WorldWideScience

Sample records for periodic health evaluation

  1. Health conditions detected in a comprehensive periodic health evaluation of 558 professional football players

    NARCIS (Netherlands)

    Bakken, Arnhild; Targett, Stephen; Bere, Tone; Adamuz, Maria-Carmen; Tol, Johannes L.; Whiteley, Rod; Wilson, Mathew G.; Witvrouw, Erik; Khan, Karim M.; Bahr, Roald

    2016-01-01

    Despite the widespread use of periodic health evaluation (PHE) to detect and prevent injury and illness in athletes, its effectiveness in detecting health conditions and relevant risk factors is still debated. To assess health conditions detected by a comprehensive PHE in professional male football

  2. The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study

    Directory of Open Access Journals (Sweden)

    Kermott Cindy A

    2012-05-01

    Full Text Available Abstract Background The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear. Methods We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention. Results The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients’ complaints (71% and would not have been identified by screening guidelines (51%. Men (odds ratio 2.67; 95% CI, 1.76, 4.03 and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19 were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort. Conclusion The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.

  3. Women Health and Psychological Functioning in Different Periods of Life: Evaluation of Nursing Approach

    Directory of Open Access Journals (Sweden)

    Fusun Terzioglu

    2011-03-01

    Full Text Available World Health Organization describes health as the state of being completely fine corporally, socially and psychologically. The state of being completely fine which is indicated in this description of health has been criticised by many scientists and with the idea that noone shall ever realise tha state of being completely fine corporally and psychologically, it was emphasized that individuals could be evaluated to be “healthy” as long as they are productive. Starting from the intrauterine period, woman passes through different periods such as childhood, adolescence, adulthood, elderliness and she experiences some physical, psychological and social differences in each of these periods within the frame of life cycle. While these differences influence productivities and life qualities of women negatively, they also make them more inclined to psychiatric illnesses. Therefore, psychological problems are more common among women and they last longer. Considering the fact that among the medical personnel, it is the nurses who spend time with patients during the phases of diagnosis, treatment and rehabilitation the most, it could be said that nurses have a significant role in intervening in problems that affect the psychological health of woman. The nurse has responsibilities such as determining the problem the woman goes through, providing protective care, getting an early diagnosis, making the convenient remedial intervention and consigning, when necessary. In this article, significant woman health problems that could be experienced starting from the intrauterine life until the end of life by woman, the effects of this problem to the psychological health of the woman and nursing approaches in view of these problems are discussed.

  4. Monitoring and evaluation of the health status of workers from the Kozloduy NPP for the period 2011-2013

    International Nuclear Information System (INIS)

    Negoycheva, Krasimira; Chobanova, Nina; Peyankov, Her; Miltchev, Audrey; Djounova, Jana

    2015-01-01

    The aim of this study was to establish the impact of occupational exposure on workers in the Kozloduy NPP through monitoring and evaluation of their health status. The study involved 302 persons from the NPP for the period 2011-2013. Based on the protocol for individual monitoring, cumulative doses of the respondents are in the range of 0.1 to 588 mSv. The probability of the occupational exposure to be a reason for the diagnosed malignant diseases has been determined (Probability of Causation is henceforth denoted as PC)

  5. Evaluating the coefficient of thermal expansion using time periods of minimal thermal gradient for a temperature driven structural health monitoring

    Science.gov (United States)

    Reilly, J.; Abdel-Jaber, H.; Yarnold, M.; Glisic, B.

    2017-04-01

    Structural Health Monitoring aims to characterize the performance of a structure from a combination of recorded sensor data and analytic techniques. Many methods are concerned with quantifying the elastic response of the structure, treating temperature changes as noise in the analysis. While these elastic profiles do demonstrate a portion of structural behavior, thermal loads on a structure can induce comparable strains to elastic loads. Understanding this relationship between the temperature of the structure and the resultant strain and displacement can provide in depth knowledge of the structural condition. A necessary parameter for this form of analysis is the Coefficient of Thermal Expansion (CTE). The CTE of a material relates the amount of expansion or contraction a material undergoes per degree change in temperature, and can be determined from temperature-strain relationship given that the thermal strain can be isolated. Many times with concrete, the actual amount of expansion with temperature in situ varies from the given values for the CTE due to thermally generated elastic strain, which complicates evaluation of the CTE. To accurately characterize the relationship between temperature and strain on a structure, the actual thermal behavior of the structure needs to be analyzed. This rate can vary for different parts of a structure, depending on boundary conditions. In a case of unrestrained structures, the strain in the structure should be linearly related to the temperature change. Thermal gradients in a structure can affect this relationship, as they induce curvature and deplanations in the cross section. This paper proposes a method that addresses these challenges in evaluating the CTE.

  6. [Evaluation of nutrition mode and nutritional status and pro health education of children during the period of pubertal spurt in the city of Szczecin].

    Science.gov (United States)

    Goluch-Koniuszy, Zuzanna; Friedrich, Mariola; Radziszewska, Magdalena

    2009-01-01

    This research was aimed at evaluation of the method of nutrition and the state of nutrition in the children aged 13 during the period of pubertal spurt who had their body mass, body height and waist measurement defined. These values led to calculation of BMI, WC, and WHtR indicators, which were related to centile distribution of children from Warszawa and Lódź. Only in 63.6% of girls and 68.9% of boys from Szczecin schools the value of BMI was proper. The problem of accumulation of fat tissue (WC > or = 90 c) around the waist refers to nearly 14% of girls and 9.4% of boys. The value of the indicator WHtR > or = 90 c was found in 11% of the children under research. Children with overweight (BMI 90-97 c) and obesity (BMI > or = 97 c) were selected based on the value of BMI indicator. Their menus of three chosen at random weekdays were obtained. Analysis of the nutrition method of children with overweight and obesity showed low energy value of the diet, general protein, complex carbohydrates, cellulose, mineral components (Ca, Mg, Fe, Cu, Zn), A, E (girls), C (boys), group B vitamins and also liquids deficiency. The children have undergone a special pro health education in the form of "live" workshops and 3 months after an evaluation inquiry was conducted to assess the effects of the workshops. The analysis of the evaluation inquiry showed that the children have included in their diet breakfasts and afternoon snacks and to their main meal menus whole wheat products, larger quantity of vegetables, fruit and water. It has been also established that sweets, meals of fast food types, chips, pizzy and energizing drinks have been limited.

  7. Evaluation of periodic safety status analyses

    International Nuclear Information System (INIS)

    Faber, C.; Staub, G.

    1997-01-01

    In order to carry out the evaluation of safety status analyses by the safety assessor within the periodical safety reviews of nuclear power plants safety goal oriented requirements have been formulated together with complementary evaluation criteria. Their application in an inter-disciplinary coopertion covering the subject areas involved facilitates a complete safety goal oriented assessment of the plant status. The procedure is outlined briefly by an example for the safety goal 'reactivity control' for BWRs. (orig.) [de

  8. The Diagnostic Utility of Computer-Assisted Auscultation for the Early Detection of Cardiac Murmurs of Structural Origin in the Periodic Health Evaluation.

    Science.gov (United States)

    Viviers, Pierre L; Kirby, Jo-Anne H; Viljoen, Jeandré T; Derman, Wayne

    Identification of the nature of cardiac murmurs during the periodic health evaluation (PHE) of athletes is challenging due to the difficulty in distinguishing between murmurs of physiological or structural origin. Previously, computer-assisted auscultation (CAA) has shown promise to support appropriate referrals in the nonathlete pediatric population. CAA has the ability to accurately detect cardiac murmurs of structural origin during a PHE in collegiate athletes. Cross-sectional, descriptive study. Level 3. A total of 131 collegiate athletes (104 men, 28 women; mean age, 20 ± 2 years) completed a sports physician (SP)-driven PHE consisting of a cardiac history questionnaire and a physical examination. An independent CAA assessment was performed by a technician who was blinded to the SP findings. Athletes with suspected structural murmurs or other clinical reasons for concern were referred to a cardiologist for confirmatory echocardiography (EC). Twenty-five athletes were referred for further investigation (17 murmurs, 6 abnormal electrocardiographs, 1 displaced apex, and 1 possible case of Marfan syndrome). EC confirmed 3 structural and 22 physiological murmurs. The SP flagged 5 individuals with possible underlying structural pathology; 2 of these murmurs were confirmed as structural in nature. Fourteen murmurs were referred by CAA; 3 of these were confirmed as structural in origin by EC. One such murmur was not detected by the SP, however, and detected by CAA. The sensitivity of CAA was 100% compared with 66.7% shown by the SP, while specificity was 50% and 66.7%, respectively. CAA shows potential to be a feasible adjunct for improving the identification of structural murmurs in the athlete population. Over-referral by CAA for EC requires further investigation and possible refinements to the current algorithm. Further studies are needed to determine the true sensitivity, specificity, and cost efficacy of the device among the athletic population. CAA may be a

  9. MOV reliability evaluation and periodic verification scheduling

    Energy Technology Data Exchange (ETDEWEB)

    Bunte, B.D.

    1996-12-01

    The purpose of this paper is to establish a periodic verification testing schedule based on the expected long term reliability of gate or globe motor operated valves (MOVs). The methodology in this position paper determines the nominal (best estimate) design margin for any MOV based on the best available information pertaining to the MOVs design requirements, design parameters, existing hardware design, and present setup. The uncertainty in this margin is then determined using statistical means. By comparing the nominal margin to the uncertainty, the reliability of the MOV is estimated. The methodology is appropriate for evaluating the reliability of MOVs in the GL 89-10 program. It may be used following periodic testing to evaluate and trend MOV performance and reliability. It may also be used to evaluate the impact of proposed modifications and maintenance activities such as packing adjustments. In addition, it may be used to assess the impact of new information of a generic nature which impacts safety related MOVs.

  10. MOV reliability evaluation and periodic verification scheduling

    International Nuclear Information System (INIS)

    Bunte, B.D.

    1996-01-01

    The purpose of this paper is to establish a periodic verification testing schedule based on the expected long term reliability of gate or globe motor operated valves (MOVs). The methodology in this position paper determines the nominal (best estimate) design margin for any MOV based on the best available information pertaining to the MOVs design requirements, design parameters, existing hardware design, and present setup. The uncertainty in this margin is then determined using statistical means. By comparing the nominal margin to the uncertainty, the reliability of the MOV is estimated. The methodology is appropriate for evaluating the reliability of MOVs in the GL 89-10 program. It may be used following periodic testing to evaluate and trend MOV performance and reliability. It may also be used to evaluate the impact of proposed modifications and maintenance activities such as packing adjustments. In addition, it may be used to assess the impact of new information of a generic nature which impacts safety related MOVs

  11. Health evaluation and affecting factors analysis of geological prospecting and mining workers in Chinese uranium mines in the past 30 years period

    International Nuclear Information System (INIS)

    Bao Shouchen; Gao Zenglin; Chang Xuezhang; Zhang Yidan; Zhang Xuzong

    2001-01-01

    To evaluate the health level of geology and mine workers in nuclear industry and to estimate objectively the effect of such factors as surroundings, society and psychology on health, the physical examination material and death cause investigation results of sampled units are summarized and analyzed. The results show that symptoms incidences of underground group is greater than that of control group (P -5 and 189.30 x 10 -5 ; SMR of whole death cause is 0.93 and 0.53 (both P > 0.05); SMR of injury and poisoning is 1.64 and 1.79 (both P 0.05). SMR of lung cancer is 1.62 (P > 0.05) and 1.50 (P 0.05) and 4.25 (P < 0.01), respectively. It is concluded that as a whole, health condition of geology and mine workers in nuclear industry is good. Dust, injury suffered on the job and radon daughters are main factors affecting health; while attaching importance to occupational safety and radiation protection, better-equipped health service guarantee people's health

  12. Therapeutic Value of the Periodic Health Examination

    Energy Technology Data Exchange (ETDEWEB)

    Lincoln, T. A.; Hurt, H. B.

    1965-09-01

    The Oak Ridge National Laboratory has been conducting periodic health examinations on all of its employees for over 10 years. The original purpose of this program was the early detection of disease to be followed by referral or appropriate counseling. Because of the relatively young age of this group, we expected that this service would be of greatest benefit to only the small percentage who had significant findings. However, over this 10 year period we have been increasingly impressed that those who had no significant findings have expressed almost as much enthusiasm and gratitude as those in whom we found early but potentially serious disease. This response caused us to look more critically at the reasons for this favorable reaction. As a result, we have become convinced that these examinations have an important therapeutic value to the healthy, as well as the sick, and that this fact should be considered in their justification. A health examination can quite properly be considered therapeutic, even though no disease is found or treated, providing it "serves" or meets some of the needs of the person being examined. After all, the literal definition of the word therapeutic is service, since it is derived from the Greek word therapeutikos, which means an attendant or servant.

  13. Health evaluation and affecting factors analysis of geological prospecting and mining workers in Chinese uranium mines in the past 30 years period

    Energy Technology Data Exchange (ETDEWEB)

    Shouchen, Bao; Zenglin, Gao; Xuezhang, Chang [China Inst. for Radiation Protection, Taiyuan (China); Yidan, Zhang [Hospital 417, Lintong (China); Xuzong, Zhang [Bureau of Safety, Protection of Environment and Health, China National Nuclear Corporation, Beijing (China)

    2001-04-01

    To evaluate the health level of geology and mine workers in nuclear industry and to estimate objectively the effect of such factors as surroundings, society and psychology on health, the physical examination material and death cause investigation results of sampled units are summarized and analyzed. The results show that symptoms incidences of underground group is greater than that of control group (P < 0.05); the percentage of incidence of hepatomegalia in these years is between 0% and 11.14%; the blood pressure of over 90% workers is within the normal limits; the mean WBC, Pts and Hgb is normal; the GPT abnormality incidence in geology system and mines is 6.44% and 3.75%, respectively; while HBsAg incidence is 7.0% and 7.43% respectively, a middle levelled HBV infection. Silicosis incidence of underground group is 2.65%, for geology system and mines, chronic bronchitis incidence is 4.72% and 3.56%; pulmonary tuberculosis incidence is 1.17% and 0.60% and neurasthenia syndrome incidence is 0.60% and 0.40%, respectively, standard mortality is 660.62 x 10{sup -5} and 189.30 x 10{sup -5} ; SMR of whole death cause is 0.93 and 0.53 (both P > 0.05); SMR of injury and poisoning is 1.64 and 1.79 (both P < 0.01), injury death suffered on the job is on the top; SMR of malignant tumor is 0.79 and 0.71 (both P > 0.05). SMR of lung cancer is 1.62 (P > 0.05) and 1.50 (P < 0.05); and RR is 0.88 (P > 0.05) and 4.25 (P < 0.01), respectively. It is concluded that as a whole, health condition of geology and mine workers in nuclear industry is good. Dust, injury suffered on the job and radon daughters are main factors affecting health; while attaching importance to occupational safety and radiation protection, better-equipped health service guarantee people's health.

  14. Health Hazard Evaluations

    Science.gov (United States)

    ... May 1, 2018 Content source: National Institute for Occupational Safety and Health Division of Surveillance, Hazard Evaluation, and Field Studies ... Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 ...

  15. A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

    Science.gov (United States)

    McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

    2015-12-01

    It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Entropy method of measuring and evaluating periodicity of quasi-periodic trajectories

    Science.gov (United States)

    Ni, Yanshuo; Turitsyn, Konstantin; Baoyin, Hexi; Junfeng, Li

    2018-06-01

    This paper presents a method for measuring the periodicity of quasi-periodic trajectories by applying discrete Fourier transform (DFT) to the trajectories and analyzing the frequency domain within the concept of entropy. Having introduced the concept of entropy, analytical derivation and numerical results indicate that entropies increase as a logarithmic function of time. Periodic trajectories typically have higher entropies, and trajectories with higher entropies mean the periodicities of the motions are stronger. Theoretical differences between two trajectories expressed as summations of trigonometric functions are also derived analytically. Trajectories in the Henon-Heiles system and the circular restricted three-body problem (CRTBP) are analyzed with the indicator entropy and compared with orthogonal fast Lyapunov indicator (OFLI). The results show that entropy is a better tool for discriminating periodicity in quasiperiodic trajectories than OFLI and can detect periodicity while excluding the spirals that are judged as periodic cases by OFLI. Finally, trajectories in the vicinity of 243 Ida and 6489 Golevka are considered as examples, and the numerical results verify these conclusions. Some trajectories near asteroids look irregular, but their higher entropy values as analyzed by this method serve as evidence of frequency regularity in three directions. Moreover, these results indicate that applying DFT to the trajectories in the vicinity of irregular small bodies and calculating their entropy in the frequency domain provides a useful quantitative analysis method for evaluating orderliness in the periodicity of quasi-periodic trajectories within a given time interval.

  17. Public health interventions: evaluating the economic evaluations

    Directory of Open Access Journals (Sweden)

    Martin Forster

    2013-10-01

    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  18. Effect of additional brief counselling after periodic health examination on motivation for health behavior change [corrected].

    Science.gov (United States)

    Son, Ki Young; Lee, Cheol Min; Cho, BeLong; Lym, Youl Lee; Oh, Seung Won; Chung, Wonjoo; Lee, Jin-Seok; Park, DuShin; Kim, Han Suk

    2012-11-01

    This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.

  19. Duty periods for establishing eligibility for health care. Final rule.

    Science.gov (United States)

    2013-12-26

    The Department of Veterans Affairs (VA) is amending its medical regulations concerning eligibility for health care to re-establish the definitions of "active military, naval, or air service,'' "active duty,'' and "active duty for training.'' These definitions were deleted in 1996; however, we believe that all duty periods should be defined in part 17 of the Code of Federal Regulations (CFR) to ensure proper determination of eligibility for VA health care. We are also providing a more complete definition of "inactive duty training.''

  20. Multidimensional journal evaluation analyzing scientific periodicals beyond the impact factor

    CERN Document Server

    Haustein, Stefanie

    2012-01-01

    Scientific communication depends primarily on publishing in journals. The most important indicator to determine the influence of a journal is the Impact Factor. Since this factor only measures the average number of citations per article in a certain time window, it can be argued that it does not reflect the actual value of a periodical. This book defines five dimensions, which build a framework for a multidimensional method of journal evaluation. The author is winner of the Eugene Garfield Doctoral Dissertation Scholarship 2011.

  1. Environmental Volunteering and Health Outcomes over a 20-Year Period

    Science.gov (United States)

    Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.

    2010-01-01

    Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period.  Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates.  Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms.  Implications: This population-based study offers the first epidemiological evidence for a significant positive relationship between environmental volunteering and health and well-being outcomes. Further research, including intervention studies, is needed to confirm and shed additional light on these initial findings. PMID:20172902

  2. Health Economic Evaluation of Telehealthcare

    DEFF Research Database (Denmark)

    Udsen, Flemming Witt

    for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...

  3. Relationships between uterine health and metabolism in dairy cows with different dry period lengths

    NARCIS (Netherlands)

    Chen, J.; Soede, N.M.; Remmelink, G.J.; Bruckmaier, R.M.; Kemp, B.; Knegsel, van A.T.M.

    2017-01-01

    The first objective of this study was to evaluate effects of dry period (DP) length and dietary energy source on ovarian activity, uterine health status, pregnancy rate, and days open in dairy cows in the second subsequent lactation after implementation of DP length and dietary treatments. The

  4. Constructive eHealth evaluation

    DEFF Research Database (Denmark)

    Høstgaard, Anna Marie Balling; Bertelsen, Pernille Scholdan; Nøhr, Christian

    2017-01-01

    Abstract Background: Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using...... traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process...... by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented...

  5. Cardinal scales for health evaluation

    DEFF Research Database (Denmark)

    Harvey, Charles; Østerdal, Lars Peter Raahave

    2010-01-01

    Policy studies often evaluate health for an individual or for a population by using measurement scales that are ordinal scales or expected-utility scales. This paper develops scales of a different type, commonly called cardinal scales, that measure changes in health. Also, we argue that cardinal...... scales provide a meaningful and useful means of evaluating health policies. Thus, we develop a means of using the perspective of early neoclassical welfare economics as an alternative to ordinalist and expected-utility perspectives....

  6. Evaluating Health Information

    Science.gov (United States)

    Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. How can ... the site have an editorial board? Is the information reviewed before it is posted? Be skeptical. Things ...

  7. Mental health consultations in the perinatal period: a cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia.

    Science.gov (United States)

    Chambers, Georgina M; Randall, Sean; Mihalopoulos, Cathrine; Reilly, Nicole; Sullivan, Elizabeth A; Highet, Nicole; Morgan, Vera A; Croft, Maxine L; Chatterton, Mary Lou; Austin, Marie-Paule

    2017-12-05

    last decade, with the introduction of numerous policies aimed at prevention, screening and improving access to treatment. Several of these policies have been aimed at perinatal depression, which affects 15% of women giving birth. What does this paper add? This is the first population-based, cost analysis of mental health consultations during the perinatal period (pregnancy to end of the first postnatal year) in Australia. Almost 9% of women giving birth in 2007 had a mental health consultation funded though the MBS, compared with more than 14% in 2010. Over the same period there was a shift from psychiatric consultations to allied health and primary care consultations. In 2010, the total cost (provider fee) of these consultations was A$29million, equating to an average cost per woman of A$689 and A$133 per service. Despite the changing policy environment, significant disparities exist in access to care according to geographic remoteness. What are the implications for practitioners? Recent policy initiatives have resulted in increasing access to mental health consultations for women around the time of childbirth. However, policies are needed that target women outside of major cities. Furthermore, evidence is needed on whether the increase in access has resulted in improved mental health outcomes for women at this vulnerable time. The cost data provided by this study are unique and will inform future mental health policy development and health economic evaluations.

  8. Aging evaluation methodology of periodic safety review in Korea

    International Nuclear Information System (INIS)

    Park, Heung-Bae; Jung, Sung-Gyu; Jin, Tae-Eun; Jeong, Ill-Seok

    2002-01-01

    In Korea plant lifetime management (PLIM) study for Kori Unit 1 has been performed since 1993. Meanwhile, periodic safety review (PSR) for all operating nuclear power plants (NPPs) has been started with Kori Unit 1 since 2000 per IAEA recommendation. The evaluation period is 10 years, and safety (evaluation) factors are 11 per IAEA guidelines as represented in table 1. The relationship between PSR factors and PLIM is also represented. Among these factors evaluation of 'management of aging' is one of the most important and difficult factor. This factor is related to 'actual condition of the NPP', 'use of experience from other nuclear NPPs and of research findings', and 'management of aging'. The object of 'management of aging' is to obtain plant safety through identifying actual condition of system, structure and components (SSCs) and evaluating aging phenomena and residual life of SSCs using operating experience and research findings. The paper describes the scope and procedure of valuation of 'management of aging', such as, screening criteria of SSCs, Code and Standards, evaluation of SSCs and safety issues as represented. Evaluating SSCs are determined using final safety analysis report (FSAR) and power unit maintenance system for Nuclear Ver. III (PUMAS/N-III). The screening criteria of SSCs are safety-related items (quality class Q), safety-impact items (quality class T), backfitting rule items (fire protection (10CFR50.48), environmental qualification (10CFR50.49), pressurized thermal shock (10CFR50.61), anticipated transient without scram (10CFR50.62), and station blackout (10CFR50.63)) and regulating authority requiring items[1∼3]. The purpose of review of Code and Standards is identifying actual condition of the NPP and evaluating aging management using effective Code and Standards corresponding to reactor facilities. Code and Standards is composed of regulating laws, FSAR items, administrative actions, regulating actions, agreement items, and other

  9. Constructive eHealth evaluation

    DEFF Research Database (Denmark)

    Høstgaard, Anna Marie Balling

    2016-01-01

    Despite the existence of an extensive body of knowledge about best practices and factors that contribute to the successful development and adoption of eHealth, many eHealth development-projects still face a number of problems - many of them of an organizational nature. This chapter presents a new...... method: “The Constructive eHealth evaluation method” aimed at supporting real end-user participation - a well-known success factor in eHealth development. It provides an analytical framework for achieving real end-user participation during the different phases in the eHealth lifecycle. The method...... was developed and used for the first time during the evaluation of an EHR planning process in a Danish region. It has proven effective for providing management at more levels on-going information and feedback from end-users, allowing management to change direction during eHealth development in order to achieve...

  10. Health economic evaluation in Greece.

    Science.gov (United States)

    Rovithis, Dimitrios

    2006-01-01

    There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.

  11. Monitoring metabolic health of dairy cattle in the transition period.

    Science.gov (United States)

    LeBlanc, Stephen

    2010-01-01

    This paper reviews the importance of energy metabolism in transition dairy cows, its associations with disease and reproduction, and strategies for monitoring cows under field conditions during this critical time. Essentially all dairy cattle experience a period of insulin resistance, reduced feed intake, negative energy balance, hypocalcemia, reduced immune function, and bacterial contamination of the uterus soon before, or in the weeks after calving. One-third of dairy cows may be affected by some form of metabolic or infectious disease in early lactation. Routine, proactive actions, observations, or analysis are intended to accurately and efficiently provide early detection of problems, to provide an opportunity for investigation and intervention in order to limit the consequences and costs of health problems and reduced animal performance or welfare. Methods of early detection include monitoring of disease and culling records, feed intake, milk production, body condition, and simple metabolic tests. Methods, strategies, and interpretation of measurement of peripartum concentrations of non-esterified fatty acids (NEFA) and beta-hydroxybutyrate (BHB) as indicators of aspects of energy status and disease risk are reviewed. High NEFA (> 0.4 mmol/l) in the last 7 to 10 days before expected calving is associated with increased risk of displaced abomasum (DA), retained placenta, culling before 60 days in milk, and less milk production in the first 4 months of lactation. Subclinical ketosis (serum BHB >1200 to 1400 micromol/l) in the first or second week after calving is associated with increased risk of DA, metritis, clinical ketosis, endometritis, prolonged postpartum anovulation, increased severity of mastitis, and lower milk production in early lactation. There are several validated and practical tools for cow-side measurement of ketosis.

  12. QUALIS PERIODIC EVALUATION: ANALYSIS OF QUALIS UPGRADE IN MEDICINE III.

    Science.gov (United States)

    Jukemura, José; Diniz, Márcio Augusto

    2015-01-01

    To evaluate the preliminary results related to journals up-grade that was used by Medicine III, through opportunity offered by Capes to all agency areas programs. Were used area document of Medicine I, II and III, besides other relevant topics available online at Capes site, between 2009 and 2013. The research was focused to answer two questions: 1) the stratification of Qualis is similar in the three areas of medicine? and 2) the evolution of Qualis in Medicine III was higher? Medicine III showed an increase in its Qualis classification and is publishing in journals with higher impact factors, virtually the same as the Medicine I and II. The area showed the strongest growth in recent three-year periods. Avaliar os resultados preliminares sobre a Medicina III do up-grade oportunizado pela Capes para todas as áreas. Foram utilizados os documentos de áreas e os relevantes ao tema disponíveis online no site da Capes entre 2009 e 2013. Procurou-se focar a pesquisa em dois aspectos para responder duas perguntas: 1) a estratificação do Qualis é semelhante nas três áreas da medicina? e 2) a evolução do Qualis da Medicina III foi maior? A Medicina III apresentou evolução em sua classificação Qualis e está publicando em revistas com maior fator de impacto e é praticamente igual ao da Medicina I e II. A área foi a que apresentou maior evolução nestes últimos triênios.

  13. 10 CFR 905.22 - How does Western periodically evaluate customer actions?

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false How does Western periodically evaluate customer actions... Resource Planning § 905.22 How does Western periodically evaluate customer actions? (a) Periodic review of customer actions. Western will periodically evaluate customer actions to determine whether they are...

  14. An evaluation of periodicals subscription and related problems at ...

    African Journals Online (AJOL)

    In this study, an attempt is made to describe the importance of periodicals among the various sources of information. Brief introduction of the federal polytechnic library and its periodical unit is given. The annual expenditure made in the last six (6) years is mentioned, after ascertaining the variation in the number of ...

  15. Health economic evaluation in England.

    Science.gov (United States)

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness. Copyright © 2014. Published by Elsevier GmbH.

  16. A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

    Science.gov (United States)

    Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

    2016-05-01

    Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies. © 2016 Michigan Association for Infant Mental Health.

  17. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

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

  18. 42 CFR 441.365 - Periodic evaluation, assessment, and review.

    Science.gov (United States)

    2010-10-01

    ... consist of at least one physician or registered nurse, and at least one other individual with health and... and will not become effective until approval has been given by the Office of Management and Budget. ...

  19. Educational services in health sciences libraries: an analysis of the periodical literature, 1975-1986.

    Science.gov (United States)

    Zachert, M J

    1987-07-01

    The periodical literature on group instructional services in health sciences libraries was analyzed to determine the nature of these services, their target audiences, and their institutional settings. Three kinds of reports were identified: descriptions of services (70%), reviews of the literature (10.5%), and future-oriented articles that advocate various group instructional services (19.5%). Five target audiences were identified: library users, staff, librarian peers, library science students, and patients. Instructional services were offered primarily in medical school/center libraries, hospital libraries, and the National Library of Medicine and its Regional Medical Libraries (RMLs). To a lesser extent, health sciences educational services are offered through other professional school libraries, library associations and consortia, and schools of library science. There are gaps in the literature in the areas of library experience with marketing, evaluation, administration of the offered educational services, and continuing education for health sciences librarians.

  20. Model of evaluating the projected payback period in energy preservation

    Directory of Open Access Journals (Sweden)

    Gorshkov Aleksandr Sergeevich

    2015-12-01

    Full Text Available Providing energy efficiency of newly designed buildings is an important state task which is considered in EPBD directive and the latest regulations on energy saving. Though reducing energy consumption of the existing building is not less important. The majority of the existing buildings had been built before the implementation of modern energy saving programs. That’s why the volume of energy consumption in the existing buildings is greater than in new buildings. In frames of the given investigation the author considers the problem of forecasting the payback period of investment into reduction of energy consumption in a building. The formula is offered for calculating the projected payback period in energy saving with account for capital costs, calculated or actual value of the achieved energy saving effect, rise in tariffs for energy sources, discounting of the future cash flows and the volume and time for return of credit funds. Basing on the offered calculation methods it is possible to compare the efficiency of different energy saving solutions.

  1. The Breast Health Intervention Evaluation Study

    National Research Council Canada - National Science Library

    Blumenthal, Daniel

    1997-01-01

    The Breast Health Intervention Evaluation (BRIE) Study will evaluate the relative effectiveness of three different approaches to breast health messages--a fear appeal, a positive affect appeal, and an affectively neutral, cognitive appeal...

  2. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    International Nuclear Information System (INIS)

    Miranda, Matheus; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu; Juliano, Yara; Buffolo, Enio

    2014-01-01

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions

  3. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Matheus, E-mail: matheus10miranda@gmail.com; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Juliano, Yara [Universidade de Santo Amaro, São Paulo, SP (Brazil); Buffolo, Enio [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-02-15

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.

