resilience among individuals living with chronic medical conditions. Minority populations, especially non-English speaking ones, are understudied across the field of medicine, and when efforts are made to include these patient

  9. Milk Donation Awareness of Parents, Health Workers and Lactation Consultants: Survey Findings

    Directory of Open Access Journals (Sweden)

    Olga L. Lukoyanova

    2016-01-01

    Full Text Available Background. Today, in Russia there is no practice of using donor milk in hospitals, while abroad it is a common technique of caring for premature and low-weight infants.Objective: Our aim was to study the milk donation awareness of parents of children under the age of 1, health workers and lactation consultants.Methods. A sample survey was carried out.Results. The study involved 2,332 respondents from 13 medical institutions in 11 cities and towns located in 6 federal districts of the Russian Federation, including 1,134 mothers, 413 fathers, 692 health workers, and 93 lactation consultants. 1,007 (65.1% parents (mothers and fathers and 541 (68.9% specialists (health workers and lactation consultants believe that feeding of a sick newborn with donor milk is useful in the absence of breast milk. Only 609 (39.4% parents and 363 (46.2% professionals would agree to use donor milk for their children in the absence or lack of mother’s milk. Only 1/3 of the respondents — 560 (36.2% parents and 259 (33.0% professionals — believe that donor milk is safe. 565 (36.5% parents and 475 (60.5% professionals have heard something about breast milk banks and 1,013 (65.5% parents and 449 (57.2% professionals believe that the establishment of such banks is reasonable. Most of the mothers (830; 73.2% involved in the study would agree to become breast milk donors, and 219 (53% fathers would approve their wives’ decision to become donors.Conclusion. The study has revealed low respondents’ awareness of the use and safety of donor milk. However, most of the mothers are willing to become breast milk donors. More than half of the parents and professionals involved in the study believe that it is reasonable to create milk banks.

  10. Pagers, Smartphones, and HIPAA: Finding the Best Solution for Electronic Communication of Protected Health Information.

    Science.gov (United States)

    Freundlich, Robert E; Freundlich, Katherine L; Drolet, Brian C

    2017-11-25

    Electronic communication is a topic that applies broadly to the professional activities of every physician and the pager has been the gold standard of communication for decades. We believe that this is a dated technology that is holding clinicians back from better, more efficient alternatives, particularly smartphones. In this manuscript, we examine the paradoxical reliance on pagers in academic medicine, at a time when the use of smartphones and text messaging is the subject of intense scrutiny with respect to its standing under the Health Insurance Portability and Accountability Act (HIPAA). We provide previously unreported data regarding the electronic communication practices of academic medical centers in the United States, which we obtained through a survey of Designated Institutional Officials. These data highlight both the controversy around text messaging and HIPAA and a puzzling widespread reliance on pagers as an alternative.

  11. Screen time in Mexican children: findings from the 2012 National Health and Nutrition Survey (ENSANUT 2012).

    Science.gov (United States)

    Janssen, Ian; Medina, Catalina; Pedroza, Andrea; Barquera, Simón

    2013-01-01

    To provide descriptive information on the screen time levels of Mexican children. 5 660 children aged 10-18 years from the 2012 National Health and Nutrition Survey (ENSANUT 2012) were studied. Screen time (watching television, movies, playing video games and using a computer) was self-reported. On average, children engaged in 3 hours/day of screen time, irrespective of gender and age. Screen time was higher in obese children, children from the northern and Federal District regions of the country, children living in urban areas, and children in the highest socioeconomic status and education categories. Approximately 33% of 10-14 year olds and 36% of 15-18 year olds met the screen time guideline of ≤ 2 hours/day. 10-18 year old Mexican children accumulate an average of 3 hours/day of screen time. Two thirds of Mexican children exceed the recommended maximal level of time for this activity.

  12. Oral health status in Sichuan Province: findings from the oral health survey of Sichuan, 2015–2016

    Science.gov (United States)

    Yin, Wei; Yang, Ying-Ming; Chen, Hong; Li, Xue; Wang, Zhuo; Cheng, Li; Yin, Qiu-Dan; Fang, Hong-Zhi; Fei, Wei; Mi, Fang-Lin; Nie, Min-Hai; Hu, Tao; Zhou, Xue-Dong

    2017-01-01

    To investigate oral health status in the residents of Sichuan Province, southwest China, a cross-sectional study was performed using the latest Oral Health Survey Basic Methods recommended by the World Health Organization. A multistage stratified random cluster-sampling method was used to enroll participants from the following three groups: children aged 3–5 years, adolescents aged 12 years, and people aged 65–74 years. In these three groups, the mean numbers of teeth that were affected by caries were 3.28, 0.86 and 5.13, respectively, resulting in a prevalence of 63.47%, 37.20% and 83.20%, respectively. Relative to the high rate of decayed teeth, the prevalence of fillings was very low in all age groups (0.97%, 7.24% and 5.43%, respectively). In the 12-year-old adolescent group, only 3.61% had good pit and fissure sealing. In addition, the rate of dental fluorosis was 24.80%, and the Community Fluorosis Index value was 0.39. In the elder group, the community periodontal index was 2.92. The prevalence in the elderly of having lost at least one tooth was 75.54%. Additionally, 4.44% of these participants were edentulous. The incidence of dental prosthesis was 51.75%, the proportion with a removable partial denture, a fixed denture, full dentures, dental implants and an informal fixed bridge was 21.59%, 11.45%, 4.64%, 0 and 16.67%, respectively. In this study, 8.2% of the elderly participants were affected by different types of oral mucosal lesions. Among such lesions, recurrent aphthous ulcers were most prevalent (2.69%) and oral lichen planuses were second (1.6%). The conclusion presented in this survey is that oral diseases, especially dental caries and periodontal disease, are frequent and common in Sichuan province, China. Moreover, the treatment rate is very low, and primary prevention and treatment options are therefore urgently needed in this population. PMID:28358035

  13. Cigarette smoking risk-reducing beliefs: Findings from the United States Health Information National Trends Survey.

    Science.gov (United States)

    Kaufman, Annette R; Coa, Kisha I; Nguyen, Anh B

    2017-09-01

    Cigarette smoking risk-reducing beliefs are ideas that certain health promoting behaviors (e.g., exercise) may mitigate the risks associated with smoking. The objective of this study was to describe smoking risk-reducing beliefs and the belief that quitting can reduce the harmful effects of smoking among the U.S. adult population and the associations between these beliefs, current smoking status, and sociodemographics. Data were from the Health Information National Trends Survey 4 (HINTS 4) Cycles 3 and 4 (2013-2014; N=6862). Descriptive analyses were conducted to examine bivariate associations among the quit smoking belief, smoking risk-reducing beliefs, and covariates. Weighted ordinal logistic regression models examined the adjusted associations between smoking status and sociodemographics, with quit smoking belief and risk-reducing beliefs. Eighty-two percent of the population reported that quitting cigarette smoking can help reduce the harmful effects of smoking a lot: former smokers and individuals with higher educational attainment were more likely to endorse this belief than never smokers and those with lower educational attainment. Many people endorsed smoking risk-reducing beliefs about exercise (79.3%), fruits and vegetables (71.8%), vitamins (67.2%), and sleep (68.5%). Former smokers were less likely to subscribe to these beliefs than never smokers. Vulnerable populations who may be most at risk of smoking attributable morbidity and mortality were more likely to endorse risk-reducing beliefs. Future studies are needed to better understand how risk-reducing beliefs are formed and if modifying these beliefs may help to reduce cigarette smoking in the U.S. Published by Elsevier Inc.

  14. Vitamin D status of refugees arriving in Canada: findings from the Calgary Refugee Health Program.

    Science.gov (United States)

    Aucoin, Michael; Weaver, Rob; Thomas, Roger; Jones, Lanice

    2013-04-01

    To determine the 25-hydroxyvitamin D (25[OH]D) serum levels in refugee women of childbearing age and in refugee children; to compare their 25(OH)D levels with the recommended levels in order to determine the prevalence of deficiency; to compare their 25(OH)D levels with those in the general Canadian population in the appropriate age and sex groups; and to investigate the association of vitamin D deficiency with potential risk factors. Cross-sectional chart review. The Calgary Refugee Health Program, an urban family practice that serves newly arrived refugees in Calgary, Alta. A total of 1217 refugee women and children screened between June 2005 and January 2010. Serum 25(OH)D values that were measured during initial screening visits. Overall, 1217 of the 1768 eligible participants (69%) had 25(OH)D laboratory values recorded. The mean concentration of 25(OH)D was 52.0 nmol/L (95% CI 50.6 to 53.3 nmol/L). Using the Institute of Medicine guideline for adequate serum vitamin D levels (>50 nmol/L), 61% of women and 42% of children had lower-than-desirable 25(OH)D levels. Considering the Osteoporosis Canada guidelines, 88% of women and 81% of children had lower-than-desirable 25(OH)D levels (refugees between the ages of 12 and 19 years old had lower mean values of 25(OH)D than male refugees in the same age group did (P=.01). Most refugees had lower-than-desirable vitamin D levels. All age groups studied had lower mean 25(OH)D levels compared with the general Canadian population. Health care providers should be aware of this concern and consider vitamin D supplementation among refugees.

  15. Asthma outcomes in children and adolescents with multiple morbidities: Findings from the National Health Interview Survey.

    Science.gov (United States)

    Patel, Minal R; Leo, Harvey L; Baptist, Alan P; Cao, Yanyun; Brown, Randall W

    2015-06-01

    More Americans are managing multiple chronic conditions (MCCs), and trends are particularly alarming in youth. The purpose of this study was to examine the prevalence and distribution of 9 chronic conditions in children and adolescents with and without asthma, and adverse asthma outcomes associated with having MCCs. Cross-sectional interview data from the National Health Interview Survey were analyzed (N = 66,790) between 2007 and 2012 in youth 0 to 17 years of age. Bivariate analysis methods and multivariate generalized linear regression were used to examine associations. Five percent of children with asthma had 1 or more coexisting health conditions. The prevalence of 1 or more comorbidities was greater among those with asthma than those without (5.07% [95% CI: 4.5-5.6] vs. 2.73% [95% CI: 2.6-2.9]). Those with asthma were twice as likely to have co-occurring hypertension (prevalence ratio [PR] = 2.2 [95% CI: 1.5-3.2]) and arthritis (PR = 2.7 [95% CI: 1.8-4.0]) compared with those without asthma. Every additional chronic condition with asthma was associated with a greater likelihood of an asthma attack (PR = 1.1 [95% CI: 1.0-1.2]), all-cause emergency department visits (PR = 1.3 [95% CI: 1.1-1.5]), and missed school days (PR = 2.3 [95% CI: 1.7-3.2]). Children and adolescents with asthma in the US who suffer from MCCs have increased asthma symptoms, missed school days, and all-cause emergency department visits. Further research on optimal management strategies for this group is needed. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Women's health, equality and empowerment in tobacco farming - findings from two counties in Yunnan, China

    Directory of Open Access Journals (Sweden)

    Weilin Jie

    2018-03-01

    Full Text Available Background Research takes place in Yunnan, the most important tobacco producing province in China, to gather empirical evidence of women´s role in tobacco farming. Methods Research adopts mixed methods. Quantitative data was collected with structured questionnaire while qualitative data was obtained through individual interviews and focus group discussions. Participatory research method was employed as well in order to better understand the workload of women. Due to sensitivity of tobacco control in Yunnan, respondents had to be reached through personal contacts. Thus a convenience sampling method was used. The information was collected from a sample of 436 female tobacco farmers in two counties in October - November 2015. Results Women spend 50% of working hours on tobacco farming. In tobacco farming season, women work 16+ hours a day and on average they spend 2-3 hours more than their husbands on tobacco farming. 50.1% of respondents had to hire temporary help and 58.0% had to exchange labour (without pay with neighbours / relatives for tobacco farming. 62.4% of respondents borrowed money for tobacco farming. The average income from tobacco farming is US$1,490, accounting for about 26-35% of the household income. Respondents experienced discomforts while growing and picking tobacco leaf, but did not associate these discomforts with tobacco farming. 50.5% of respondents were not aware of negative health effect of tobacco farming. There is no mechanism or entity representing tobacco farmers to bargain with the tobacco corporation. Instead, farmers lost autonomy over farming activity under the pressure of both government and tobacco corporation. Women are even more vulnerable because they rarely participate in decision making at community and above levels although they have significant power over family finance and household farming activity.. Conclusions Being at the bottom of exploitation chain, women lack awarness, knowledge, resource and

  17. Prevalence of Breastfeeding: Findings from the First Health Service Household Interview in Hunan Province, China

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    Hong Qin

    2017-02-01

    Full Text Available Background: With the development of economy and urbanization, methods of child-feeding have significantly changed in China over the past three decades. However, little is known about breastfeeding in China since 2009. This study aims to update information on the prevalence of breastfeeding in China. Methods: Data were obtained from the first Health Service Household Interview Survey of Hunan Province, China. Of 24,282 respondents, 1659 were aged five years or younger. We ran multivariable logistic regression to examine the impact of urban/rural setting, gender, age and household income per capita on the use of breastfeeding. Results: A total of 79.4% of children aged 5 years or younger had been breastfed at some point and 44.9% been breastfed exclusively in the first 6 months of life. After controlling for setting urban/rural setting, gender and child age, children from households with average family income were more likely to be breastfed than those from households with the lowest family income (adjusted odds ratio: 2.28. Children from households with higher and the highest family income were less likely to be exclusively breastfed in the first 6 months of life compared to those from households with the lowest family income (adjusted odds ratio: 0.51 and 0.68, respectively. Conclusions: It is encouraging that the prevalence of exclusive breastfeeding for infants in the first 6 months of life in Hunan Province, China is approaching the goal of 50% proposed by the World Health Organization (WHO. Nevertheless, more efforts are needed to further promote exclusive breastfeeding in the first 6 months after birth.