  4. 77 FR 37839 - Veterans' Group Life Insurance (VGLI) No-Health Period Extension

    Science.gov (United States)

    2012-06-25

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 9 RIN 2900-AO24 Veterans' Group Life Insurance (VGLI) No-Health Period Extension AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY... Veterans' Group Life Insurance (VGLI) to extend to 240 days the current 120-day ``no-health'' period during...

  5. An evaluation of rural health care research.

    Science.gov (United States)

    Kane, R; Dean, M; Solomon, M

    1979-05-01

    Reviews the state of the art of rural health research and evaluation in the U.S. with particular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer a promising source of primary care for rural areas: recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-sufficiency requirement may mean those who need services most will be least likely to receive them.

  6. 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,…

  7. Analysis of premature births for the period from 2009. to 2013. in Health Center Kosovska Mitrovica

    OpenAIRE

    Adžić V.; Galjak S.; Radojević G.; Relić G.

    2015-01-01

    Delivery before 37th week of gestation is defined as preterm, independently of body mass of babies, according to the World Health Organization. Premature birth is the current problem in the world due to the high risk of neonatal morbidity and mortality and incompletely clear etiology. In our country the frequency of preterm delivery is 6%. We have retrospectively analyzed early deliveries in Health Center Kosovska Mitrovica in the period from 2009 to 2013. In this five-year period, there were...

  8. Cardinal Scales for Public Health Evaluation

    DEFF Research Database (Denmark)

    Harvey, Charles M.; Østerdal, Lars Peter

    Policy studies often evaluate health for a population by summing the individuals' health as measured by a scale that is ordinal or that depends on risk attitudes. We develop a method using a different type of preferences, called preference intensity or cardinal preferences, to construct scales...... that measure changes in health. The method is based on a social welfare model that relates preferences between changes in an individual's health to preferences between changes in health for a population...

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

    Science.gov (United States)

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

    2014-06-01

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

  10. Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring

    Directory of Open Access Journals (Sweden)

    John Reilly

    2018-03-01

    Full Text Available Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc. and generalized displacement (deflection, rotation, etc. to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature–deformation–displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i the range of raw temperatures on the structure, and (ii the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University.

  11. Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring.

    Science.gov (United States)

    Reilly, John; Glisic, Branko

    2018-03-01

    Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM) analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc.) and generalized displacement (deflection, rotation, etc.) to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature-deformation-displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i) the range of raw temperatures on the structure, and (ii) the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University.

  12. Effects of dry period length on clinical mastitis and other major clinical health disorders

    DEFF Research Database (Denmark)

    Enevoldsen, Carsten; Sørensen, J.T.

    1992-01-01

    Four, 7-, and 10-wk dry periods were randomly assigned to 366 dairy cows in eight herds. A multiple polytomous logistic regression analysis was conducted with the objective to reveal possible important effects of the dry period on the risk of contracting major clinical health disorders. Several...... complex statistical interactions were revealed. Complications around and after drying off occurred least frequently at 7-wk dry periods. There was little evidence of an effect of the dry period on the risk of clinical mastitis and other severe clinical disorders around and after calving. With short...... like milk yield at drying off and previous mastitis are much more important predisposing factors....

  13. How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses

    NARCIS (Netherlands)

    Ammenwerth, Elske; de Keizer, Nicolet; Brender McNair, Jytte; Craven, Catherine K.; Eisenstein, Eric; Georgiou, Andrew; Khairat, Saif; Magrabi, Farah; Nykänen, Pirkko; Otero, Paula; Rigby, Michael; Scott, Philip; Weir, Charlene

    2017-01-01

    Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust

  14. Can health insurance improve employee health outcome and reduce cost? An evaluation of Geisinger's employee health and wellness program.

    Science.gov (United States)

    Maeng, Daniel D; Pitcavage, James M; Tomcavage, Janet; Steinhubl, Steven R

    2013-11-01

    To evaluate the impact of a health plan-driven employee health and wellness program (known as MyHealth Rewards) on health outcomes (stroke and myocardial infarction) and cost of care. A cohort of Geisinger Health Plan members who were Geisinger Health System (GHS) employees throughout the study period (2007 to 2011) was compared with a comparison group consisting of Geisinger Health Plan members who were non-GHS employees. The GHS employee cohort experienced a stroke or myocardial infarction later than the non-GHS comparison group (hazard ratios of 0.73 and 0.56; P employee health and wellness programs similarly designed as MyHealth Rewards can potentially have a desirable impact on employee health and cost.

  15. Periodic safety re-evaluations in NPPs in EC member states, Finland and Sweden

    International Nuclear Information System (INIS)

    1990-01-01

    The work on periodic safety re-evaluations summarized in this report was performed by a Task Force of the CEC Working Group on the Safety of Thermal Reactors. The periodic safety re-evaluations under review in this study were those that are carried out in addition to other reviews which represent the primary means of safety assurance. The periodic safety re-evaluation is broader and more comprehensive in nature. The cumulative effects of experience (national and international), advances in knowledge and analysis techniques, improvements in safety standards and operating practices, overall effects of plant ageing, and the totality of all modifications over the period in question need to be taken into account. All countries have recognized the value of such periodic reviews, and licensees, either as a regulatory requirement or as a voluntary action, are carrying them out. The scope and contents of each country's review showed many similarities of approach, any differences being explained by the age and type of reactor in operation. Many similarities emerged in the topics selected for re-evaluation and in the approach to re-evaluation itself. The overall conclusion was that while approaches may differ in some respects, for practical purposes comparable levels of safety are achieved in the periodic safety re-evaluation of nuclear power plants

  16. Dental Electronic Health Record Evaluation

    Czech Academy of Sciences Publication Activity Database

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

    2013-01-01

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

  17. Multidisciplinary eHealth Survey Evaluation Methods

    Science.gov (United States)

    Karras, Bryant T.; Tufano, James T.

    2006-01-01

    This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the…

  18. Health economic evaluation: important principles and methodology.

    Science.gov (United States)

    Rudmik, Luke; Drummond, Michael

    2013-06-01

    To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Relationships between uterine health and metabolism in dairy cows with different dry period lengths.

    Science.gov (United States)

    Chen, J; Soede, N M; Remmelink, G J; Bruckmaier, R M; Kemp, B; van Knegsel, A T M

    2017-10-01

    The first objective of this study was to evaluate effects of dry period (DP) length and dietary energy source on ovarian activity, uterine health status, pregnancy rate, and days open in dairy cows in the second subsequent lactation after implementation of DP length and dietary treatments. The second objective was to determine relationships of uterine health status with ovarian activity, milk yield, energy balance (EB), and metabolic status in dairy cows. Holstein-Friesian dairy cows (n = 167) were assigned randomly to 1 of 3 DP lengths (0-, 30-, or 60-d) and 1 of 2 early lactation diets (glucogenic or lipogenic diet) for 2 subsequent lactations. Milk samples were collected three times a week. At least two succeeding milk samples with concentration of progesterone ≥2 ng/mL were used to indicate the occurrence of luteal activity. Vaginal discharge was scored in wk 2 and 3 after calving to evaluate uterine health status and cows were classified as having a healthy uterine environment [HU, vaginal discharge score (VDS) = 0 or 1 in both wk 2 and 3], a recovering uterine environment (RU, VDS = 2 or 3 in wk 2 and VDS = 0 or 1 in wk 3), or a non-recovering uterine environment (NRU, VDS = 2 or 3 in wk 3). Cows were monitored for milk yield, dry matter intake (DMI), and blood was sampled weekly to determine metabolic status from calving to wk 3 postcalving. Dry period length was not related with uterine health status in early lactation, pregnancy rate, or days open in dairy cows. Independent of DP length, feeding a glucogenic diet shortened the interval from calving to onset of luteal activity (25.3 vs. 31.0 d, P = 0.04), but decreased pregnancy rate compared with a more lipogenic diet (68.2 vs. 78.1 d, P = 0.03). In the first 3 wk after calving, cows with a NRU had lower milk yield (36.8 vs. 36.8 vs. 32.4 kg for cows with a HU, RU, or NRU, respectively; P cows with a HU or RU. Cows with a RU had lower plasma glucose and insulin concentrations than

  20. Mobile health technology evaluation: the mHealth evidence workshop.

    Science.gov (United States)

    Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-08-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

  1. Seasonal agricultural youth workers' concerns on development - growth in adolescence period and utilization of health services

    Directory of Open Access Journals (Sweden)

    Zeynep simsek

    2015-06-01

    Full Text Available Aim: Physical, psychological and social changes occurring in adolescence period may be cause for concern. In this study, it was aimed to determine concerns on growth and development in adolescence period, related factors and utilization of health services. Methods: In this study, data related youths' concerns, utilization of health services and socio-demographic variables obtained from multi-purpose cross-sectional survey named Needs Assesment of Seasonal Agricultural Worker Families Survey-2011 were used. Survey framework was consisted of aged 15-24 young people of families who worked as a seasonal agricultural farmworker in the year of research conducted. Survey was completed in 1021 households total 915 youths selected by probability cluster sampling method of 1200 households by Turkish Statistical Institution (Response rates were 90,7% in women, and 77,2% in men. and lsquo;Woman and Men Questionnaires' were applied by face to face interview. University Research Ethics Committee approval was obtained. Data entry and analysis performed using SPSS 11.5 software, descriptive statistics, t-test, chi-square test and logistic regression analysis were conducted. Results: Of participants 63,6% of female and 46,6% of male adolescents reported at least one concern related to growth and development inadolescent period. While having any concern prevalence in women were changed working time in the fields and health perception, marital status and education level with adolescent's concerns were related in men significantly (P <0,05. 13,8% of females and 10,9% of males utilized the health services because of concerns. Conclusion: By Family Health Centers at this risky young group during their period of residence in their address, adolescent follow-up should be done, should be asked concerns and given early diagnosis and treatment. On the other hand, health education programs on adolescence period by Community Health Centers will be useful. [TAF Prev Med Bull

  2. Periodic health examination, 1995 update: 1. Screening for human papillomavirus infection in asymptomatic women. Canadian Task Force on the Periodic Health Examination.

    Science.gov (United States)

    Johnson, K

    1995-02-15

    To develop recommendations for practising physicians on the advisability of screening for human papillomavirus (HPV) infection in asymptomatic women. Visual inspection, Papanicolaou testing, colposcopy or cervicography, use of HPV group-specific antigen, DNA hybridization, dot blot technique, Southern blot technique or polymerase chain reaction followed by physical or chemical therapeutic intervention. Evidence for a link between HPV infection and cervical cancer, sensitivity and specificity of HPV screening techniques, effectiveness of treatments for HPV infection, and the social and economic costs incurred by screening. MEDLINE was searched for articles published between January 1966 to June 1993 with the use of the key words "papillomavirus," "cervix neoplasms," "mass screening," "prospective studies," "prevalence," "sensitivity," "specificity," "human" and "female." Proven cost-effective screening techniques that could lead to decreased morbidity or mortality were given a high value. The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. Potential benefits are to prevent cervical cancer and eliminate HPV infection. Potential harmful effects include the creation of an unnecessary burden on the health care system and the labelling of otherwise healthy people as patients with a sexually transmitted disease for which therapy is generally ineffective. Potential costs would include expense of testing, increased use of colposcopy and treatment. There is fair evidence to exclude HPV screening (beyond Papanicolaou testing for cervical cancer) in asymptomatic women (grade D recommendation). The report was reviewed by members of the task force and three external reviewers who were selected to represent different areas of expertise. These guidelines were developed and endorsed by the task force, which is funded by Health Canada and the National Health Research and Development Program. The principal author (K.J.) was

  3. Evaluation of the Use of Periodicals Collection of the Higher Education Council Documentation and Online Search Center: Arts and Humanities Periodicals

    OpenAIRE

    Elçin Özbudak

    1995-01-01

    Evaluation of the use perodicals collections in libraries is important as perodicals report the results of the latest scientific research and they are usually more expensive than other types of library materials. In this study we evaluate the use of Arts and Humanities periodicals in the collection of the Higher Education Council Documentation Center. Although the use of Arts and Humanities periodicals was found to be lower than, say, Biomedical periodicals collection, the number of journal t...

  4. Quality dimensions in health evaluation: manager's conceptions.

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães; Pontes, Ricardo José Soares; Vasconcelos, Suziana Martins de

    2010-04-01

    To understand manager's perceptions and experiences in regards to qualitative evaluations in basic health care. A qualitative study, based on the critical interpretive approach, was performed in 2006, in the city of Fortaleza, Northeastern Brazil. The sample consisted of the group responsible for planning basic health care at the state level. In order to obtain the empirical data, the focus group technique was utilized. Two central themes emerged concerning the perceptions about quality and the dimensions of quality employed in health evaluations, which were revealed in distinct ways. The concepts of quality evaluation and qualitative evaluation did not appear clearly understood, confusing qualitative evaluation with formal quality evaluations. Likewise, the inherent multidimensionality of quality was not recognized. Despite the criticism expressed by the participants regarding the improper quantification of certain dimensions, the necessary technical skills and understanding were not observed for the approach to include the distinct dimensions of quality in the evaluation process. The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.

  5. Evaluation of the Use of Periodicals Collection of the Higher Education Council Documentation and Online Search Center: Arts and Humanities Periodicals

    Directory of Open Access Journals (Sweden)

    Elçin Özbudak

    1995-06-01

    Full Text Available Evaluation of the use perodicals collections in libraries is important as perodicals report the results of the latest scientific research and they are usually more expensive than other types of library materials. In this study we evaluate the use of Arts and Humanities periodicals in the collection of the Higher Education Council Documentation Center. Although the use of Arts and Humanities periodicals was found to be lower than, say, Biomedical periodicals collection, the number of journal titles in Arts and Humanities appears to be quite satisfactory. Some suggestions are made so as to increase the use of Arts and Humanities periodicals collection.

  6. Periodization Strategies in Older Adults: Impact on Physical Function and Health.

    Science.gov (United States)

    Conlon, Jenny A; Newton, Robert U; Tufano, James J; Banyard, Harry G; Hopper, Amanda J; Ridge, Ashley J; Haff, G Gregory

    2016-12-01

    This study compared the effect of periodized versus nonperiodized (NP) resistance training (RT) on physical function and health outcomes in older adults. Forty-one apparently healthy untrained older adults (women = 21, men = 20; 70.9 ± 5.1 yr; 166.3 ± 8.2 cm; 72.9 ± 13.4 kg) were recruited and randomly stratified to a NP, block periodized, or daily undulating periodized training group. Outcome measures were assessed at baseline and after a 22-wk × 3 d·wk RT intervention, including; anthropometrics, body composition, blood pressure and biomarkers, maximal strength, functional capacity, balance confidence, and quality of life. Thirty-three subjects satisfied all study requirements and were included in analyses (women = 17, men = 16; 71.3 ± 5.4 yr; 166.3 ± 8.5 cm; 72.5 ± 13.7 kg). The main finding was that all three RT models produced significant improvements in several physical function and physiological health outcomes, including; systolic blood pressure, blood biomarkers, body composition, maximal strength, functional capacity and balance confidence, with no between-group differences. Periodized RT, specifically block periodization and daily undulating periodized, and NP RT are equally effective for promoting significant improvements in physical function and health outcomes among apparently healthy untrained older adults. Therefore, periodization strategies do not appear to be necessary during the initial stages of RT in this population. Practitioners should work toward increasing RT participation in the age via feasible and efficacious interventions targeting long-term adherence in minimally supervised settings.

  7. Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis.

    Science.gov (United States)

    Delaruelle, Katrijn; Buffel, Veerle; Bracke, Piet

    2015-11-01

    Researchers have recently been investigating the temporal variation in the educational gradient in health. While there is abundant literature concerning age trajectories, theoretical knowledge about cohort differences is relatively limited. Therefore, in analogy with the life course perspective, we introduce two contrasting cohort-specific hypotheses. The diminishing health returns hypothesis predicts a decrease in educational disparities in health across cohorts. By contrast, the cohort accretion hypothesis suggests that the education-health gap will be more pronounced among younger cohorts. To shed light on this, we perform a hierarchical age-period-cohort analysis (HAPC), using data from a subsample of individuals between 25 and 85 years of age (N = 232,573) from 32 countries in the European Social Survey (six waves: 2002-2012). The analysis leads to three important conclusions. First, we observe a widening health gap between different educational levels over the life course. Second, we find that these educational differences in the age trajectories of health seem to strengthen with each successive birth cohort. However, the two age-related effects disappear when we control for employment status, household income, and family characteristics. Last, when adjusting for these mediators, we reveal evidence to support the diminishing health returns hypothesis, implying that it is primarily the direct association between education and health that decreases across cohorts. This finding raises concerns about potential barriers to education being a vehicle for empowerment and the promotion of health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Teenage pregnancy and mental health beyond the postpartum period: a systematic review.

    Science.gov (United States)

    Xavier, Chloé; Benoit, Anita; Brown, Hilary K

    2018-02-08

    Teenage mothers are at increased risk for adverse social outcomes and short-term health problems, but long-term impacts on mental health are poorly understood. The aims of our systematic review were to determine the association between teenage pregnancy and mental health beyond the postpartum period, critically appraise the literature's quality and guide future research. We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus and Web of Science from inception to June 2017 for peer-reviewed articles written in English or French. Data were collected using a modified Cochrane Data Extraction Form. Study quality was assessed using the Effective Public Health Practice Project critical appraisal tool. Heterogeneity of studies permitted only a qualitative synthesis. Nine quantitative studies comprising the results from analyses of 11 cohorts met our criteria and were rated as strong (n=5), moderate (n=2) or weak (n=2). Three cohorts found a statistically significant association between teenage pregnancy and poor long-term mental health after adjustment, three found a statistically significant association before but not after adjustment and five did not find a statistically significant association. Studies observed varying degrees of attenuation after considering social context. Studies with statistically significant findings tended to comprise earlier cohorts, with outcomes measured at older ages. The association between teenage pregnancy and mental health beyond the postpartum period remains unclear. Future studies should employ age-period-cohort frameworks to disentangle effects of normative patterns and stress accumulation. Social factors are important in determining long-term mental health of teenage mothers and should be prioritised in prevention and intervention strategies. © 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

  9. The Practice of Health Program Evaluation.

    Science.gov (United States)

    Lewis, Sarah R

    2017-11-01

    The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

  10. Assessment of financial flow in the health system of Serbia in a period 2003-2006

    Directory of Open Access Journals (Sweden)

    Gajić-Stevanović Milena

    2010-01-01

    Full Text Available Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA. NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was

  11. A Blueprint to Evaluate One Health

    DEFF Research Database (Denmark)

    Rüegg, Simon R; McMahon, Barry J; Häsler, Barbara

    2017-01-01

    , and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone......One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation...... and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring...

  12. Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

    Science.gov (United States)

    Barnardo, Catherine; Jivanni, Amin

    2009-01-01

    Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

  13. Working Health Services Scotland: a 4-year evaluation

    Science.gov (United States)

    Hanson, M; Bakhshi, A; Kennedy, M; Macdonald, E B

    2018-01-01

    Abstract Background Working Health Service Scotland (WHSS) supports the self-employed and employees of small and medium-sized enterprises (SMEs) in Scotland with a health condition affecting their ability to work, who are either absent or at risk of becoming absent due to it. Aims To evaluate the impact on health and work outcomes of WHSS clients over a 4-year period. Methods Data were collected at enrolment, entry, discharge and follow-up at 3 and 6 months after discharge. Clients completed up to three validated health questionnaires at entry and discharge—EuroQol five dimensions (EQ-5D) and visual analogue scale (VAS); Hospital Anxiety and Depression Scale (HADS); and Canadian Occupational Performance Measure (COPM). Results A total of 13463 referrals occurred in the 4-year period; 11748 (87%) were eligible and completed entry assessment and 60% of the latter completed discharge paperwork. The majority of referrals were due to musculoskeletal conditions (84%) while 12% were referred with mental health conditions. Almost a fifth (18%) of cases were absent at entry and back at work at discharge. Work days lost while in WHSS was associated with age, length of absence prior to entering WHSS, primary health condition and time in programme. All health measures showed significant improvements from entry to discharge. Improvement in general health was sustained at 3- and 6-month follow-up. Conclusions The WHSS evaluation findings indicate that participation was associated with positive changes to health and return-to-work. The extent of the positive change in health measures and work ability can be highly important economically for employees and employers. PMID:29390161

  14. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.

    Science.gov (United States)

    Stephenson, Judith; Heslehurst, Nicola; Hall, Jennifer; Schoenaker, Danielle A J M; Hutchinson, Jayne; Cade, Janet E; Poston, Lucilla; Barrett, Geraldine; Crozier, Sarah R; Barker, Mary; Kumaran, Kalyanaraman; Yajnik, Chittaranjan S; Baird, Janis; Mishra, Gita D

    2018-05-05

    A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high-income and low-income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents. Several studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little effect on maternal and newborn health outcomes. Comparatively few interventions have been made for preconception diet and lifestyle. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that it is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception. We propose novel definitions of the preconception period relating to embryo development and actions at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable diseases. Alongside continued efforts to reduce smoking, alcohol consumption, and obesity in the population, we call for heightened

  15. Evaluation of a nursing student health fair program: Meeting curricular standards and improving community members' health.

    Science.gov (United States)

    Salerno, John P; McEwing, Evan; Matsuda, Yui; Gonzalez-Guarda, Rosa M; Ogunrinde, Olutola; Azaiza, Mona; Williams, Jessica R

    2018-04-17

    Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open-ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. We report that results from participants surveyed indicated that PHN-student delivered health fairs improved health knowledge among community members in this sample (p = .000). Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community. © 2018 Wiley Periodicals, Inc.

  16. Unpaid work in health economic evaluations.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Evaluation of scientific periodicals and the Brazilian production of nursing articles.

    Science.gov (United States)

    Erdmann, Alacoque Lorenzini; Marziale, Maria Helena Palucci; Pedreira, Mavilde da Luz Gonçalves; Lana, Francisco Carlos Félix; Pagliuca, Lorita Marlena Freitag; Padilha, Maria Itayra; Fernandes, Josicelia Dumêt

    2009-01-01

    This study aimed to identify nursing journals edited in Brazil indexed in the main bibliographic databases in the areas of health and nursing. It also aimed to classify the production of nursing graduate programs in 2007 according to the QUALIS/CAPES criteria used to classify scientific periodicals that disseminate the intellectual production of graduate programs in Brazil. This exploratory study used data from reports and documents available from CAPES to map scientific production and from searching the main international and national indexing databases. The findings from this research can help students, professors and coordinators of graduate programs in several ways: to understand the criteria of classifying periodicals; to be aware of the current production of graduate programs in the area of nursing; and to provide information that authors can use to select periodicals in which to publish their articles.

  18. Health care evaluation, utilitarianism and distortionary taxes.

    Science.gov (United States)

    Calcott, P

    2000-09-01

    Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

  19. Comparison of Cardiovascular Risk Factors in Different Areas of Health Care Over a 20-Year Period

    Directory of Open Access Journals (Sweden)

    Thiago Veiga Jardim

    2014-12-01

    Full Text Available Background: Cardiovascular diseases (CVDs are the leading cause of death worldwide. Knowledge about cardiovascular risk factors (CVRFs in young adults and their modification over time are measures that change the risks and prevent CVDs. Objectives: To determine the presence of CVRFs and their changes in different health care professionals over a period of 20 years. Methods: All students of medicine, nursing, nutrition, odontology, and pharmacy departments of Federal University of Goiás who agreed to participate in this study were evaluated when they started their degree courses and 20 years afterward. Questionnaires on CVRFs [systemic arterial hypertension (SAH, diabetes mellitus, dyslipidemia, and family history of early CVD, smoking, alcohol consumption, and sedentarism] were administered. Cholesterol levels, blood sugar levels, blood pressure, weight, height, and body mass index were determined. The Kolmogorov-Smirnov test was used to evaluate distribution, the chi-square test was used to compare different courses and sexes, and the McNemar test was used for comparing CVRFs. The significance level was set at a p value of < 0.05. Results: The first stage of the study included 281 individuals (91% of all the students, of which 62.9% were women; the mean age was 19.7 years. In the second stage, 215 subjects were reassessed (76% of the initial sample, of which 59.07% were women; the mean age was 39.8 years. The sample mostly consisted of medical students (with a predominance of men, followed by nursing, nutrition, and pharmacy students, with a predominance of women (p < 0.05. Excessive weight gain, SAH, and dyslipidemia were observed among physicians and dentists (p < 0.05. Excessive weight gain and SAH and a reduction in sedentarism (p < 0.05 were observed among pharmacists. Among nurses there was an increase in excessive weight and alcohol consumption (p < 0.05. Finally, nutritionists showed an increase in dyslipidemia (p < 0.05. Conclusion

  20. Comparison of Cardiovascular Risk Factors in Different Areas of Health Care Over a 20-Year Period

    International Nuclear Information System (INIS)

    Jardim, Thiago Veiga; Sousa, Ana Luiza Lima; Povoa, Thais Rolim; Barroso, Weimar Sebba; Chinem, Brunela; Jardim, Paulo Cesar Veiga

    2014-01-01

    Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Knowledge about cardiovascular risk factors (CVRFs) in young adults and their modification over time are measures that change the risks and prevent CVDs. To determine the presence of CVRFs and their changes in different health care professionals over a period of 20 years. All students of medicine, nursing, nutrition, odontology, and pharmacy departments of Federal University of Goiás who agreed to participate in this study were evaluated when they started their degree courses and 20 years afterward. Questionnaires on CVRFs [systemic arterial hypertension (SAH), diabetes mellitus, dyslipidemia, and family history of early CVD, smoking, alcohol consumption, and sedentarism] were administered. Cholesterol levels, blood sugar levels, blood pressure, weight, height, and body mass index were determined. The Kolmogorov-Smirnov test was used to evaluate distribution, the chi-square test was used to compare different courses and sexes, and the McNemar test was used for comparing CVRFs. The significance level was set at a p value of < 0.05. The first stage of the study included 281 individuals (91% of all the students), of which 62.9% were women; the mean age was 19.7 years. In the second stage, 215 subjects were reassessed (76% of the initial sample), of which 59.07% were women; the mean age was 39.8 years. The sample mostly consisted of medical students (with a predominance of men), followed by nursing, nutrition, and pharmacy students, with a predominance of women (p < 0.05). Excessive weight gain, SAH, and dyslipidemia were observed among physicians and dentists (p < 0.05). Excessive weight gain and SAH and a reduction in sedentarism (p < 0.05) were observed among pharmacists. Among nurses there was an increase in excessive weight and alcohol consumption (p < 0.05). Finally, nutritionists showed an increase in dyslipidemia (p < 0.05). In general, there was an unfavorable progression of CVRFs in the

  1. Comparison of Cardiovascular Risk Factors in Different Areas of Health Care Over a 20-Year Period

    Energy Technology Data Exchange (ETDEWEB)

    Jardim, Thiago Veiga, E-mail: thiagoveiga@cardiol.br; Sousa, Ana Luiza Lima [Liga de Hipertensão Arterial - Universidade Federal de Goiás, Goiânia, GO (Brazil); Povoa, Thais Rolim [Faculdade de Educação Física - Universidade Estadual de Goiás, Goiânia, GO (Brazil); Barroso, Weimar Sebba; Chinem, Brunela; Jardim, Paulo Cesar Veiga [Liga de Hipertensão Arterial - Universidade Federal de Goiás, Goiânia, GO (Brazil)

    2014-12-15

    Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Knowledge about cardiovascular risk factors (CVRFs) in young adults and their modification over time are measures that change the risks and prevent CVDs. To determine the presence of CVRFs and their changes in different health care professionals over a period of 20 years. All students of medicine, nursing, nutrition, odontology, and pharmacy departments of Federal University of Goiás who agreed to participate in this study were evaluated when they started their degree courses and 20 years afterward. Questionnaires on CVRFs [systemic arterial hypertension (SAH), diabetes mellitus, dyslipidemia, and family history of early CVD, smoking, alcohol consumption, and sedentarism] were administered. Cholesterol levels, blood sugar levels, blood pressure, weight, height, and body mass index were determined. The Kolmogorov-Smirnov test was used to evaluate distribution, the chi-square test was used to compare different courses and sexes, and the McNemar test was used for comparing CVRFs. The significance level was set at a p value of < 0.05. The first stage of the study included 281 individuals (91% of all the students), of which 62.9% were women; the mean age was 19.7 years. In the second stage, 215 subjects were reassessed (76% of the initial sample), of which 59.07% were women; the mean age was 39.8 years. The sample mostly consisted of medical students (with a predominance of men), followed by nursing, nutrition, and pharmacy students, with a predominance of women (p < 0.05). Excessive weight gain, SAH, and dyslipidemia were observed among physicians and dentists (p < 0.05). Excessive weight gain and SAH and a reduction in sedentarism (p < 0.05) were observed among pharmacists. Among nurses there was an increase in excessive weight and alcohol consumption (p < 0.05). Finally, nutritionists showed an increase in dyslipidemia (p < 0.05). In general, there was an unfavorable progression of CVRFs in the

  2. Health evaluation of energy-generating sources

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The American Medical Association's House of Delegates, at its December 1976 Clinical Convention, requested that an evaluation be made of the health hazards of nuclear, fossil, and alternative energy-generating sources, for employees of energy-producing facilities as well as for the general population. This report is a summary evaluation of such hazards prepared in response to that request. This report, which was adopted by the House of Delegates on June 21, 1978, appears here in a revised and corrected version

  3. Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

    Science.gov (United States)

    Rose, Barbara L; Mansour, Mona; Kohake, Kelli

    2005-12-01

    The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

  4. Physical health problems experienced in the early postoperative recovery period following total knee replacement

    DEFF Research Database (Denmark)

    Szötz, Kirsten; Pedersen, Preben Ulrich; Hørdam, Britta

    2015-01-01

    of exercising in the early recovery period after discharge from hospital following total knee replacement. METHOD: A cross-sectional survey was conducted using a questionnaire. A total of 86 patients were included following first-time elective total knee replacement. Descriptive statistics were used. RESULTS......: The majority of the patients experienced leg oedema (90.7%). Secondary to this were pain (81.4%), sleeping disorders (47.7%) problems with appetite (38.4%) and bowel function (34.9%) were the most frequently identified physical health problems. In total, 69.8% of the patients indicated that they did...... not exercise or only partly exercise as recommended, but without associated experience of pain. CONCLUSION: Patients experienced a wide range of physical health problems following total knee replacement and deviation from recommended self-training was identified. These findings are valuable for health...

  5. Abortion and Mental Health: Evaluating the Evidence

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  6. NATIONAL EVALUATION OF THE WEATHERIZATION ASSISTANCE PROGRAM DURING THE ARRA PERIOD: PROGRAM YEARS 2009-2011

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, Bruce Edward [ORNL; Rose, Erin M [ORNL; Schmoyer, Richard L [ORNL; Eisenberg, Joel Fred [ORNL; Ternes, Mark P [ORNL; Schweitzer, Martin [ORNL; Hendrick, Timothy P [ORNL

    2012-08-01

    This report describes the third major evaluation of the Program, encompassing program years 2009 to 2011. In this report, this period of time is referred to as the ARRA Period. This is a special period of time for the Program because the American Recovery and Reinvestment Act (ARRA) of 2009 has allocated $5 billion of funding for the Program. In normal program years, WAP s annual appropriation is in the range of $200-250 million, supporting the weatherization of approximately 100,000 homes. With the addition of ARRA funding during these program years, the expectation is that weatherization activity will exceed 300,000 homes per year. In addition to saving energy and reducing low-income energy bills, expanded WAP funding is expected to stimulate the economy by providing new jobs in the weatherization field and allowing low-income households to spend more money on goods and services by spending less on energy.

  7. Health services research evaluation principles. Broadening a general framework for evaluating health information technology.

    Science.gov (United States)

    Sockolow, P S; Crawford, P R; Lehmann, H P

    2012-01-01

    Our forthcoming national experiment in increased health information technology (HIT) adoption funded by the American Recovery and Reinvestment Act of 2009 will require a comprehensive approach to evaluating HIT. The quality of evaluation studies of HIT to date reveals a need for broader evaluation frameworks that limits the generalizability of findings and the depth of lessons learned. Develop an informatics evaluation framework for health information technology (HIT) integrating components of health services research (HSR) evaluation and informatics evaluation to address identified shortcomings in available HIT evaluation frameworks. A systematic literature review updated and expanded the exhaustive review by Ammenwerth and deKeizer (AdK). From retained studies, criteria were elicited and organized into classes within a framework. The resulting Health Information Technology Research-based Evaluation Framework (HITREF) was used to guide clinician satisfaction survey construction, multi-dimensional analysis of data, and interpretation of findings in an evaluation of a vanguard community health care EHR. The updated review identified 128 electronic health record (EHR) evaluation studies and seven evaluation criteria not in AdK: EHR Selection/Development/Training; Patient Privacy Concerns; Unintended Consequences/ Benefits; Functionality; Patient Satisfaction with EHR; Barriers/Facilitators to Adoption; and Patient Satisfaction with Care. HITREF was used productively and was a complete evaluation framework which included all themes that emerged. We can recommend to future EHR evaluators that they consider adding a complete, research-based HIT evaluation framework, such as HITREF, to their evaluation tools suite to monitor HIT challenges as the federal government strives to increase HIT adoption.

  8. [Health care in today's Western Belarus in the inter-war period (1921-1939)].

    Science.gov (United States)

    Tiszczenko, E M

    2001-01-01

    During the inter-war period, today's Western Belarus, which under the Treaty of Riga constituted part of the Second Polish Republic, stood out for its higher morbidity in various disease categories than other regions of the country. Heightened threats of epidemics prevailed in that area, and typhoid fever, trachoma, tuberculois and venereal disease were serious health problems. Specific features of the health care of today's Western Belarus could be observed that set it apart from both that of Eastern Belarus forming a part of the Soviet Union as well as from the central and western provinces of Poland. Compared with Eastern Belarus, there was a lack of health services, including anti-tuberculosis, anti-venereal and paediatric dispensaries, or they were in the process of being created. But physicians' self-government bodies functioned, as did out-patient care with dispensary-like elements and health care provided by local health centres. There also existed the institution of full-time family doctors within the insured health-care system - something lacking in Eastern Belarus. As in other voivodships (provinces) of the Second Republic, there existed multi-sector health care: state, local, insurance-based and private. The Western Belarus had Poland's smallest number of physicians, new hospital beds and pharmacies. On the other hand, today's Western Belarus stands out by virtue of maintaining field-medicine traditions. To this day, assistant medical officers provide health care to the rural population - an arrangement not typical of the central and western provinces fo pre-war Poland.

  9. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  10. Evaluating interventions in health: a reconciliatory approach.

    Science.gov (United States)

    Wolff, Jonathan; Edwards, Sarah; Richmond, Sarah; Orr, Shepley; Rees, Geraint

    2012-11-01

    Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that 'experience' is a better basis for evaluation. The other, inspired by Amartya Sen, argues that 'capability' should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing 'instruments' designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. © 2011 Blackwell Publishing Ltd.

  11. Health and Safety Research Division progress report for the period April 1, 1990--September 30, 1991

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, S.V.

    1992-03-01

    This is a brief progress report from the Health and Safety Research Division of Oak Ridge National Laboratory. Information is presented in the following sections: Assessment Technology including Measurement Applications and Development, Pollutant Assessments, Measurement Systems Research, Dosimetry Applications Research, Metabolism and Dosimetry Research and Nuclear Medicine. Biological and Radiation Physics including Atomic, Molecular, and High Voltage Physics, Physics of Solids and Macromolecules, Liquid and Submicron Physics, Analytic Dosimetry and Surface Physics and Health Effects. Chemical Physics including Molecular Physics, Photophysics and Advanced Monitoring Development. Biomedical and Environmental Information Analysis including Human Genome and Toxicology, Chemical Hazard Evaluation and Communication, Environmental Regulations and Remediation and Information Management Technology. Risk Analysis including Hazardous Waste.

  12. Health communication, information technology and the public’s attitude toward periodic general health examinations [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Quan-Hoang Vuong

    2016-12-01

    Full Text Available Background: Periodic general health examinations (GHEs are gradually becoming more popular as they employ subclinical screenings, as a means of early detection. This study considers the effect of information technology (IT, health communications and the public’s attitude towards GHEs in Vietnam. Methods: A total of 2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas. Results: In total, 42.12% of participants stated that they were willing to use IT applications to recognise illness symptoms, and nearly 2/3 of them rated the healthcare quality at average level or below. Discussion: The data, which was processed by the BCL model, showed that IT applications (apps reduce hesitation toward GHEs; however, older people seem to have less confidence in using these apps. Health communications and government’s subsidy also increased the likelihood of people attending periodic GHEs. The probability of early check-ups where there is a cash subsidy could reach approximately 80%.

  13. Analysis of premature births for the period from 2009. to 2013. in Health Center Kosovska Mitrovica

    Directory of Open Access Journals (Sweden)

    Adžić V.

    2015-01-01

    Full Text Available Delivery before 37th week of gestation is defined as preterm, independently of body mass of babies, according to the World Health Organization. Premature birth is the current problem in the world due to the high risk of neonatal morbidity and mortality and incompletely clear etiology. In our country the frequency of preterm delivery is 6%. We have retrospectively analyzed early deliveries in Health Center Kosovska Mitrovica in the period from 2009 to 2013. In this five-year period, there were totaly 3398 deliveries, of which 148 or 4.35 % were preterm delivery. The aim of this study was to investigate the incidence of premature birth in the five-year period in relation to: the total number of births in a given period, the age of the patients, the manner of completion of delivery, gestational week of pregnancy, parity and the most common causes that led to the PTP. In the analysis we have included the body weight and Apgar score of premature infants. We have used protocols of births, maternal history of disease, neonatal protocols and lists of newborns. Most of them were multiparas (41.2 %,56.7 % of pregnant women were aged of 21-30 years and pregnancy in 79.9 % of cases ended with 33 to 37 ng. Vaginal deliveries were completed in 84.4% of premature births, and caesarean in 15.6%. Twin pregnancies with preterm deliveries were represented in 10.2%. The most common weight of premature infants ranged from 2000 to 2500 grams (48.6 %. The most common causes that led to the PTP were PPROM (22.9 %, unknown causes (27. 1 %, multiple pregnancy (18.2 %, genital infection (8.7 %, cervical incompetence (6.7 %, IUGR (5.4%, PIH (4.2%, placental abruption and placenta previa (2.1 % and other (4.7% .

  14. [Reliability of HOMA-IR for evaluation of insulin resistance during perioperative period].

    Science.gov (United States)

    Fujino, Hiroko; Itoda, Shoko; Sako, Saori; Matsuo, Kazuki; Sakamoto, Eiji; Yokoyama, Takeshi

    2013-02-01

    Hyperglycemia due to increase in insulin resistance (IR) is often observed after surgery in spite of normal insulin secretion. To evaluate the degree of IR, the golden standard method is the normoglycemic hyperinsulinemic clamp technique (glucose clamp: GC). The GC using the artificial pancreas, STG-22 (Nikkiso, Tokyo, Japan), was established as a more reliable method, since it was evaluated during steady-state period under constant insulin infusion. Homeostasis model assessment insulin resistance (HOMA-IR), however, is frequently employed in daily practice because of its convenience. We, therefore, investigated the reliability of HOMA-IR in comparison with the glucose clamp using the STG-22. Eight healthy patients undergoing maxillofacial surgery were employed in this study after obtaining written informed consent. Their insulin resistance was evaluated by HOMA-IR and the GC using the STG-22 before and after surgery. HOMA-IR increased from 0.81 +/- 0.48 to 1.17 +/- 0.50, although there were no significant differences between before and after surgery. On the other hand, M-value by GC significantly decreased after surgery from 8.82 +/- 2.49 mg x kg(-1) x min(-1) to 3.84 +/- 0.79 mg x kg(-1) x min(-1) (P = 0.0003). In addition, no significant correlation was found between the values of HOMA-IR and the M-value by GC. HOMA-IR may not be reliable to evaluate IR for perioperative period.

  15. Periodic health examination, 1996 update: 1. Prenatal screening for and diagnosis of Down syndrome. Canadian Task Force on the Periodic Health Examination.

    Science.gov (United States)

    Dick, P T

    1996-02-15

    To make recommendations to physicians providing prenatal care on (1) whether prenatal screening for and diagnosis of Down syndrome (DS) is advisable and (2) alternative screening and diagnosis manoeuvres. "Triple-marker" screening of maternal serum levels of alpha-fetoprotein, human chorionic gonadotropin and unconjugated estriol; fetal ultrasonographic examination; amniocentesis; and chorionic villus sampling (CVS). Accuracy of detection of DS in fetuses, and risks to the mother, including psychologic distress, and to the fetus from the screening and diagnostic interventions. A MEDLINE search for relevant articles published from Jan. 1, 1966, to Mar. 31, 1994, with the use of MeSH terms "Down syndrome," "prenatal diagnosis," "screening," "prevention," "amniocentesis," "chorionic villus sampling," "ultrasonography," "anxiety," "depression" and "psychological stress" and a manual search of bibliographies, recent issues of key journals and Current Contents. The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. A high value was placed on providing pregnant women with the opportunity to determine whether they are carrying a fetus with DS and to make choices concerning the termination of the pregnancy. The economic issues involved are complex and were not considered. Triple-marker screening identifies an estimated 58% of fetuses with DS, but it has an estimated rate of true-positive results of 0.1% and of false-positive results of 3.7% (given a risk cut-off of one chance in 190 of DS). These rates vary with maternal age and the risk cut-off chosen. Women with a known risk of having a fetus with DS (e.g., those who have had a previous child with DS) may benefit from a reduction in anxiety after confirmation that their fetus does not have DS. Screening allows women at low risk of having a child with DS to detect fetuses with the syndrome, but may cause psychologic distress if there is a false-positive screening test

  16. [Community health course--student's evaluation].

    Science.gov (United States)

    Juresa, Vesna; Musil, Vera; Sosić, Zvonko; Majer, Marjeta; Pavleković, Gordana

    2010-12-01

    Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar

  17. South Africa's universal health coverage reforms in the post-apartheid period.

    Science.gov (United States)

    van den Heever, Alexander Marius

    2016-12-01

    In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers. This article reviews both reform paths and attempts to reconcile what may appear to be very different approaches. The scale of the more recent set of proposals requires a very long reform path because in the mid-term (the next 25 years) no single scheme will be able to raise sufficient revenue to provide a universal package for the entire population. In the interim, reforms that maintain and improve existing forms of coverage are required. The earlier reform framework (1994-2008) largely addressed this concern while leaving open the final form of the system. Both reform approaches are therefore compatible: the earlier reforms addressed medium- to long-term coverage concerns, while the more recent define the long-term institutional goal. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Managing preventive occupational health and safety activities in Danish enterprises during a period of financial crisis

    DEFF Research Database (Denmark)

    Andersen, Hans H. K.; Bach, Elsa

    2017-01-01

    The onset of the financial crisis in 2008 has put pressure on enterprises that in turn have downsized and reorganized. Research has shown that economic recession has an effect on psychological and behavioral health that is attributed to working environment problems. The objective of this study is...... focus on the management of preventive workplace health and safety activities in enterprises during a period of economic recession....... is to unravel whether the onset of a general economic recession has had an impact on companies’ and public institutions’ preventive occupational health and safety activities. Hypotheses of the role of pro-cyclical and countercyclical effects are presented. This study is based on a survey of enterprise...... preventive occupational health safety activities. The baseline for the survey was established, in 2006 before the onset of the recession, with a follow up in 2011. Findings are discussed that support both the pro-cyclical and the countercyclical hypotheses. It is concluded that there is a need for a special...

  19. BILIARY ATRESIA: evaluation on two distinct periods at a reference pediatric service

    Directory of Open Access Journals (Sweden)

    Thais Costa Nascentes QUEIROZ

    2014-03-01

    Full Text Available Context Biliary atresia is a progressive, idiopathic, fibro-obliterative disease of the extrahepatic biliary tree that pre­sents with biliary obstruction exclusively in the neonatal period. Objectives To assess the differences regarding age at referral, age at surgery, duration of propaedeutics and waiting time for surgery between two groups of infants in different periods. Methods Retrospective study of infants diagnosed with biliary atresia on two periods: 1983-1993 and 1998-2011. Results Biliary atresia was diagnosed in 129 infants, being 48 in casuistic I and 81 in casuistic II. The median age at admission was 94 and 60 days, respectively (P = 0.0001. On evaluating patients who had undergone portoenterostomy before 120 days of age, no difference was observed regarding the duration of propaedeutics or waiting time for surgery (P = 0.15, but difference was found when comparing the age at surgery (P = 0.002. Among those infants with no biliary flow and without liver transplantation or death after 18 post-operative months, the estimated probability of survival was 44.6% and 38.7% in casuistics I and II, respectively. In casuistic I, all infants who showed biliary flow were alive during the observation period and, in casuistic II, 80.3% were alive after 7 years of follow-up. Conclusions Even though patients were admitted and treated earlier, it is clear that surgery could be done sooner. Delay in referral and timely propaedeutics were the main contributors.

  20. Biliary atresia: evaluation on two distinct periods at a reference pediatric service.

    Science.gov (United States)

    Queiroz, Thais Costa Nascentes; Ferreira, Alexandre Rodrigues; Fagundes, Eleonora Druve Tavares; Roquete, Mariza Leitão Valadares; Penna, Francisco José

    2014-01-01

    Biliary atresia is a progressive, idiopathic, fibro-obliterative disease of the extrahepatic biliary tree that presents with biliary obstruction exclusively in the neonatal period. To assess the differences regarding age at referral, age at surgery, duration of propaedeutics and waiting time for surgery between two groups of infants in different periods. Retrospective study of infants diagnosed with biliary atresia on two periods: 1983-1993 and 1998-2011. Biliary atresia was diagnosed in 129 infants, being 48 in casuistic I and 81 in casuistic II. The median age at admission was 94 and 60 days, respectively (P = 0.0001). On evaluating patients who had undergone portoenterostomy before 120 days of age, no difference was observed regarding the duration of propaedeutics or waiting time for surgery (P = 0.15), but difference was found when comparing the age at surgery (P = 0.002). Among those infants with no biliary flow and without liver transplantation or death after 18 post-operative months, the estimated probability of survival was 44.6% and 38.7% in casuistics I and II, respectively. In casuistic I, all infants who showed biliary flow were alive during the observation period and, in casuistic II, 80.3% were alive after 7 years of follow-up. Even though patients were admitted and treated earlier, it is clear that surgery could be done sooner. Delay in referral and timely propaedeutics were the main contributors.

  1. Relationships between rumination time, metabolic conditions, and health status in dairy cows during the transition period.

    Science.gov (United States)

    Soriani, N; Trevisi, E; Calamari, L

    2012-12-01

    The main objective of this experiment was to monitor the rumination pattern during the transition period in primiparous (PR) and pluriparous (PL) dairy cows and to investigate its relationships with metabolic conditions, milk yield, and health status. The study was carried out in an experimental free-stall barn and involved 32 Italian Friesian cows (9 PR and 23 PL) during the transition phase. The rumination time (RT) was recorded with an automatic system (HR-Tag), and data were calculated and summarized in 2-h intervals. Blood samples were collected during the transition phase to assess biochemical variables related to energy, protein, and mineral metabolism, as well as markers of inflammatory conditions and some enzyme activity. Daily milk yield, BW, nutritional condition, and health status were also recorded. The average RT before calving (-20 to -6 d) was 463 min/d in PR (range 270 to 620) and 522 min/d in PL (range 411 to 640). In the early lactation [15 to 40 d in milk (DIM)], the average RT was 504 min/d in PR (range 400 to 585) and 562 min/d in PL (range 414 to 685) and was positively correlated with milk yield (r = 0.36; P Cows with reduced RT before calving maintained reduced RT after calving and suffered a greater frequency of disease than cows with greater RT in late pregnancy. Moreover, cows characterized by mild inflammatory conditions and without health disorders or only mild health disorders during the puerperium showed a greater average rumination time (over 520 min/d) during the first 10 d of lactation. Conversely, the decreased RT (450 min/d) during the first few days of lactation was observed in cows with subclinical diseases or health disorders. Cows affected by clinical mastitis during the trial showed a reduction of RT and a change in its variability already some days before the drug treatment. Our results suggest that the automatic measurement of RT is useful to predict calving time and to quickly obtain information on health status of the

  2. Primeval health economics in Britain: a personal retrospect of the pre-HESG (Health Economists' Study Group) period.

    Science.gov (United States)

    Williams, A

    1998-08-01

    There is a danger that the history of health economics in Britain comes to be regarded as roughly co-terminous with the history of the Health Economists' Study Group (HESG). As one of the founders of that Group, I would take some pride from that, if it were true. But it is not. Just as primitive human societies existed before recorded history, so there was primeval health economics in Britain prior to 1972. There is probably more of this primeval health economics than even I know about, but as one of the ancient relics of that period I have been offered the opportunity to reminisce about what I saw during those dark ages! When one reaches the advanced age of 70, there is no escaping the fact that your past is bound to be more extensive (and probably more enjoyable) than your future, which is why the old enjoy looking back more than they enjoy looking forward! I am no exception. Hence this essay, which may either be seen as a rather self-indulgent bout of nostalgia concerning the early days of health economics in Britain, or as an archaeological enterprise, exhibiting, for all to wonder at, the treasures to be found at carefully selected ancient (i.e., pre-HESG) sites in Britain. Either way, my purpose is to suggest that most of the fundamental issues with which health economists have grappled in the last 25 years had already been identified and addressed in a careful way during the decade preceding the formation of the HESG.

  3. Evaluation of environmental qualification period for Conax electrical penetration assemblies. Final report

    International Nuclear Information System (INIS)

    Doroshuk, B.; Hager, M.; Brown, R.

    1995-05-01

    This report evaluates the environmental qualification period of Conax electrical penetration assemblies (EPAs) for extension from forty (40) years to sixty (60) years. The evaluation was performed based on a review of Conax EPAs supplied to Baltimore Gas ampersand Electric's (BGE) Calvert Cliffs Nuclear Power Plant Units 1 and 2. The report has been prepared so that it may be of use to any utility involved in the extension of the environmental qualification period for Conax EPAs installed in their plant(s). The report includes a section on the strategy which was developed for the effort to extend the qualified lives of the Conax EPAs. A review of documentation and plant conditions specific to BGE is included in the report to demonstrate the methodology. The documentation included qualification testing performed by Conax of the materials of construction of the EPA models. The plant conditions reviewed included both normal and accident environments, both of which are specific to Calvert Cliffs Nuclear Power Plant Units 1 and 2. This report can be used as a guide in the evaluation of similar installations of Conax electrical penetration assemblies in other nuclear power plants by applying the methodologies used herein in conjunction with the plant specific test reports, materials, and conditions

  4. Evaluation of cytotoxicity and degree of conversion of orthodontic adhesives over different time periods

    Directory of Open Access Journals (Sweden)

    Matheus Melo Pithon

    2010-06-01

    Full Text Available As new orthodontic resin adhesives continue to be marketed, rapid and sensitive tests for examining their toxic effects at the ' cell and tissue level ' are needed because patient safety has been identifi ed as a legal concept. The objective of the present study was to evaluate the cytotoxicity and degree of monomer conversion of orthodontic adhesives over different time periods. Seven adhesives: Transbond® XT, Transbond® Color Change, Quick Cure, EagleBond, Orthobond®, Fill Mágic® and Biofix® were evaluated for their cytotoxicity in L929 fibroblastic cells and for their degree of monomer conversion over different time periods. Three control groups were also analysed: Positive control (C+, consisting of Tween 80 cell detergent; Negative control (C-, consisting of PBS; and cell control (CC, consisting of cells exposed to any material. The dye-uptake technique that involves the absorption of a neutral red dye in viable cells was used for the cytotoxicity evaluation and the degree of conversion was evaluated using spectroscopy with infrared. The results showed the cytotoxicity of the adhesives at 24, 48, 72 and 168 hours. At these times, the viability values presented for these materials were statistically different from the groups CC and C- (p 0.05. In the monomer conversions there was a percentage increase of monomer conversion from 24 to 72 hours. A direct correlation could be observed between cytotoxicity and monomer conversions. From this work it can be concluded that all adhesives evaluated are cytotoxic at the times of 24, 48 and 72 hours. Monomers continued conversion even after photopolymerization had stopped.

  5. Abortion and mental health: Evaluating the evidence.

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-12-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women's varied experiences of abortion be recognized, validated, and understood. 2009 APA.

  6. Evaluation of two dairy herd reproductive performance indicators that are adjusted for voluntary waiting period

    Directory of Open Access Journals (Sweden)

    Löf Emma

    2012-01-01

    Full Text Available Abstract Background Overall reproductive performance of dairy herds is monitored by various indicators. Most of them do not consider all eligible animals and do not consider different management strategies at farm level. This problem can be alleviated by measuring the proportion of pregnant cows by specific intervals after their calving date or after a fixed time period, such as the voluntary waiting period. The aim of this study was to evaluate two reproductive performance indicators that consider the voluntary waiting period at the herd. The two indicators were: percentage of pregnant cows in the herd after the voluntary waiting period plus 30 days (PV30 and percentage of inseminated cows in the herd after the voluntary waiting period plus 30 days (IV30. We wanted to assess how PV30 and IV30 perform in a simulation of herds with different reproductive management and physiology and to compare them to indicators of reproductive performance that do not consider the herd voluntary waiting period. Methods To evaluate the reproductive indicators we used the SimHerd-program, a stochastic simulation model, and 18 scenarios were simulated. The scenarios were designed by altering the reproductive management efficiency and the status of reproductive physiology of the herd. Logistic regression models, together with receiver operating characteristics (ROC, were used to examine how well the reproductive performance indicators could discriminate between herds of different levels of reproductive management efficiency or reproductive physiology. Results The logistic regression models with the ROC analysis showed that IV30 was the indicator that best discriminated between different levels of management efficiency followed by PV30, calving interval, 200-days not-in calf-rate (NotIC200, in calf rate at100-days (IC100 and a fertility index. For reproductive physiology the ROC analysis showed that the fertility index was the indicator that best discriminated

  7. Evaluating the optimum rest period prior to blood collection for fractionated plasma free metanephrines analysis

    LENUS (Irish Health Repository)

    Griffin, T.P.

    2016-05-01

    The high diagnostic accuracy of plasma metanephrines (PMets) in the di-agnosis of Phaeochromocytoma\\/Paraganglioma (PPGL) is well established. Considerable controversy exists regarding optimum sampling conditions for PMets. The use of reference intervals that do not compromise diagnostic sensitivity is recommended. However, the optimum rest period prior to sampling has yet to be clearly established. The aim of this study was to evaluate PMets concentrations in paired blood samples collected following 30 and 40 min seated-rest prior to sampling, in patients in whom it was clinically rea-sonable to suspect that PPGL may be present.

  8. Planning and management for health in periods of economic stringency and instability: a contingency approach.

    Science.gov (United States)

    van der Werff, A

    1986-01-01

    The mid-1970s marked the end of the longest period of uninterrupted economic growth in history, and initiated in Europe--and other parts of the world--a period of economic stagnation and instability. Along with the prosperity explosion of the past, the pattern of health problems has changed and is still changing. Moreover, the demand for health care has kept on rising, without much improvement of health status in general. Thus, there is a critical need to rethink policies, and to ensure that future changes occur within the limits of shrinking resources and the allotted time-span. In particular, the change in priorities envisaged by the Health for All 2000 (HFA 2000) strategies will need to take place against the background of an ageing population, social instability, and continuing development of new lifestyles and persistent economic scarcity. It is by analysing that background that this article seeks to make recommendations as to how health planning and management might successfully cope with the policy reorientation of the HFA 2000 strategy. The structure of this article is as follows. Firstly, the changes taking place in planning conditions will be reviewed, and form the basis of a framework for subsequent analysis of the planning environment. Following this framework, some of the conflicts likely to be faced in planning and management will be discussed, many of which are the consequence of economic stringency and instability. Also the requirements for an improvement of the effectiveness and efficiency of planning will be identified. Finally, a limited number of approaches to planning will be considered, for their appropriateness to the present-day economic circumstances. The point of view elucidated throughout is that there is no single solution which is 'best' under all circumstances. The conclusion, rather, is that the selection of particular theory or method of planning and management should depend both on the objectives of the decision maker and on the

  9. The impact of controlled nutrition during the dry period on dairy cow health, fertility and performance.

    Science.gov (United States)

    Beever, David E

    2006-12-01

    Average dairy herd fertility is declining, with more serves per successful conception, extended calving intervals and increased culling due to failure to rebreed, all adding significant costs to milk production. Genetics, management and nutrition have all contributed to this decline in fertility; the paper focuses primarily on nutritional issues. The extent of body condition loss after calving and its possible impact on fertility is considered, with evidence that this phenomenon is common in many herds irrespective of average milk yields. Body tissue mobilisation after calving increases the flux of non-esterified fatty acids to the liver and pathways of fatty acid metabolism are considered. Particular attention is given to the effects of high plasma non-esterified fatty acid levels on fat accumulation in liver cells and possible impacts on nitrogen and glucose metabolism. Current nutritional practices with early lactation cows which aim to stimulate milk yield and peak milk production but have been shown to exacerbate body condition loss, are reviewed. The paper also considers cow health issues during the peri-parturient period and how these may affect milk yield and fertility. It is concluded that current feeding practices for dry cows, with the provision of increasing amounts of the lactation ration during the Close-up period to accustom the rumen microbes and offset the expected reduction in feed intake as pregnancy reaches term, have largely failed to overcome peri-parturient health problems, excessive body condition loss after calving or declining fertility. From an examination of the energy and protein requirements of dry cows, it is suggested that current Close-up feeding practices can lead to luxury intakes of nutrients that can increase fat deposition in the viscera and the liver. Under such conditions, metabolism of nutrients by the cow may be compromised. In contrast, limited feeding throughout the whole dry period has been shown to prevent many of the

  10. Evaluation of 'period-generated' control laws for the time-optimal control of reactor power

    International Nuclear Information System (INIS)

    Bernard, J.A.

    1988-01-01

    Time-Optimal control of neutronic power has recently been achieved by developing control laws that determine the actuator mechanism velocity necessary to produce a specified reactor period. These laws are designated as the 'MIT-SNL Period-Generated Minimum Time Control Laws'. Relative to time-optimal response, they function by altering the rate of change of reactivity so that the instantaneous period is stepped from infinity to its minimum allowed value, held at that value until the desired power level is attained, and then stepped back to infinity. The results of a systematic evaluation of these laws are presented. The behavior of each term in the control laws is shown and the capability of these laws to control properly the reactor power is demonstrated. Factors affecting the implementation of these laws, such as the prompt neutron lifetime and the differential reactivity worth of the actuators, are discussed. Finally, the results of an experimental study in which these laws were used to adjust the power of the 5 MWt MIT Research Reactor are shown. The information presented should be of interest to those designing high performance control systems for test, spacecraft, or, in certain instances, commercial reactors

  11. Mental Health of HIV-Seropositive Women During Pregnancy and Postpartum Period: A Comprehensive Literature Review

    Science.gov (United States)

    Dass-Brailsford, Priscilla; Nora, Diana; Talisman, Nicholas

    2014-01-01

    With growing numbers of HIV-seropositive (HIV+) women of child-bearing age and increased access to effective clinical protocols for preventing mother-to-child transmission (MTCT) of HIV, mental health-related factors have become increasingly relevant due to their potential to affect the women’s quality of life, obstetric outcomes and risk of MTCT. This review synthesizes evidence from 53 peer-reviewed publications examining mental health-related variables in pregnant and postpartum HIV+ women. The presentation of results is organized by the level of socioeconomic resources in the countries where studies were conducted (i.e., high-, middle-, and low-income countries). It is concluded that psychiatric symptoms, particularly depression, and mental health vulnerabilities (e.g., inadequate coping skills) are widespread among pregnant HIV+ women globally and have a potential to affect psychological well-being, quality of life and salient clinical outcomes. The current body of evidence provides rationale for developing and evaluating clinical and structural interventions aimed at improving mental health outcomes and their clinical correlates in pregnant HIV+ women. PMID:24584458

  12. Critical evaluation of international health programs: Reframing global health and evaluation.

    Science.gov (United States)

    Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

    2018-01-05

    Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Evaluation of raw milk quality in different production systems and periods of the year

    Directory of Open Access Journals (Sweden)

    Marcos Inácio Marcondes

    2014-12-01

    Full Text Available The objective of this study was to evaluate the quality of raw milk in different production systems and its variation throughout the year. The data were collected from 943 dairy farms in the South, Central-West and Central regions of the state of Minas Gerais, and in Vale do Paraíba, in the state of São Paulo, Brazil. The data were collected in the period from January 2009 to September 2011, in a total of 18,206 samples. The properties were divided into confinement, semi-confinement and extensive production systems. The evaluated factors were somatic cell count (SCC, total bacterial count (TBC and protein and fat contents. There was no effect of production system on the contents of protein, fat and SCC. Total bacterial count, however, was affected by production. Seasonal variations were found for SCC, TBC, protein and fat; the highest protein values were found from March to June; the highest fat contents were obtained from May to August; and TBC and SCC, from December to March. The production system does not interfere with the percentage of fat and protein and SCC of the milk. However, confinement systems present a better TBC content. Both month and year are factors that interfere with TBC, SCC, protein and milk fat, and the best patterns are found in the coldest periods of the year.

  14. Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

    Science.gov (United States)

    Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

    2016-02-01

    Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  15. Public Health Promoted by the Cabildo of Lima in the Colonial Period

    Directory of Open Access Journals (Sweden)

    Paula Ermila Rivasplata

    2014-01-01

    Full Text Available In the Colonial period, the city of Lima featured such overcrowding that it generated all sorts of garbage and faced problems regarding the final disposal of solid, liquid, and gas waste. The purpose of this article is to discuss the active participation of the cabildo (council in the city’s public health, from a cultural perspective and on the basis of administrative documents and secondary sources. The study shows that the cabildo was engaged in disease prevention, sanitary control, the city’s supply system, and even the conservation of its resources. Through commissions, the regidores (council members supervised markets, butcher shops, slaughterhouses, mills, bakeries, tanneries, corner shops, and pharmacies. However, these and other efforts were never enough to keep the city clean and free of epidemics.