  18. Distribution of major health risks: findings from the Global Burden of Disease study.

    Directory of Open Access Journals (Sweden)

    Anthony Rodgers

    2004-10-01

    Full Text Available Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness.For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median.Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden.

  19. Diabetes and hypertension: public awareness and lifestyle-findings of a health mela

    International Nuclear Information System (INIS)

    Rafique, G.; Khuwaja, A.K.

    2003-01-01

    Objective: To determine the frequencies of diabetes, hypertension and their established lifestyle risk factors and to assess the level of awareness about diabetes and hypertension amongst persons attending a health mela at the Aga Khan University Hospital (AKUH), Karachi. Subjects and methods: A total of 264 participants were administered structured questionnaire to obtain demographic data and perceptions about diabetes and hypertension after taking verbal informed consent. Height, weight, blood pressure and random blood glucose were measured. Results: Overall frequency of type-2 diabetes was 13.5%, impaired glucose tolerance (IGT) 8.3% and hypertension 24%. Frequency of diabetes and hypertension in both men and women increased with increasing age (p< .001) and body mass index (p=0.02). Over half the men and women with type 2 diabetes (53% and 57% respectively) and 42% men and 60% women with IGT also had hypertension. Diabetes and hypertension were correctly defined by 52% and 37% subjects respectively and this was significantly associated with educational level (p=.001). Lack of physical exercise was observed in 59% participants, while 53.6% men and 67.5% women were overweight/obese. As compared to women, men used more additional salt (p = 0.03) and had more outside meals (p<0.001) and lack of physical exercise was observed in 59% participants, while 53.6% men and 67% women were overweight/obese. As compared to women, men used more additional salts (p=0.03) and had a more outside meals (p<0.001) and snacks (p=0.01). Conclusion: High frequencies of diabetes, hypertension, obesity, unhealthy nutrition and lack of exercise were observed in the study population. Emphasis on health education is needed to increase public awareness of the warming signs and risk factors of these common conditions. (author)

  20. Racial and Ethnic Differences in Tobacco Information Seeking and Information Sources: Findings From the 2015 Health Information National Trends Survey.

    Science.gov (United States)

    Nguyen, Anh B; Robinson, Joelle; O'Brien, Erin Keely; Zhao, Xiaoquan

    2017-09-01

    This article describes sources of health information, types of tobacco information sought, and trust in sources of tobacco information among U.S. racial/ethnic groups (Whites, Blacks, Hispanics, Asian and Pacific Islanders, and Other). Cross-sectional data (N = 3,788) from a nationally representative survey, HINTS-FDA 2015, were analyzed to examine unadjusted and adjusted associations between race/ethnicity and (a) first source of health information, (b) tobacco information seeking, and (c) trust in sources of tobacco information. Adjusted associations controlled for current tobacco product use and sociodemographic variables. Findings indicated that the Internet was the most common first source of health information while health care providers were the second most common source for all racial/ethnic groups. Tobacco-related health information seeking was more prevalent than other tobacco product information seeking. Unadjusted analyses indicated that a higher proportion of Whites sought other tobacco product information compared to Asians and Pacific Islanders. Trust was rated highest for doctors while trust for health organizations was rated second highest. Asians and Pacific Islanders had higher trust in the government compared to all other groups. Blacks had higher trust in religious organizations compared to all other groups besides Hispanics. Blacks had higher trust for tobacco companies compared to Whites and Other. Many of these differences were attenuated in adjusted analyses. This research has implications for tobacco control practice and policymaking by identifying potential dissemination strategies.

  1. Predictors of experiences of discrimination and positive treatment in people with mental health problems: findings from an Australian national survey.

    Science.gov (United States)

    Reavley, Nicola J; Morgan, Amy J; Jorm, Anthony F

    2017-03-01

    The aim of the study was to assess the factors predicting experiences of avoidance, discrimination and positive treatment in people with mental health problems. In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered experiences of avoidance, discrimination and positive treatment by friends, spouse, other family, workplace, educational institution and others in the community; as well as disclosure of mental health problems. Avoidance, discrimination and positive treatment scores were calculated by counting the number of domains in which each occurred. Predictors of avoidance, discrimination and positive treatment were modelled with negative binomial regression analyses. After adjusting for the effects of other predictors in multivariate analyses, symptom severity and a diagnosis of 'any other disorder' (most commonly psychotic disorders or eating disorders) predicted experiences of both avoidance and discrimination but not positive treatment. Disclosing a mental health problem in more settings was also associated with higher rates of avoidance and discrimination, but also with positive treatment. Disclosure of mental health problems to others may increases experiences of discrimination, but may also increase experiences of positive treatment. These findings can help to inform decision making by people with mental health problems about disclosure, particularly in the case of more severe or low-prevalence disorders.

  2. Public health impacts of city policies to reduce climate change: findings from the URGENCHE EU-China project.

    Science.gov (United States)

    Sabel, Clive E; Hiscock, Rosemary; Asikainen, Arja; Bi, Jun; Depledge, Mike; van den Elshout, Sef; Friedrich, Rainer; Huang, Ganlin; Hurley, Fintan; Jantunen, Matti; Karakitsios, Spyros P; Keuken, Menno; Kingham, Simon; Kontoroupis, Periklis; Kuenzli, Nino; Liu, Miaomiao; Martuzzi, Marco; Morton, Katie; Mudu, Pierpaolo; Niittynen, Marjo; Perez, Laura; Sarigiannis, Denis; Stahl-Timmins, Will; Tobollik, Myriam; Tuomisto, Jouni; Willers, Saskia

    2016-03-08

    Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments. Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys. There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied. The climate-change reduction policies reduced

  3. How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

    Science.gov (United States)

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beautel, Sophie

    2017-08-01

    ISSUE: Prior to the Affordable Care Act (ACA), one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problems excluded from their plans. Beginning in 2010, ACA consumer protections, particularly coverage for preventive care screenings with no cost-sharing and a ban on plan benefit limits, improved the quality of health insurance for women. In 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid. GOALS: To examine the effects of ACA health reforms on women’s coverage and access to care. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2016. FINDINGS AND CONCLUSIONS: Women ages 19 to 64 who shopped for new coverage on their own found it significantly easier to find affordable plans in 2016 compared to 2010. The percentage of women who reported delaying or skipping needed care because of costs fell to an all-time low. Insured women were more likely than uninsured women to receive preventive screenings, including Pap tests and mammograms.

  4. Receipt and Perceived Helpfulness of Mental Illness Information: Findings from the Australian National Survey of Mental Health and Wellbeing.

    Science.gov (United States)

    Graham, Annette L; Brooker, Joanne; Hasking, Penelope; Clarke, David; Meadows, Graham

    2017-10-20

    The distribution of mental illness information is a crucial element of mental health promotion initiatives. We assessed the receipt and perceived helpfulness of such information in Australia. Data from the Australian National Survey of Mental Health and Wellbeing indicated that, during the year prior to the survey, 33.7% of Australians received mental illness information; of these, 51.2% found it helpful. Among people with a mental disorder, 46.1% received information; of these, 67.4% found it helpful. Non-English speakers and the socially disadvantaged were less likely to receive mental illness information. Older and less educated respondents were less likely to both receive mental illness information and find it helpful. Mental health service users were more likely to receive mental illness information perceived as helpful than those who had not accessed such services. Better targeted information interventions are required to ensure those most likely to benefit receive mental illness-related information.

  5. Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians

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    Vecchio Nerina

    2011-05-01

    Full Text Available Abstract Background The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. Methods We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. Results For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Conclusions Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

  6. Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians.

    Science.gov (United States)

    Holden, Libby; Scuffham, Paul A; Hilton, Michael F; Ware, Robert S; Vecchio, Nerina; Whiteford, Harvey A

    2011-05-31

    The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

  7. Addressing the Health and Wellness Needs of Vulnerable Rockaway Residents in the Wake of Hurricane Sandy: Findings From a Health Coaching and Community Health Worker Program.

    Science.gov (United States)

    Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen

    To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for

  8. Mental disorders in megacities: findings from the Sao Paulo megacity mental health survey, Brazil.

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    Laura Helena Andrade

    Full Text Available BACKGROUND: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. METHODS AND RESULTS: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI, to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%, followed by mood (11%, impulse-control (4.3%, and substance use (3.6% disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. DISCUSSION: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion

  9. Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil

    Science.gov (United States)

    Andrade, Laura Helena; Wang, Yuan-Pang; Andreoni, Solange; Silveira, Camila Magalhães; Alexandrino-Silva, Clovis; Siu, Erica Rosanna; Nishimura, Raphael; Anthony, James C.; Gattaz, Wagner Farid; Kessler, Ronald C.; Viana, Maria Carmen

    2012-01-01

    Background World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. Methods and Results A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. Discussion Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the

  10. Association of Cataract Surgery With Mortality in Older Women: Findings from the Women's Health Initiative.

    Science.gov (United States)

    Tseng, Victoria L; Chlebowski, Rowan T; Yu, Fei; Cauley, Jane A; Li, Wenjun; Thomas, Fridtjof; Virnig, Beth A; Coleman, Anne L

    2018-01-01

    Previous studies have suggested an association between cataract surgery and decreased risk for all-cause mortality potentially through a mechanism of improved health status and functional independence, but the association between cataract surgery and cause-specific mortality has not been previously studied and is not well understood. To examine the association between cataract surgery and total and cause-specific mortality in older women with cataract. This prospective cohort study included nationwide data collected from the Women's Health Initiative (WHI) clinical trial and observational study linked with the Medicare claims database. Participants in the present study were 65 years or older with a diagnosis of cataract in the linked Medicare claims database. The WHI data were collected from January 1, 1993, through December 31, 2015. Data were analyzed for the present study from July 1, 2014, through September 1, 2017. Cataract surgery as determined by Medicare claims codes. The outcomes of interest included all-cause mortality and mortality attributed to vascular, cancer, accidental, neurologic, pulmonary, and infectious causes. Mortality rates were compared by cataract surgery status using the log-rank test and Cox proportional hazards regression models adjusting for demographics, systemic and ocular comorbidities, smoking, alcohol use, body mass index, and physical activity. A total of 74 044 women with cataract in the WHI included 41 735 who underwent cataract surgery. Mean (SD) age was 70.5 (4.6) years; the most common ethnicity was white (64 430 [87.0%]), followed by black (5293 [7.1%]) and Hispanic (1723 [2.3%]). The mortality rate was 2.56 per 100 person-years in both groups. In covariate-adjusted Cox models, cataract surgery was associated with lower all-cause mortality (adjusted hazards ratio [AHR], 0.40; 95% CI, 0.39-0.42) as well as lower mortality specific to vascular (AHR, 0.42; 95% CI, 0.39-0.46), cancer (AHR, 0.31; 95% CI, 0

  11. Health-related quality of life among US military personnel injured in combat: findings from the Wounded Warrior Recovery Project.

    Science.gov (United States)

    Woodruff, Susan I; Galarneau, Michael R; McCabe, Cameron T; Sack, Daniel I; Clouser, Mary C

    2018-05-01

    Little is known about the long-term, health-related quality of life (HRQOL) of those wounded in combat during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. The present study described the overall HRQOL for a large group of US service members experiencing mild-to-severe combat-related injuries, and assessed the unique contribution of demographics, service- and injury-related characteristics, and mental health factors on long-term HRQOL. The Wounded Warrior Recovery Project examines patient-reported outcomes in a cohort of US military personnel wounded in combat. Participants were identified from the Expeditionary Medical Encounter Database, a US Navy-maintained deployment health database, and invited to complete a web-based survey. At the time of this study, 3245 service members consented and completed the survey. Hierarchical linear regression analyses were conducted to assess the unique contribution of each set of antecedents on HRQOL scores. HRQOL was uniquely associated with a number of demographics, and service- and injury-related characteristics. Nevertheless, screening positive for posttraumatic stress disorder (B = - .09; P < .001), depression (B = - .10; P < .001), or both as a set (B = - .19; P < .001) were the strongest predictors of lower long-term HRQOL. Postinjury HRQOL among service members wounded in combat was associated with service and injury experience, and demographic factors, but was most strongly linked with current mental health status. These findings underscore the significance of mental health issues long after injury. Further, findings reinforce that long-term mental health screening, services, and treatment are needed for those injured in combat.