  16. Evaluating a Sexual Health Patient Education Resource.

    Science.gov (United States)

    Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty

    2015-01-01

    This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncology professionals are committed to addressing quality-of-life concerns for patients across the trajectory of illness. Sexuality is a key concern for patients and impacts relationships and overall quality of life. Through careful assessment, patient education, and support, clinicians can ensure that sexuality is respected as an essential part of patient-centered care.

  17. [Evaluating cost/equity in the Colombian health system, 1998-2005].

    Science.gov (United States)

    Eslava-Schmalbach, Javier; Barón, Gilberto; Gaitán-Duarte, Hernando; Alfonso, Helman; Agudelo, Carlos; Sánchez, Carolina

    2008-01-01

    An economic analysis of cost-equity (from society's viewpoint) for evaluating the impact of Law 100/93 in Colombia between 1998 and 2005. An economic analysis compared costs and equity in health in Colombia between 1998 and 2005. Data was taken from the Colombian Statistics' Administration Department ( Departamento Administrativo Nacional de Estadistica - DANE) and from national demographic and health surveys carried out in 2000 and 2005. Information regarding costs was taken from the National Health Accounts' System. Inequity in Health was considered in line with the Inequity in Health Index (IHI). Incremental and average cost-equity analysis covered three sub-periods; 1998-1999 (during which time per capita gross internal product became reduced in Colombia ), 2000-2001 (during which time total health expense became reduced) and 2001 -2005. An unstable tendency for inequity in health becoming reduced during the period was revealed. There was an inverse relationship between IHI and public health spending and a direct relationship between out-of-pocket spending on health and equity in health (Spearman, p<0.05). The second period had the best incremental cost-equity ratio. Fluctuations in IHI and marginal cost-equity during the periods being analysed suggested that health spending depended on equity in health in Colombia during the period being studied.

  18. A survey for the evaluation of the training period of cardiology specialists in Turkey.

    Science.gov (United States)

    Yıldız, Bekir Serhat; Alkan, Mustafa Beyazıt; Güngör, Hasan; Gül, Ilker; Bilgin, Murat; Akın, Mustafa; Nalbantgil, Sanem; Zoghi, Mehdi

    2011-12-01

    To evaluate postgraduate training period, social life and problems of cardiology residents in Turkey by using a questionnaire form and to compare with the core curriculum of European Society of Cardiology for general cardiology. Overall, 529 residents of cardiology ages in range of 24-35 years (mean age: 26.5±2.0 years, 81.4% male) participated as volunteers in this cross-sectional survey study. An 86-item questionnaire form was used to evaluate the education process, capacity of knowledge and skill and social effectiveness level of participants. The questionnaire were composed both closed- and open-ended questions. The questionnaire form was filled in with the face-to-face communication method. The data of survey were compared with the core curriculum of European Society of Cardiology for general cardiology training period. Chi-square or Fischer exact test was used for statistical analysis. The participants were working in various university hospitals (70.3%) and training-research (state) hospitals in 31 different provinces in Turkey (40.8% in Marmara region). They visited 40±10 outpatients and 10±5 hospitalized pts daily in the clinics. The 3-5 residents worked at the clinic on night shifts and mostly (89%) 8 or more night shifts per month were held in their first training years. During first three-years of training 76% of residents have performed echocardiography, 40.8%-transesophageal echocardiography and 10% - intraoperative echocardiography. The 84.3% of them evaluated exercise tests, 76.4%-Holter electrocardiography and 53.3%-tilt-table tests. The rate of residents working in coronary angiography laboratories was 54.3%. The 53.7% of residents performed coronary angiography and 64%-only in the 4th year of their training. The number of coronary angiography performance was under expected when compared with European Society of Cardiology curriculum. The 18.5% of residents were participated as assistant researcher in an international multi-center study and

  19. Agronomic evaluation of four improved rice varieties in different sowing periods

    Directory of Open Access Journals (Sweden)

    Genry Hernández Carrillo

    2017-04-01

    Full Text Available A study to evaluate the agronomic performance of four rice varieties in different seasons, on flooded soil, using direct plantation, was developed at the Local Station for Grain Research, in the municipality of Vertientes, province of Camaguey, Cuba. A block random design was used in the study, with five replicas, through a bifactorial experiment with four treatments (Prosequisa 4, IA Cuba 31, IACuba 40, and Jucarito 104, as control, the sowing period included January, February, March, April, May, June, July, and August. The parameters evaluated were, cycle (days from germination to harvest, final plant height, fertile panicles per m2, filled grain per panicle, 1000-grain mass (14% humidity, crop yields and industrial quality. The highest yields were accomplished in February and June (pattern variety and Prosequisa 4, with 8.2 t/ha-1, in each month. Concerning industrial yields, the best results were achieved in IACuba 31 (66.4; 66.1; and 63.3% full white grain in February, June and July. The most profitable varieties were Prosequisa 4, Jucarito 104, and IACuba 31, in the different seasons evaluated.

  20. Evaluating the efficiency of a zakat institution over a period of time using data envelopment analysis

    Science.gov (United States)

    Krishnan, Anath Rau; Hamzah, Ahmad Aizuddin

    2017-08-01

    It is crucial for a zakat institution to evaluate and understand how efficiently they have operated in the past, thus ideal strategies could be developed for future improvement. However, evaluating the efficiency of a zakat institution is actually a challenging process as it involves the presence of multiple inputs or/and outputs. This paper proposes a step-by-step procedure comprising two data envelopment analysis models, namely dual Charnes-Cooper-Rhodes and slack-based model to quantitatively measure the overall efficiency of a zakat institution over a period of time. The applicability of the proposed procedure was demonstrated by evaluating the efficiency of Pusat Zakat Sabah, Malaysia from the year of 2007 up to 2015 by treating each year as a decision making unit. Two inputs (i.e. number of staff and number of branches) and two outputs (i.e. total collection and total distribution) were used to measure the overall efficiency achieved each year. The causes of inefficiency and strategy for future improvement were discussed based on the results.

  1. Evaluating the effectiveness of health care teams.

    Science.gov (United States)

    Mickan, Sharon M

    2005-05-01

    While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.

  2. Evaluation of a Sexual and Reproductive Health Education ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Faculty of Health, Sports and Social Work, Research Centre Mental Health Nursing, Inholland ... Evaluation research concerning the impact of sexual and reproductive health (SRH) ..... awareness of the existence of HIV, pregnancy and.

  3. EVALUATION OF PRODUCTION IN SEASONALITY PERIODS: ANALYSIS OF THE CONSTRUCTION INDUSTRY IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Marcos William Kaspchak Machado

    2013-06-01

    Full Text Available The present work has as an objective to evaluate the impacts of production seasonality in seasonality periods in the Brazilian construction industry. The adopted methodology was based on the qualitative and quantitative approaches of the aspects inherent to the seasonality factors in the construction industry and its possible causes. Besides that, literature data were collected in year report books and devices provided by institutions of the sector. The results demonstrated the importance of production management mechanisms to optimize the use of productive factors through cost analysis, which are fundamental to understand the operational flux of resources used in the operational media. Obtaining this information, connected to market indicators helped in the decision making process related to the development of prospective scenarios which will give support to the decision making strategy aiming to stabilize the production levels.

  4. Geologic disposal evaluation program semiannaul report for period ending March 31, 1975

    International Nuclear Information System (INIS)

    1975-07-01

    The Radioactive Waste Repository Project at the Oak Ridge National Laboratory has for some time been engaged in a program directed toward establishing a Federal Repository for radioactive wastes, primarily solidified high-level waste, in a bedded salt formation. Early in 1974, the project was restructured and, to more nearly reflect its broadened scope, was renamed the Geologic Disposal Evaluation (GDE) Program. This report is the first in a series of semiannual progress reports which will be issued to document the progress made in the GDE Program. Most of the subject matter discussed is either geologic or developmental in nature, as would be expected, since the engineering assessment depends on the data generated in these two areas. In addition, since this report also covers the transition period between the Radioactive Waste Repository Project (RWRP) and the GDE Program, information on several RWRP programs, is included. (U.S.)

  5. Evaluation of bionanocomposites as packaging material on properties of soft white cheese during storage period.

    Science.gov (United States)

    Youssef, Ahmed M; El-Sayed, Samah M; Salama, Heba H; El-Sayed, Hoda S; Dufresne, A

    2015-11-05

    Novel bionanocomposites based on chitosan/poly(vinyl alcohol)/titanium nanoparticles (CS/PVA/TiO2 nanocomposite) were prepared and used as packaging materials for soft white cheese. The prepared bionanocomposites were characterized using XRD, SEM, TEM and FT-IR. The CS/PVA/TiO2 bionanocomposites exhibited good mechanical properties. Furthermore, the obtained bionanocomposites exhibited superior antibacterial activity against gram positive (Staphylococcus aureus), gram negative (Pseudomonas aeruginosa, Escherichia coli) bacteria and fungi (Candidia albicans). The soft white cheese was manufactured and packaged within the CS/PVA/TiO2 nanocomposite films and stored at 7 °C for 30 days. The color, rheological and chemical properties of cheese were evaluated, also the influence of CS/PVA/TiO2 bionanocomposites on microbiological analysis of soft white cheese was assessed, the results indicated that the total bacterial counts, mold & yeast and coliform decreased with the increasing storage period and disappeared at the end of storage period compared with control. Consequently, CS/PVA/TiO2 bionanocomposite can be used in food packaging applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Evaluation of head movement periodicity and irregularity during locomotion of Caenorhabditis elegans

    Directory of Open Access Journals (Sweden)

    Ryuzo eShingai

    2013-03-01

    Full Text Available Caenorhabditis elegans is suitable for studying the nervous system, which controls behavior. C. elegans shows sinusoidal locomotion on an agar plate. The head moves not only sinusoidally but also more complexly, which reflects regulation of the head muscles by the nervous system. The head movement becomes more irregular with senescence. To date, the head movement complexity has not been quantitatively analyzed. We propose two simple methods for evaluation of the head movement regularity on an agar plate using image analysis. The methods calculate metrics that are a measure of how the head end movement is correlated with body movement. In the first method, the length along the trace of the head end on the agar plate between adjacent intersecting points of the head trace and the quasi-midline of the head trace, which was made by sliding an averaging window of 1/2 the body wavelength, was obtained. Histograms of the lengths showed periodic movement of the head and deviation from it. In the second method, the intersections between the trace of the head end and the trace of the 5 (near the pharynx or 50% (the mid-body point from the head end in the centerline length of the worm image were marked. The length of the head trace between adjacent intersections was measured, and a histogram of the lengths was produced. The histogram for the 5% point showed deviation of the head end movement from the movement near the pharynx. The histogram for the 50% point showed deviation of the head movement from the sinusoidal movement of the body center. Application of these methods to wild type and several mutant strains enabled evaluation of their head movement periodicity and irregularity, and revealed a difference in the age-dependence of head movement irregularity between the strains. A set of five parameters obtained from the histograms reliably identifies differences in head movement between strains.

  7. A common evaluation framework for the African Health Initiative

    Science.gov (United States)

    2013-01-01

    Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

  8. An evaluation of school health services in Sagamu, Nigeria

    African Journals Online (AJOL)

    2013-07-01

    Jul 1, 2013 ... scores (63.6%), while 96.2% of the private primary schools had poor health service evaluation scores. Conclusions: SHS are ... Key words: School Health Services, School Health Services Evaluation scale, Health knowledge, Nigeria ..... Since food and nutrition is an aspect of home economics, teaching.

  9. Periodicity of dental recall visits for young children first seen in community health centers

    Science.gov (United States)

    Kuthy, RA; Kavand, G; Momany, ET; Jones, MP; Askelson, NM; Chi, DL; Wehby, GL; Damiano, PC

    2014-01-01

    Objectives To study whether young children who had their first dental visit (FDV) at a Federally Qualified Health Center (FQHC) are likely to return within 12 months for a second dental episode. Methods 200 Medicaid-enrolled children who were less than 6-years-old were randomly selected from five Iowa FQHCs. Dental charts were abstracted and all Medicaid claims data, regardless of provider, were followed for 36 months. Medical and dental Medicaid claims data were also appended to the data set, along with relevant data from the child’s birth certificate. Multivariable logistic regression, using backward elimination, was used to determine variables that predicted whether a child returned for his or her dental recall visit with one year of the initial dental episode. Results 56.5% of these children returned within one year. The number of children in the household demonstrated a positive impact for children returning for a second dental episode. However, an increase in the frequency of medical well-child visits at the FQHC prior to the FDV had a negative influence. There was an inverse association between dental caries at the FDV and likelihood of returning for the second visit; however, it was not statistically significant. Age at FDV did not make a difference in regard to returning for a second episode within the allotted time period. Conclusions There has been a recent emphasis for children to visit a dentist by age 1. We should not overlook the importance of diligently working with higher risk families to instill the importance of regular, periodic preventive dental care. PMID:23574299

  10. Evaluation and selection of NPPs for medium term period around 2020

    International Nuclear Information System (INIS)

    Zezula, L.

    2004-01-01

    The Czech Republic is one of the European countries where a nuclear option remains open as a part of an energy mix. This will help the country to meet its international commitments under the Kyoto Protocol. Moreover the country has also its own industrial potential which can significantly contribute to possible construction of a new nuclear source both in the Czech Republic and abroad. Therefore, the selection of a new nuclear source which could be connected to the national grid after 2020 is actually a pressing issue. General features of economics assessment philosophy as to electricity generation costs are briefly discussed, and an overview of basic economic assessment methods is presented. An example of the economic calculations for a small grid is also given. General approach to the evaluation of advanced nuclear power plants projects (feasible for the period around 2020) are discussed. A simple method of the preliminary evaluation and selection of a suitable type of the plant is presented and general targets which are prerequisite and follow also from important international activities (GIF project and INPRO project) are elucidated. (author)

  11. Health economic evaluations in orthodontics: a systematic review.

    Science.gov (United States)

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  12. A comprehensive health service evaluation and monitoring framework.

    Science.gov (United States)

    Reeve, Carole; Humphreys, John; Wakerman, John

    2015-12-01

    To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands

    NARCIS (Netherlands)

    Bruggink, Jan-Willem; de Goeij, Moniek C. M.; Otten, Ferdy; Kunst, Anton E.

    2016-01-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health,

  14. Forest health status in the Carpahian Mountains over the period 1997-2001

    International Nuclear Information System (INIS)

    Badea, Ovidiu; Tanase, Mihai; Georgeta, Jianu; Anisoara, Lazar; Peiov, Agata; Uhlirova, Hana; Pajtik, Josef; Wawrzoniak, Jerzy; Shparyk, Yuri

    2004-01-01

    The results of forest health status assessments in the Carpathian Mountains from the monitoring networks developed by the European Union Scheme on the Protection of Forest Against Atmospheric Pollution (EU Scheme) and International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP-Forests), have led to a better understanding of the impact of air pollution and other stressors on forests at the regional scale. During the period 1997-2001, forests in the Carpathian Mountains were severely affected by air pollution and natural stresses with 29.7-34.9% of the trees included in defoliation classes 2-4. The broadleaves were slightly healthier than the conifers, and European beech (Fagus sylvatica) was the least affected species. Norway spruce (Picea abies) has poor health status, with 42.9-46.6% of the trees damaged (2-4% defoliation classes). Silver fir (Abies alba) damage was also high, with 46.0-50.9% in defoliation classes 2-4. Pines (primarily Pinus sylvestris) were the least affected of the conifers, with 24.9-33.8% in defoliation classes 2-4. The results from the transnational networks (16x16 km) show that the Carpathian forests are slightly more damaged than the average for the entire Europe. The correlative studies performed in individual European countries show the relationships between air pollution stressors with trends in defoliation and a possible effect of natural stresses at each site. More specific, effects of tree age, drought, ozone and acid deposition critical level exceedances were demonstrated to affect crown condition. - About 1/3 of the Carpathian forest trees are damaged by natural stressors and air pollution

  15. Screening Models for Cardiac Risk Evaluation in Emergency Abdominal Surgery. I. Evaluation of the Intraoperative Period Risk based on Data from the Preoperative Period

    Directory of Open Access Journals (Sweden)

    Mikhail Matveev

    2008-04-01

    Full Text Available A classification of intraoperative cardio-vascular complications (CVC was performed, based on data from 466 patients subjected to emergency surgery, due to severe abdominal surgical diseases or traumas, in accordance with the severe criteria of ACC/AHA for CVC in noncardiac surgery. There were 370 intraoperative CVC registered, distributed as follows: groups with low risk (148, moderate risk (200, and high risk (22. Patient groups were formed, according to the CVC risk level, during the intraoperative period, for which the determinant factor for the group distribution of patients was the complication with the highest risk. Individual data was collected for each patient, based on 65 indices: age, physical status, diseases, surgical interventions, anaesthesiological information, intra and postoperative cardio-vascular complications, disease outcome, causes of death, cardiovascular disease anamnesis, anamnesis of all other nonsurgical diseases present, laboratory results, results from all imaging and instrumental examinations, etc. On the basis of these indices, a new distribution of the risk factors was implemented, into groups with different levels of risk of CVC during intraoperative period. This result is a solid argument, substantiating the proposal to introduce these adjustments for determining the severity of CVC in the specific conditions of emergency abdominal surgery.

  16. Benefits of applying a proxy eligibility period when using electronic health records for outcomes research: a simulation study.

    Science.gov (United States)

    Yu, Tzy-Chyi; Zhou, Huanxue

    2015-06-09

    Electronic health records (EHRs) can provide valuable data for outcomes research. However, unlike administrative claims databases, EHRs lack eligibility tables or a standard way to define the benefit coverage period, which could lead to underreporting of healthcare utilization or outcomes, and could result in surveillance bias. We tested the effect of using a proxy eligibility period (eligibility proxy) when estimating a range of health resource utilization and outcomes parameters under varying degrees of missing encounter data. We applied an eligibility proxy to create a benchmark cohort of chronic obstructive pulmonary disease (COPD) patients with 12 months of follow-up, with the assumption of no missing encounter data. The benchmark cohort provided parameter estimates for comparison with 9,000 simulated datasets representing 10-90% of COPD patients (by 10th percentiles) with between 1 and 11 months of continuous missing data. Two analyses, one for datasets using an eligibility proxy and one for those without an eligibility proxy, were performed on the 9,000 datasets to assess estimator performance under increasing levels of missing data. Estimates for each study variable were compared with those from the benchmark dataset, and performance was evaluated using bias, percentage change, and root-mean-square error. The benchmark dataset contained 6,717 COPD patients, whereas the simulated datasets where the eligibility proxy was applied had between 671 and 6,045 patients depending on the percentage of missing data. Parameter estimates had better performance when an eligibility proxy based on the first and last month of observed activity was applied. This finding was consistent across a range of variables representing patient comorbidities, symptoms, outcomes, health resource utilization, and medications, regardless of the measures of performance used. Without the eligibility proxy, all evaluated parameters were consistently underestimated. In a large COPD patient

  17. Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands.

    Science.gov (United States)

    Bruggink, Jan-Willem; de Goeij, Moniek C M; Otten, Ferdy; Kunst, Anton E

    2016-10-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  18. On the Evaluation of Solar Greenhouse Efficiency in Building Simulation during the Heating Period

    Directory of Open Access Journals (Sweden)

    Francesco Asdrubali

    2012-06-01

    Full Text Available Among solar passive systems integrated in buildings, sunspaces or solar greenhouses represent a very interesting solution. A sunspace is a closed, southbound volume, constituted by transparent surfaces, adjacent to a building, which reduces winter energy demand thanks to the use of solar gains. The effect of a typical solar greenhouse on the energy balance of a building was evaluated during the heating period with two stationary procedures (Method 5000 and EN ISO 13790 and with a dynamic tool (TRNSYS. After the analysis of the greenhouse alone, the behavior of an entire house was simulated; a flat equipped with a sunspace, recently built thanks to public contributions provided by the Umbria Region in Italy to widespread bio-climatic architecture, was used as case-study. Simulations were carried out for the examined flat, both with a steady-state tool and with a dynamic one; the contribution of the sunspace was estimated thanks to the various methods previously mentioned. Finally, the simulated data were satisfactorily compared with the real energy consumptions (natural gas for heating of the flat; the sunspace allows a reduction of winter energy demand of the flat of about 20%.

  19. Human factors evaluation of man-machine interface for periodic safety review of nuclear power plants

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang; Hwang, In Koo; Lee, Hyun Cheol; Jang, Tong Il; Ku, Jin Young; Kim, Soo Jin

    2004-12-01

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Nuclear Power Plants(NPPs). As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area

  20. Colour traits in the evaluation of the ripening period of Asiago cheese

    Directory of Open Access Journals (Sweden)

    Igino Andrighetto

    2010-01-01

    Full Text Available The research was carried out on Asiago d’Allevo cheese samples produced in a single farm located in the Altopiano dei Sette Comuni (above 1000m a.s.l.. After 6-12-18 and 36 months of ripening, samples were analyzed for quality traits, in order to evaluate the effect of ripening on colour and gross composition. As expected crude protein and fat significantly increased through the considered period. Ripening led to a significant decrease of L*, a* and b* values. Lightness showed a negative relationship with crude protein, meanwhile a* and b* were both negatively related to fat content. Concerning L*, the trend could be explained by water loss and N-soluble compounds concentration, which could alter protein matrix. a* and b* reduction was probably related to degradation processes such as lipolysis, which seemed to be extensive in hard and long ripened cheese. Ripening affected significantly the light reflectance at all λ with green cheese having the higher values.

  1. Sleep and health in oil rig workers--before and after a two week work period offshore.

    Science.gov (United States)

    Waage, Siri; Pallesen, Ståle; Moen, Bente Elisabeth; Bjorvatn, Bjørn

    2013-01-01

    This study compared subjective sleep and subjective health complaints among Norwegian oil rig workers, before and after a two week work period. The study also compared differences between two different work schedules. The workers worked either two weeks of day shift (n=90) or two weeks of a swing shift schedule (n=93), involving one week of night shifts, immediately followed by one week of day shifts. Overall, the workers reported significantly poorer sleep quality and more complaints of insomnia at the end compared to the start of the work period. However, there was no significant difference in terms of subjective health complaints. Furthermore, there were no clear differences in changes in sleep quality, insomnia or subjective health complaints during the work period between day- and swing shift workers. However, at the end of the work period a higher proportion of insomniacs were seen among swing shift workers compared with day workers. To conclude, sleep quality and complaints of insomnia became worse during the work period. However, there were few differences in changes in terms of sleep or subjective health complaints between day- and swing shift, suggesting that 12 h day shift affected sleep and health similarly to the schedule involving night work.

  2. [Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands].

    Science.gov (United States)

    Buggink, J W; de Goeij, M C M; Otten, F W J; Kunst, A

    2016-01-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. Cross-sectional study using routinely collected data from surveys of the Dutch population. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis-period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis.

  3. Screening mixed depression and bipolarity in the postpartum period at a primary health care center.

    Science.gov (United States)

    Çelik, Sercan Bulut; Bucaktepe, Gamze Erten; Uludağ, Ayşegül; Bulut, İbrahim Umud; Erdem, Özgür; Altınbaş, Kürşat

    2016-11-01

    Mixed depression is a clinical condition accompanied by the symptoms of (hypo)mania and is considered to be a predictor for bipolar disorder. Compared to pure major depression, mixed depression is worse in progress. There are limited data on the prevalence of mixed depression since it is a relatively new entity. Therefore, the present study aimed to investigate the prevalence of mixed depression during the postpartum period which is risky for mood disorders. The study included 63 postpartum women. The participants were administered Beck Depression Scale, Edinburgh Postnatal Depression Scale (EPDS), Mood Disorders Questionnaire (MDQ), and Modified Hypomania Symptom Checklist-32 (mHCL-32). The MDQ scores of the women with expected depression according to the EPDS cut-off scores, were significantly higher than the women with lower EPDS scores (t=-4.968; pdepression scores compared to the women under EPDS cut-off scores (t=-4.713; pdepression, respectively. In addition, 3 (4.8%) women require additional clinical examination for bipolar disorder. The scores for the first item of MDQ were above the cut-off value in 11 (17.5%) women. According to the mHCL-32 results, 50 (79.4%) women had at least 1 symptom, 45 (71.4%) women had at least 3 symptoms, and 43 (68.3%) women had at least 5 symptoms of mixed depression. Postpartum mixed depression should be promptly diagnosed by using appropriate diagnostic tools, particularly by primary health care physicians. Patients with mixed depression should be closely monitored to avoid manic switch. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    In this paper we explore the implications of normative principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which...

  5. Evaluation of the return periods of water crises and evaporation in Monte Cotugno reservoir (Southern Italy)

    Science.gov (United States)

    Copertino, Vito; Lo Vecchio, Giuseppina; Marotta, Lucia; Pastore, Vittoria; Ponzio, Giuseppe; Scavone, Giuseppina; Telesca, Vito; Vita, Michele

    2010-05-01

    In the past water resources management has been dealt and solved increasing water availabilities; today such opportunities have been considerably reduced and the technical-scientific perspectives are addressed above all to improve water system effectiveness and to promote an use of water resources that holds account of the droughts frequency and based on a correct estimate of the hydrologic balance. In this work a study on the water stored in Monte Cotugno reservoir in Sinni river - Basilicata (Southern Italy) - is proposed, estimating water crises return periods and reservoir evaporation. For such purpose the runs method was applied, based on the comparison between the temporal series of the "water volume" hydrological variable and a threshold representative of the "normal" conditions regarding which the availability in excess or defect was estimated. This allowed to individualize the beginning and the end of a water crisis event and to characterize the droughts in terms of duration, sum deficit and intensity. Therefore the return period was evaluated by means of the methodology proposed by Shiau and Shen in 2001, turned out equal approximately to 6 years. Such value was then verified with a frequency analysis of the "water volume" random variable, using the Weibull's distribution. Subsequently, the Fourier's analysis in the last twenty years was carried out, obtaining the same result of the previous methods. Moreover, in proximity of the Monte Cotugno reservoir the weather station of Senise is located, managed by ALSIA (Agenzia Lucana di Sviluppo e Innovazione in Agricultura), that provides in continuous measurements of air temperature and humidity, wind speed and direction, and global solar radiation since 2000. Such parameters allowed to apply five methods for reservoir evaporation estimate selected from those proposed in the literature, of which the first three, the Jensen-Haise's method, Makkink's method and Stephens-Stewart's one are based on solar radiation

  6. The NLM evaluation lecture series: introduction to the special section on evaluating health communication programs.

    Science.gov (United States)

    Logan, Robert A; Kreps, Gary L

    2014-12-01

    This article introduces the Journal of Health Communication's special section, Evaluating Health Communication Programs. This special section is based on a public lecture series supported by the National Library of Medicine titled "Better Health: Evaluating Health Communication Programs" designed to share best practices for using evaluation research to develop, implement, refine, and institutionalize the best health communication programs for promoting public health. This introduction provides an overview to the series, summarizes the major presentations in the series, and describe implications from the series for translational health communication research, interventions, and programs that can enhance health outcomes.

  7. BRAZILIAN HIGHER EDUCATION - considerations for policy evaluation in health

    Directory of Open Access Journals (Sweden)

    Claudia Maffini Griboski

    2012-01-01

    Full Text Available This paper focuses on the front of the Brazilian higher education practices of evaluation, highlighting the importance of its use in academic management and institutional guarantee for the permanent monitoring of the quality of supply. With this objective discusses the trajectory of the evaluation policy of higher education with an emphasis on construction of the current National Assessment of Higher Education (Sinaes. From this perspective, conducts exploratory research with a descriptive analysis of the constituent elements of Sinaes, instruments and indicators, and evaluation results of the cycle in 2004, 2007 and 2010 in order to characterize and compare the evolution of courses in health and design improvements in its development. Finally, the comparison of these results, especially the nursing courses, the remarkable expansion in the period, shows its importance as an inducer of changing personal and professional attitudes of teachers and others involved in the educational process. It also enables the IES, proposing changes to the curriculum to meet the prospect of improving the training of students, contributing to the establishment of the evaluation culture in higher education to society to ensure reliable results on the quality and credibility of the courses offered.

  8. Barriers to midwives and nurses addressing mental health issues with women during the perinatal period: The Mind Mothers study.

    Science.gov (United States)

    Higgins, Agnes; Downes, Carmel; Monahan, Mark; Gill, Ailish; Lamb, Stephen A; Carroll, Margaret

    2018-01-03

    To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period. The research used a descriptive design. A total of 809 midwives and nurses completed an anonymous, online or hard copy survey. Designed by the research team, the survey listed 26 potential barriers to the provision of perinatal mental health care. Participants identified organisational factors as presenting the greatest barriers. Organisational barriers included lack of perinatal mental health services, absence of care pathways, heavy workload, lack of time, lack of privacy and not seeing women regularly enough to build a relationship. Over 50% of participants identified practitioner-related barriers, such as lack of knowledge on perinatal mental health and cultural issues; lack of skill, in particular, skills to respond to a disclosure of a mental health issue; and fears of causing women offence and distress. Findings also indicated that the context of care and education influenced the degree to which participants perceived certain items as barriers. Midwives and primary care nurses encounter many organisational- and practitioner-related barriers that negatively impact on their ability to incorporate mental health care into their practice. Midwifery and nursing services need to develop strategies to address system- and practitioner-related barriers, including the development of services and care pathways, and the provision of culturally sensitive education on perinatal mental health in order to support practitioners to address issues with

  9. The life course model as a framework for post-conflict health analysis: reflections on the Gulf War critical period.

    Science.gov (United States)

    Cange, Charles W

    2016-01-01

    In the Kuwait context, from January 1991 to December 1991, there were a series of chemical and psychological Gulf War-era exposures that left persistent, long-term damage. Extreme stress from a critical event speeds up the usual disease latency period, and may be part of a synergistic effect that leads to higher disease rates over a shorter period of time. I am interested in the impact of armed conflict on health outcomes over the life course in Kuwait, and particularly the pathways through which armed conflict causes changes in health on a population level. In this paper, I propose a culturally sensitive, post-conflict socio-ecological model that informs a three-pronged health study. I propose a macro-micro mix that includes an ecological study, a case-control study and a qualitative study to investigate Kuwait's post-conflict health concerns. Thus, I revise the concept of 'post-conflict health' as a trajectory that is mediated through different, complex social levels and develops over time during the latency period. The main advantage of a macro-micro mix approach for post-conflict health is that it contextualizes the Gulf War as an environmental health issue.

  10. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  11. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    International Nuclear Information System (INIS)

    Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

    2016-01-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  12. A framework for including family health spillovers in economic evaluation

    NARCIS (Netherlands)

    H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)

    2016-01-01

    textabstractHealth care interventions may affect the health of patients' family networks. It has been suggested that these health spillovers? should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health

  13. Peer Sexual Health Education: Interventions for Effective Programme Evaluation

    Science.gov (United States)

    Sriranganathan, Gobika; Jaworsky, Denise; Larkin, June; Flicker, Sarah; Campbell, Lisa; Flynn, Susan; Janssen, Jesse; Erlich, Leah

    2012-01-01

    Peer education is used as a health promotion strategy in a number of areas, including sexual health. Although peer education programmes have been around for some time, published systematic evaluations of youth sexual health peer education programmes are rare. This article discusses the advantages and disadvantages of youth sexual health peer…

  14. 78 FR 17313 - Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage...

    Science.gov (United States)

    2013-03-21

    ... health insurance issuer conditions eligibility on any employee's (part-time or full-time) having... the contracting provisions of the Federal Employee Health Benefits Program (FEHBP). OPM has... estimate that 4.1 million new employees receive group health insurance coverage through private sector...

  15. Attendance at Mental Health Appointments by Women Who Were Referred During Pregnancy or the Postpartum Period.

    Science.gov (United States)

    Albaugh, Avril S; Friedman, Susan Hatters; Yang, Sarah Nagle; Rosenthal, Miriam

    2018-01-01

    To describe characteristics of women referred to mental health care during pregnancy or the year after giving birth and to identify characteristics associated with attendance at mental health intake visits. Retrospective record review of referral documentation. Women's health practices and perinatal mental health clinics in urban areas. The sample included 647 women during pregnancy or the year after giving birth who were referred for mental health treatment. We reviewed the referral data sent from women's health care providers to perinatal mental health clinics to determine if mental health visits occurred. Fifty percent of the 647 women who accepted perinatal mental health referrals had intake appointments. Women were more likely to participate in an intake appointment if in-home services were offered (p women who accepted referrals to mental health services, only half attended intake appointments. For this group of pregnant women and those in the first year after birth, in-home mental health visits were most likely to result in care engagement, which has important implications for service delivery. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  16. Changes in primary health care centres over the transition period in Slovenia.

    NARCIS (Netherlands)

    Albreht, T.; Delnoij, D.M.J.; Klazinga, N.

    2006-01-01

    BACKGROUND: Primary health care centres (PHCCs) were a characteristic of the former Yugoslav health care system introduced widely in Slovenia. Transition brought structural changes to health care and the position of the PHCC's was challenged. This paper investigates (i) PHCCs' perception of

  17. Changes in primary health care centres over the transition period in Slovenia

    NARCIS (Netherlands)

    Albreht, Tit; Delnoij, Diana M. J.; Klazinga, Niek

    2006-01-01

    BACKGROUND: Primary health care centres (PHCCs) were a characteristic of the former Yugoslav health care system introduced widely in Slovenia. Transition brought structural changes to health care and the position of the PHCC's was challenged. This paper investigates (i) PHCCs' perception of

  18. Defence Health Service Mentoring Program Evaluation 2001

    National Research Council Canada - National Science Library

    Highfield, Jane

    2002-01-01

    The Defense Health Services (DHS) Steering Committee has considered the concept of Mentoring as part of an effort to assist in the development of future health leaders in the Australian Defense Force (ADF...

  19. Hybrid FEA/SEA Assessment for an Orthogrid Cylindrical Panel Section and Periodic Subsystem Modeling Evaluation

    Science.gov (United States)

    Smith, Andrew M.; LaVerde, Bruce; Teague, David W.

    2010-01-01

    In the lower frequency range, where particular boundary conditions can make a significant difference to panel response characteristics Statistical Energy Analysis (SEA) has never been the analytical tool of choice. In addition to boundary condition effects, SEA is not well suited in frequency bands where no modes or less than a few modes exist. The advent of the Hybrid Module has enabled integration of Finite Element Analysis to expand and enhance the capability for response calculations within VA One into the lower frequency range. Exploration of several additional modeling approaches was completed for the cylindrical orthogrid panel test article that was examined in Reference 1. Comparison of the new analytical response predictions with the measured response data from ground test and the pure SEA results from the reference will be presented. One approach that is considered promising is the periodic subsystem capability. Initially, a detailed FEM of just one region of the test article is defined. After evaluating this small region using symmetric boundary conditions, the FEM may be expanded to determine the properties of the entire system using similar connected regions that map over the entire test article. Another approach is the direct use of a very detailed finite element model of the entire panel, explicitly modeling pocket and rib details of the structure. A third approach is to approximate localized structure geometry details with a smeared property generalization using a PCOMP (NASTRAN card used to define layered composite structures) to define skin layer and ribbed layer for the orthogrid panel. The authors expect to demonstrate that the integrated Hybrid/FEM approach increases confidence in response prediction in the lower frequency range (for example from 20-300 Hz for the test article under consideration). In addition the strength and weakness of each additional approach will be highlighted and compared to those reported with those reported in an

  20. Evaluation of specialist referrals at a rural health care clinic.

    Science.gov (United States)

    Biggerstaff, Mary Ellen; Short, Nancy

    2017-07-01

    Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

  1. Evaluating a Health Risk Reduction Program.

    Science.gov (United States)

    Nagelberg, Daniel B.

    1981-01-01

    A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

  2. Evaluation of school health instruction in public primary schools in ...

    African Journals Online (AJOL)

    Evaluation of school health instruction in public primary schools in Bonny Local Government Area, Rivers state. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Effective school health instruction in primary schools is ...

  3. [Evaluation of eating habits and nutritional behaviors of women in the perimenopausal period with the diagnosed celiac disease].

    Science.gov (United States)

    Friedrich, Mariola; Podlaszewska, Grazyna; Kuchlewska, Magdalena

    2012-01-01

    The aim of this study was to evaluate eating habits and nutritional behaviors of women in the perimenopausal period with celiac disease diagnosed within the last 4 years. The study covered a group of 26 women, at the age of 51-54 years, with celiac disease diagnosed in the last 4 years and staying on a gluten-free diet for 6 months to 4 years and agreed to participate in this studies. Information of nutrition were collected from the women, who, after an appropriate instruction, recorded the timing, type and amount of food consumed in the three days a week, selected at random. The amount of consumed portions was defined on the basis of the "Book of portions, products and dishes". The menus (78) were recorded in April and May. Collected data were prepared, based on a computer program Dietetyk 2009 Prof. The analysis of results achieved in this study enabled concluding that--from the viewpoint of the diagnosed disease--the nutritional patterns of the women were very appropriate. However, it failed to meet basic nutritional guidelines, which was reflected in, among other things, unsatisfactory intake of vegetables, fruits, oils and water, and in excessive intake of protein of animal origin. In addition, it did not cover demands resulting from the perimenopausal period the surveyed women were in, which is likely to facilitate, e.g. disorders in lipid metabolism and water-mineral balance, as well as development of osteoporosis. The general picture of behaviors, including the nutritional ones, pointed to a strong predominance of the diagnosed disease but also to the need of compensating for the resultant restrictions, with the latter being perceived by the surveyed women as health-promoting actions.

  4. Improvement in health expectancy at ages 50 and 65 in Denmark during the period 2004-2011

    DEFF Research Database (Denmark)

    Jeune, Bernard; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen

    2015-01-01

    was even longer in both genders and it increased by 1.5-4.0 years depending on age, gender and health indicator. Consequently, expected lifetime in an unhealthy state decreased and the proportions of lifetime in a healthy state increased. The disability effect of the health gain was stronger than......-2011. METHODS: The study was based on nationwide register data on mortality and data on health status from the SHARE surveys carried out in 2004/2005, 2006/2007 and 2010/2011. Expected lifetime in various health states was estimated by Sullivan's method. Changes from 2004 to 2011 were decomposed...... into contributions from changes in mortality and prevalence of activity limitations. RESULTS: During the period 2004-2011 LE increased by about 1 year at both age 50 and age 65. However, the increase in expected lifetime in self-rated good health, without long-term health problems and without activity limitations...

  5. Evaluation and considerations about fundamental periods of damaged reinforced concrete buildings

    Directory of Open Access Journals (Sweden)

    R. Ditommaso

    2013-07-01

    Full Text Available The aim of this paper is an empirical estimation of the fundamental period of reinforced concrete buildings and its variation due to structural and non-structural damage. The 2009 L'Aquila earthquake has highlighted the mismatch between experimental data and code provisions value not only for undamaged buildings but also for the damaged ones. The 6 April 2009 L'Aquila earthquake provided the first opportunity in Italy to estimate the fundamental period of reinforced concrete (RC buildings after a strong seismic sequence. A total of 68 buildings with different characteristics, such as age, height and damage level, have been investigated by performing ambient vibration measurements that provided their fundamental translational period. Four different damage levels were considered according with the definitions by EMS 98 (European Macroseismic Scale, trying to regroup the estimated fundamental periods versus building heights according to damage. The fundamental period of RC buildings estimated for low damage level is equal to the previous relationship obtained in Italy and Europe for undamaged buildings, well below code provisions. When damage levels are higher, the fundamental periods increase, but again with values much lower than those provided by codes. Finally, the authors suggest a possible update of the code formula for the simplified estimation of the fundamental period of vibration for existing RC buildings, taking into account also the inelastic behaviour.

  6. Monitoring 'monitoring' and evaluating 'evaluation': an ethical framework for monitoring and evaluation in public health.

    Science.gov (United States)

    Gopichandran, Vijayaprasad; Indira Krishna, Anil Kumar

    2013-01-01

    Monitoring and evaluation (M&E) is an essential part of public health programmes. Since M&E is the backbone of public health programmes, ethical considerations are important in their conduct. Some of the key ethical considerations are avoiding conflicts of interest, maintaining independence of judgement, maintaining fairness, transparency, full disclosure, privacy and confidentiality, respect, responsibility, accountability, empowerment and sustainability. There are several ethical frameworks in public health, but none focusing on the monitoring and evaluation process. There is a need to institutionalise the ethical review of M&E proposals. A theoretical framework for ethical considerations is proposed in this paper. This proposed theoretical framework can act as the blueprint for building the capacity of ethics committees to review M&E proposals. A case study is discussed in this context. After thorough field testing, this practical and field-based ethical framework can be widely used by donor agencies, M&E teams, institutional review boards and ethics committees.

  7. Development of a Customizable Health IT Usability Evaluation Scale

    Science.gov (United States)

    Yen, Po-Yin; Wantland, Dean; Bakken, Suzanne

    2010-01-01

    We developed a customizable questionnaire, the Health Information Technology (IT) Usability Evaluation Scale (Health-ITUES) and conducted an exploratory factor analysis to examine the scale’s psychometric properties. Nurses (n=377) completed Health-ITUES to rate the usability of a web-based communication system for scheduling nursing staff. The analysis revealed a four-factor structure of Health-ITUES. The results provided preliminary evidence for the factorial validity and internal consistency reliability of Health-ITUES. PMID:21347112

  8. Evaluation of a 'virtual' approach to commissioning health research.

    Science.gov (United States)

    McCourt, Christine A; Morgan, Philip A; Youll, Penny

    2006-10-18

    The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme--the 'Health of Londoners Programme'--in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. There is potential for using computer-mediated communication within the research commissioning process. This may enhance access

  9. Evaluation of a 'virtual' approach to commissioning health research

    Directory of Open Access Journals (Sweden)

    Morgan Philip A

    2006-10-01

    Full Text Available Abstract Background The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated approach to health research commissioning. This had been introduced experimentally in a DOH programme – the 'Health of Londoners Programme' – in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. Methods A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66; structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. Results The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. Conclusion There is potential for using computer-mediated communication within

  10. Evaluations of health promoting schools: a review of nine studies.

    Science.gov (United States)

    Mũkoma, Wanjirũ; Flisher, Alan J

    2004-09-01

    The concept of 'health promoting schools' has been embraced internationally as an effective way of promoting the health of children, adolescents, and the wider school community. It is only recently that attempts have been made to evaluate health promoting schools. This paper reviews evaluations of health promoting schools and draws useful evaluation methodology lessons. The review is confined to school-based interventions that are founded explicitly on the concept of the health promoting school and employ the concept beyond one school domain. We included nine evaluations in this review. Seven of these were published in the peer reviewed scientific literature. Two were unpublished reports. One study was a randomized controlled trial, while a quasi-experimental research design with comparison schools was used in three studies. With three exceptions, combinations of quantitative and qualitative data were collected. There was evidence that the health promoting school has some influence on various domains of health for the school community. It is also possible to integrate health promotion into the school curriculum and policies successfully. However, the evaluation of health promoting schools is complex. We discuss some of the methodological challenges of evaluating health promoting schools and make suggestions for improving future evaluations.

  11. Impressions of health in the new South Africa: a period of convalescence.

    Science.gov (United States)

    Kale, R

    1995-04-29

    The White minority population in South Africa long oppressed and disenfranchised the country's Black majority. The apartheid system, however, was finally put to rest with the election of Nelson Mandela as President of South Africa during April 27-29, 1994. During apartheid, the White minority enjoyed the best health care available among developed countries, while Blacks were forced to receive some of the worst care provided in the Third World. The doctor/patient ratios in 1981 for White and Black patients, respectively, were 330 and 91,000. In 1985, infant mortality for White infants was 13.1/1000 compared to 70/1000 for Blacks. The existence of fourteen separate health departments caused major duplication and waste. South Africa now has the opportunity to effect revolutionary changes in its health care. To that end, President Mandela announced free health care for pregnant women and children younger than age six years on May 24, 1994. A subsequent uptake in health service utilization was quickly observed in small towns. Structurally, a central health department with a provincial department for each of the four provinces replaced the redundant predemocracy system of fourteen health departments. This change, however, for now, exists only on paper and net financial gains from the reorganization have yet to be realized. Finally, there have been frequent strikes in hospitals throughout the country by health workers demanding better pay and working conditions.

  12. Life-course and cohort trajectories of mental health in the UK, 1991-2008--a multilevel age-period-cohort analysis.

    Science.gov (United States)

    Bell, Andrew

    2014-11-01

    There is ongoing debate regarding the shape of life-course trajectories in mental health. Many argue the relationship is U-shaped, with mental health declining with age to mid-life, then improving. However, I argue that these models are beset by the age-period-cohort (APC) identification problem, whereby age, cohort and year of measurement are exactly collinear and their effects cannot be meaningfully separated. This means an apparent life-course effect could be explained by cohorts. This paper critiques two sets of literature: the substantive literature regarding life-course trajectories in mental health, and the methodological literature that claims erroneously to have 'solved' the APC identification problem statistically (e.g. using Yang and Land's Hierarchical APC-HAPC-model). I then use a variant of the HAPC model, making strong but justified assumptions that allow the modelling of life-course trajectories in mental health (measured by the General Health Questionnaire) net of any cohort effects, using data from the British Household Panel Survey, 1991-2008. The model additionally employs a complex multilevel structure that allows the relative importance of spatial (households, local authority districts) and temporal (periods, cohorts) levels to be assessed. Mental health is found to increase throughout the life-course; this slows at mid-life before worsening again into old age, but there is no evidence of a U-shape--I argue that such findings result from confounding with cohort processes (whereby more recent cohorts have generally worse mental health). Other covariates were also evaluated; income, smoking, education, social class, urbanity, ethnicity, gender and marriage were all related to mental health, with the latter two in particular affecting life-course and cohort trajectories. The paper shows the importance of understanding APC in life-course research generally, and mental health research in particular. Copyright © 2014 Elsevier Ltd. All rights

  13. Clinical evaluation of the treatment in male patient with thyrotoxic periodic paralysis: 131I treatment compared with antithyroid drug therapy

    International Nuclear Information System (INIS)

    Su Li; Chen Jing; Zhao Ming

    2007-01-01

    Objective: To evaluate clinical efficacy of 131 I treatment for thyrotoxic periodic paralysis. Methods: 100 male patients with thyrotoxic periodic paralysis were divided equally into two groups, and treated with 131 I or antithyroid drugs (ATD). They were followed up regularly for 3 years with the cure rate, the incidence of hypothyroidism, the recurrence tree of thyrotoxic periodic paralysis and the side effects, which included granulocytopenia, liver function damage and skin rash from medicinal herbs resource. Results: The cure rate of 131 I therapy and ATD therapy for thyrotoxic periodic paralysis is 80% and 52%, respectively. And there is significant difference between them (χ 2 =8.73, P 2 =18.92, P 2 =11.11, P 131 I therapy has a higher incidence of hypothyroidism (χ = 6.35, P 131 I is preferable to effectively control the recurrent attacks of thyrotoxic periodic paralysis. (authors)

  14. [Evaluation of a workplace health promotion program].

    Science.gov (United States)

    Forette, Françoise; Brieu, Marie-Anne; Lemasson, Hervé; Salord, Jean-Claude; Le Pen, Claude

    2014-01-01

    Some studies suggest that a workplace prevention programme could reduce health inequalities related to education level and improve the health status of the employees. The objective of the study was to demonstrate the advantages for a company to implement a health prevention programme in the workplace in order to: 1-improve health literacy 2 - change health-related behaviours 3-improve the company image. A "before - after" methodology was used in a population of 2153 employees of three companies. Three areas of prevention were considered: nutrition, physical activity and prevention of back pain. The successive steps of the EBS programme included general communication, group workshops and individual coaching. Data collection was carried out using anonymous questionnaires sent by e-mail. A global assessment was performed based on the companies' pooled data, with separate analysis according to the steps of the programme. The programme mobilized employees with participation rates ranging from 25% to 45.5%. After completion of the full programme, 77.5% of respondents reported an improvement of their health knowledge versus 50.3% of those who only received general communication. Behavioural modification was observed, especially in the fields of nutrition and back pain.. EBS can be considered to be a vector of the company image for almost 7 out of 10 employees. A health prevention education programme provided by the company in the workplace mobilizes employees and contributes to improvement of health knowledge and behaviour change. All approaches tested were important and applicable to various types of companies or workers.

  15. Health care justice and its implications for current policy of a mandatory waiting period for elective tubal sterilization.

    Science.gov (United States)

    Moaddab, Amirhossein; McCullough, Laurence B; Chervenak, Frank A; Fox, Karin A; Aagaard, Kjersti Marie; Salmanian, Bahram; Raine, Susan P; Shamshirsaz, Alireza A

    2015-06-01

    Tubal sterilization during the immediate postpartum period is 1 of the most common forms of contraception in the United States. This time of the procedure has the advantage of 1-time hospitalization, which results in ease and convenience for the woman. The US Collaborative Review of Sterilization Study indicates the high efficacy and effectiveness of postpartum tubal sterilization. Oral and written informed consent is the ethical and legal standard for the performance of elective tubal sterilization for permanent contraception for all patients, regardless of source of payment. Current health care policy and practice regarding elective tubal sterilization for Medicaid beneficiaries places a unique requirement on these patients and their obstetricians: a mandatory waiting period. This requirement originates in decades-old legislation, which we briefly describe. We then introduce the concept of health care justice in professional obstetric ethics and explain how it originates in the ethical concepts of medicine as a profession and of being a patient and its deontologic and consequentialist dimensions. We next identify the implications of health care justice for the current policy of a mandatory 30-day waiting period. We conclude that Medicaid policy allocates access to elective tubal sterilization differently, based on source of payment and gender, which violates health care justice in both its deontologic and consequentialist dimensions. Obstetricians should invoke health care justice in women's health care as the basis for advocacy for needed change in law and health policy, to eliminate health care injustice in women's access to elective tubal sterilization. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Health and Safety Research Division progress report for period ending April 30, 1978

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, S.V.

    1978-08-01

    The research goal of the Health and Safety Research Division is to conduct basic and applied research that contributes new scientific knowledge with emphasis in biophysical areas that lead to a better understanding of how alternative energy-related technologies affect man. Included in the basic research are fundamental processes that are important to understand formation, mobility, toxicity, detection, and characterization of pollutants. The applied research includes the integration of data from basic and applied studies through development of concepts and methodologies that can be used for energy-related assessments with primary focus on the health and safety of man. The division has no responsibilities for on-site health and safety.

  17. Health and Safety Research Division progress report for the period April 1, 1987--September 30, 1988

    International Nuclear Information System (INIS)

    Kaye, S.V.

    1989-03-01

    The mission of the Health and Safety Research Division (HASRD) is to provide a sound scientific basis for the measurement and assessment of human health impacts of radiological and chemical substances. Our approach to fulfilling this mission is to conduct a broad program of experimental, theoretical, and field research based on a strong foundation of fundamental physical studies that blend into well-established programs in life sciences. Topics include biomedical screening techniques, biological and chemical sensors, risk assessment, health hazards, dosimetry, nuclear medicine, environmental pollution monitoring, electron-molecule interactions, interphase physics, surface physics, data base management, environmental mutagens, carcinogens, and tetratogens

  18. Health and Safety Research Division progress report for the period April 1, 1987--September 30, 1988

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, S.V.

    1989-03-01

    The mission of the Health and Safety Research Division (HASRD) is to provide a sound scientific basis for the measurement and assessment of human health impacts of radiological and chemical substances. Our approach to fulfilling this mission is to conduct a broad program of experimental, theoretical, and field research based on a strong foundation of fundamental physical studies that blend into well-established programs in life sciences. Topics include biomedical screening techniques, biological and chemical sensors, risk assessment, health hazards, dosimetry, nuclear medicine, environmental pollution monitoring, electron-molecule interactions, interphase physics, surface physics, data base management, environmental mutagens, carcinogens, and tetratogens.

  19. A health literacy and usability heuristic evaluation of a mobile consumer health application.

    Science.gov (United States)

    Monkman, Helen; Kushniruk, Andre

    2013-01-01

    Usability and health literacy are two critical factors in the design and evaluation of consumer health information systems. However, methods for evaluating these two factors in conjunction remain limited. This study adapted a set of existing guidelines for the design of consumer health Web sites into evidence-based evaluation heuristics tailored specifically for mobile consumer health applications. In order to test the approach, a mobile consumer health application (app) was then evaluated using these heuristics. In addition to revealing ways to improve the usability of the system, this analysis identified opportunities to augment the content to make it more understandable by users with limited health literacy. This study successfully demonstrated the utility of converting existing design guidelines into heuristics for the evaluation of usability and health literacy. The heuristics generated could be applied for assessing and revising other existing consumer health information systems.

  20. Health Insurance Marketplace: Summary Enrollment Data for the Initial Annual Open Enrollment Period

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file includes data for states that are implementing their own Marketplaces, also known as State-Based Marketplaces or SBMs, and states with Marketplaces that...

  1. FAMILY HEALTH MANAGEMENT AND POVERTY IN AN ECONOMIC RECESSION PERIOD IN PORTUGAL

    OpenAIRE

    Carvalho, Ana Branca; Oliveira, Ivo; Nogueira, Fernanda

    2015-01-01

    Abstract: The main purpose of this article, in the management and health, was to assess the contribution of family health and its role in local development in the context of economic recession and worsening poverty in Portugal. Material and Methods. Data were collected through the questionnaire, 1021 individuals were inquired in Portugal, with statistical treatment through inferential analysis, factorial and regression. They were asked to participate voluntarily in writing through email pa...

  2. [The structure of financial planning of public health in Ukraine during the transitional period].

    Science.gov (United States)

    Koretskiy, V L

    1995-01-01

    Based on the newly developed concept of multilevel functional system of primary health care which is to replace the current multicomponent system, the author discusses the computer-aided realization of the system for estimation and analysis of the integral model of outpatient and inpatient medical care of the population of the Ukraine. This system is intended to solve the problems associated with intensification of the resources of the public health system of the Republic (district).

  3. Low health literacy and evaluation of online health information: a systematic review of the literature.

    Science.gov (United States)

    Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

    2015-05-07

    Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

  4. Importance of historical seismicity in the evaluation of large return period hazards

    International Nuclear Information System (INIS)

    Oliveira, C.S.

    1983-01-01

    This paper reports the results from an historical investigation on earthquake activity in Portugal based on data collected from original sources. A detailed revision of earthquake catalogues in what concerns date of occurrence, isosseismal maps, epicentral location, magnitude and duration of vibration was made for most of the 260 events identified in the period 1000 to 1900. Introducing this new piece of information which exhibits a much higher degree of quality into standard hazard models, uncertainties on final estimates for the zones of large return periods, RP, (RP > 200 years) are greatly reduced

  5. Coded Statutory Data Sets for Evaluation of Public Health Law

    Science.gov (United States)

    Costich, Julia Field

    2012-01-01

    Background and objectives: The evaluation of public health law requires reliable accounts of underlying statutes and regulations. States often enact public health-related statutes with nonuniform provisions, and variation in the structure of state legal codes can foster inaccuracy in evaluating the impact of specific categories of law. The optimal…

  6. Handbook of evaluation methods for health informatics

    National Research Council Canada - National Science Library

    Brender, Jytte

    2006-01-01

    .... Amsterdam: lOS Press, Studies in Health Technology and Informatics 1997; 42, with permission. This book is printed on acid-free paper. (~ Copyright 92006, Elsevier Inc. All rights reserved. No part ...

  7. Leadership for health improvement--implementation and evaluation.

    Science.gov (United States)

    Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

    2009-01-01

    The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

  8. Improving occupational health care for construction workers: a process evaluation

    NARCIS (Netherlands)

    Boschman, Julitta S.; van der Molen, Henk F.; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

    2013-01-01

    To evaluate the process of a job-specific workers' health surveillance (WHS) in improving occupational health care for construction workers. From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service

  9. [Basic principles and methodological considerations of health economic evaluations].

    Science.gov (United States)

    Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

    2011-01-01

    Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

  10. Critical evaluation of factors required to terminate the postclosure monitoring period at solid waste landfills

    DEFF Research Database (Denmark)

    Barlaz, M.A.; Rooker, A.P.; Kjeldsen, Peter

    2002-01-01

    Regulations governing the disposal of solid waste in landfills specify that they must be monitored for 30 years after closure unless this period is extended by the governing regulatory authority. Given the wide range of conditions under which refuse is buried, technical criteria, rather than...

  11. 75 FR 24501 - Fatigue Tolerance Evaluation of Metallic Structures; Extension of Comment Period

    Science.gov (United States)

    2010-05-05

    ... notice responds to a request from the European Aviation Safety Agency (EASA) to extend the comment period... comments to Docket Operations at 202-493-2251. Hand Delivery or Courier: Deliver comments to Docket... Federal holidays. FOR FURTHER INFORMATION CONTACT: Minh-Hai Tran-Lam, ARM-207, Office of Rulemaking...

  12. Evaluation of short-period rainfall estimates from Kalpana-1 satellite

    Indian Academy of Sciences (India)

    The INSAT Multispectral Rainfall Algorithm (IMSRA) technique for rainfall estimation, has recently been developed to meet the shortcomings of the Global Precipitation Index (GPI) technique of rainfall estimation from the data of geostationary satellites; especially for accurate short period rainfall estimates. This study ...

  13. Evaluation a Community Maternal Health Programme: Lessons Learnt

    OpenAIRE

    Sharma, Sheetal; Simkhada, Padam; Hundley, Vanora; Van Teijlingen, Edwin; Stephens, Jane; Silwal, R.C.; Angell, Catherine

    2017-01-01

    Abstract Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation. In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel healt...

  14. Investigations on Health Conditions of Chernobyl Nuclear Power Plant Accident Recovery Workers from Latvia in Late Period after Disaster

    Directory of Open Access Journals (Sweden)

    Reste Jeļena

    2016-10-01

    Full Text Available The paper summarises the main findings on Chernobyl Nuclear Power Plant (CNPP accident recovery workers from Latvia and their health disturbances, which have been studied by the authors during the last two decades. Approximately 6000 persons from Latvia participated in CNPP clean-up works in 1986–1991. During their work period in Chernobyl they were exposed to external as well as to internal irradiation, but since their return to Latvia they were living in a relatively uncontaminated area. Regular careful medical examinations and clinical studies of CNPP clean-up workers have been conducted during the 25 years after disaster, gathering knowledge on radiation late effects. The aim of the present review is to summarise the most important information about Latvian CNPP clean-up worker health revealed by thorough follow-up and research conducted in the period of 25 years after the accident. This paper reviews data of the Latvian State Register of Persons Exposed to Radiation due to CNPP Accident and gives insight in main health effects found by the researchers from the Centre of Occupational and Radiological Medicine (Pauls Stradiņš Clinical University Hospital and Rīga Stradiņš University in a number of epidemiological, clinical, biochemical, immunological, and physiological studies. Latvian research data on health condition of CNPP clean-up workers in the late period after disaster indicate that ionising radiation might cause premature ageing and severe polymorbidity in humans.

  15. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. © The Author(s) 2015.

  16. Evaluation of radioactivity gross-α from exhaust air of IEBE during period of 2007-2012

    International Nuclear Information System (INIS)

    Nudia Barenzani; Arca Datam Sugiarto; Sri Wahyuningsih

    2013-01-01

    An evaluation of the radioactivity gross-α from the exhaust air-IEBE laboratory during the period of 2007 to 2012 has been done. The method used in the evaluation is divided into two periods. During period of 2007 to 2010 by placing a filter paper in air sampler which is connected to output pipe from the chimney (manually). Filters paper enumerated by Portable Scaler Ratemeter (PSR-8). While the period 2011-2012, IEBE has installed Smart Cam from Laboratory Impex Systems production. Where the equipment can be monitoring exhaust air automatically and continuously. Objective evaluation to compare the 2 different ways, which automatically and manually, and to find out whether the exhaust air coming out of the research and development activities during the period above IEBE safe for workers, communities and the environment. Result from the monitoring during 6 (six) consecutive years as follows: 0.06 Bq/m 3 , 0.16 Bq/m 3 , 0.11 Bq/m 3 , 0.040 Bq/m 3 , 0.091 Bq/m 3 and 0.043 Bq/m 3 . The highest radioactivity concentration in February 2008 is 0.490 Bq/m 3 or 0.24 % of the maximum permissible concentration (MPC = 2 Bq/m 3 ). So it can be concluded that the radioactivity gross-α exhaust air from the laboratory IEBE declared safe for employees, communities and the environment. (author)

  17. CURRENT APPROACHES IN PERFORMANCE EVALUATION OF INVESTMENT FUND AND A PROPOSAL FOR TURKEY FOR THE PERIOD AFTER THE TEFAŞ PLATFORM

    Directory of Open Access Journals (Sweden)

    Fatih Temizel

    2016-01-01

    Investment Fund Industry, data sets and periods of the studies in Turkey and the world are analyzed. From those analysis we try to discover the advantages/disadvantages of different approaches. Thus, arecent performance evaluation of investment funds traded on Turkey will be recommended.

  18. Impact evaluation on health: three case studies for Colombia

    OpenAIRE

    Gaviria Garces, Carlos Felipe

    2017-01-01

    The present work uses impact evaluation tools in health economics to analyze three different issues in Colombia. The first issue is how losing health insurance for young adults affects medical service usage and health outcomes. Results show that losing health insurance when turning 18 years old increases visits to the ED, reduces preventive care visits with a physician, and increases the usage of private medical services (out-of-pocket) for young adults. For the second issue, we measure how e...