  12. Underinsurance in children with special health care needs: the impact of definition on findings.

    Science.gov (United States)

    Preskitt, Julie K; McEldowney, Rene P; Mulvihill, Beverly A; Wingate, Martha S; Menachemi, Nir

    2013-10-01

    To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyzed. Only CSHCN who were continuously-insured for 12 months were included in analyses. We identified groups of underinsured CSHCN using two general definitions ("economic" and "attitudinal") and three mutually-exclusive groups (identified by both definitions, identified by attitudinal but not economic, and identified by economic but not attitudinal). Key variables included demographics and condition characteristics. Different underinsurance rates were identified [attitudinal = 30.9 % (n = 11,470); economic = 22.7 % (n = 8,447)] with fair agreement by kappa score (κ = 0.3194; Z = 65.91; p > 0.0001). Differences across mutually-exclusive groups included family income ≥400 % FPL (attitudinal only = 34.2 %, economic only = 16.3 %, both = 18.4 %; p needed equipment/supplies/home health (OR = 1.31, p needs.

  13. Health-related quality of life in epilepsy: findings obtained with a new Italian instrument.

    Science.gov (United States)

    Piazzini, Ada; Beghi, Ettore; Turner, Katherine; Ferraroni, Monica

    2008-07-01

    The aim of the present study was to evaluate the Epi-QoL, a new Italian-specific measure of health-related quality of life (HRQOL) for adults with epilepsy; the clinical variables that affected the HRQOL score were also assessed. The Epi-QoL is a 46-item self-administered questionnaire focusing on six domains: Physical Functioning, Cognitive Functioning, Emotional Well-Being, Social Functioning, Seizure Worry, and Medication Effects. Eight hundred fifteen patients recruited from 24 secondary and tertiary Italian centers for the care of epilepsy were assessed. The results supported the reliability and validity of the Epi-QoL as a measure of HRQOL. The variables that significantly affected HRQOL scores were: geographic area, gender, seizure frequency, prognostic categories, number of medications, comorbidity, presence of cognitive impairment, psychiatric disturbances, and disability. We believe that a new specific questionnaire for the evaluation of HRQOL in Italy can contribute much to the understanding of the influence of epilepsy on patients' lives.

  14. Screen time in Mexican children: findings from the 2012 National Health and Nutrition Survey (ENSANUT 2012.

    Directory of Open Access Journals (Sweden)

    Ian Janssen

    2013-09-01

    Full Text Available Objective. To provide descriptive information on the screen time levels of Mexican children. Materials and methods. 5 660 children aged 10-18 years from the 2012 National Health and Nutrition Survey (ENSANUT 2012 were studied. Screen time (watching television, movies, playing video games and using a computer was self-reported. Results. On average, children engaged in 3 hours/day of screen time, irrespective of gender and age. Screen time was higher in obese children, children from the northern and Federal District regions of the country, children living in urban areas, and children in the highest socioeconomic status and education categories. Approximately 33% of 10-14 year olds and 36% of 15-18 year olds met the screen time guideline of ≤2 hours/day. Conclusions. 10-18 year old Mexican children accumulate an average of 3 hours/day of screen time. Two thirds of Mexican children exceed the recommended maximal level of time for this activity.

  15. LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County, Kentucky, USA.

    Science.gov (United States)

    Jones, Jeff; Poole, Asheley; Lasley-Bibbs, Vivian; Johnson, Mark

    2016-04-07

    Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19-26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Core courses in public health laboratory science and practice: findings from 2006 and 2011 surveys.

    Science.gov (United States)

    DeBoy, John M; Beck, Angela J; Boulton, Matthew L; Kim, Deborah H; Wichman, Michael D; Luedtke, Patrick F

    2013-01-01

    We identified academic training courses or topics most important to the careers of U.S. public health, environmental, and agricultural laboratory (PHEAL) scientist-managers and directors, and determined what portions of the national PHEAL workforce completed these courses. We conducted electronic national surveys in 2006 and 2011, and analyzed data using numerical ranking, Chi-square tests comparing rates, and Spearman's formula measuring rank correlation. In 2006, 40 of 50 PHEAL directors identified 56 course topics as either important, useful, or not needed for someone in their position. These course topics were then ranked to provide a list of 31 core courses. In 2011, 1,659 of approximately 5,555 PHEAL scientific and technical staff, using a subset of 25 core courses, evidenced higher core course completion rates associated with higher-level job classification, advanced academic degree, and age. The 2011 survey showed that 287 PHEAL scientist-managers and directors, on average, completed 37.7% (n=5/13) of leadership/managerial core courses and 51.7% (n=6/12) of scientific core courses. For 1,659 laboratorians in all scientific and technical classifications, core-subject completion rates were higher in local laboratories (42.8%, n=11/25) than in state (36.0%, n=9/25), federal (34.4%, n=9/25), and university (31.2%, n=8/25) laboratories. There is a definable range of scientific, leadership, and managerial core courses needed by PHEAL scientist-managers and directors to function effectively in their positions. Potential PHEAL scientist-managers and directors need greater and continuing access to these courses, and academic and practice entities supporting development of this workforce should adopt curricula and core competencies aligned with these course topics.

  17. Weight change from 3-year observational data: findings from the worldwide schizophrenia outpatient health outcomes database.

    Science.gov (United States)

    Bushe, Chris J; Slooff, Cees J; Haddad, Peter M; Karagianis, Jamie L

    2012-06-01

    Weight change data from randomized clinical trials are often of limited duration and trials do not always report a full range of clinically relevant categorical end points. We conducted a post hoc analysis of data from the observational Worldwide Schizophrenia Outpatient Health Outcomes database (2000-2005) on weight change in 4,626 patients completing 3 years of antipsychotic monotherapy with amisulpride, clozapine, olanzapine, quetiapine, risperidone, and oral and depot first-generation antipsychotics (FGAs). Reported outcomes included mean and categorical weight changes and the trajectories of different measures of weight change. Mean weight gain was lowest with amisulpride (1.8 kg; 95% CI, 0.2-3.3) and highest with olanzapine (4.2 kg; 95% CI, 3.9-4.5). Weight change for all antipsychotics was most rapid during the first 6 months; subsequent weight change was slower but did not plateau. All drugs showed considerable individual variation in weight change. The proportion losing ≥7% of their baseline bodyweight was highest with quetiapine (10%; 95% CI, 7%-16%) and lowest with depot FGAs (5%; 95% CI, 3%-10%). Between 7% and 15% of patients moved into an overweight or obese body mass index (kg/m2)category (≥25). The degree of weight gain varied between antipsychotics. All antipsychotics were associated with significant (≥7%) weight loss and gain from baseline. The mean rate of weight gain was maximal during the first 6 months but continued over 3 years without a plateau in this specific cohort. Patients should receive regular monitoring of weight throughout treatment. © Copyright 2012 Physicians Postgraduate Press, Inc.

  18. Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010*

    Science.gov (United States)

    FORD, Earl S.; CUNNINGHAM, Timothy J.; MERCADO, Carla I.

    2015-01-01

    Background Considerable uncertainty remains about obstructive lung function (OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. Methods We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007–2010. Subjects’ MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. Results After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9% (1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Conclusions Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. PMID:26677470

  19. Thyroid hormones and electrocardiographic parameters: findings from the third national health and nutrition examination survey.

    Directory of Open Access Journals (Sweden)

    Yiyi Zhang

    Full Text Available Altered thyroid status exerts a major effect on the heart. Individuals with hypo- or hyperthyroidism showed various changes in electrocardiograms. However, little is known about how variations in thyroid hormone levels within the normal range affect electrical activities of the heart in the general population.We conducted a cross-sectional analysis of 5,990 men and women from the Third National Health and Nutrition Examination Survey. Serum total T4 was measured by immunoassay and TSH was measured by chemiluminescent assay. We categorized T4 and TSH into 7 groups with cut-offs at the 5(th, 20(th, 40(th, 60(th, 80(th, and 95(th percentiles of the weighted population distribution. Electrocardiographic parameters were measured from the standard 12-lead electrocardiogram. We found a positive linear association between serum total T4 level and heart rate in men, and a U-shape association between T4 and PR interval in men and women. TSH level was positively associated with QRS interval in men, while a U-shape association between TSH and QRS was observed in women. No clear graded association between thyroid hormones and corrected QT or JT was found, except that men in the highest category of T4 levels appeared to have longer corrected QT and JT, and men in the lowest category of T4 appeared to have shorter corrected QT and JT.Variation in thyroid hormone levels in the general population, even within the normal range, was associated with various ECG changes.

  20. Finding solid ground: law enforcement, key populations and their health and rights in South Africa.

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    Scheibe, Andrew; Howell, Simon; Müller, Alexandra; Katumba, Munyaradzi; Langen, Bram; Artz, Lillian; Marks, Monique

    2016-01-01

    Sex workers, people who use drugs, men who have sex with men, women who have sex with women and transgender people in South Africa frequently experience high levels of stigma, abuse and discrimination. Evidence suggests that such abuse is sometimes committed by police officers, meaning that those charged with protection are perpetrators. This reinforces cycles of violence, increases the risk of HIV infection, undermines HIV prevention and treatment interventions and violates the constitutional prescriptions that the police are mandated to protect. This paper explores how relationship building can create positive outcomes while taking into account the challenges associated with reforming police strategies in relation to key populations, and vice versa. We argue that relationships between law enforcement agencies and key populations need to be re-examined and reconstituted to enable appropriate responses and services. The antagonistic positioning, "othering" and blame assignment frequently seen in interactions between law enforcement officials and key populations can negatively influence both, albeit for different reasons. In addressing these concerns, we argue that mediation based on consensual dialogue is required, and can be harnessed through a process that highlights points of familiarity that are often shared, but not understood, by both parties. Rather than laying blame, we argue that substantive changes need to be owned and executed by all role-players, informed by a common language that is cognisant of differing perspectives. Relational approaches can be used to identify programmes that align goals that are part of law enforcement, human rights and public health despite not always being seen as such. Law enforcement champions and representatives of key populations need to be identified and supported to promote interventions that are mutually reinforcing, and address perceived differences by highlighting commonality. Creating opportunities to share experiences

  1. A Mental Health Storytelling Intervention Using Transmedia to Engage Latinas: Grounded Theory Analysis of Participants’ Perceptions of the Story’s Main Character

    Science.gov (United States)

    Martinez, Adrienne; Soderlund, Patricia D

    2018-01-01

    Background Transmedia storytelling was used to attract English-speaking Latina women with elevated symptoms of depression and anxiety to engage in an intervention that included videos and a webpage with links to symptom management resources. However, a main character for the storyline who was considered dynamic, compelling, and relatable by the target group was needed. Objective We conducted interviews with 28 English-speaking Latinas (target group) with elevated symptoms of depression or anxiety who participated in an Internet-accessible transmedia storytelling intervention. The objective of this study was to examine participants’ perceptions of the lead character of the story. Development of this character was informed by deidentified data from previous studies with members of the target group. Critique of the character from a panel of therapists informed editing, as did input from women of the target group. Methods All interviews were conducted via telephone, audio-recorded, and transcribed. Data analysis was guided by grounded theory methodology. Results Participants embraced the main character, Catalina, related to her as a person with an emotional life and a temporal reality, reported that they learned from her and wanted more episodes that featured her and her life. Grounded theory analysis led to the development of one category (She “just felt so real”: relating to Catalina as a real person with a past, present, and future) with 4 properties. Properties included (1) relating emotionally to Catalina’s vulnerability, (2) recognizing shared experiences, (3) needing to support others while simultaneously lacking self-support, and (4) using Catalina as a springboard for imagining alternative futures. Participants found Catalina’s efforts to pursue mental health treatment to be meaningful and led them to compare themselves to her and consider how they might pursue treatment themselves. Conclusions When creating a story-based mental health intervention

  2. A Mental Health Storytelling Intervention Using Transmedia to Engage Latinas: Grounded Theory Analysis of Participants' Perceptions of the Story's Main Character.