  19. The E-health Literacy Demands of Australia's My Health Record: A Heuristic Evaluation of Usability.

    Science.gov (United States)

    Walsh, Louisa; Hemsley, Bronwyn; Allan, Meredith; Adams, Natalie; Balandin, Susan; Georgiou, Andrew; Higgins, Isabel; McCarthy, Shaun; Hill, Sophie

    2017-01-01

    My Health Record is Australia's electronic personal health record system, which was introduced in July 2012. As of August 2017, approximately 21 percent of Australia's total population was registered to use My Health Record. Internationally, usability issues have been shown to negatively influence the uptake and use of electronic health record systems, and this scenario may particularly affect people who have low e-health literacy. It is likely that usability issues are negatively affecting the uptake and use of My Health Record in Australia. To identify potential e-health literacy-related usability issues within My Health Record through a heuristic evaluation method. Between September 14 and October 12, 2016, three of the authors conducted a heuristic evaluation of the two consumer-facing components of My Health Record-the information website and the electronic health record itself. These two components were evaluated against two sets of heuristics-the Health Literacy Online checklist and the Monkman Heuristics. The Health Literacy Online checklist and Monkman Heuristics are evidence-based checklists of web design elements with a focus on design for audiences with low health literacy. During this heuristic evaluation, the investigators individually navigated through the consumer-facing components of My Health Record, recording instances where the My Health Record did not conform to the checklist criteria. After the individual evaluations were completed, the investigators conferred and aggregated their results. From this process, a list of usability violations was constructed. When evaluated against the Health Literacy Online Checklist, the information website demonstrated violations in 12 of 35 criteria, and the electronic health record demonstrated violations in 16 of 35 criteria. When evaluated against the Monkman Heuristics, the information website demonstrated violations in 7 of 11 criteria, and the electronic health record demonstrated violations in 9 of 11

  20. Evaluation of physicochemical properties and antioxidant activities of kombucha "Tea Fungus" during extended periods of fermentation.

    Science.gov (United States)

    Amarasinghe, Hashani; Weerakkody, Nimsha S; Waisundara, Viduranga Y

    2018-05-01

    Kombucha fermentation is traditionally carried out by inoculating a previously grown tea fungal mat into a freshly prepared tea broth and incubating under aerobic conditions for 7-10 days. In this study, four kombucha beverages were prepared by placing the tea fungal mats in sugared Sri Lankan black tea at varying concentrations for a period of 8 weeks. The antioxidant activities, physicochemical, and qualitative properties were monitored prior to the commencement of the fermentation process, one day after the inoculation with the microorganisms and subsequently on a weekly basis. All samples displayed a statistically significant decrease ( p  kombucha on human organs following the extended period of fermentation.

  1. Surfing for health: user evaluation of a health information website. Part one: Background and literature review.

    Science.gov (United States)

    Williams, Peter; Nicholas, David; Huntington, Paul; McLean, Fiona

    2002-06-01

    The Government in Britain is set on using the Internet to expand the provision of health information to the general public. Concerns over the quality of the health information have preoccupied commentators and organizations rather than the way users interact with health information systems. This report examines the issues surrounding the provision of electronic health information, and describes an evaluation undertaken of a commercial health website-that of Surgerydoor (http://www.surgerydoor.co.uk/), and comprises two parts. Part one outlines the literature on electronic health information evaluation. It discusses quality issues, but also redresses the imbalance by exploring other evaluative perspectives. Part two describes an evaluation of a health information Internet site in terms of its usability and appeal, undertaken as part of a Department of Health funded study on the impact of such systems.

  2. Determinants of health-related quality of life in the postpartum period after obstetric complications

    NARCIS (Netherlands)

    Prick, Babette W.; Bijlenga, Denise; Jansen, A. J. Gerard; Boers, Kim E.; Scherjon, Sicco A.; Koopmans, Corine M.; van Pampus, Marielle G.; Essink-Bot, Marie-Louise; van Rhenen, Dick J.; Mol, Ben W.; Duvekot, Johannes J.

    Objective: To determine the influence of socio-demographic, clinical parameters and obstetric complications on postpartum health-related quality of life (HRQoL). Study design: We used data of three randomized controlled trials to investigate HRQoL determinants in women after an obstetric

  3. Health and Safety Research Division progress report for the period October 1, 1991--March 31, 1993

    International Nuclear Information System (INIS)

    Berven, B.A.

    1993-09-01

    This is a progress report from the Health and Safety Research Division of Oak Ridge National Laboratory. Information is presented in the following sections: Assessment Technology, Biological and Radiation Physics, Chemical Physics, Biomedical and Environmental Information Analysis, Risk Analysis, Center for Risk Management, Associate Laboratories for Excellence in Radiation Technology (ALERT), and Contributions to National and Lead Laboratory Programs and Assignments--Environmental Restoration

  4. STABILITY AND CHANGES IN HEALTH BEHAVIORS IN YOUNG-ADULTS OVER A ONE-YEAR PERIOD

    NARCIS (Netherlands)

    STEPTOE, A; SANDERMAN, R; WARDLE, J

    1995-01-01

    Data concerning 19 health-related behaviours and associated beliefs were collected by questionnaire from 282 students in the Netherlands on two occasions over one year. While all behaviours showed moderate stability, there were variations in the degree of change. The highest stability was reported

  5. Health and Safety Research Division progress report for the period October 1, 1991--March 31, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Berven, B.A.

    1993-09-01

    This is a progress report from the Health and Safety Research Division of Oak Ridge National Laboratory. Information is presented in the following sections: Assessment Technology, Biological and Radiation Physics, Chemical Physics, Biomedical and Environmental Information Analysis, Risk Analysis, Center for Risk Management, Associate Laboratories for Excellence in Radiation Technology (ALERT), and Contributions to National and Lead Laboratory Programs and Assignments--Environmental Restoration.

  6. 75 FR 34453 - Risk Evaluation and Mitigation Strategies; Notice of Public Meeting; Reopening of Comment Period

    Science.gov (United States)

    2010-06-17

    ... dispensing a drug. a. What, if any, privacy concerns are raised by these programs? b. Does enrollment in a... the same privacy concerns? 2. What steps should FDA take to reduce concerns about patient privacy when... raised concerns about the impact of various REMS, and the growing number of REMS on the health care...

  7. Changes and specificities in health behaviors among healthcare students over an 8-year period

    Science.gov (United States)

    Delay, J.; Grigioni, S.; Déchelotte, P.; Ladner, J.

    2018-01-01

    Background Healthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors. Objectives To assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students: Methods Two cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs. Results 2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20–1.83) and AOR = 1.33 CI95% (1.11–1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19–0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students. Conclusion Our findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare

  8. Defence Health Service Mentoring Program Evaluation 2001

    National Research Council Canada - National Science Library

    Highfield, Jane

    2002-01-01

    ...). DHS commissioned the Directorate of Strategic Personnel Planning and Research (DSPPR) to evaluate a recent Mentoring Program trial in order to assess the effectiveness and organizational value of Mentoring within DHS...

  9. Evaluation of health centre community nurse team.

    Science.gov (United States)

    Dixon, P N; Trounson, E

    1969-02-01

    This report gives an account of the work during six months of a community nurse team attached to the doctors working from a new health centre. The team consisted of two community nurses, who had both health visiting and Queen's nursing qualifications, and a State-enrolled nurse. The community nurses, in addition to undertaking all the health visiting for the population at risk, assessed the social and nursing needs of patients at the request of the general practitioners and ensured that these needs were met. When necessary they undertook practical nursing tasks in the home and in the health centre, but most of the bedside nursing in the home was done by the State-enrolled nurse.The needs of the population at risk were such that only one State-enrolled nurse could usefully be employed, and this proved to be a considerable disadvantage. Despite this, the experimental work pattern held advantages to patients, doctors, and nurses, and is potentially capable of providing a satisfying and economic division of responsibilities, with different tasks being carried out by the individual most appropriately qualified.

  10. Understanding Stakeholder Interests and Perspectives in Evaluations of Health IT.

    Science.gov (United States)

    Lee, Lisa; Sheikh, Aziz

    2016-01-01

    Appropriately identifying and representing stakeholders' interests and viewpoints in evaluations of health information technology (health IT) is a critical part of ensuring continued progress and innovation in eHealth. This contribution therefore seeks to clarify the principles of stakeholder analysis in an eHealth context. We describe this with reference to a mixed methods national evaluation of ePrescribing systems in English hospitals. We use this evaluation to exemplify the engagement and analytical tools required to ensure a detailed understanding of the issues, challenges and lessons learnt across stakeholder groups. We conclude that this type of approach may support the robustness of evaluations of health IT as well as their longer term impact on innovation in the field.

  11. [Principles of health economic evaluation for use by caregivers].

    Science.gov (United States)

    Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

    2017-01-01

    The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Clinical survey of blood dyscrasias among Hiroshima a-bomb survivors by the periodical health examination, 5

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Okita, Hajime; Kamada, Nanao; Kuramoto, Atsushi

    1980-01-01

    Certain blood examinations were performed on a-bomb survivors having anemia more than moderate stage (the hemoglobin value under 9.0 g/dl), who were found out by the periodical health examination performed in Hiroshima-A-bomb Survivors Health Control Clinic during the latter period of the fiscal year 1975. The total number of a-bomb survivors who received the periodical health examination was 50,973, and the number of survivors whose hemoglobin value was under 9.0 g/dl was 201 (0.39%). The incidence of such anemia was high in women. There was not a relationship between this anemia and the exposure distance from the hypocenter. The incidence of this anemia was high in young a-bomb survivors, and more than 50% of a-bomb survivors having this anemia was under the age of 50. Iron-deficiency anemia was found in 88% of a-bomb survivors, and the course of their anemia ran in many years in many a-bomb survivors. (Tsunoda, M.)

  13. Evaluations of A Bibliography of Periodicals Published in Ankara 1923-2015

    Directory of Open Access Journals (Sweden)

    Selahattin Öztürk

    2017-03-01

    Full Text Available The quality of a research depends on the access of the accurate information. Bibliographies are the most important tools to provide this access. Therefore, the data in the bibliographies must be as detailed as possible and consist of consistent and accurate information. The amount of information in the publication named “A bibliography of periodicals published between 1923 and 2015 in Ankara” were examined in terms of its accuracy and order. All the deficiencies identified in the publication were assessed under general headings, rather than by individual examples; a short proposal and solutions for eliminating these deficiencies that will result inconveniences have been tried to reveal.

  14. VIEWS OF GENERAL PRACTITIONERS ON INDOOR ENVIRONMENTAL HEALTH RISKSIN THE PERINATAL PERIOD

    Directory of Open Access Journals (Sweden)

    Gladys eIbanez

    2015-05-01

    Full Text Available IntroductionThe aim of this study was to determine the views of general practitioners (GP on pollution in infant's home.MethodsFour semi-structured focus group with 31 general practitioners (GP were conducted in two french departments in November 2009, February, March and April 2010. The focus group meetings were analysed using a general thematic analysis.ResultsPerinatal care is a special health issue and a time of privileged sensitisation. The attitude of health risks are well known in the case of traditionally toxic substances. In the case of emerging environmental exposure, these attitudes depend on the knowledge, beliefs and experience specific to each practitioner. GPs were acquiring a new role in the field of environmental health, whilst at the same time coming to grips with their own strengths and limitations. The implementation of prevention depends on factors which are specific to the practitioner, but also related to the parents and the organisation of the medical practice.DiscussionThe sensitisation of GPs to environmental medicine, promotion of eco-citizen education, development of research, and the distribution of information, are some of the means which need to be implemented to prevent harmful exposure of the infant.

  15. Results of evaluation of periodic safety review for No. 1 plant in Mihama Power Station, Kansai Electric Power Co., Inc

    International Nuclear Information System (INIS)

    1994-01-01

    No. 1 plant in Mihama Power Station started the commercial power generation in November, 1970, and has continued the operation for more than 23 years. During this period, the counter measures to troubles, periodic inspections and the maintenance by the electric power company have been carried out. These states of No. 1 plant in Mihama Power Station for more than 23 years are to be recollected from the view-points of the comprehensive evaluation of operation experiences and the reflection of latest technological knowledge, and the safety and reliability are to be further improved in the periodic safety review. Agency of Natural Resources and Energy evaluated the report of the periodic safety review for No. 1 plant in Mihama Power Station made by Kansai Electric Power Co., and summarized the results. The course of the evaluation of the report is shown. The facility utilization factor is 43.3% on the average of about 23 years, but in the last 10 years, it was improved to 69.4%. In the last five years, the rate of occurrence of unexpected shutoff was 0.6 times/year. These are the results of preventive maintenance and the improvement of the facilities and operation management. Operation management, maintenance management, fuel management, radiation control, and radioactive waste management have been carried out properly. The work plan for preventing disasters was established, and the experience of troubles and the latest technological knowledge were well reflected to improve the safety. (K.I.)

  16. Program Development and Evaluation - Nutrition / Health

    OpenAIRE

    2004-01-01

    Martha Archuleta: Kitchen Creations - A Cooking School for People with Diabetes. Darlene Christensen: University of Wyoming Food & Nutrition Extension Website. Judith L. Corbus: Hawaii Five-A-Day A Taste of the Tropics with Fruits and Vegetables. Luanne J. Hughes: Reaching Key Audiences with Food Safety Messages. Darlene Liesch: Pregnancy Prevention for Latino Teens. Karen Richey: Food Irradiation - Insuring your Food’s Safety. Carole Rison: Farmers Markets – Impacting Health through Economic...

  17. Evaluating the Efficacy of Primary Treatment for Graves’ Disease Complicated by Thyrotoxic Periodic Paralysis

    Directory of Open Access Journals (Sweden)

    Rita Yuk-Kwan Chang

    2014-01-01

    Full Text Available Objective. Thyrotoxic periodic paralysis (TPP is a potentially life-threatening complication of Graves’ disease (GD. The present study compared the long-term efficacy of antithyroid drugs (ATD, radioactive iodine (RAI, and surgery in GD/TPP. Methods. Sixteen patients with GD/TPP were followed over a 14-year period. ATD was generally prescribed upfront for 12–18 months before RAI or surgery was considered. Outcomes such as thyrotoxic or TPP relapses were compared between the three modalities. Results. Eight (50.0% patients had ATD alone, 4 (25.0% had RAI, and 4 (25.0% had surgery as primary treatment. Despite being able to withdraw ATD in all 8 patients for 37.5 (22–247 months, all subsequently developed thyrotoxic relapses and 4 (50.0% had ≥1 TPP relapses. Of the four patients who had RAI, two (50% developed thyrotoxic relapse after 12 and 29 months, respectively, and two (50.0% became hypothyroid. The median required RAI dose to render hypothyroidism was 550 (350–700 MBq. Of the 4 patients who underwent surgery, none developed relapses but all became hypothyroid. Conclusion. To minimize future relapses, more definitive primary treatment such as RAI or surgery is preferred over ATD alone. If RAI is chosen over surgery, a higher dose (>550 MBq is recommended.

  18. THE EVALUATION OF VORONEZH REGION RADIATION CONTAMINATION IMPACT OVER THIRTY YEARS’ PERIOD FOLLOWING THE CHERNOBYL ACCIDENT

    Directory of Open Access Journals (Sweden)

    Yu. I. Stepkin

    2016-01-01

    Full Text Available The study aimed at radiation contamination impact assessment due to the 1986 Chernobyl accident in Voronezh Region territory more than 600 kilometers away from the ground zero. The major Chernobyl accident impact assessment indicators were the characteristics of 137Cs and 90Sr radionuclides’ soil surface contamination (Ci/km2 as well as the average annual effective dose of critical population group ( mSv/year over 1986–2014. The Population oncological morbidity indicators were analyzed (all malignant neoplasms, including those in thyroid gland, lymphatic and hematopoietic tissue in the territories contrastingly differing on the levels of radiation factor impact. The study covered the period of 2010–2014.It was established that for Voronezh Region territories referred to as the post- Chernobyl radioactively contaminated zone over 29 years period the maximum soil surface contamination by 137Cs and 90Sr radionuclides reduced by 1.90 and 1.91 times (from 3,15 Ci/km2 to 1,66 Ci/km2 and from 0,063 Ci/km2 to 0,0033 Ci/km2, respectively.Currently the relationship was not found between the radioactive contamination density in Voronezh Region and the levels of malignant neoplasms for the local residents.The present situation related to radiation factor impact on Voronezh Region territories remains stable and safe. Mindful of the indicators results the assessment of ionizing sources impact did not identify any exceeding the normative values.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abdul Wajid

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

  1. Evaluation of short-period rainfall estimates from Kalpana-1 satellite ...

    Indian Academy of Sciences (India)

    This study evaluates the 3-hourly precipitation estimates by this technique as well ... product) and surface raingauge data for stations over the Indian region for ... in case of IMSRA estimates, is also validated independently with respect to ... consistent with the nature and development of pre- ... Raingauge networks, though.

  2. 42 CFR 485.641 - Condition of participation: Periodic evaluation and quality assurance review.

    Science.gov (United States)

    2010-10-01

    ... member of the CAH staff who is a doctor of medicine or osteopathy or by another doctor of medicine or osteopathy under contract with the CAH; (4) The quality and appropriateness of the diagnosis and treatment furnished by doctors of medicine or osteopathy at the CAH are evaluated by— (i) One hospital that is a...

  3. 78 FR 48123 - Federal Acquisition Regulation; Contractor Comment Period, Past Performance Evaluations

    Science.gov (United States)

    2013-08-07

    ....regulations.gov , including any personal and/or business confidential information provided. FOR FURTHER... equivalent of ``providing'' the past performance evaluation to the contractor, and it starts the suspense... explanations included, available to source selection officials within 14 days will be to the advantage of most...

  4. Zachowania zdrowotne kobiet w okresie menopauzalnym = The health behavior of women during menopausal period

    Directory of Open Access Journals (Sweden)

    Magdalena Weber-Rajek

    2016-02-01

      Streszczenie   Wstęp Menopauza to naturalny etap życia każdej kobiety. Zmiany hormonalne zachodzące w organizmie w tym okresie powodują często wiele dolegliwości. Jedną z metod łagodzenia objawów menopauzy jest stosowanie hormonalnej terapii zastępczej, jak również przestrzeganie zachowań sprzyjających zdrowiu. Hormonalna terapia zastępcza łagodzi objawy menopauzy, ale także niesie za sobą pewne zagrożenia, które można minimalizować poprzez zachowania prozdrowotne. Cel badań  Celem badań była ocena zachowań zdrowotnych kobiet w okresie około menopauzalnym. Materiał i Metody W niniejszej pracy przebadano 50 kobiet w przedziale wiekowym 45-63 lata (średnia wieku 52,8 lat, które podzielono na 3 grupy w zależności od występowania objawów menopauzalnych i stosowania hormonalnej terapii zastępczej. Wyniki W badanej grupie kobiet w okresie menopauzalnym wykazano przeciętny poziom zachowań zdrowotnych. W całej badanej grupie najwyższe wyniki uzyskano w kategorii „zachowania profilaktyczne”, najniższe w kategoriach „prawidłowe nawyki żywieniowe” i „praktyki zdrowotne”. Porównując wyniki między grupami nie wykazano różnic istotnych statystycznie.   Summary   Introduction Menopause is a natural stage of life of every woman. The hormonal changes that occur the body often cause a lot of discomfort. One method of alleviating the symptoms of menopause is hormone replacement therapy, as well as the observance of behavior conducive to health. Hormone replacement therapy eases the symptoms of menopause, but also entails certain risks, which can be minimized by health behaviors. The aim of the study The aim of this reaserch was to present health behaviours of women in perimenopausal age. Material and Methods In this reaserch, 50 women in the age range 45-63 years old (average age 52,8 were examined and divided into 3 groups according to their menopausal symptoms and the use of hormonal replacement therapy. Results In

  5. Evaluation of extrapolation methods for actual state expenditures on health care in Russian Federation

    Directory of Open Access Journals (Sweden)

    S. A. Banin

    2016-01-01

    Full Text Available Forecasting methods, extrapolation ones in particular, are used in health care for medical, biological and clinical research. The author, using accessible internet space, has not met a single publication devoted to extrapolation of financial parameters of health care activities. This determined the relevance of the material presented in the article: based on health care financing dynamics in Russia in 2000–2010 the author examined possibility of application of basic perspective extrapolation methods - moving average, exponential smoothing and least squares. It is hypothesized that all three methods can equally forecast actual public expenditures on health care in medium term in Russia’s current financial and economic conditions. The study result was evaluated in two time periods: within the studied interval and a five-year period. It was found that within the study period all methods have an average relative extrapolation error of 3–5%, which means high precision of the forecast. The study shown a specific feature of the least squares method which were gradually accumulating results so their economic interpretation became possible only in the end of the studied period. That is why the extrapolating results obtained by least squares method are not applicable in an entire study period and rather have a theoretical value. Beyond the study period, however, this feature was found to be the most corresponding to the real situation. It was the least squares method that proved to be the most appropriate for economic interpretation of the forecast results of actual public expenditures on health care. The hypothesis was not confirmed, the author received three differently directed results, while each method had independent significance and its application depended on evaluation study objectives and real social, economic and financial situation in Russian health care system.

  6. Stress, burnout and health in the clinical period of dental education.

    Science.gov (United States)

    Pöhlmann, K; Jonas, I; Ruf, S; Harzer, W

    2005-05-01

    The study examined the extent of stress, burnout and health problems experienced by fourth and fifth year dental students from the three universities of Dresden, Freiburg and Bern. The objectives of the study were to: (i) identify frequent sources of stress and to report the prevalence rates of burnout and health problems in dental students, (ii) determine the rate of students suffering from severe burnout symptoms and (iii) identify stress factors related to the burnout symptoms of emotional exhaustion and depersonalization. A total of 161 dental students from Dresden, Freiburg and Bern participated in the study. They completed the Psychosocial Stress Inventory, the Maslach Burnout Inventory and the Health Survey Questionnaire. Frequent sources of stress were limitation of leisure time, examination anxiety and the transition stress that was related to the adaptation to the demands of the clinical phase of dental education. Few differences existed between the students of the fourth and the fifth study year. Study-related stress was lowest in Bern and considerably higher in Dresden. Differences of mean levels of burnout symptoms were found only for the burnout dimension of emotional exhaustion. Students from Dresden and Freiburg were more emotionally exhausted than students from Bern, students from Dresden also reported more health problems than students from Bern or Freiburg. Ten per cent of the dental students suffered from severe emotional exhaustion, 17% complained about a severe lack of accomplishment and 28% reported severe depersonalization symptoms. Forty-four per cent of the variance of emotional exhaustion was explained by study-related factors such as lack of leisure time, examination anxiety and transition stress. The only predictor of depersonalization was a lack of social integration, accounting for 3% of the variance. A lack of social integration may be an indicator of low social competence which may cause difficulties in dealing with patients

  7. Health physics division annual progress report for period ending June 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    This annual progress report follows, as in the past, the organizational structure of the Health Physics Division. Each part is a report of work done by a section of the division: Assessment and Technology Section (Part I), headed by H.W. Dickson; Biological and Radiation Physics Section (Part II), H.A. Wright; Chemical Physics and Spectroscopy Section (Part III), W.R. Garrett; Emergency Technology Section (Part IV), C.V. Chester, Medical Physics and Internal Dosimetry Section (Part V), K.E. Cowser; and the Analytic Dosimetry and Education Group (Part VI), J.E. Turner.

  8. Animal health risk of legally imported exotic animals into the Netherlands in the period 2013-2014

    NARCIS (Netherlands)

    Vos-de Jong, de Clazien; Swanenburg, Manon; Tafro, Nedzib; Roon, van Annika; Stenvers, Olaf F.J.; Elbers, Armin R.W.

    2017-01-01

    The worldwide trade in exotic animals is a potential moderator for the global dispersion of infectious disease agents. Better insight into the pathogens that could be introduced by these trade flows can help to target surveillance efforts. The aim of this study was to evaluate the animal health risk

  9. Evaluation of domain randomness in periodically poled lithium niobate by diffraction noise measurement.

    Science.gov (United States)

    Dwivedi, Prashant Povel; Choi, Hee Joo; Kim, Byoung Joo; Cha, Myoungsik

    2013-12-16

    Random duty-cycle errors (RDE) in ferroelectric quasi-phase-matching (QPM) devices not only affect the frequency conversion efficiency, but also generate non-phase-matched parasitic noise that can be detrimental to some applications. We demonstrate an accurate but simple method for measuring the RDE in periodically poled lithium niobate. Due to the equivalence between the undepleted harmonic generation spectrum and the diffraction pattern from the QPM grating, we employed linear diffraction measurement which is much simpler than tunable harmonic generation experiments [J. S. Pelc, et al., Opt. Lett.36, 864-866 (2011)]. As a result, we could relate the RDE for the QPM device to the relative noise intensity between the diffraction orders.

  10. The fate of medications evaluated for ischemic stroke pharmacotherapy over the period 1995–2015

    Directory of Open Access Journals (Sweden)

    Xiaoling Chen

    2016-10-01

    Full Text Available Stroke is a brain damage caused by a loss of blood supply to a portion of the brain, which requires prompt and effective treatment. The current pharmacotherapy for ischemic stroke primarily relies on thrombolysis using recombinant tissue plasminogen activators (rt-PAs to breakdown blood clots. Neuroprotective agents that inhibit excitatory neurotransmitters are also used to treat ischemic stroke but have failed to translate into clinical benefits. This poses a major challenge in biomedical research to understand what causes the progressive brain cell death after stroke and how to develop an effective pharmacotherapy for stroke. This brief review analyzes the fate of about 430 potentially useful stroke medications over the period 1995–2015 and describes in detail those that successfully reached the market. Hopefully, the information from this analysis will shed light on how future stroke research can improve stroke drug discovery.

  11. Optimal duration of fasting period after endoscopic submucosal dissection for gastric epithelial neoplasia: A prospective evaluation.

    Science.gov (United States)

    Oh, Kwang Hoon; Lee, Sang Jin; Park, Jong Kyu

    2017-08-01

    There are currently no standardized guidelines for adequately determining the fasting period following gastric endoscopic submucosal dissection (ESD). The aim of this study was to determine the appropriate fasting period. The enrolled patients were randomized into a short and a long-fasting group. In the short-fasting group, patients had fasted until the day after the ESD. In the long-fasting group, patients had fasted until 2 days after the ESD. A second-look endoscopy was performed immediately prior to starting to eat meals. The primary end-point was the measurement of discomfort-related ESD after starting meals such as epigastric pain, heartburn, regurgitation, nausea and vomiting. Secondary end-points included the bleeding rate after starting meals, hospital stay, patient satisfaction and hemostasis upon second-look endoscopy. We analyzed data from 101 of 110 randomized patients. Both groups demonstrated similar baseline characteristics. There were no significant differences in reports of epigastric pain, heartburn, regurgitation, nausea and vomiting after starting meals. Both groups demonstrated similar hemostasis rates upon second-look endoscopy (26% vs 31.4%, P = 0.551) and bleeding rate (4% vs 0%, P = 0.149). The duration of hospital stay was significantly shorter in the short-fasting group (4.3 days vs 5.1 days, P fasting group. A short fasting protocol does not cause discomfort related to ESD or influence post-ESD bleeding. Moreover, the short fasting protocol results in shorter hospital stays and greater patient satisfaction. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  12. Health status evaluation in extremely premature infants

    Directory of Open Access Journals (Sweden)

    M. Yu. Arkhipova

    2016-01-01

    Full Text Available The health status was analyzed in extremely preterm infants at a postconceptual age of 38–40 weeks and in the first year of life. All the infants in the analyzed group were shown to have respiratory disorders, severe perinatal CNS lesions, and the high incidence of bronchopulmonary dysplasia and infectious and inflammatory diseases. In the first year of life, these children belonged to a group of the frequently ill. Dysfunction of the digestive system and intestinal microflora and residual signs of rickets were detected in the majority of the patients; the manifestations of bronchopulmonary dysplasia persisted in 50%. 40% of the infants had disabling complications.

  13. Health risk evaluation of nitrogen oxides

    Energy Technology Data Exchange (ETDEWEB)

    Berglund, M; Ewetz, L; Gustafsson, L; Moldeus, P; Pershagen, G; Victorin, K [Karolinska Inst., Stockholm (Sweden). Inst. of Environmental Medicine

    1996-12-31

    At the request of the Swedish Environmental Protection Agency a criteria document on nitrogen oxides has been prepared, and is intended to serve as a basis for revised air quality standards in Sweden. The criteria document is based on a thorough literature survey, and the health risk assessment is summarized in this presentation. The present standard for nitrogen dioxide (NO{sub 2}) is 110 {mu}g/m{sup 3} as 1-hour mean (98th percentile); 75 {mu}g/m{sup 3} as 24- hour mean (98th percentile); and 50 {mu}g/m{sup 3} as 6-month mean (arithmetic eman during winter half-year). (author)

  14. Health risk evaluation of nitrogen oxides

    Energy Technology Data Exchange (ETDEWEB)

    Berglund, M.; Ewetz, L.; Gustafsson, L.; Moldeus, P.; Pershagen, G.; Victorin, K. [Karolinska Inst., Stockholm (Sweden). Inst. of Environmental Medicine

    1995-12-31

    At the request of the Swedish Environmental Protection Agency a criteria document on nitrogen oxides has been prepared, and is intended to serve as a basis for revised air quality standards in Sweden. The criteria document is based on a thorough literature survey, and the health risk assessment is summarized in this presentation. The present standard for nitrogen dioxide (NO{sub 2}) is 110 {mu}g/m{sup 3} as 1-hour mean (98th percentile); 75 {mu}g/m{sup 3} as 24- hour mean (98th percentile); and 50 {mu}g/m{sup 3} as 6-month mean (arithmetic eman during winter half-year). (author)

  15. Evaluating the radiological health compliance of some beach ...

    African Journals Online (AJOL)

    Journal of Applied Sciences and Environmental Management ... Evaluating the radiological health compliance of some beach environments in Delta State ... as well as specified members of the public (customers) are not at radiological risk.

  16. Ethnographic methods for process evaluations of complex health behaviour interventions.

    Science.gov (United States)

    Morgan-Trimmer, Sarah; Wood, Fiona

    2016-05-04

    This article outlines the contribution that ethnography could make to process evaluations for trials of complex health-behaviour interventions. Process evaluations are increasingly used to examine how health-behaviour interventions operate to produce outcomes and often employ qualitative methods to do this. Ethnography shares commonalities with the qualitative methods currently used in health-behaviour evaluations but has a distinctive approach over and above these methods. It is an overlooked methodology in trials of complex health-behaviour interventions that has much to contribute to the understanding of how interventions work. These benefits are discussed here with respect to three strengths of ethnographic methodology: (1) producing valid data, (2) understanding data within social contexts, and (3) building theory productively. The limitations of ethnography within the context of process evaluations are also discussed.