    Science.gov (United States)

    Heilemann, MarySue V; Martinez, Adrienne; Soderlund, Patricia D

    2018-05-02

    Transmedia storytelling was used to attract English-speaking Latina women with elevated symptoms of depression and anxiety to engage in an intervention that included videos and a webpage with links to symptom management resources. However, a main character for the storyline who was considered dynamic, compelling, and relatable by the target group was needed. We conducted interviews with 28 English-speaking Latinas (target group) with elevated symptoms of depression or anxiety who participated in an Internet-accessible transmedia storytelling intervention. The objective of this study was to examine participants' perceptions of the lead character of the story. Development of this character was informed by deidentified data from previous studies with members of the target group. Critique of the character from a panel of therapists informed editing, as did input from women of the target group. All interviews were conducted via telephone, audio-recorded, and transcribed. Data analysis was guided by grounded theory methodology. Participants embraced the main character, Catalina, related to her as a person with an emotional life and a temporal reality, reported that they learned from her and wanted more episodes that featured her and her life. Grounded theory analysis led to the development of one category (She "just felt so real": relating to Catalina as a real person with a past, present, and future) with 4 properties. Properties included (1) relating emotionally to Catalina's vulnerability, (2) recognizing shared experiences, (3) needing to support others while simultaneously lacking self-support, and (4) using Catalina as a springboard for imagining alternative futures. Participants found Catalina's efforts to pursue mental health treatment to be meaningful and led them to compare themselves to her and consider how they might pursue treatment themselves. When creating a story-based mental health intervention to be delivered through an app, regardless of type, careful

  3. Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace.

    Science.gov (United States)

    Weber, Danielle; Janson, Anneka; Nolan, Michelle; Wen, Li Ming; Rissel, Chris

    2011-11-30

    Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively), with little perceived support from the organisation (13%) and human resources (6%). Most women (92%) had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%). Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Enabling women to continue breastfeeding at work has benefits for the infant, employee and organisation. However, this

  4. Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace

    Directory of Open Access Journals (Sweden)

    Weber Danielle

    2011-11-01

    Full Text Available Abstract Background Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. Methods A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Results Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively, with little perceived support from the organisation (13% and human resources (6%. Most women (92% had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%. Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Conclusions Enabling women to continue breastfeeding at work has

  5. Safer sex and condom use: findings from the Second Australian Study of Health and Relationships.

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    de Visser, Richard O; Badcock, Paul B; Rissel, Chris; Richters, Juliet; Smith, Anthony M A; Grulich, Andrew E; Simpson, Judy M

    2014-11-01

    Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. A representative sample of 20094 men and women aged 16-69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001-02 and 2012-13. Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.

  6. Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application.

    Science.gov (United States)

    Tsai, Alexander C; Tomlinson, Mark; Dewing, Sarah; le Roux, Ingrid M; Harwood, Jessica M; Chopra, Mickey; Rotheram-Borus, Mary Jane

    2014-10-01

    Randomized controlled trials conducted in resource-limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment, lay health workers can be trained to effectively administer psychological treatments. We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones. Pregnant, Xhosa-speaking women were recruited independently in two cross-sectional studies (N = 1,144 and N = 361) conducted in Khayelitsha, South Africa and assessed for antenatal depression. In the smaller study, community health workers with no training in human subject research were trained to administer the Edinburgh Postnatal Depression Scale (EPDS) during the routine course of their community-based outreach. We compared the operating characteristics of four short and ultrashort versions of the EPDS with the criterion standard of probable depression, defined as an EPDS-10 ≥ 13. The prevalence of probable depression (475/1144 [42 %] and 165/361 [46 %]) was consistent across both samples. The 2-item subscale demonstrated poor internal consistency (Cronbach's α ranged from 0.55 to 0.58). All four subscales demonstrated excellent discrimination, with area under the receiver operating characteristic curve (AUC) values ranging from 0.91 to 0.99. Maximal discrimination was observed for the 7-item depressive symptoms subscale: at the conventional screening threshold of ≥10, it had 0.97 sensitivity and 0.76 specificity for detecting probable antenatal depression. The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression.

  7. Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria

    Directory of Open Access Journals (Sweden)

    Spencer Nick J

    2009-06-01

    Full Text Available Abstract Background Despite the attention the situation of the Roma in Central and Eastern Europe has received in the context of European Union enlargement, research on their access to health services is very limited, in particular with regard to child health services. Methods 50 qualitative in-depth interviews with users, providers and policy-makers concerned with child health services in Bulgaria, conducted in two villages, one town of 70,000 inhabitants, and the capital Sofia. Results Our findings provide important empirical evidence on the range of barriers Roma children face when accessing health services. Among the most important barriers are poverty, administrative and geographical obstacles, low levels of parental education, and lack of ways to accommodate the cultural, linguistic and religious specifics of this population group. Conclusion Our research illustrates the complexity of the problems the Roma face. Access to health care cannot be discussed in isolation from other problems this population group experiences, such as poverty, restricted access to education, and social exclusion.

  8. Cannabis Use in Adolescence and Young Adulthood: A Review of Findings from the Victorian Adolescent Health Cohort Study.

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    Coffey, Carolyn; Patton, George C

    2016-06-01

    The Victorian Adolescent Health Cohort Study (VAHCS) is a long-term Australian cohort study that has documented cannabis use in young Australians from the mid-teens to the mid-30s. The study findings have described the natural history of early cannabis use, remission, and escalation and the social and mental health consequences of different patterns of use. The adverse consequences of cannabis use are most clear-cut in heavy early adolescent users. These consequences include educational failure, persisting mental health problems, and progression to other substance use. For later onset and occasional users, the risks are lower and appear to entail modest elevations in risk for other drug use compared with never users. With growing evidence of health consequences, there is a strong case for actions around early heavy adolescent users. Prevention of early use, identification and treatment of early heavy users, and harm reduction through diversion of early heavy users away from the custodial justice system into health care are all priority responses. © The Author(s) 2016.

  9. Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010.

    Science.gov (United States)

    Ford, Earl S; Cunningham, Timothy J; Mercado, Carla I

    2014-11-01

    Considerable uncertainty remains about obstructive lung function( OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007-2010. Subjects'MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9%(1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  10. Elicitation effect of Saccharomyces cerevisiae yeast extract on main health-promoting compounds and antioxidant and anti-inflammatory potential of butter lettuce (Lactuca sativa L.).

    Science.gov (United States)

    Złotek, Urszula; Świeca, Michał

    2016-05-01

    This paper presents a study on changes in the main phytochemical levels and antioxidant and anti-inflammatory activity of lettuce caused by different doses and times of application of yeast extracts. Elicitation with yeast extract caused an increase in the total phenolic compounds and chlorophyll content, which varied according to the dose and time of spraying, but it did not have a positive impact on vitamin C, flavonoid and carotenoid content in lettuce. The best effect was achieved by double spraying with 1% yeast extract and by single spraying with 0.1% yeast extract. The increase in phytochemical content was positively correlated with the antioxidant and anti-inflammatory activity of the studied lettuce leaves. Chicoric acid seems to be the major contributor to these antioxidant activities. Yeast extract may be used as a natural, environmentally friendly and safe elicitor for improving the health-promoting qualities of lettuce. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

  11. Applying findings from a systematic review of workplace-based e-learning: implications for health information professionals.

    Science.gov (United States)

    Booth, Andrew; Carroll, Christopher; Papaioannou, Diana; Sutton, Anthea; Wong, Ruth

    2009-03-01

    To systematically review the UK published literature on e-learning in the health workplace and to apply the findings to one of the most prolific UK e-learning initiatives in the health sector--the National Library for Health Facilitated Online Learning Interactive Opportunity (FOLIO) Programme. Sensitive searches were conducted across ASSIA, Australian Education Index, British Education Index, cinahl, CSA Abstracts, Dissertation Abstracts, Emerald, ERIC, IBSS, Index to Theses, LISA, MEDLINE, PSYCINFO and Social Science Citation Index. Additional citations were identified from reference lists of included studies and of relevant reviews; citation tracking and contact with experts. Twenty-nine studies met the inclusion criteria and were coded and analysed using thematic analysis as described by Miles & Huberman (Qualitative Data Analysis: A Sourcebook of New Methods. Newbury Park, CA: Sage, 1984). Five broad themes were identified from the 29 included studies: (i) peer communication; (ii) flexibility; (iii) support; (iv) knowledge validation; and (v) course presentation and design. These broad themes were supported by a total of eleven sub-themes. Components from the FOLIO Programme were analysed and existing and proposed developments were mapped against each sub-theme. This provides a valuable framework for ongoing course development. Librarians involved in delivering and supporting e-learning can benefit from applying the findings from the systematic review to existing programmes, exemplified by the FOLIO Programme. The resultant framework can also be used in developing new e-learning programmes.

  12. The social and behavioural determinants of health in Europe: findings from the European Social Survey (2014) special module on the social determinants of health.

    Science.gov (United States)

    Huijts, Tim; Stornes, Per; Eikemo, Terje A; Bambra, Clare

    2017-02-01

    Previous studies comparing the social and behavioural determinants of health in Europe have largely focused on individual countries or combined data from various national surveys. In this article, we present the findings from the new rotating module on social determinants of health in the European Social Survey (ESS) (2014) to obtain the first comprehensive comparison of estimates on the prevalence of the following social and behavioural determinants of health: working conditions, access to healthcare, housing quality, unpaid care, childhood conditions and health behaviours. We used the 7th round of the ESS. We present separate results for men and women. All estimates were age-standardized in each separate country using a consistent metric. We show country-specific results as well as pooled estimates for the combined cross-national sample. We found that social and behavioural factors that have a clear impact on physical and mental health, such as lack of healthcare access, risk behaviour and poor working conditions, are reported by substantial numbers of people in most European countries. Furthermore, our results highlight considerable cross-national variation in social and behavioural determinants of health across European countries. Substantial numbers of Europeans are exposed to social and behavioural determinants of health problems. Moreover, the extent to which people experience these social and behavioural factors varies cross-nationally. Future research should examine in more detail how these factors are associated with physical and mental health outcomes, and how these associations vary across countries. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  13. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey.

    Science.gov (United States)

    Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy

    2013-10-10

    Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to

  14. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

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    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  15. Behavioral and Social Sciences at the National Institutes of Health: adoption of research findings in health research and practice as a scientific priority.

    Science.gov (United States)

    Riley, William T

    2017-06-01

    The National Institutes of Health's Office of Behavioral and Social Sciences Research (OBSSR) recently released its Strategic Plan for 2017 to 2021. This plan highlights three scientific priorities: (1) improve the synergy of basic and applied behavioral and social sciences research, (2) enhance and promote the research infrastructure, methods, and measures needed to support a more cumulative and integrated approach to behavioral and social sciences research, and (3) facilitate the adoption of behavioral and social sciences research findings in health research and in practice. This commentary focuses on the challenges and opportunities to facilitate the adoption of research findings in health research and in practice. In addition to the ongoing NIH support for dissemination and implementation (D&I) research, we must address transformative challenges and opportunities such as better disseminating and implementing D&I research, merging research and practice, adopting more rigorous and diverse methods and measures for both D&I and clinical trials research, evaluating technological-based delivery of interventions, and transitioning from minimally adaptable intervention packages to planned adaptations rooted in behavior change principles. Beyond translation into practice and policy, the OBSSR Strategic Plan also highlights the need for translation of behavioral and social science findings into the broader biomedical research enterprise.

  16. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh

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    Susmita Das

    2017-02-01

    Full Text Available Abstract Background Health literacy (HL helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh’s health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. Materials and Methods The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh. HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Results Chambers of the rural practitioners of allopathic medicine, commonly known as ‘village doctors’, were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6% and Union Health and Family Welfare Centres (28.6%. Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively. The top three sources of information for diabetes were neighbours (85.7%, followed by relatives (27.9% and MBBS (Bachelor of Medicine and Bachelor of Surgery doctors (20.4%. For hypertension, the sources were neighbours (78.0%, followed by village doctors (38.2%, MBBS doctors (23.2% and relatives (15%. The proportions of respondents who knew diabetes and hypertension control measures

  17. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.

    Science.gov (United States)

    Das, Susmita; Mia, Mohammad Nahid; Hanifi, Syed Manzoor Ahmed; Hoque, Shahidul; Bhuiya, Abbas

    2017-02-16

    Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh's health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh). HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Chambers of the rural practitioners of allopathic medicine, commonly known as 'village doctors', were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6%) and Union Health and Family Welfare Centres (28.6%). Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively). The top three sources of information for diabetes were neighbours (85.7%), followed by relatives (27.9%) and MBBS (Bachelor of Medicine and Bachelor of Surgery) doctors (20.4%). For hypertension, the sources were neighbours (78.0%), followed by village doctors (38.2%), MBBS doctors (23.2%) and relatives (15%). The proportions of respondents who knew diabetes and hypertension control measures were 40.9% and 28.0%, respectively. More females knew about the

  18. Experience of home health nursing personnel in actual and simulated case finding of wife abuse in Korea.

    Science.gov (United States)

    Han, Young Ran

    2008-01-01

    The purpose of this study was to examine the experience of home health nursing personnel (HHNP) in identifying wife abuse and intervening with victims during home health visits, and to analyze responses to a what-if scenario involving visiting a woman who implies her husband is abusive. A cross-sectional, descriptive design with a questionnaire survey was used and included the public health nurse's practice response to women who are abused (PHNR). From 243 public health centers nationwide, 373 HHNPs participated. Over the past year, 31.6% had identified abused women (average of 2.2 victims per HHNP) and 12.3% had intervened. The mean score for the PHNR was 55.76 (out of a possible 80), indicating higher value on thoughts, feelings, and actions to support abused women. Significant differences were found in the mean scores for age and position (nurse or nurse aide). The mean percentage of correct PHNR responses was 70.4%. The results showed a low level of competency and difficulty in initiating the topic of abuse, and a higher level of understanding methods to approach abused women. Time limit was not a hindrance to intervention. The findings indicate the need for education programs to increase self-efficacy and promote effective recognition and interventions for these women.