  17. An Interactive Website to Reduce Sexual Risk Behavior: Process Evaluation of TeensTalkHealth.

    Science.gov (United States)

    Brady, Sonya S; Sieving, Renee E; Terveen, Loren G; Rosser, B R Simon; Kodet, Amy J; Rothberg, Vienna D

    2015-09-02

    Different theoretical frameworks support the use of interactive websites to promote sexual health. Although several Web-based interventions have been developed to address sexual risk taking among young people, no evaluated interventions have attempted to foster behavior change through moderated interaction among a virtual network of adolescents (who remain anonymous to one another) and health professionals. The objective was to conduct a summative process evaluation of TeensTalkHealth, an interactive sexual health website designed to promote condom use and other healthy decision making in the context of romantic and sexual relationships. Evaluation data were obtained from 147 adolescents who participated in a feasibility and acceptability study. Video vignettes, teen-friendly articles, and other content served as conversation catalysts between adolescents and health educators on message boards. Adolescents' perceptions that the website encouraged condom use across a variety of relationship situations were very high. Almost 60% (54/92, 59%) of intervention participants completed two-thirds or more of requested tasks across the 4-month intervention. Adolescents reported high levels of comfort, perceived privacy, ease of website access and use, and perceived credibility of health educators. Potential strategies to enhance engagement and completion of intervention tasks during future implementations of TeensTalkHealth are discussed, including tailoring of content, periodic website chats with health educators and anonymous peers, and greater incorporation of features from popular social networking websites. TeensTalkHealth is a feasible, acceptable, and promising approach to complement and enhance existing services for youth.

  18. Epidemics in the news: Health and hygiene in the press in periods of crisis.

    Science.gov (United States)

    de Almeida, Maria Antónia Pires

    2013-10-01

    How did scientific knowledge reach the public? Using the press and keeping in mind the population's limited access to written material, this paper establishes how the latest scientific news was divulged to unspecialised audiences. In times of sanitary crisis in Oporto, such as the cholera morbus epidemic of 1854-1856, the bubonic plague in 1899 and the 1918 influenza pandemic, newspapers were important sources to access the information and advice given to the public. A database of 6700 articles, medical reports and advertisements published in daily newspapers reveals the state of the art of medical science. It also reveals the importance given by health authorities and journalists to the publication of recent discoveries and adequate hygiene procedures to prevent the spread of the epidemics. This is a subject that contributes to the debates on the dissemination of science and on the place that Portugal occupied in the international scientific community.

  19. Technical Letter Report: Evaluation and Analysis of a Few International Periodic Safety Review Summary Reports

    Energy Technology Data Exchange (ETDEWEB)

    Chopra, Omesh K. [Argonne National Lab., IL (United States). Environmental Science Division; Diercks, Dwight R. [Argonne National Lab., IL (United States). Nuclear Engineering Division; Ma, David Chia-Chiun [Argonne National Lab., IL (United States). Environmental Science Division; Garud, Yogendra S. [Argonne National Lab., IL (United States). Environmental Science Division

    2013-12-17

    At the request of the United States (U.S.) government, the International Atomic Energy Agency (IAEA) assembled a team of 20 senior safety experts to review the regulatory framework for the safety of operating nuclear power plants in the United States. This review focused on the effectiveness of the regulatory functions implemented by the NRC and on its commitment to nuclear safety and continuous improvement. One suggestion resulting from that review was that the U.S. Nuclear Regulatory Commission (NRC) incorporate lessons learned from periodic safety reviews (PSRs) performed in other countries as an input to the NRC’s assessment processes. In the U.S., commercial nuclear power plants (NPPs) are granted an initial 40-year operating license, which may be renewed for additional 20-year periods, subject to complying with regulatory requirements. The NRC has established a framework through its inspection, and operational experience processes to ensure the safe operation of licensed nuclear facilities on an ongoing basis. In contrast, most other countries do not impose a specific time limit on the operating licenses for NPPs, they instead require that the utility operating the plant perform PSRs, typically at approximately 10-year intervals, to assure continued safe operation until the next assessment. The staff contracted with Argonne National Laboratory (Argonne) to perform a pilot review of selected translated PSR assessment reports and related documentation from foreign nuclear regulatory authorities to identify any potential new regulatory insights regarding license renewal-related topics and NPP operating experience (OpE). A total of 14 PSR assessment documents from 9 countries were reviewed. For all of the countries except France, individual reports were provided for each of the plants reviewed. In the case of France, three reports were provided that reviewed the performance assessment of thirty-four 900-MWe reactors of similar design commissioned between 1978

  20. Technical Letter Report: Evaluation and Analysis of a Few International Periodic Safety Review Summary Reports

    International Nuclear Information System (INIS)

    Chopra, Omesh K.; Diercks, Dwight R.; Ma, David Chia-Chiun; Garud, Yogendra S.

    2013-01-01

    At the request of the United States (U.S.) government, the International Atomic Energy Agency (IAEA) assembled a team of 20 senior safety experts to review the regulatory framework for the safety of operating nuclear power plants in the United States. This review focused on the effectiveness of the regulatory functions implemented by the NRC and on its commitment to nuclear safety and continuous improvement. One suggestion resulting from that review was that the U.S. Nuclear Regulatory Commission (NRC) incorporate lessons learned from periodic safety reviews (PSRs) performed in other countries as an input to the NRC's assessment processes. In the U.S., commercial nuclear power plants (NPPs) are granted an initial 40-year operating license, which may be renewed for additional 20-year periods, subject to complying with regulatory requirements. The NRC has established a framework through its inspection, and operational experience processes to ensure the safe operation of licensed nuclear facilities on an ongoing basis. In contrast, most other countries do not impose a specific time limit on the operating licenses for NPPs, they instead require that the utility operating the plant perform PSRs, typically at approximately 10-year intervals, to assure continued safe operation until the next assessment. The staff contracted with Argonne National Laboratory (Argonne) to perform a pilot review of selected translated PSR assessment reports and related documentation from foreign nuclear regulatory authorities to identify any potential new regulatory insights regarding license renewal-related topics and NPP operating experience (OpE). A total of 14 PSR assessment documents from 9 countries were reviewed. For all of the countries except France, individual reports were provided for each of the plants reviewed. In the case of France, three reports were provided that reviewed the performance assessment of thirty-four 900-MWe reactors of similar design commissioned between 1978 and

  1. Variable impedance cardiography waveforms: how to evaluate the preejection period more accurately

    International Nuclear Information System (INIS)

    Ermishkin, V V; Kolesnikov, V A; Lukoshkova, E V; Mokh, V P; Sonina, R S; Dupik, N V; Boitsov, S A

    2012-01-01

    Impedance method has been successfully applied for left ventricular function assessment during functional tests. The preejection period (PEP), the interval between Q peak in ECG and a specific mark on impedance cardiogram (ICG) which corresponds to aortic valve opening, is an important indicator of the contractility state and its neurogenic control. Accurate identification of ejection onset by ICG is often problematic, especially in the cardiologic patients, due to peculiar waveforms. An essential obstacle is variability of the shape of the ICG waveform during the exercise and subsequent recovery. A promissing solution can be introduction of an additional pulse sensor placed in the nearby region. We tested this idea in 28 healthy subjects and 6 cardiologic patients using a dual-channel impedance cardiograph for simultaneous recording from the aortic and neck regions, and an earlobe photoplethysmograph. Our findings suggest that incidence of abnormal complicated ICG waveforms increases with age. The combination of standard ICG with ear photoplethysmography and/or additional impedance channel significantly improves the efficacy and accuracy of PEP estimation.

  2. Human Factors Evaluation of Procedures for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the results of human factors assessment on the plant operating procedures as part of Periodic Safety Review(PSR) of Yonggwang Nuclear Power Plant Unit no. 1, 2. The suitability of item and appropriateness of format and structure in the key operating procedures of nuclear power plants were investigated by the review of plant operating experiences and procedure documents, field survey, and experimental assessment on some part of procedures. A checklist was used to perform this assessment and record the review results. The reviewed procedures include EOP(Emergency Operating Procedures), GOP(General Operating Procedures), AOP(Abnormal Operating Procedures), and management procedures of some technical departments. As results of the assessments, any significant problem challenging the safety was not found on the human factors in the operating procedures. However, several small items to be changed and improved were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on the operating procedure.

  3. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  4. Evaluating Youth Sexual Health Peer Education Programs: "Challenges and Suggestions for Effective Evaluation Practices"

    Science.gov (United States)

    Jaworsky, Denise; Larkin, June; Sriranganathan, Gobika; Clout, Jerri; Janssen, Jesse; Campbell, Lisa; Flicker, Sarah; Stadnicki, Dan; Erlich, Leah; Flynn, Susan

    2013-01-01

    Although peer sexual health education is a common form of sexual health promotion for youth, systematic reviews of these programs are relatively rare. In this study we interviewed youth peer educators to inquire about their experience of program evaluation and their perception of what is needed to develop effective evaluation practices. Data were…

  5. The evaluation of minimum cooling period for loading of PWR spent nuclear fuel of a dual purpose metal cask

    Energy Technology Data Exchange (ETDEWEB)

    Dho, Ho Seog; Kim, Tae Man; Cho, Chun Hyung [Korea Radioactive Waste Agency, Daejeon (Korea, Republic of)

    2016-12-15

    Recently, because the wet pool storage facilities of NPPs in Korea has become saturated, there has been much active R and D on an interim dry storage system using a transportation and storage cask. Generally, the shielding evaluation for the design of a spent fuel transportation and storage cask is performed by the design basis fuel, which selects the most conservative fuel among the fuels to be loaded into the cask. However, the loading of actual spent fuel into the transportation metal cask is not limited to the design basis fuel used in the shielding evaluation; the loading feasibility of actual spent fuel is determined by the shielding evaluation that considers the characteristics of the initial enrichment, the maximum burnup and the minimum cooling period. This study describes a shielding analysis method for determining the minimum cooling period of spent fuel that meets the domestic transportation standard of the dual purpose metal cask. In particular, the spent fuel of 3.0-4.5wt% initial enrichment, which has a large amount of release, was evaluated by segmented shielding calculations for efficient improvement of the results. The shielding evaluation revealed that about 81% of generated spent fuel from the domestic nuclear power plants until 2008 could be transported by the dual purpose metal cask. The results of this study will be helpful in establishing a technical basis for developing operating procedures for transportation of the dual purpose metal cask.

  6. The evaluation of minimum cooling period for loading of PWR spent nuclear fuel of a dual purpose metal cask

    International Nuclear Information System (INIS)

    Dho, Ho Seog; Kim, Tae Man; Cho, Chun Hyung

    2016-01-01

    Recently, because the wet pool storage facilities of NPPs in Korea has become saturated, there has been much active R and D on an interim dry storage system using a transportation and storage cask. Generally, the shielding evaluation for the design of a spent fuel transportation and storage cask is performed by the design basis fuel, which selects the most conservative fuel among the fuels to be loaded into the cask. However, the loading of actual spent fuel into the transportation metal cask is not limited to the design basis fuel used in the shielding evaluation; the loading feasibility of actual spent fuel is determined by the shielding evaluation that considers the characteristics of the initial enrichment, the maximum burnup and the minimum cooling period. This study describes a shielding analysis method for determining the minimum cooling period of spent fuel that meets the domestic transportation standard of the dual purpose metal cask. In particular, the spent fuel of 3.0-4.5wt% initial enrichment, which has a large amount of release, was evaluated by segmented shielding calculations for efficient improvement of the results. The shielding evaluation revealed that about 81% of generated spent fuel from the domestic nuclear power plants until 2008 could be transported by the dual purpose metal cask. The results of this study will be helpful in establishing a technical basis for developing operating procedures for transportation of the dual purpose metal cask

  7. Data Management for Evaluating Complications of Health Care

    OpenAIRE

    Streed, Stephen A.; Massanari, R. Michael

    1988-01-01

    This paper describes the design and operating characteristics of a microcomputer-based data management system for assessing complications associated with the delivery of health care. The system was developed in response to the need to promote “risk management” as an essential component of the Quality Assurance effort within the health care delivery environment. The system herein described allows the epidemiological evaluation of complications of health care in a tertiary care referral center....

  8. Evaluation of Oral Health Status and Influential Factors in Children ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... preferred by children's parents were analyzed. ... knowledge of dentists regarding autism increases, it is ... How to cite this article: Onol S, Kırzıoğlu Z. Evaluation of oral health ..... France: World Health Organization; 2013. p.

  9. Evaluation of two communication strategies to improve udder health management

    NARCIS (Netherlands)

    Jansen, J.; Renes, R.J.; Lam, T.J.G.M.

    2010-01-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

  10. Evaluating Health Workers' Knowledge Following the Introduction of ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    African Journal of Reproductive Health September 2015; 19 (3): 118. ORIGINAL RESEARCH ARTICLE. Evaluating Health Workers' ... of Clinical Mentoring in Jigawa State, Northern Nigeria. .... Organization (WHO) in 2011 estimates the maternal ... International ..... Dental Education: Supporting doctors and dentists at work: ...

  11. Social comparison as a mediator between health problems and subjective health evaluations.

    NARCIS (Netherlands)

    Van der Zee, K.I.; Buunk, Abraham (Bram); Sanderman, R.

    The role of social comparison in mediating the relation between 'objective' health status and subjective health evaluations was examined. In a random population sample (N = 361) it was shown that health problems were related to psychological distress, which in turn induced a downward comparison

  12. Comparative evaluation of two methods care of the perioperative period after laparoscopic operations on uterine appendages

    Directory of Open Access Journals (Sweden)

    О. S. Lashkul

    2017-10-01

    Full Text Available Aim – тo assess the impact of the early multimodal rehabilitation concept on postoperative period after laparoscopic operations on uterine appendages. Маterials and methods. The study involved 79 patients who were randomized by envelope method in two groups. In the main group (26 patients, a protocol of early multimodal rehabilitation (ERAS was used. In the control group (53 patients, the traditional perioperative regimen was used. In both groups, laparoscopic operations were performed under general anesthesia with mechanical ventilation (propofol + fentanyl. In perioperative anesthesia NSAIDs (dexketoprofen, ketorolac, paracetamol were included. Non-invasive monitoring was performed by the «Leon» monitor (StO2, blood pressure, heart rate, capnogram, hourly diuresis was taken into account, thermometry was performed. In the postoperative period analgesia with combination with systemic administration of dexketoprofen (100–150 mg/day + ketorolac (60 mg/day + paracetamol (3000 mg/day was used. Results. The groups were homogeneous according to anamnestic (the beginning of menstruation, the number of pregnancies, childbirth, abortions, miscarriages, anthropometric and demographic characteristics, the duration of operations, blood loss and baseline values of systolic, diastolic, mean arterial pressures and heart rate. In groups the volumes of diuresis did not differ significantly (p < 0.05. Positive intraoperative hemohydrate balance in the FTS group was almost half that in the control group. When assessing pain at rest by VAS, a statistically significant difference was found at the 6 and 24 hours study stages. Nevertheless, at the study stages the pain level in the control group did not exceed 30 mm, which indicates adequate analgesia at rest. The level of cough pain in the control group exceeded the level of pain in the main group, the statistical difference was determined after 6 hours and 24 hours, but was above 30 mm, which required

  13. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by periodical health examination, (6)

    International Nuclear Information System (INIS)

    Abe, Tsutomu; Dohy, Hiroo; Okita, Hajime

    1980-01-01

    Serum ferritin was determined in A-bomb survivors, and its significance was evaluated. A low-ferritin group included many of the females under the age of 50, who mostly had iron deficient anemia. A high-ferritin group included many older-aged A-bomb survivors who had secondary anemia due to hemochromatosis, paroxismal nocturnal hemoglobinuria (PNH), and multiple myeloma. Secondary anemia due to hemochromatosis, PNH, leukemia, and sideroblastic anemia was detected in those who were old and had underlying moderate or severe anemia with a high ferritin level. As the results of this investigation, blood examination combined with serum ferritin determination is valuable for diagnosis of anemia and detection of underlying diseases. (Ueda, J.)

  14. The modest but growing Brazilian presence in psychiatric, psychobiological and mental health research: assessment of the 1998-2002 period

    Directory of Open Access Journals (Sweden)

    Bressan R.A.

    2005-01-01

    Full Text Available The objective of the present survey was to assess the Brazilian scientific production in psychiatry, psychobiology, and mental health during the 1998-2002 period. The universities' graduate programs concentrate the vast majority of the scientific production in Brazil. We assessed the annual reports from the graduate programs to the Brazilian Ministry of Education concerning master's and doctoral theses and the articles published in journals indexed by the Institute of Scientific Information (ISI. There are nine Master's and Doctoral graduate programs dedicated to research in psychiatry, neuropsychiatry, psychobiology, and mental health in the country, seven being located in southern states. During the 5-year period, from 1998 to 2002, 186 students received their doctorate degree (37/year. The programs published 637 articles in journals indexed by ISI, the majority of them in journals with an impact factor higher than 2. The research advisors' productivity varied among graduate programs, ranging from 0.6 to 2.0 articles per year in ISI-indexed journals. Despite the substantial barriers faced by the Brazilian scientific community (mainly financial and writing difficulties, Brazil's scientific mental health production is on the rise. The number of articles published in ISI-indexed journals has doubled without a significant increase in the number of graduate theses, suggesting that there was an improvement in both the quality of the scientific production and the productivity of the graduate programs. Based on these data, it is reasonable to predict a tendency to an increase in production over the next few years.

  15. EVALUATION OF MANUFACTURING AND AGRICULTURAL PRODUCTION BY THE END OF THE FINANCIAL PERIOD

    Directory of Open Access Journals (Sweden)

    Mincho Minev

    2016-06-01

    Full Text Available This article is dedicated on the matter of evaluation of manufacturing and agricultural production after the initial appraisal. Accounting standards and regulations, concerning the reappraisal of production, are discussed with emphasis on the key and most disputable requirements. The most commonly met difficulties in the process of reappraisal of production are pointed out. A research is done over the leading manufacturing and agricultural entities in Bulgaria. The point of the research is to study the degree on witch entities met the requirements and regulations of accounting standards when they reevaluate their production by the end of the year. The results of the research are shown and analyzed. Conclusions are made along with some recommendations in order to improve the quality of reappraisal of manufacturing and agricultural production.

  16. On the evaluation of the correction factor μ (rho', tau') for the periodic pulse method

    International Nuclear Information System (INIS)

    Mueller, J.W.

    1976-01-01

    The inconveniences associated with the purely numerical approach we have chosen to solve some of the problems which arise in connection with the source-pulser method are twofold. On the one hand, there is the trouble of calculating the tables for μ, requiring several nights of computer time. On the other hand, apart from some simple limiting values as μ = 1 for tau' = 0 or 1, μ = 1/0.5 + /0.5 - tau'/ for rho' → 0 (and 0 > 1, no appropriate analytical form for the correction factor μ of sufficient precision is known for the moment. This drawback, we hope, is partly removed by a tabulation which should cover the whole region of practical interest. The computer programs for both the evaluation of μ and the Monte Carlo simulation are available upon request

  17. Importance of Economic Evaluation in Health Care: An Indian Perspective.

    Science.gov (United States)

    Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

    2016-05-01

    Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. A normative foundation for equity-sensitive health evaluation

    DEFF Research Database (Denmark)

    Moreno-Ternero, Juan D.; Østerdal, Lars Peter

    2017-01-01

    are the so-called multiplicative Quality Adjusted Life Years (QALYs) and multiplicative Healthy Years Equivalents (HYEs), as well as generalizations of the two. Our axiomatic approach assumes social preferences over distributions of individual health states experienced in a given period of time. It conveys...

  19. Evaluating the effect of integrated microfinance and health interventions: an updated review of the evidence.

    Science.gov (United States)

    Lorenzetti, Lara M J; Leatherman, Sheila; Flax, Valerie L

    2017-06-01

    Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor populations. Integrated microfinance and health interventions leverage networks of women to promote financial inclusion, build livelihoods, and safeguard against high cost illnesses. Our understanding of the effect of integrated interventions has been limited by variability in intervention, outcome, design, and methodological rigour. This systematic review synthesises the literature through 2015 to understand the effect of integrated microfinance and health programs. We searched PubMed, Scopus, Embase, EconLit, and Global Health databases and sourced bibliographies, identifying 964 articles exclusive of duplicates. Title, abstract, and full text review yielded 35 articles. Articles evaluated the effect of intentionally integrated microfinance and health programs on client outcomes. We rated the quality of evidence for each article. Most interventions combined microfinance with health education, which demonstrated positive effects on health knowledge and behaviours, though not health status. Among programs that integrated microfinance with other health components ( i.e. health micro-insurance, linkages to health providers, and access to health products), results were generally positive but mixed due to the smaller number and quality of studies. Interventions combining multiple health components in a given study demonstrated positive effects, though it was unclear which component was driving the effect. Most articles (57%) were moderate in quality. Integrated microfinance and health education programs were effective, though longer intervention periods are necessary to measure more complex pathways to health status. The effect of microfinance combined with other health components was less clear. Stronger randomized research designs with multiple study arms are required to improve evidence and disentangle the effects of multiple component

  20. [Tuberculosis control in the Central Health Region of Catalonia during the period 1986-2000].

    Science.gov (United States)

    Miret Cuadras, P; Pina Gutiérrez, J M; López Sanmartín, J L; Sala Farré, M R

    2003-10-01

    To assess tuberculosis control in the Central Health Region, Catalonia, Spain, from the implementation of the area's Tuberculosis Control Program in 1986 until the year 2000. To study the epidemiological profile of tuberculosis and the outcome of the following control measures in sputum smear-positive patients: final outcome of treatment and monitoring, and the percentage of patients for whom a contact investigation (CI) was carried out. Tuberculosis control is considered effective if the sum of noncompliant patients, plus the cases in which treatment failed, plus the patients transferred out remains below 10% of the cohort of patients studied, and if a CI has been conducted in at least 80% of this cohort. The number of cases reported was 6326, of which 7% were retreatments. A total of 5865 new cases was detected. Of these, 5652 (96%) were patients born in Spain. The number of cases reported annually peaked in 1990 (474) and then declined continuously until 2000, when it was 54% lower (220). Foreign-born patients numbered 213 (4%), and 95% of them came from countries with a high prevalence of tuberculosis. In the cohort of patients studied between 1997 and 2000, the sum of noncompliant patients, plus cases in which treatment failed, plus the patients transferred out came to 11%. Since 1994, a CI has been carried out for over 80% of patients, and this figure reached 92% in 2000. We consider that a substantial degree of tuberculosis control has been achieved given the decline in tuberculosis morbidity among people born in Spain, the fact that the percentage of noncompliant patients, treatment failures and transfers was only slightly over 10%, and that a CI has been conducted for over 80% of patients since 1994 (92% in 2000).

  1. World Health Organization guideline development: an evaluation.

    Directory of Open Access Journals (Sweden)

    David Sinclair

    Full Text Available BACKGROUND: Research in 2007 showed that World Health Organization (WHO recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures. METHODS AND FINDINGS: We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3% and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%. Four main themes emerged from the interviews: (1 high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2 views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3 staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4 the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. CONCLUSIONS: Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance

  2. High-Resolution Regional Reanalysis in China: Evaluation of 1 Year Period Experiments

    Science.gov (United States)

    Zhang, Qi; Pan, Yinong; Wang, Shuyu; Xu, Jianjun; Tang, Jianping

    2017-10-01

    Globally, reanalysis data sets are widely used in assessing climate change, validating numerical models, and understanding the interactions between the components of a climate system. However, due to the relatively coarse resolution, most global reanalysis data sets are not suitable to apply at the local and regional scales directly with the inadequate descriptions of mesoscale systems and climatic extreme incidents such as mesoscale convective systems, squall lines, tropical cyclones, regional droughts, and heat waves. In this study, by using a data assimilation system of Gridpoint Statistical Interpolation, and a mesoscale atmospheric model of Weather Research and Forecast model, we build a regional reanalysis system. This is preliminary and the first experimental attempt to construct a high-resolution reanalysis for China main land. Four regional test bed data sets are generated for year 2013 via three widely used methods (classical dynamical downscaling, spectral nudging, and data assimilation) and a hybrid method with data assimilation coupled with spectral nudging. Temperature at 2 m, precipitation, and upper level atmospheric variables are evaluated by comparing against observations for one-year-long tests. It can be concluded that the regional reanalysis with assimilation and nudging methods can better produce the atmospheric variables from surface to upper levels, and regional extreme events such as heat waves, than the classical dynamical downscaling. Compared to the ERA-Interim global reanalysis, the hybrid nudging method performs slightly better in reproducing upper level temperature and low-level moisture over China, which improves regional reanalysis data quality.

  3. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (9)

    International Nuclear Information System (INIS)

    Dohy, Hiroo; Taketomi, Yoshinori; Oguma, Nobuo; Takamatsu, Yumiko; Kamada, Nanao

    1984-01-01

    Of 195,146 A-bomb survivors undergoing the periodic health examination, 607 in whom anemia was confirmed were investigated. Iron deficiency anemia was seen in 77.3% of the survivors (mostly consisting of women under the age of 54 years). There was no significant difference in other types of anemia between men and women. Renal anemia was frequent in survivors aged between 60 and 80 years. Refractory anemia was frequent in survivors older than those with renal anemia. The white blood cell count and platelet count were within the normal range in three types of anemia. (Namekawa, K.)

  4. An Evaluation of the Physical Environments of a Nuclear Power Plants for Human Factors Review in Periodic Safety Review

    International Nuclear Information System (INIS)

    Kim, Dae Ho; Lee, Yong Hee

    2006-01-01

    Currently, operation of a nuclear power plants(NPP) is highly emphasized by the integrity of the H/W and the human factors security, so the periodic safety review(PSR) is performed to NPP. The PSR activities on human factors include physical environments (illumination, noise, vibration, temperature and humidity etc). The review on these physical environments is to verify the possible affect to the human error during the operation of the man machine interface. Physical environments affect the health, job stress and job satisfaction of NPP's employees. On the ground of the reason, we need integrating the management program for the sufficient satisfaction of the regulatory basis and standards of physical environment and considering a health, a job stress and satisfaction of NPP's employees. So, this paper describes the planning of the setup procedures of physical environments and the adequate management program for the field applications in NPPs

  5. An Evaluation of the Physical Environments of a Nuclear Power Plants for Human Factors Review in Periodic Safety Review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Lee, Yong Hee [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2006-07-01

    Currently, operation of a nuclear power plants(NPP) is highly emphasized by the integrity of the H/W and the human factors security, so the periodic safety review(PSR) is performed to NPP. The PSR activities on human factors include physical environments (illumination, noise, vibration, temperature and humidity etc). The review on these physical environments is to verify the possible affect to the human error during the operation of the man machine interface. Physical environments affect the health, job stress and job satisfaction of NPP's employees. On the ground of the reason, we need integrating the management program for the sufficient satisfaction of the regulatory basis and standards of physical environment and considering a health, a job stress and satisfaction of NPP's employees. So, this paper describes the planning of the setup procedures of physical environments and the adequate management program for the field applications in NPPs.

  6. An Evaluation Tool for Agricultural Health and Safety Mobile Applications.

    Science.gov (United States)

    Reyes, Iris; Ellis, Tammy; Yoder, Aaron; Keifer, Matthew C

    2016-01-01

    As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist. However, the abundance and diversity of such applications also presents challenges regarding evaluation practices and assignation of value. This is particularly true in the agricultural workspace, as there is currently little information on the value of these apps for agricultural safety and health. This project proposes a framework for developing and evaluating apps that have potential usefulness in agricultural health and safety. The evaluation framework is easily transferable, with little modification for evaluation of apps in several agriculture-specific areas.

  7. [Decision modeling for economic evaluation of health technologies].

    Science.gov (United States)

    de Soárez, Patrícia Coelho; Soares, Marta Oliveira; Novaes, Hillegonda Maria Dutilh

    2014-10-01

    Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.

  8. Dental health and alimentation among the Quintana Roo Mayas: coastal and inland sites of the classic-postclassic periods.

    Science.gov (United States)

    Ortega-Muñoz, Allan

    2015-01-01

    The goal of this study is to compare both dental and skeletal stress indicators of the Classic and Postclassic coastal and inland sites of the State of Quintana Roo, Mexico. The hypothesis is that coastal populations will show osteo and dental pathologies characteristic of a primarily marine food source combined with a diet of horticultural resources. This kind of alimentation provides people with less environmental stress and therefore a better health status. However, over time, in the Postclassic period, the health conditions deteriorated among both coastal and inland inhabitants, according to the hierarchization of the society, militarization, and commercial activities of all the coastal sites. The sample was drawn from 19 sites (196 individuals of both sexes) from the east coast of the Yucatan Peninsula, as well as from inland localities within the boundaries of Quintana Roo. Both dental and osteological stress indicators were analyzed, and crosstabs were applied for absolute and relative frequencies and their corresponding χ(2) and F Fisher analyses. The osteopathological index of the coastal and inland sites of the Classic period were compared over time between the Classic coastal inhabitants and the Postclassic coastal inhabitants so as to understand how life conditions changed over time. The Mantel-Haenszel odds ratio, with the crosstabs controlling for sex (males and females), was also carried out. There are low frequencies of dental pathologies and anemia present in both the coastal and inland populations of Quintana Roo in the Classic and Postclassic times. Only the presence of periostitis is highly common in both types of site, and this is the only indicator with significant differences. The dental pathologies, anemia and periostitis, in general, present a slight upward trend in both the coastal and inland populations over time. The coastal populations have fewer frequencies of the above than the inland sites whilst, in the Postclassic period, both the

  9. [Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces].

    Science.gov (United States)

    Gala, Ángela; Toledo, María Eugenia; Arias, Yanisnubia; Díaz González, Manuel; Alvarez Valdez, Angel Manuel; Estévez, Gonzalo; Abreu, Rolando Miyar; Flores, Gustavo Kourí

    2012-09-01

    Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.

  10. [Evaluation auditing of the quality of health care in accreditation of health facilities].

    Science.gov (United States)

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

    This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

  11. The role of the European Structural and Investment Funds in Financing Health System in Lithuania: Experience from 2007 to 2013 funding period and implications for the future.

    Science.gov (United States)

    Murauskiene, Liubove; Karanikolos, Marina

    2017-07-01

    European Structural and Investment Funds (ESIF) are a major source of investments in the newer EU member states. In Lithuania's health sector, the amount for the 2007-2013 funding period reached more than €400 million. In this paper we aim to (i) identify the key areas in the health sector which were supported by ESIF, (ii) determine the extent to which ESIF assisted the implementation of the ongoing health system reform; and (iii) assess whether the use of funds has led to expected improvements in healthcare. We review the national strategic documents and legislation, and perform calculations to determine funding allocations by specific area, based on the available data. We analyse changes according to a set of selected indicators. We find that implementation of programmes funded by the ESIF lacks formal evaluation. Existing evidence suggests that some improvement has been achieved by 2013. However, there are persisting challenges, including failure to reach a broad agreement on selection of health and healthcare indicators, lack of transparency in allocations, and absence of coherent assessment measures of healthcare quality and accessibility. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, 2

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Kamada, Nanao; Takahashi, Hiroshi; Ohkita, Takeshi; Ito, Chikako.