  19. Service utilization by children with conduct disorders: findings from the 2004 Great Britain child mental health survey.

    Science.gov (United States)

    Shivram, Raghuram; Bankart, John; Meltzer, Howard; Ford, Tamsin; Vostanis, Panos; Goodman, Robert

    2009-09-01

    Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.

  20. Interwoven histories: Mental health nurses with experience of mental illness, qualitative findings from a mixed methods study.

    Science.gov (United States)

    Oates, Jennifer; Drey, Nicholas; Jones, Julia

    2018-02-15

    The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.

  1. Co-occurrence and clustering of health conditions at age 11: cross-sectional findings from the Millennium Cohort Study

    Science.gov (United States)

    Hesketh, Kathryn R; Fagg, James; Muniz-Terrera, Graciela; Law, Catherine; Hope, Steven

    2016-01-01

    Objectives To identify patterns of co-occurrence and clustering of 6 common adverse health conditions in 11-year-old children and explore differences by sociodemographic factors. Design Nationally representative prospective cohort study. Setting Children born in the UK between 2000 and 2002. Participants 11 399 11-year-old singleton children for whom data on all 6 health conditions and sociodemographic information were available (complete cases). Main outcome measures Prevalence, co-occurrence and clustering of 6 common health conditions: wheeze; eczema; long-standing illness (excluding wheeze and eczema); injury; socioemotional difficulties (measured using Strengths and Difficulties Questionnaire) and unfavourable weight (thin/overweight/obese vs normal). Results 42.4% of children had 2 or more adverse health conditions (co-occurrence). Co-occurrence was more common in boys and children from lower income households. Latent class analysis identified 6 classes: ‘normative’ (57.4%): ‘atopic burdened’ (14.0%); ‘socioemotional burdened’ (11.0%); ‘unfavourable weight/injury’ (7.7%); ‘eczema/injury’ (6.0%) and ‘eczema/unfavourable weight’ (3.9%). As with co-occurrence, class membership differed by sociodemographic factors: boys, children of mothers with lower educational attainment and children from lower income households were more likely to be in the ‘socioemotional burdened’ class. Children of mothers with higher educational attainment were more likely to be in the ‘normative’ and ‘eczema/unfavourable weight’ classes. Conclusions Co-occurrence of adverse health conditions at age 11 is common and is associated with adverse socioeconomic circumstances. Holistic, child focused care, particularly in boys and those in lower income groups, may help to prevent and reduce co-occurrence in later childhood and adolescence. PMID:27881529

  2. Assessment of the World Health Organization's HIV Drug Resistance Early Warning Indicators in Main and Decentralized Outreach Antiretroviral Therapy Sites in Namibia.

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    Nicholus Mutenda

    Full Text Available The World Health Organization (WHO early warning indicators (EWIs of HIV drug resistance (HIVDR assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR.In 2014, the Namibia HIV care and treatment program abstracted the following adult and pediatric EWIs from all public ART sites (50 main sites and 143 outreach sites: On-time pill pick-up, Retention in care, Pharmacy stock-outs, Dispensing practices, and Viral load suppression. Comparisons were made between main and outreach sites and between 2014 and 2012 using the Wilcoxon signed-rank test in a matched analysis.The national estimates were: On-time pill pick-up 81.9% (95% CI 81.1-82.8 for adults and 82.4% (81.3-83.4 for pediatrics, Retention in care 79% retained on ART after 12 months for adults and 82% for pediatrics, Pharmacy stock-outs 94% of months without a stock-out for adults and 88% for pediatrics, and Dispensing practices 0.01% (0.001-0.056 dispensed mono- or dual-therapy for adults and 0.01% (0.001-0.069 for pediatrics. Viral load suppression was significantly affected by low rates of Viral load completion. Main sites had higher On-time pill pick-up than outreach sites for adults (p<0.001 and pediatrics (p<0.001, and no difference between main and outreach sites for Retention in care for adults (p = 0.761 or pediatrics (p = 0.214. From 2012 to 2014 in adult sites, On-time pill pick-up (p = 0.001, Retention in care (p<0.001, and Pharmacy stock-outs (p = 0.002 worsened. In pediatric sites, On-time pill pick-up (p<0.001 and Pharmacy stock-outs (p = 0.012 worsened.Results of EWIs monitoring in Namibia provide evidence about ART programmatic functioning and contextualize results from national surveys of HIVDR. These results are worrisome as they show a decline in program performance over time. The national ART program is taking steps to minimize the emergence of HIVDR by strengthening adherence and retention of patients on ART

  3. Eficacia escolar: antecedentes, hallazgos y futuro (School Effectiveness: Background, main findings and future (Efficacité scolaire: antécedents, résultats et avenir (Eficácia Escolar; Background, principais resultados e futuro

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    Mauricio Carvallo-Pontón

    2010-12-01

    Full Text Available ResumenSe presenta una breve historia de la corriente de efi- cacia escolar y las etapas por las que ha pasado, mos- trando sus hallazgos más relevantes, como los asocia- dos a los factores de escuela, profesor, alumno, padres de familia y contexto que impactan el desempeño del alumno. Explica la situación actual de la corriente de eficacia escolar, plasmada en el modelo dinámico de Bert Creemers y Leonard Kyriakides (2008, el cual en- globa los avances más recientes y presenta los retos que enfrentan los estudios de eficacia escolar, que es- tarán en función del paradigma que se tenga acerca de escuela eficaz, ya que afecta de forma significativa el enfoque de estos estudios.AbstractThis article presents a brief history of the school effectiveness research and the stages it has passed, briefly show- ing its main findings; the factors related to the school, teacher, student, parents and context that affect student's per- formance. The present situation of the school effectiveness research summarize in the dynamic model developed by Bert Creemers and Leonard Kyriakides (2008. This model includes the recent develop- ments and presents the challenges these researches must face. The approach of these researches will also be significantly affected by the school effectiveness par- adigm chosen.RésuméOn présente dans cet article une courte histoire du courant de l'efficacité scolaire et les étapes par lesquelles ce courant a traversé, on veut montrer aussi les ré- sultats les plus importants, par exemple ceux qui sont en relation directe avec l'école, les professeurs, les élèves, les parents et le contexte qui ont un impact dans le développement des étudiants. On explique aussi la situation actuelle du courant de l'efficacité scolaire, qui se voit dans le modèle dynamique de Bert Cree- mers et de Leonard Kyriakides (2008, ce- lui-ci inclut les résultats les plus récents et présente les défis auxquels

  4. Assessing quality of a worksite health promotion programme from participants’ views: findings from a qualitative study in Malaysia

    Science.gov (United States)

    Liau, Siow‐Yen; Hassali, Mohamed‐Azmi A.; Shafie, Asrul A.; Ibrahim, Mohamed‐Izham M.

    2014-01-01

    Abstract Background  An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. Objective  To explore the participants’ perceptions of the quality and effectiveness of the ‘Love Your Heart Programme’. Design  A qualitative study using semi‐structured interviews with a purposive sample of participants of the ‘Love Your Heart’ programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio‐recorded, transcribed verbatim and analysed using the principles of grounded theory. Results  A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the ‘Road to a Healthy Heart’ booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. Discussion and conclusions  In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme. PMID:22050457

  5. Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

    2008-12-17

    Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). We undertook a multi-method study in three phases - a survey, interviews, and case descriptions that drew on site visits - and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. This synthesis of

  6. Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

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    Moynihan Ray

    2008-12-01

    Full Text Available Abstract Background Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs. Methods We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1 collaborate with other organizations; 2 establish strong links with policymakers and involve stakeholders in the work; 3 be independent and manage conflicts of interest among those involved in the work; 4 build capacity among those working in the organization; 5 use good methods and be transparent in the work; 6 start small, have a clear audience and scope, and address important questions; and 7 be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO and other international organizations and networks: 1 support collaborations among organizations; 2 support local adaptation efforts; 3 mobilize support; and 4 create

  7. Self-rated function, self-rated health, and postmortem evidence of brain infarcts: findings from the Nun Study.

    Science.gov (United States)

    Greiner, P A; Snowdon, D A; Greiner, L H

    1999-07-01

    Self-rated function is a new global measure. Previous findings suggest that self-rated function predicts future functional decline and is strongly associated with all-cause mortality. We hypothesized that the strength of the relationship of self-rated function to all-cause mortality was in part due to functional decline, such as would occur with brain infarcts. Self-ratings of function and health (on a 5-point scale, ranging from excellent to poor) were assessed annually on 630 participants in the Nun Study. Mortality surveillance extended from October 31, 1991 to March 1, 1998, and, among those who died, neuropathological examination determined postmortem evidence of brain infarcts. Cox regression modeling with self-rated function and health as time-dependent covariates and stratification by assessment period were used in these analyses. Self-rated function and health ratings of good, fair, and poor were significantly associated with doubling of the risk of mortality, compared with ratings of very good and excellent. Self-rated function ratings of fair or poor were associated with a threefold increase in the risk of mortality with brain infarcts, but self-rated function and health ratings of fair and poor were comparable in their association with all-cause mortality and mortality without brain infarcts. Self-rated function was significantly associated with mortality with brain infarcts, suggesting that brain infarcts may be experienced as functional loss but not recognized or labeled as disease. Our results suggest that self-rated function and health should be explored simultaneously in future research.

  8. Nexus between preventive policy inadequacies, workplace bullying, and mental health: Qualitative findings from the experiences of Australian public sector employees.

    Science.gov (United States)

    Hurley, John; Hutchinson, Marie; Bradbury, Joanne; Browne, Graeme

    2016-02-01

    Public sector organizations have been shown to have high levels of workplace bullying, despite widespread adoption of zero-tolerance policy. Given the level of harm that stems from bullying, it has been suggested that it might be one of the most serious problems facing modern organizations. The qualitative findings from a large cross sectional study of public servants in Australia are reported in the present study. The results highlight palpable mental distress and illness stemming from exposure to workplace bullying. This distress was exacerbated by failures in prohibitive workplace procedures. Reporting bullying through formal organization processes did not lead to resolution of the problem; it instead highlighted feelings of powerlessness and mistrust. In light of the findings, we suggest that an alternative discourse is required, one that gives attention to enhancing employee resilience and self-healing behaviours to the emotional trauma of workplaces. Organizations might be better placed investing resources in fostering the resilience and emotional intelligence of their workforce, rather than continuing to invest resources in prohibitive policies that fail to address the problem. Employees should be supported to prioritize responsibility for their own mental health, rather than an overreliance on organizational responses. © 2016 Australian College of Mental Health Nurses Inc.

  9. What "best practice" could be in Palliative Care: an analysis of statements on practice and ethics expressed by the main Health Organizations

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    Borreani Claudia

    2010-01-01

    Full Text Available Abstract Background In palliative care it would be necessary to refer to a model. Nevertheless it seems that there are no official statements which state and describe that model. We carried out an analysis of the statements on practice and ethics of palliative care expressed by the main health organizations to show which dimensions of end-of-life care are taken into consideration. Methods The official documents by the most representative health organisations committed to the definition of policies and guidelines for palliative and end-of-life care had been considered. The documents were analysed through a framework of the components of end-of-life care derived from literature, which was composed of 4 main "areas" and of 12 "sub-areas". Results Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States. Up to 56 documents were selected and analysed. Most of them (38 are position statements. Relevant quotations from the documents were presented by "areas" and "sub-areas". In general, the "sub-areas" of symptoms control as well as those referring to relational and social issues are more widely covered by the documents than the "sub-areas" related to "preparation" and to "existential condition". Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance. Conclusions An integrated model of the best palliative care practice is generally lacking in the documents. It might be argued that the lack of a fixed and coherent model is due to the relevance of unavoidable context issues in palliative care, such as specific cultural settings, patient-centred variables, and family specificity. The implication is that palliative care staff have continuously to adapt their model of caring to the specific needs and values of

  10. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study

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    Gonzalez Andrea

    2012-09-01

    Full Text Available Abstract Background Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI; however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties and family level (parental income and education, parental mental and physical health, and family functioning on BMI in early adulthood. Methods We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4–16 years enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21–35 years. Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. Results At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. Conclusion Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

  11. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study.

    Science.gov (United States)

    Gonzalez, Andrea; Boyle, Michael H; Georgiades, Katholiki; Duncan, Laura; Atkinson, Leslie R; MacMillan, Harriet L

    2012-09-09

    Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4-16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21-35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

  12. Impacts of casinos on key pathways to health: qualitative findings from American Indian gaming communities in California

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    Stephen R. Kodish

    2016-07-01

    Full Text Available Abstract Background Three decades ago, casino gaming on sovereign American Indian lands was legalized with differential economic and social implications. While casinos have improved the incomes of tribal communities, there have been both positive and negative findings in relation to health impacts. We sought to understand the perceived pathways by which casinos impact individual and community health through voices of the community. Methods We conducted semi-structured, interviews with tribal leaders (n =12 and tribal members (n =24 from tribal communities (n = 23 representing different regions of California. We inductively analyzed textual data drawing from Grounded Theory, first using line-by-line coding to identify analytic categories from emergent themes in consideration of the study objective. Then, focused codes were applied to identify salient themes, which we represented through exemplar quotes and an overall conceptual framework. Data were managed and coded using Dedoose software. Results American Indian-owned casinos are perceived to influence the health of tribal communities through three pathways: 1 improving the tribal economy 2 altering the built environment, and 3 disrupting the the social landscape. Forming these pathways are a series of interrelated health determinants. Improvement of the tribal economy, through both job creation for tribal members and improved tribal cash flow, was perceived by participants to both influence health. Specifically, improved cash flow has resulted in new wellness programs, community centers, places for recreation, and improved social services. Higher disposable incomes have led to better financial stability, increased access to healthy food, and more opportunities for physical activity. Yet, higher disposable incomes were perceived to also contribute to negative health behaviors, most notably increased drug and alcohol abuse. Casinos were also perceived to alter built environments, resulting in

  13. The role of mHealth intervention on maternal and child health service delivery: findings from a randomized controlled field trial in rural Ethiopia.

    Science.gov (United States)

    Atnafu, Asfaw; Otto, Kate; Herbst, Christopher H

    2017-01-01

    The provision of consistent and quality maternal and child health (MCH) services is a challenge for Ethiopia where most of the population lives in the rural setup. Health service delivery is constrained mainly by shortage of health professionals, meager resources, limited awareness among the society and bureaucratic procedures. Low health service utilization of antenatal care (ANC), delivery services, and postnatal care (PNC) are believed to contribute for high maternal and child mortality rates. Innovative approach like mHealth based technological intervention believed to alleviate such challenges in countries like ours. However, currently, there are few evidences that demonstrate the impact of mHealth technology applications on the level of service utilization. Therefore, the objective our study is to assess the role of mobile phone equipped with short message service (SMS) based data-exchange software linking community health workers to Health Centers in rural Ethiopia affect selected MCH outcomes. A community-based randomized control trial (RCT) was conducted in three woredas of Guraghe zone (Ezha, partial &Abeshge full intervention, Sodo Control). Mobile phones equipped with FrontlineSMS based, locally developed application was distributed to all health extension workers (HEWs) to both intervention woredas who filled maternal, child and stock related forms and submitted to the central server which in turn sends reminder about the scheduled date of ANC visit, expected date of delivery, PNC, immunization schedule and vaccine and contraceptive stock status. Moreover, in Abeshge, the voluntary health workers (vCHW) and HEW supervisors in both intervention woreda were given a phone to facilitate communication with the HEW. No mobile was offered to the control woreda.Pre [2012] and post [2013] intervention community based survey on mothers who have under 5 and under 1 year old child was done to assess the effect of the mobile intervention on selected MCH process

  14. Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.

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    Rajnish Joshi

    2007-08-01

    Full Text Available More than half of all health care workers (HCWs in high TB-incidence, low and middle income countries are latently infected with tuberculosis (TB. We determined radiological lesions in a cohort of HCWs with latent TB infection (LTBI in India, and determined their association with demographic, occupational and T-cell immune response variables.We obtained chest radiographs of HCWs who had undergone tuberculin skin test (TST and QuantiFERON-TB Gold In Tube (QFT, an interferon-gamma release assay, in a previous cross-sectional study, and were diagnosed to have LTBI because they were positive by either TST or QFT, but had no evidence of clinical disease. Two observers independently interpreted these radiographs using a standardized data form and any discordance between them resolved by a third observer. The radiological diagnostic categories (normal, suggestive of inactive TB, and suggestive of active TB were compared with results of TST, QFT assay, demographic, and occupational covariates.A total of 330 HCWs with positive TST or QFT underwent standard chest radiography. Of these 330, 113 radiographs (34.2% were finally classified as normal, 206 (62.4% had lesions suggestive of inactive TB, and 11 (3.4% had features suggestive of active TB. The mean TST indurations and interferon-gamma levels in the HCWs in these three categories were not significantly different. None of the demographic or occupational covariates was associated with prevalence of inactive TB lesions on chest radiography.In a high TB incidence setting, nearly two-thirds of HCWs with latent TB infection had abnormal radiographic findings, and these findings had no clear correlation with T cell immune responses. Further studies are needed to verify these findings and to identify the causes and prognosis of radiologic abnormalities in health care workers.

  15. Challenges in tackling tuberculosis on the Thai-Myanmar border: findings from a qualitative study with health professionals.

    Science.gov (United States)

    Kaji, Aiko; Thi, Sein Sein; Smith, Terrence; Charunwatthana, Prakaykaew; Nosten, Francois H

    2015-10-09

    Myanmar and Thailand belong to the top 22 high burden countries for tuberculosis (TB). Health care organizations play an essential role in addressing TB control in the two bridging border jurisdictions, Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. However, health professionals face difficulties in TB control effort due to the nature of fluid population movements, resource constraints and ambiguous mechanisms to implement collaboration along the border. The purpose of this study is to identify the challenges to TB control among Myanmar migrants faced by stakeholders, focusing on the area of collaboration and interaction along the border. The study conducted in-depth interviews with health policy makers and health care providers responsible for developing and implementing policies and TB programs in Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. The participants included members of government organizations, United Nations agencies, community based organizations, and international NGO. One or two key stakeholders from each organization were approached to participate in the study. We gathered baseline information to identify TB policies and programs available on websites, brochures, and publications. Observations including field notes were made on site. The data transcriptions were coded for qualitative data analysis. Coding also developed categories that led to key themes. A total of 31 respondents (18 in Thailand and 13 in Myanmar) participated in the study. The main theme reported by participants was challenges in limited corroboration and coordination among stakeholders. Unstructured information sharing and lack of communication hindered the stakeholders from engaging in TB control. The respondents stressed that referral mechanisms across the border need to be strengthened. Other challenges were associated with increasing loss to follow up and subsequent MDR cases, constraints of service delivery, shortage of human

  16. Women's exposure to intimate partner violence and child malnutrition: findings from demographic and health surveys in Bangladesh.

    Science.gov (United States)

    Ziaei, Shirin; Naved, Ruchira Tabassum; Ekström, Eva-Charlotte

    2014-07-01

    Domestic violence, in particular intimate partner violence (IPV), has been recognized as a leading cause of mortality and morbidity among women of reproductive age. The effects of IPV against women on their children's health, especially their nutritional status has received less attention but needs to be evaluated to understand the comprehensive public health implications of IPV. The aim of current study was to investigate the association between women's exposure to IPV and their children's nutritional status, using data from the 2007 Bangladesh Demographic and Health Survey (BDHS). Logistic regression models were used to estimate association between ever-married women's lifetime exposure to physical and sexual violence by their spouses and nutritional status of their children under 5 years. Of 2042 women in the BDHS survey with at least one child under 5 years of age, 49.4% reported lifetime experience of physical partner violence while 18.4% reported experience of sexual partner violence. The prevalence of stunting, wasting and underweight in their children under 5 years was 44.3%, 18.4% and 42.0%, respectively. Women were more likely to have a stunted child if they had lifetime experience of physical IPV [odds ratio n = 2027 (OR)adj, 1.48; 95% confidence interval (CI), 1.23-1.79] or had been exposed to sexual IPV (n = 2027 OR(adj), 1.28; 95% CI, 1.02-1.61). The present findings contribute to growing body of evidence showing that IPV can also compromise children's growth, supporting the need to incorporate efforts to address IPV in child health and nutrition programmes and policies. © 2012 John Wiley & Sons Ltd.

  17. Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012.

    Science.gov (United States)

    Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

    2017-10-05

    Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, PHIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT in terms of sociodemographic and health characteristics

  18. [Economic Crisis and Portuguese National Health Service Physicians: Findings from a Descriptive Study of Their Perceptions and Reactions from Health Care Units in the Greater Lisbon Area].

    Science.gov (United States)

    Rego, Inês; Russo, Giuliano; Gonçalves, Luzia; Perelman, Julian; Pita Barros, Pedro

    2017-04-28

    In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians reported a decrease in public remuneration (- 30.5%) and a small increase of public sector hours. A general reduction in living standard was identified as the main adaptation strategy to the crisis. Passion for the profession, its independence and flexibility, were the most frequently mentioned compensating factors. A percentage of 15% of physicians declared considering migration as a possibility for the near future. The crisis has brought non-negligible changes to physicians' working conditions and to the wider market for medical services in Portugal. The physicians' intrinsic motivation for the professions helped counterbalance salary cuts and deteriorating working conditions.

  19. Preventive child health care findings on early childhood predict peer-group social status in early adolescence.

    Science.gov (United States)

    Jaspers, Merlijne; de Winter, Andrea F; Veenstra, René; Ormel, Johan; Verhulst, Frank C; Reijneveld, Sijmen A

    2012-12-01

    A disputed social status among peers puts children and adolescents at risk for developing a wide range of problems, such as being bullied. However, there is a lack of knowledge about which early predictors could be used to identify (young) adolescents at risk for a disputed social status. The aim of this study was to assess whether preventive child health care (PCH) findings on early childhood predict neglected and rejected status in early adolescence in a large longitudinal community-based sample. Data came from 898 participants who participated in TRAILS, a longitudinal study. Information on early childhood factors was extracted from the charts of routine PCH visits registered between infancy and age of 4 years. To assess social status, peer nominations were used at age of 10-12 years. Multinomial logistic regression showed that children who had a low birth weight, motor problems, and sleep problems; children of parents with a low educational level (odds ratios [ORs] between 1.71 and 2.90); and those with fewer attention hyperactivity problems (ORs = .43) were more likely to have a neglected status in early adolescence. Boys, children of parents with a low educational level, and children with early externalizing problems were more likely to have a rejected status in early adolescence (ORs between 1.69 and 2.56). PCH findings on early childhood-on motor and social development-are predictive of a neglected and a rejected status in early adolescence. PCH is a good setting to monitor risk factors that predict the social status of young adolescents. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. [Fact-finding survey on regional healthcare services for patients with epilepsy based on a questionnaire administered to public health centers in Japan].

    Science.gov (United States)

    Fujii, Masami; Ishimaru, Yasutaka; Takahashi, Hiroyuki; Egami, Hirofumi; Nishida, Hideki; Oka, Shinji; Shirabe, Komei

    2015-01-01

    Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. The prevalence of epilepsy is about 1%, and its incidence is increasing with the aging population. In addition to their medical problems, epilepsy patients face many social problems, including schooling, working, and maintaining their driver's licenses. However, these problems are not fully recognized by the regional healthcare centers (HCCs), and the inadequacy of collaboration between medical services, healthcare, and welfare is sometimes pointed out. Under these circumstances, this fact-finding survey was administered in the form of a questionnaire to HCCs across the nation for the purpose of improving the support system and educational activities for epilepsy in Japan. A mail-back survey on regional healthcare services for epilepsy patients was sent out to 490 HCCs across the nation. Public health nurses (PHNs) responded to the self-completed questionnaire on behalf of each HCC. The questionnaire was comprised of the presence or absence of consultations on epilepsy, content of the consultations, and holding of workshops, lectures, or conferences in the community covered by the HCC. We obtained responses from 347 HCCs (response rate 71%). Seventy-three percent of the PHNs had experience with consultations regarding the medical and healthcare issues associated with epilepsy. However, only 10% of the PHNs responded that they could provide appropriate consultation for these issues. The content of the consultations mainly included medical services, clinical symptoms of epilepsy, and anxieties about their social life and their future. Workshops, lectures, or conferences on epilepsy were held for residents or health and welfare professionals in only 8% of the communities. This percentage is lower than those (21-70%) for other intractable or mental disorders that are mainly managed by HCCs (Prestrictions. To improve these situations, regional education programs for

  1. Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    McKenna, Caoimhe; Law, Catherine; Pearce, Anna

    2017-03-09

    There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. Published by the BMJ Publishing Group Limited. For

  2. Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Nunes, Maria A; Pinheiro, Andréa P; Bessel, Marina; Brunoni, André R; Kemp, Andrew H; Benseñor, Isabela M; Chor, Dora; Barreto, Sandhi; Schmidt, Maria I

    2016-01-01

    To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score ≥ 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. CMD (CIS-R score ≥ 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address health inequities related to mental disorders.

  3. Age and Gender Differences in Psychological Distress among African Americans and Whites: Findings from the 2016 National Health Interview Survey

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    Daphne C. Watkins

    2018-01-01

    Full Text Available Previous studies report a race and mental health paradox: Whites score higher on measures of major depression compared to African Americans, but the opposite is true for psychological distress (i.e., African Americans score higher on distress measures compared to Whites. Independently, race, age, and gender outcomes for psychological distress are well documented in the literature. However, there is relatively little research on how psychological distress interferes with the lives of African Americans and Whites at the intersection of their various race, age, and gender identities. This study uses data from the 2016 National Health Interview Survey to examine age and gender differences in psychological distress and how much psychological distress interferes with the lives of African Americans and Whites. Our study findings are contrary to the paradox such that young White women (M = 3.36, SD = 1.14 and middle-aged White men (M = 2.55, SD = 3.97 experienced higher psychological distress than all other race, age, and gender groups. Psychological distress interference was relatively high among the high distress groups, except for older African American men (M = 1.73, SD = 1.05 and young African American women (M = 1.93, SD = 0.95. Implications for studies that consider cultural experiences of psychological distress, and how it impacts different demographic groups are discussed.

  4. Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment.

    Science.gov (United States)

    Li, Junxin; Cacchione, Pamela Z; Hodgson, Nancy; Riegel, Barbara; Keenan, Brendan T; Scharf, Mathew T; Richards, Kathy C; Gooneratne, Nalaka S

    2017-02-01

    To examine the cross-sectional associations between self-reported postlunch napping and structured cognitive assessments in Chinese older adults. Cross-sectional cohort study. China. Individuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974). Interview-based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self-reported or interview-based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non-nappers (0 minutes), short nappers (90 minutes). Postlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P napping was significantly associated with better cognition than non- (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration. A cross-sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross-sectional design and self-reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Design and Baseline Findings of a Multi-site Non-randomized Evaluation of the Effect of a Health Programme on Microfinance Clients in India

    OpenAIRE

    Saha, Somen

    2013-01-01

    Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages...

  6. Attribution of global foodborne disease to specific foods: Findings from a World Health Organization structured expert elicitation.

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    Sandra Hoffmann

    Full Text Available Recently the World Health Organization, Foodborne Disease Burden Epidemiology Reference Group (FERG estimated that 31 foodborne diseases (FBDs resulted in over 600 million illnesses and 420,000 deaths worldwide in 2010. Knowing the relative role importance of different foods as exposure routes for key hazards is critical to preventing illness. This study reports the findings of a structured expert elicitation providing globally comparable food source attribution estimates for 11 major FBDs in each of 14 world subregions.We used Cooke's Classical Model to elicit and aggregate judgments of 73 international experts. Judgments were elicited from each expert individually and aggregated using both equal and performance weights. Performance weighted results are reported as they increased the informativeness of estimates, while retaining accuracy. We report measures of central tendency and uncertainty bounds on food source attribution estimate. For some pathogens we see relatively consistent food source attribution estimates across subregions of the world; for others there is substantial regional variation. For example, for non-typhoidal salmonellosis, pork was of minor importance compared to eggs and poultry meat in the American and African subregions, whereas in the European and Western Pacific subregions the importance of these three food sources were quite similar. Our regional results broadly agree with estimates from earlier European and North American food source attribution research. As in prior food source attribution research, we find relatively wide uncertainty bounds around our median estimates.We present the first worldwide estimates of the proportion of specific foodborne diseases attributable to specific food exposure routes. While we find substantial uncertainty around central tendency estimates, we believe these estimates provide the best currently available basis on which to link FBDs and specific foods in many parts of the world

  7. Attribution of global foodborne disease to specific foods: Findings from a World Health Organization structured expert elicitation.

    Science.gov (United States)

    Hoffmann, Sandra; Devleesschauwer, Brecht; Aspinall, Willy; Cooke, Roger; Corrigan, Tim; Havelaar, Arie; Angulo, Frederick; Gibb, Herman; Kirk, Martyn; Lake, Robin; Speybroeck, Niko; Torgerson, Paul; Hald, Tine

    2017-01-01

    Recently the World Health Organization, Foodborne Disease Burden Epidemiology Reference Group (FERG) estimated that 31 foodborne diseases (FBDs) resulted in over 600 million illnesses and 420,000 deaths worldwide in 2010. Knowing the relative role importance of different foods as exposure routes for key hazards is critical to preventing illness. This study reports the findings of a structured expert elicitation providing globally comparable food source attribution estimates for 11 major FBDs in each of 14 world subregions. We used Cooke's Classical Model to elicit and aggregate judgments of 73 international experts. Judgments were elicited from each expert individually and aggregated using both equal and performance weights. Performance weighted results are reported as they increased the informativeness of estimates, while retaining accuracy. We report measures of central tendency and uncertainty bounds on food source attribution estimate. For some pathogens we see relatively consistent food source attribution estimates across subregions of the world; for others there is substantial regional variation. For example, for non-typhoidal salmonellosis, pork was of minor importance compared to eggs and poultry meat in the American and African subregions, whereas in the European and Western Pacific subregions the importance of these three food sources were quite similar. Our regional results broadly agree with estimates from earlier European and North American food source attribution research. As in prior food source attribution research, we find relatively wide uncertainty bounds around our median estimates. We present the first worldwide estimates of the proportion of specific foodborne diseases attributable to specific food exposure routes. While we find substantial uncertainty around central tendency estimates, we believe these estimates provide the best currently available basis on which to link FBDs and specific foods in many parts of the world, providing guidance

  8. Noticing cigarette health warnings and support for new health warnings among non-smokers in China: findings from the International Tobacco Control project (ITC China survey

    Directory of Open Access Journals (Sweden)

    Zejun Li

    2017-05-01

    Full Text Available Abstract Background Health warnings labels (HWLs have the potential to effectively communicate the health risks of smoking to smokers and non-smokers, and encourage smokers to quit. This study sought to examine whether non-smokers in China notice the current text-only HWLs and whether they support adding more health information and including pictures on HWLs. Methods Adult non-smokers (n = 1324 were drawn from Wave 4 (September 2011–November 2012 of the International Tobacco Control (ITC China Survey. The proportion of non-smokers who noticed the HWLs, and supported adding more health information and pictures to the HWLs was examined. Additionally, the relation between non-smokers’ demographic characteristics, including whether they had a smoking partner, their number of smoking friends, and noticing the HWLs and support for adding health information and pictures was examined. Because the HWLs changed during the survey period (April 2012, differences between non-smokers who completed the survey before and after the change were examined. Results 12.2% reported they noticed the HWLs often in the last month. The multivariate model, adjusting for demographics showed that respondents with a smoking partner (OR = 2.41, 95% CI 1.42–4.13, p = 0.001 noticed the HWLs more often. 64.8% of respondents agreed that the HWLs should have more information, and 80.2% supported including pictures. The multivariate model showed that non-smokers who completed the survey after the HWLs were implemented (OR = 0.63, 95% CI 0.40–0.99, p = 0.04 were less likely to support adding more health information. The multivariate model showed a significant relation between having a smoking partner and supporting pictorial HWLs (OR = 2.03, 95% CI 1.24–3.33, p = 0.005. Conclusions The findings indicate that the Chinese HWLs are noticed by a minority of non-smokers and that non-smokers strongly support strengthening the Chinese warning labels with more health

  9. Ecosystem scale acoustic sensing reveals humpback whale behavior synchronous with herring spawning processes and re-evaluation finds no effect of sonar on humpback song occurrence in the Gulf of Maine in fall 2006.

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    Zheng Gong

    Full Text Available We show that humpback-whale vocalization behavior is synchronous with peak annual Atlantic herring spawning processes in the Gulf of Maine. With a passive, wide-aperture, densely-sampled, coherent hydrophone array towed north of Georges Bank in a Fall 2006 Ocean Acoustic Waveguide Remote Sensing (OAWRS experiment, vocalizing whales could be instantaneously detected and localized over most of the Gulf of Maine ecosystem in a roughly 400-km diameter area by introducing array gain, of 18 dB, orders of magnitude higher than previously available in acoustic whale sensing. With humpback-whale vocalizations consistently recorded at roughly 2000/day, we show that vocalizing humpbacks (i were overwhelmingly distributed along the northern flank of Georges Bank, coinciding with the peak spawning time and location of Atlantic herring, and (ii their overall vocalization behavior was strongly diurnal, synchronous with the formation of large nocturnal herring shoals, with a call rate roughly ten-times higher at night than during the day. Humpback-whale vocalizations were comprised of (1 highly diurnal non-song calls, suited to hunting and feeding behavior, and (2 songs, which had constant occurrence rate over a diurnal cycle, invariant to diurnal herring shoaling. Before and during OAWRS survey transmissions: (a no vocalizing whales were found at Stellwagen Bank, which had negligible herring populations, and (b a constant humpback-whale song occurrence rate indicates the transmissions had no effect on humpback song. These measurements contradict the conclusions of Risch et al. Our analysis indicates that (a the song occurrence variation reported in Risch et al. is consistent with natural causes other than sonar, (b the reducing change in song reported in Risch et al. occurred days before the sonar survey began, and (c the Risch et al. method lacks the statistical significance to draw the conclusions of Risch et al. because it has a 98-100% false-positive rate

  10. The impact of shift and night work on health related quality of life of working women: findings from the Korea Health Panel.

    Science.gov (United States)

    Kim, Woorim; Kim, Tae Hyun; Lee, Tae-Hoon; Choi, Jae Woo; Park, Eun-Cheol

    2016-11-28

    Night and shift work status has been associated with health related quality of life (HRQoL) in economically active women. This study aimed to investigate the association between night or shift work status and HRQoL of economically active women and to further analyze how marital status interplays in the objected relationship. Data were from the Korea Health Panel, 2011 to 2013. A total of 2238 working women were included for analysis. Work status was categorized into day work, night work, and rotating shift work and its association with HRQoL, measured using the EuroQol-5D (EQ-5D) index, was investigated using the generalized estimating equation (GEE) model. Compared to the day work reference group, the night work group (β: -0.9757, P = 0.0202) and the rotating shift work group (β: -0.7947, P = 0.0363) showed decreases in EQ-5D scores. This trend was maintained regardless of marital status, although decreases in health related quality of life were particularly pronounced among night shift workers with a spouse. Night and rotating shift work status was associated with HRQoL of economically active women as individuals working night and rotating shifts showed decreases in EQ-5D scores compared to individuals working day shifts. The findings of this study signify the importance of monitoring the HRQoL status of women working night and rotating shifts as these individuals may be comparatively vulnerable to reduced HRQoL.

  11. The influence of parenting style on health related behavior of children: findings from the ChiBS study.

    Science.gov (United States)

    Philips, Nele; Sioen, Isabelle; Michels, Nathalie; Sleddens, Ester; De Henauw, Stefaan

    2014-07-23

    constructs) and (4) a small negative association between the parenting construct "coercive control" and sleep duration (β = -0.23). The significant but small associations between parenting constructs and the investigated variables suggest that different aspects of parenting style play an important role in the genesis of the health related behavior of children. Overall, our findings suggest that health professionals should encourage parents to apply the more positive parenting constructs i.e., more "structure" and "behavioral control", and less "coercive control". They could, for instance, supervise and manage their child's activities and help their child to achieve certain goals.

  12. Finding Important Terms for Patients in Their Electronic Health Records: A Learning-to-Rank Approach Using Expert Annotations

    Science.gov (United States)

    Zheng, Jiaping; Yu, Hong

    2016-01-01

    Background Many health organizations allow patients to access their own electronic health record (EHR) notes through online patient portals as a way to enhance patient-centered care. However, EHR notes are typically long and contain abundant medical jargon that can be difficult for patients to understand. In addition, many medical terms in patients’ notes are not directly related to their health care needs. One way to help patients better comprehend their own notes is to reduce information overload and help them focus on medical terms that matter most to them. Interventions can then be developed by giving them targeted education to improve their EHR comprehension and the quality of care. Objective We aimed to develop a supervised natural language processing (NLP) system called Finding impOrtant medical Concepts most Useful to patientS (FOCUS) that automatically identifies and ranks medical terms in EHR notes based on their importance to the patients. Methods First, we built an expert-annotated corpus. For each EHR note, 2 physicians independently identified medical terms important to the patient. Using the physicians’ agreement as the gold standard, we developed and evaluated FOCUS. FOCUS first identifies candidate terms from each EHR note using MetaMap and then ranks the terms using a support vector machine-based learn-to-rank algorithm. We explored rich learning features, including distributed word representation, Unified Medical Language System semantic type, topic features, and features derived from consumer health vocabulary. We compared FOCUS with 2 strong baseline NLP systems. Results Physicians annotated 90 EHR notes and identified a mean of 9 (SD 5) important terms per note. The Cohen’s kappa annotation agreement was .51. The 10-fold cross-validation results show that FOCUS achieved an area under the receiver operating characteristic curve (AUC-ROC) of 0.940 for ranking candidate terms from EHR notes to identify important terms. When including term

  13. School Performance : A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

    NARCIS (Netherlands)

    Ruijsbroek, Annemarie; Wijga, Alet H.; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariel

    2015-01-01

    Background Performance in primary school is a determinant of children's educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent

  14. School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

    NARCIS (Netherlands)

    Ruijsbroek, Annemarie; Wijga, Alet H; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

    2015-01-01

    BACKGROUND: Performance in primary school is a determinant of children's educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent

  15. School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

    NARCIS (Netherlands)

    Ruijsbroek, Annemarie; Wijga, Alet H.; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

    2015-01-01

    Performance in primary school is a determinant of children's educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory

  16. "Because if we talk about health issues first, it is easier to talk about human trafficking"; findings from a mixed methods study on health needs and service provision among migrant and trafficked fishermen in the Mekong.

    Science.gov (United States)

    Pocock, Nicola S; Tadee, Reena; Tharawan, Kanokwan; Rongrongmuang, Wansiri; Dickson, Brett; Suos, Soksreymom; Kiss, Ligia; Zimmerman, Cathy

    2018-05-09

    Human trafficking in the fishing industry or "sea slavery" in the Greater Mekong Subregion is reported to involve some of the most extreme forms of exploitation and abuse. A largely unregulated sector, commercial fishing boats operate in international waters far from shore and outside of national jurisdiction, where workers are commonly subjected to life-threatening risks. Yet, research on the health needs of trafficked fishermen is sparse. This paper describes abuses, occupational hazards, physical and mental health and post-trafficking well-being among a systematic consecutive sample of 275 trafficked fishermen using post-trafficking services in Thailand and Cambodia. These findings are complemented by qualitative interview data collected with 20 key informants working with fishermen or on issues related to their welfare in Thailand. Men and boys trafficked for fishing (aged 12-55) were mainly from Cambodia (n = 217) and Myanmar (n = 55). Common physical health problems included dizzy spells (30.2%), exhaustion (29.5%), headaches (28.4%) and memory problems (24.0%). Nearly one-third (29.1%) reported pain in three or more areas of their body and one-quarter (26.9%) reported being in "poor" health. Physical health symptoms were strongly associated with: severe violence; injuries; engagement in long-haul fishing; immigration detention or symptoms of mental health disorders. Survivors were exposed to multiple work hazards and were perceived as disposable when disabled by illness or injuries. Employers struggled to apply internationally recommended Personal Protective Equipment (PPE) practices in Thailand. Non-governmental organizations (NGOs) encountered challenges when trying to obtain healthcare for uninsured fishermen. Challenges included fee payment, service provision in native languages and officials siding with employers in disputes over treatment costs and accident compensation. Survivors' post-trafficking concerns included: money problems (75

  17. Final Rule for Finding That Greenhouse Gas Emissions From Aircraft Cause or Contribute to Air Pollution That May Reasonably Be Anticipated To Endanger Public Health and Welfare

    Science.gov (United States)

    The EPA finalized findings that greenhouse gas (GHG) emissions from certain classes of engines used in aircraft contribute to the air pollution that causes climate change endangering public health and welfare under section 231(a) of the Clean Air Act.

  18. Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey.

    Science.gov (United States)

    Kane, J C; Luitel, N P; Jordans, M J D; Kohrt, B A; Weissbecker, I; Tol, W A

    2018-06-01

    functioning was less strongly associated with PTSD symptoms. Four months after the earthquakes in Nepal, one out of three adults experienced symptoms of depression and distressing levels of anger, one out of five engaged in hazardous drinking, and one out of ten had suicidal thoughts. However, posttraumatic stress symptoms and functional impairment were comparatively less frequent. Taken together, the findings suggest that there were significant levels of psychological distress but likely low levels of disorder. The findings highlight the importance of indicated prevention strategies to reduce the risk of distress progressing to disorder within post-disaster mental health systems of care.

  19. Limited Knowledge of Chronic Kidney Disease and Its Main Risk Factors among Iranian Community: An Appeal for Promoting National Public Health Education Programs

    Directory of Open Access Journals (Sweden)

    Peyman Roomizadeh

    2014-05-01

    Full Text Available Background The aim of this survey was to explore the baseline knowledge of the Iranian community about Chronic Kidney Disease (CKD definition and its two main risk factors, i.e. diabetes and hypertension. This study also introduced a model of public education program with the purpose of reducing the incidence of CKD in high-risk groups and thereby decreasing the economic burden of CKD in Iran. Methods This cross-sectional study was conducted on world kidney day 2013 in Isfahan, Iran. Self-administered anonymous questionnaires evaluating the knowledge of CKD and its risk factors were distributed among subjects who participated in a kidney disease awareness campaign. Chi-square test and logistic regression analysis were used to examine the differences in the level of knowledge across different socio-demographic groups. Results The questionnaires were completed by 748 respondents. The majority of these respondents believed that “pain in the flanks” and “difficulty in urination” was the early symptoms of CKD. Roughly, 10.4% knew that CKD could be asymptomatic in the initial stages. Only 12.7% knew diabetes and 14.4% knew hypertension was a CKD risk factor. The respondents who had a CKD risk factor (i.e. diabetes and/or hypertension were significantly more likely than respondents without CKD risk factor to select “unmanaged diabetes” [Odds Ratio (OR= 2.2, Confidence Interval (CI (95%: 1.4–3.6] and “unmanaged hypertension” [OR= 1.9, CI(95%: 1.2–3.0] as “very likely to result in CKD”. No more than 34.6% of all respondents with diabetes and/or hypertension reported that their physician has ever spoken with them about their increased risk for developing CKD. Conclusion The knowledge of Iranian population about CKD and its risk factors is low. Future public health education programs should put efforts in educating Iranian community about the asymptomatic nature of CKD in its initial stages and highlighting the importance of regular

  20. "Health regains but livelihoods lag": findings from a study with people on ART in Zambia and Kenya.

    Science.gov (United States)

    Samuels, Fiona A; Rutenberg, Naomi

    2011-06-01

    Although ART is increasingly accessible and eases some stresses, it creates other challenges including the importance of food security to enhance ART-effectiveness. This paper explores the role livelihood strategies play in achieving food security and maintaining nutritional status among ART patients in Kenya and Zambia. Ongoing quantitative studies exploring adherence to ART in Mombasa, Kenya (n=118) and in Lusaka, Zambia (n=375) were used to identify the relationship between BMI and adherence; an additional set of in-depth interviews with people on ART (n=32) and members of their livelihood networks (n=64) were undertaken. Existing frameworks and scales for measuring food security and a positive deviance approach was used to analyse data. Findings show the majority of people on ART in Zambia are food insecure; similarly most respondents in both countries report missing meals. Snacking is important for dietary intake, especially in Kenya. Most food is purchased in both countries. Having assets is key for achieving livelihood security in both Kenya and Zambia. Food supplementation is critical to survival and for developing social capital since most is shared amongst family members and others. Whilst family and friends are key to an individual's livelihood network, often more significant for daily survival is proximity to people and the ability to act immediately, characteristics most often found amongst neighbours and tenants. In both countries findings show that with ART health has rebounded but livelihoods lag. Similarly, in both countries respondents with high adherence and high BMI are more self-reliant, have multiple income sources and assets; those with low adherence and low BMI have more tenuous livelihoods and were less likely to have farms/gardens. Food supplementation is, therefore, not a long-term solution. Building on existing livelihood strategies represents an alternative for programme managers and policy-makers as do other strategies including

  1. Health facility-based Active Management of the Third Stage of Labor: findings from a national survey in Tanzania

    Directory of Open Access Journals (Sweden)

    Mfinanga Godfrey S

    2009-04-01

    ergometrine for AMTSL instead of oxytocin as recommended by ICM/FIGO. The study also observed harmful practices during delivery. These findings indicate that there is a need for updating the STGs, curricula and training of health providers on AMTSL and monitoring its practice.

  2. Education for Public Health Capacity in the Nursing Workforce: Findings from a Review of Education and Practice Issues.

    Science.gov (United States)

    Latter, Sue; Speller, Viv; Westwood, Greta; Latchem, Susan

    2003-01-01

    Literature review and interviews with nine public health and nursing education informants in Britain indicated that, although National Health Service policy highlights public health, clinical placements in this area are limited and curriculum content needs to be applicable to public health. Needs assessments show skills gaps in practicing nurses…

  3. Prevalence and correlates of atypical patterns of drug use progression: findings from the South African Stress and Health Study

    Science.gov (United States)

    Myers, B; van Heerden, MS; Grimsrud, A; Myer, L; Williams, DR; Stein, DJ

    2012-01-01

    Objective Atypical sequences of drug use progression are thought to have important implications for the development of substance dependence. The extent to which this assumption holds for South African populations is unknown. This paper attempts to address this gap by examining the prevalence and correlates of atypical patterns of drug progression among South Africans. Method Data on substance use and other mental health disorders from a nationally representative sample of 4351 South Africans were analysed. Weighted cross tabulations were used to estimate prevalence and correlates of atypical patterns of drug use progression. Results Overall, 12.2% of the sample reported atypical patterns of drug use progression. The most common violation was the use of extra-medical drugs prior to alcohol and tobacco. Gender was significantly associated with atypical patterns of drug use with the risk pattern varying by the type of drug. None of the anxiety or mood disorders were associated with atypical patterns of use. Atypical patterns of drug use were not associated with increased risk for a lifetime substance use disorder. Conclusion Atypical patterns of drug use initiation seem more prevalent in South Africa compared to other countries. The early use of extra-medical drugs is common, especially among young women. Drug availability and social environmental factors may influence patterns of drug use. The findings have important implications for prevention initiatives and future research. PMID:21509404

  4. Utilizing the ECHO Model in the Veterans Health Affairs System: Guidelines for Setup, Operations and Preliminary Findings

    Directory of Open Access Journals (Sweden)

    Herschel Knapp

    2015-06-01

    Full Text Available Background: In 2011, the Veterans Health Administration (VHA consulted with the Project ECHO (Extension for Community Healthcare Outcomes team at the University of New Mexico, Albuquerque, to reproduce their successful model within the VHA. Methods: The VHA launched SCAN-ECHO (Specialty Care Access Network-Extension for Community Healthcare Outcomes, a multisite videoconferencing system to conduct live clinical consultations between specialists at a VHA Medical Center (hospital and primary care providers stationed at satellite VHA CBOCs (Community-Based Outpatient Clinic. Results: Analysis of the first three years rendered a mean attendee satisfaction of 89.53% and a consultation satisfaction score of 88.10%. About half of the SCAN-ECHO consultations resulted in patients receiving their treatment from their local primary care providers; the remaining half were referred to the VHA Medical Center when the treatment involved equipment or services not available at the CBOCs (e.g., MRI, surgery. Conclusion: This paper details the setup, operation logistics and preliminary findings, suggesting that SCAN-ECHO is a viable model for providing quality specialty clinical consultation service, prompter access to care, reduced commutes and continuing education. Additionally, the use of a secured Internet-based videoconferencing system that supports connectivity to multiple (mobile devices could expand the utilization of this service.

  5. Adolescent over-general memory, life events and mental health outcomes: Findings from a UK cohort study.

    Science.gov (United States)

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J Mark G

    2016-01-01

    Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations.

  6. Alcohol Marketing, Drunkenness, and Problem Drinking among Zambian Youth: Findings from the 2004 Global School-Based Student Health Survey

    Directory of Open Access Journals (Sweden)

    Monica H. Swahn

    2011-01-01

    Full Text Available This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS conducted in Zambia (2004 of students primarily 11 to 16 years of age (=2257. Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09–2.02 and problem drinking (AOR = 1.41; 95% CI: 1.06–1.87 among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.

  7. Alcohol marketing, drunkenness, and problem drinking among Zambian youth: findings from the 2004 Global School-Based Student Health Survey.

    Science.gov (United States)

    Swahn, Monica H; Ali, Bina; Palmier, Jane B; Sikazwe, George; Mayeya, John

    2011-01-01

    This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09-2.02) and problem drinking (AOR = 1.41; 95% CI: 1.06-1.87) among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.

  8. Achados principais de exames laboratoriais no diagnóstico de apendicite aguda: uma avaliação prospectiva Main findings in laboratory tests diagnosis of acute appendicitis: a prospective evaluation

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    Rafael Nunes Goulart

    2012-06-01

    Full Text Available RACIONAL: Apendicite aguda é a doença abdominal cirúrgica mais comum nas unidades de emergência. Embora o diagnóstico seja clínico, a realização de exames complementares pode ser útil na dúvida diagnóstica. OBJETIVO: Avaliar as principais alterações de exames laboratoriais em pacientes com apendicite aguda, assim como sua relação com a fase evolutiva da doença. MÉTODOS: Avaliação prospectiva de pacientes com diagnóstico de apendicite aguda submetidos ao tratamento cirúrgico. RESULTADOS: Cento e setenta e nove pacientes participaram deste estudo, a maioria do sexo masculino. A idade méd