    1976-01-01

    An actual condition of anemia in A-bomb survivors was discussed from the periodical health examination of the fiscal years 1972 and 1973. Under 11.5 g/dl of hemoglobin was determined as anemia. An actual number of cases with anemia in both fiscal years was nearly the same, but ratio of anemia to the total number of recipient of periodical health examination increased 1.9% in the fiscal year 1973. 35.3% of the subjects with anemia in both fiscal years was the same persons. In the following examination of 478 subjects with under 10.0 g/dl of hemoglobin, in the fiscal year 1972, 96 subjects (20.1%) still showed under 10.0 g/dl of hemoglobin in the fiscal year 1975. Characteristics of anemia were that hypochromic anemia was comparatively frequent in the young, and normochromic anemia was frequent in the aged. In the former, marked decrease of value of iron in serum was recognized, and in the latter, fall of hematopoiesis by old age and secondary anemia were recognized. Marked relationship between exposure distance and anemia in each group was not recognized. 17.9% of cases with moderate anemia showed positive in stool guaiac test and 8.9% and past history of duodenal or peptic ulcer. (Kanao, N.)

  13. Systematic overview of economic evaluations of health-related rehabilitation.

    Science.gov (United States)

    Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

    2016-01-01

    Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Evaluation of Electronic Health Record Implementation in Hospitals.

    Science.gov (United States)

    Tubaishat, Ahmad

    2017-07-01

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

  15. Simulation studies for the evaluation of health information technologies

    DEFF Research Database (Denmark)

    Ammenwerth, Elske; Hackl, Werner; Binzer, Kristine

    2012-01-01

    It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated...... is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management...... system on the appropriateness of prescriptions and drugrelated activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences...

  16. PUBLIC SERVANT TEACHERS' EVALUATION DURING THE INTERNSHIP PERIOD WITHIN THE AUTONOMOUS COMMUNITY OF THE BASQUE COUNTRY: TOWARDS THE EVALUATION OF THE TEACHING ROLE

    Directory of Open Access Journals (Sweden)

    Karmele Totoricagüena Barandica

    2016-07-01

    Full Text Available The aim of this communication is to present the experience developed in the Basque Country regarding to the evaluation of the public servants in their internship period during the academic year 2015-16. The aim of this work is also to contribute the obtained conclusions to the teachers practice evaluation corpus. In that direction, and for the formalisation of the evaluation, new tools and specific materials had been prepared. The intervention carried out by the inspection had been done first informing and then interacting with the participants involved. From the developed experience can be determined that the classroom observation, the autoevaluation and the exchange/contrast of the observed practices done between the inspection and the evaluated participant should be the key elements to monitor the teaching role.

  17. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  18. Process evaluation of health fairs promoting cancer screenings.

    Science.gov (United States)

    Escoffery, Cam; Liang, Shuting; Rodgers, Kirsten; Haardoerfer, Regine; Hennessy, Grace; Gilbertson, Kendra; Heredia, Natalia I; Gatus, Leticia A; Fernandez, Maria E

    2017-12-18

    Low income and uninsured individuals often have lower adherence to cancer screening for breast, cervical and colorectal cancer. Health fairs are a common community outreach strategy used to provide cancer-related health education and services. This study was a process evaluation of seven health fairs focused on cancer screening across the U.S. We conducted key-informant interviews with the fair coordinator and conducted baseline and follow-up surveys with fair participants to describe characteristics of participants as well as their experiences. We collected baseline data with participants at the health fairs and telephone follow-up surveys 6 months following the fair. Attendance across the seven health fairs ranged from 41 to 212 participants. Most fairs provided group or individual education, print materials and cancer screening during the event. Overall, participants rated health fairs as very good and participants reported that the staff was knowledgeable and that they liked the materials distributed. After the fairs, about 60% of participants, who were reached at follow-up, had read the materials provided and had conversations with others about cancer screening, and 41% talked to their doctors about screening. Based on findings from evaluation including participant data and coordinator interviews, we describe 6 areas in planning for health fairs that may increase their effectiveness. These include: 1) use of a theoretical framework for health promotion to guide educational content and activities provided, 2) considering the community characteristics, 3) choosing a relevant setting, 4) promotion of the event, 5) considerations of the types of services to deliver, and 6) evaluation of the health fair. The events reported varied in reach and the participants represented diverse races and lower income populations overall. Most health fairs offered education, print materials and onsite cancer screening. Participants reported general satisfaction with these events

  19. Evaluating child care in the Family Health Strategy.

    Science.gov (United States)

    da Silva, Simone Albino; Fracolli, Lislaine Aparecida

    2016-01-01

    to evaluate the healthcare provided to children under two years old by the Family Health Strategy. evaluative, quantitative, cross-sectional study that used the Primary Care Assessment Tool - Child Version for measuring the access, longitudinality, coordination, integrality, family orientation and community orientation. a total of 586 adults responsible for children under two years old and linked to 33 health units in eleven municipalities of the state of Minas Gerais, Brazil, were interviewed. The evaluation was positive for the attributes longitudinality and coordination, and negative for access, integrality, Family orientation and community orientation. there are discrepancies between health needs of children and what is offered by the service; organizational barriers to access; absence of counter-reference; predominance of curative and long-standing and individual preventive practices; verticalization in organization of actions; and lack of good communication between professionals and users.

  20. Impact of periodic health examination on surgical treatment for uterine fibroids in Beijing: a case-control study

    Directory of Open Access Journals (Sweden)

    Yang Ling-Ling

    2010-12-01

    Full Text Available Abstract Background During the past 2 decades, there has been a rapid proliferation of "health examination center (HEC" across China. The effects of their services on public's health have not been systemically investigated. This study aimed to assess the impact of periodic health examination (PHE at HEC on surgical treatment for uterine fibroids in Beijing residents. Methods We identified 224 patients with a primary diagnosis of uterine fibroids who had surgical treatment at four Level-1 general hospitals in Beijing, from June 1, 2009 to October 20, 2009. Controls were women who did not have surgery for uterine fibroids, matched (1:1 ratio for age (within 2 years. A standard questionnaire was used to inquire about whether participants had PHE at HEC during the previous 2 years. Results PHE at HEC within 2 years were associated with surgical treatment for uterine fibroids. Odds ratios was 4.05 (95% CI, 2.61-6.29 P Conclusions Our study showed PHE currently provided at HEC in China were associated with significantly increased use of surgical treatment for uterine fibroids in women. Further studies are needed to assess the effects of PHE on clinical as well as on broad societal outcomes in Chinese in contemporary medical settings.

  1. Evaluation of health care system reform in Hubei Province, China.

    Science.gov (United States)

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-02-21

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

  2. Evaluation on equality and efficiency of health resources allocation and health services utilization in China.

    Science.gov (United States)

    Sun, Jian; Luo, Hongye

    2017-07-14

    China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource

  3. The training for health equity network evaluation framework: a pilot study at five health professional schools.

    Science.gov (United States)

    Ross, Simone J; Preston, Robyn; Lindemann, Iris C; Matte, Marie C; Samson, Rex; Tandinco, Filedito D; Larkins, Sarah L; Palsdottir, Bjorg; Neusy, Andre-Jacques

    2014-01-01

    The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection comprising of workshops, qualitative interviews and focus group discussions, document review and collation and analysis of existing quantitative data. The evaluation framework allowed each school to contextually gather evidence on how it was meeting the aspirational goals of social accountability across a range of school activities, and to identify strengths and areas for improvement and development. The evaluation framework pilot study demonstrated how social accountability can be assessed through a critically reflective and comprehensive process. As social accountability focuses on the relationship between health professions schools and health system and health population outcomes, each school was able to demonstrate to students, health professionals, governments, accrediting bodies, communities and other stakeholders how current and future health care needs of populations are addressed in terms of education, research, and service learning.

  4. Towards a Framework for Evaluating Mobile Mental Health Apps.

    Science.gov (United States)

    Chan, Steven; Torous, John; Hinton, Ladson; Yellowlees, Peter

    2015-12-01

    Mobile phones are ubiquitous in society and owned by a majority of psychiatric patients, including those with severe mental illness. Their versatility as a platform can extend mental health services in the areas of communication, self-monitoring, self-management, diagnosis, and treatment. However, the efficacy and reliability of publicly available applications (apps) have yet to be demonstrated. Numerous articles have noted the need for rigorous evaluation of the efficacy and clinical utility of smartphone apps, which are largely unregulated. Professional clinical organizations do not provide guidelines for evaluating mobile apps. Guidelines and frameworks are needed to evaluate medical apps. Numerous frameworks and evaluation criteria exist from the engineering and informatics literature, as well as interdisciplinary organizations in similar fields such as telemedicine and healthcare informatics. We propose criteria for both patients and providers to use in assessing not just smartphone apps, but also wearable devices and smartwatch apps for mental health. Apps can be evaluated by their usefulness, usability, and integration and infrastructure. Apps can be categorized by their usability in one or more stages of a mental health provider's workflow. Ultimately, leadership is needed to develop a framework for describing apps, and guidelines are needed for both patients and mental health providers.

  5. The effect of an aerobic training period on mental health and depression in Iranian women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Saremi A*

    2016-06-01

    Full Text Available Introduction: Polycystic Ovary Syndrome (PCOS is among the common endocrine women disorders that can create manifestations such as anxiety and depression. In this study, the effect of aerobic training on mental health and depression among Iranian women suffering from PCOS has been examined. Methods: This semi experimental study was carried out based on pre-test and post-test on experiment and control groups in Arak, Iran. Twenty-two women with polycystic ovary syndrome (aged 27.82 ±5.23 yr were selected and randomly divided to training (n=12 and control (n=10 groups. Aerobic training program was performed 25-40 min/d, 3d/wk, for 10 weeks. Mental health and depression were evaluated using a general health questionnaire-28 (GHQ-28 and a Beck depression inventory (BAI-II in the two groups before and after the study. Results: The 10 week aerobic training had a significant effect on mental health, subscales of physical symptoms, anxiety and depression (p0.05. Conclusion: The result of present study suggests that aerobic exercise can improve the mental disorders in women with polycystic ovary syndrome.

  6. The equity lens in the health care performance evaluation system.

    Science.gov (United States)

    Barsanti, Sara; Nuti, Sabina

    2014-01-01

    The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the 'equity process' by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Consumer Health: Does Advertising Work on You? and Evaluating a Product's Health Claims.

    Science.gov (United States)

    Cox, Carolyn C.

    This paper describes lessons for teaching middle and high school students how to determine if they are influenced by the power of advertising and how to evaluate a product's health claims. To determine the influence of advertising, teachers have high school students discuss what their latest health product/service purchase was, why they bought it,…

  8. Tests to evaluate public health disease reporting systems in local public health agencies (electronic resource)

    National Research Council Canada - National Science Library

    Ricci, Karen; Lurie, Nicole; Stoto, Michael A; Wasserman, Jeffrey; Dausey, David J; Meade, Barbara; Diamond, Alexis; Molander, Roger C

    2005-01-01

    ... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

  9. Tests to evaluate public health disease reporting systems in local public health agencies

    National Research Council Canada - National Science Library

    Dausey, David J

    2005-01-01

    ... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

  10. Low health literacy and evaluation of online health information: A systematic review of the literature

    NARCIS (Netherlands)

    Diviani, N.; van den Putte, B.; Giani, S.; van Weert, J.C.M.

    2015-01-01

    Background: Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to

  11. Evaluation of services of the integrative health clinic in Hong Kong.

    Science.gov (United States)

    Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S

    2008-10-01

    (i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

  12. Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period.

    Science.gov (United States)

    Mohanty, Sanjay K; Kastor, Anshul

    2017-09-18

    The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods. The unit data from the 60th and 71st rounds of National Sample Survey (NSS) is used in the analyses. Descriptive statistics is used to understand the differentials in OOPE and CHS. The CHS is estimated based on capacity to pay, derived from household consumption expenditure, the subsistence expenditure (based on state specific poverty line) and household OOPE on maternal care. Data of both rounds are pooled to understand the impact of NHM on OOPE and CHS. The log-linear regression model and the logit regression models adjusted for state fixed effect, clustering and socio-economic and demographic correlates are used in the analyses. Women availing themselves of ante natal, natal and post natal care (all three maternal care services) from public health centres have increased from 11% in 2004 to 31% by 2014 while that from private health centres had increased from 12% to 20% during the same period. The mean OOPE on all three maternal care services from public health centres was US$60 in pre-NHM and US$86 in post-NHM periods while that from private health center was US$170 and US$300 during the same period. Controlling for socioeconomic and demographic correlates, the OOPE on delivery care from public health center had not shown any significant increase in post NHM period. The OOPE on delivery care in private health center had increased by 5.6 times compared to that from public health centers in pre NHM

  13. Evaluating community-based public health leadership training.

    Science.gov (United States)

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  14. Women's health after a first myocardial infarction: a comprehensive perspective on recovery over a 4-year period.

    Science.gov (United States)

    Wickholm, Maritha; Fridlund, Bengt

    2003-04-01

    Little attention has so far been focused on follow ups of women's long-term recovery after a myocardial infarction (MI), especially from a comprehensive perspective. The aim of this study was to prospectively determine women's self-rated health after a first MI from a comprehensive perspective on recovery over a 4-year period. Consecutively chosen women (n=240) who had suffered a first MI were asked to complete a self-rated questionnaire regarding health (including not only biophysical, but also behavioral, emotional, social and working conditions) before being discharged from hospital as well as 1 and 4 years later. The results were analyzed by descriptive and inferential statistics. Health improvements, especially during the first year, could be observed in the women's behavioral condition regarding their attitude to diet consciousness, exercise, simultaneous capability and smoking behavior as well as in the emotional condition regarding their stressful life events, depressed mood and loss of control. In the social condition, the women considered that the healthcare professionals had improved their support over time as well as treating the women's complaints more seriously. Regarding the working condition, the women felt that they were being controlled at work, especially during the first year after the MI. Based on a comprehensive perspective on women's recovery after a first MI, a favorable development of the women's health was observed in the behavioral and emotional conditions while deterioration in the social and working conditions was observed over time. Thus, further efforts are needed in the two latter conditions by means of further studies in combination with greater support from healthcare professionals.

  15. The digital health divide: evaluating online health information access and use among older adults.

    Science.gov (United States)

    Hall, Amanda K; Bernhardt, Jay M; Dodd, Virginia; Vollrath, Morgan W

    2015-04-01

    Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50-92 years, M = 68.9 years, SD = 10.4) participated in the study. Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = -7.29, p information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults. © 2014 Society for Public Health Education.

  16. Evaluation of the relationship between physiological FDG uptake in the heart and age, blood glucose level, fasting period, and hospitalization

    International Nuclear Information System (INIS)

    Kaneta, Tomohiro; Hakamatsuka, Takashi; Takanami, Kentaro

    2006-01-01

    Positron emission tomography (PET) with fluorodeoxyglucose (FDG) is widely used for evaluation of cancer and ischemic heart disease. Recently, increased myocardial FDG uptake has been reported to be related to some types of heart disease, such as sarcoidosis. However, the physiological increased FDG uptake in the heart often mimics the abnormal high uptake in these cases. In this study, we investigated the relationships between myocardial uptake and age, blood glucose level, fasting period, and hospitalization status (inpatient vs. outpatient). A total of 159 non-diabetic patients were enrolled in the present study. Patients were imaged on a PET/CT scanner, and a three-dimensional region of interest (ROI) was drawn on the fused PET/CT image to measure the maximum standardized uptake value (SUV max ) of the whole left ventricle. No significant relationships were observed between myocardial uptake and age or fasting period. Blood glucose level showed a significant relationship (p=0.025) with myocardial uptake, but the R-square was extremely small (r 2 =0.03). With an SUV max threshold of 3.0, there was no significant difference between inpatients and outpatients. However, outpatients showed a significantly higher frequency of myocardial uptake over SUV max of 5.0 (x 2 test: p=0.046). It is difficult to predict the degree of physiological uptake in the heart from data regarding age, fasting period, or blood glucose level. Outpatients tend to show higher myocardial uptake than inpatients, which may make it difficult to detect abnormally increased uptake in the heart. A long fasting period, such as overnight fasting, is an inadequate means to reduce the physiological uptake of FDG in the heart. (author)

  17. Health Literacy Training for Public Health Nurses in Fukushima: A Multi-site Program Evaluation.

    Science.gov (United States)

    Goto, Aya; Lai, Alden Yuanhong; Rudd, Rima E

    2015-09-01

    Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information. This paper presents an evaluation of an identical training program using data combined from multiple sites, and further included proximal and distal evaluations to document the impact of health literacy training in a post-disaster setting. A total of 64 participants, primarily experienced PHNs, attended one of three multi-session health literacy workshops conducted in multiple sites across Fukushima. Quantitative and qualitative data on PHNs' training satisfaction, self-evaluation of achievements regarding training goals, and application of learned skills were collected and analyzed. Each workshop consisted of two 2-hour sessions introducing health literacy and assessment tools and developing skills to improve written materials, followed by a one-month follow-up assessment on PHNs' application of the gained skills in the field. Post-training evaluations on the appropriateness and usefulness of the workshop were highly positive. At the end of the one-month follow-up, 45% of participants had gained confidence in assessing and revising written materials and had applied the skills they had gained to develop and communicate health information in various settings and modes. This increase in confidence was associated with further application of the learned skills at the municipal level. However, participants reported difficulties in explaining risks, and the need to learn more about plain language to be able to paraphrase professional terms. This paper highlighs the positive outcomes of health literacy training among PHNs. Practical

  18. [Evaluation of the nutrition mode in children during the pubertal period with BMI < or = 5 percentile in the city of Szczecin].

    Science.gov (United States)

    Goluch-Koniuszy, Zuzanna

    2010-01-01

    This research was aimed at evaluation of the method of nutrition in the children aged 13 during the period of pubertal spurt who had their body mass, body weight and this values led to calculation of BMI indicator which was related to centile distribution of children from Warszawa. From the group 1464 children selected 79 persons (5.4% the whole of investigated) with BMI < or = 5 percentile with underweight and considerable underweight. Their menus of three chosen at random weekdays were obtained. Analysis of the nutrition method of children with underweight and considerable underweight showed low energy value of the diet, cellulose, mineral components (K, Ca, Mg) also liquids deficiency at simultaneously occurrent the general and animal protein, the fat, the cholesterol, mineral components (Na, P, Fe, Cu, Zn), vitamins A, C, E (girls) and from the group B. The children have undergone a special pro health education in the form "live" workshop.

  19. Human exposure to unconventional natural gas development: A public health demonstration of periodic high exposure to chemical mixtures in ambient air.

    Science.gov (United States)

    Brown, David R; Lewis, Celia; Weinberger, Beth I

    2015-01-01

    Directional drilling and hydraulic fracturing of shale gas and oil bring industrial activity into close proximity to residences, schools, daycare centers and places where people spend their time. Multiple gas production sources can be sited near residences. Health care providers evaluating patient health need to know the chemicals present, the emissions from different sites and the intensity and frequency of the exposures. This research describes a hypothetical case study designed to provide a basic model that demonstrates the direct effect of weather on exposure patterns of particulate matter smaller than 2.5 microns (PM2.5) and volatile organic chemicals (VOCs). Because emissions from unconventional natural gas development (UNGD) sites are variable, a short term exposure profile is proposed that determines 6-hour assessments of emissions estimates, a time scale needed to assist physicians in the evaluation of individual exposures. The hypothetical case is based on observed conditions in shale gas development in Washington County, Pennsylvania, and on estimated emissions from facilities during gas development and production. An air exposure screening model was applied to determine the ambient concentration of VOCs and PM2.5 at different 6-hour periods of the day and night. Hourly wind speed, wind direction and cloud cover data from Pittsburgh International Airport were used to calculate the expected exposures. Fourteen months of daily observations were modeled. Higher than yearly average source terms were used to predict health impacts at periods when emissions are high. The frequency and intensity of exposures to PM2.5 and VOCs at a residence surrounded by three UNGD facilities was determined. The findings show that peak PM2.5 and VOC exposures occurred 83 times over the course of 14 months of well development. Among the stages of well development, the drilling, flaring and finishing, and gas production stages produced higher intensity exposures than the

  20. Evaluation of Electronic Medical Record (EMR at large urban primary care sexual health centre.

    Directory of Open Access Journals (Sweden)

    Christopher K Fairley

    Full Text Available OBJECTIVE: Despite substantial investment in Electronic Medical Record (EMR systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. METHODS: We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. RESULTS: There were 9,752 doctor consultations (in 5,512 consulting hours in the Paper Medical Record (PMR period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08 after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17. A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01 and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61. CONCLUSION: The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided.

  1. Reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period: data from a multihospital health care system.

    Science.gov (United States)

    Jopling, Jeffery; Henry, Erick; Wiedmeier, Susan E; Christensen, Robert D

    2009-02-01

    "Reference ranges" are developed when it is impossible or inappropriate to establish "normal ranges" by drawing blood on healthy normal volunteers. Reference ranges for the hematocrit and the blood hemoglobin concentration of newborn infants have previously been reported from relatively small sample sizes by using measurement methods that now are considered outmoded. We sought to develop reference ranges for hematocrit and hemoglobin during the neonatal period (28 days) by using very large sample sizes and modern hematology analyzers, accounting for gestational and postnatal age and gender. Data were assembled from a multihospital health care system after exclusion of patients with a high likelihood of an abnormal value and those who were receiving blood transfusions. During the interval from 22 to 40 weeks' gestation, the hematocrit and blood hemoglobin concentration increased approximately linearly. For every week advance in gestational age, the hematocrit increased by 0.64% and the hemoglobin concentration increased by 0.21 g/dL. No difference was seen on the basis of gender. During the 4-hour interval after birth, hematocrit/hemoglobin values of late preterm and term neonates (35-42 weeks' gestation) increased by 3.6% +/- 0.5% (mean +/- SD), those of neonates of 29 to 34 weeks' gestation remained unchanged, and those of hematocrit/hemoglobin occurred. The figures presented herein describe reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period, accounting for gestational and postnatal age.

  2. Health care consumer reports: an evaluation of employer perspectives.

    Science.gov (United States)

    Longo, Daniel R

    2004-01-01

    The proliferation of health care consumer reports (also known as "consumer guides," "report cards," and "performance reports") designed to assist consumers in making more informed health care decisions makes it vital to understand the perspective of employers who provide the vast majority of health insurance to the working population regarding the use of these reports. There is little empirical evidence on how consumer reports are used by employers to make health care purchasing decisions. This study fills that gap by surveying 154 businesses in Boone County, Missouri, regarding their evaluation of a consumer guide. The majority of employers surveyed indicate that the report will not have a direct effect on their health care purchasing decisions. However, they indicate that the reports are "positive and worthwhile" and their responses reflect a favorable view of the health care organization that developed and disseminated the report. Additionally, findings indicate that employers generally prefer consumer reports as a means to compare local health care institutions, rather than reviewing national averages to locate the same information. Report developers should take precautions to determine the intent of such reports, as they may not achieve the objective of changing employers' health care purchasing behavior.

  3. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Systematic Review of Health Economic Impact Evaluations of Risk Prediction Models : Stop Developing, Start Evaluating

    NARCIS (Netherlands)

    van Giessen, Anoukh; Peters, Jaime; Wilcher, Britni; Hyde, Chris; Moons, Carl; de Wit, Ardine; Koffijberg, Erik

    2017-01-01

    Background: Although health economic evaluations (HEEs) are increasingly common for therapeutic interventions, they appear to be rare for the use of risk prediction models (PMs). Objectives: To evaluate the current state of HEEs of PMs by performing a comprehensive systematic review. Methods: Four

  5. The Health Care in North Korea during the Period(1945-1948 between Liberation from Japanese Occupation and Establishment of North Korean Government

    Directory of Open Access Journals (Sweden)

    HWANG Sang-Ik

    2007-06-01

    Full Text Available This paper, mainly based on literature and documents from North Korea and Russia, described how health care system had been formulated during the period of between liberation from Japanese Occupation and formation of its own government in North Korea, which is so-called 'the Period of People's Democracy'.North Korea authorities, by themselves, address that their health care system is characterized by state medicine, universal free medical care, emphasis on preventive medicine, community(ho doctors in charge, provisions of modern medical services in parallel with traditional ones, imposed high value on ideologies of medical personnel, and mass participation of health programs so on, taken rise since this period.Under North Korea's socialistic regime, authorities started to restructure health care system through national health care organizations and institutes, which partially provided medical service free. Also, they emphasized preventive medicine against 'capitalistic' treatment-oriented medicine, and community(ho doctor in-charge was derived from this period.It showed that the mass participation on health program was equal hereafter and they had under bias toward more emphasis on ideology of medical personnel rather than their professionalism. The attempt to develop traditional medicine had been made during this period, however, much funding and support was not observed.In this period, it showed that a series of action to restructure health care system had been gradually carried out.

  6. EVALUATION OF THE SUB-NATIONAL DECENTRALIZATION OF THE HEALTH IN VENEZUELA INFANTILE MATERNAL PROGRAM

    Directory of Open Access Journals (Sweden)

    Maritza Ávila Urdaneta

    2009-11-01

    Full Text Available The work approaches the evaluation of the decentralization of the health at sub-national level in Venezuela, maternal program Infantile (PROMIN, period 1998-2004: Case of study, Estado Zulia. With the samples of ten Municipalities and Coordinators of Health (CH. Of the results and conclusions, it is appraised that in Venezuela with the Model of Integral Attention with respect to the PROMIN (1998-2004, the reason of Maternal Mortality RMM average for the country ascends to 60 by 100,000 NVR (OPS, 2003, whereas in Zulia was in 79,9; they emphasize the Municipalities: Cañada de Urdaneta with but the high one of 214.13, followed of Mara 149.44 by 100,000 NVR. Key words: Sub-national decentralization of the Health, Infantile Maternal Program, Indicating of Morbidity and Mortality, Coordination of the Municipal Health.

  7. Evaluation of poultry processing practices, related public health laws ...

    African Journals Online (AJOL)

    Evaluation of poultry processing practices, related public health laws and diseases of chickens at slaughter: A pilot study in Kaduna state. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more ...

  8. Evaluation of oral health among pregnant women in a Nigerian ...

    African Journals Online (AJOL)

    Objective: This study evaluates the oral health knowledge and practise among pregnant women in a Nigerian population. Consecutive pregnant women attending three tertiary level of care were recruited. An interviewer administered questionnaire was used to assessing socio-demographic variables, dental visiting habits, ...

  9. Health-educator performance evaluation for quality teaching ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the efficacy of health educator performance evaluation procedures using the Integrated Quality Management System. This quantitative study used questionnaires to collect data from three hundred and thirty eight respondents selected through a convenient sampling procedure.

  10. Evaluation of a Health Education Programme about Traumatic Brain Injury

    Science.gov (United States)

    Garcia, Jane Mertz; Sellers, Debra M.; Hilgendorf, Amy E.; Burnett, Debra L.

    2014-01-01

    Objective: Our aim was to evaluate a health education programme (TBIoptions: Promoting Knowledge) designed to increase public awareness and understanding about traumatic brain injury (TBI) through in-person (classroom) and computer-based (electronic) learning environments. Design: We used a pre-post survey design with randomization of participants…

  11. Evaluation of health promotion training for the Western Australian Aboriginal maternal and child health sector.

    Science.gov (United States)

    Wilkins, Alexa; Lobo, Roanna C; Griffin, Denese M; Woods, Heather A

    2015-04-01

    The evaluation of health promotion training for the Western Australian (WA) Aboriginal maternal and child health (MCH) sector. Fifty-one MCH professionals from five regions in WA who attended one of three health promotion short courses in 2012-2013 were invited to complete an online survey or a telephone interview, between 4 to 17 months post-course. Respondents were asked how they had utilised the information and resources from the training and to identify the enabling factors or barriers to integrating health promotion into their work practices subsequently. Overall response rate was 33% (n=17); 94% of respondents reported they had utilised the information and resources from the course and 76% had undertaken health promotion activities since attending the course. Building contacts with other MCH providers and access to planning tools were identified as valuable components of the course. Barriers to translating knowledge into practice included financial constraints and lack of organisational support for health promotion activity. Health promotion training provides participants with the skills and confidence to deliver health promotion strategies in their communities. The training presents an opportunity to build health professionals' capacity to address some determinants of poor health outcomes among pregnant Aboriginal women and their babies. SO WHAT?: Training would be enhanced if accompanied by ongoing support for participants to integrate health promotion into their work practice, organisational development including health promotion training for senior management, establishing stronger referral pathways among partner organisations to support continuity of care and embedding training into MCH workforce curricula.

  12. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne

    2016-01-01

    Safe work processes and information systems are vital in health care. Methods for design of health IT focusing on patient safety are one of many initiatives trying to prevent adverse events. Possible patient safety hazards need to be investigated before health IT is integrated with local clinical...... work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...... tasks. Clinical simulation study assesses effects on clinical workflow and enables identification and evaluation of patient safety hazards before implementation at a hospital. Clinical simulation also offers an opportunity to create a space in which healthcare professionals working in different...

  13. Postdeployment military mental health training: cross-national evaluations.

    Science.gov (United States)

    Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

    2013-05-01

    Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  14. [Postgraduate studies in public health: the problem of efficiency evaluation].

    Science.gov (United States)

    Boczkowski, Andrzej

    2003-01-01

    The satisfaction of customer is the main measure and the most important, generally recognized criterion for evaluating the quality of products and services. In the case of education and training, the quality is frequently understood as effectiveness, i.e., the degree to what educational objectives of a training institution are met; the objectives previously formulated on the basis of analyzed and defined demands and expectations of customers (clients). In the first part of the paper: (1) the problems related to the question who in fact is the customer in the context of an institution providing education in public health are discussed; (2) a proposal for resolving these problems is presented; and (3) the main directions of evaluation activities, which should be undertaken under monitoring and effectiveness assessment of postgraduate training in public health are pointed out. In the years 1998-2002, the students' assessment data on educational programs, curriculum contents and subject teachers in the field of postgraduate studies in the School of Public Health, Nofer Institute of Occupational Medicine, Łódź, were collected with the help of specially-designed evaluation questionnaires. The data on the students' self-assessment of gained professional competencies were also collected. All students who completed the School of Public Health in these years were subjected to the evaluation inquiries. The data collected were analyzed. Due to the analysis it was possible to define: the quality of the curriculum contents, as well as the professional and didactic skills of the teaching staff as perceived by the students; the degree to what particular curriculum in public health contributed to the increase in professional competence as perceived by the students; the degree to what particular teaching subjects influenced the students' knowledge of and skills in Public Health. The results obtained provided information very useful in the teaching process, designing of

  15. Evaluation of the support schemes of The District Heating Program during the period 2008 to 2011; Evaluering av stoetteprogrammene for fjernvarme i perioden 2008 til 2011

    Energy Technology Data Exchange (ETDEWEB)

    Lindland, Odd Ivar; Johansen, Staale; Holstad, Jon; Vennes, Wenche; Kallset, Eirik

    2012-11-01

    The District Heating Program as they are designed today, are evaluated after four years of operation, to see if the program works as intended and meet the goals that were set up at the start of 2008. It is also seen in the evaluation of the development of district heating market in the period, to see if there are trends and changes in the regulatory framework that makes it appropriate to make changes to the programs. Users 'perception of the program and the programs' direct and indirect influence on the development of district heating market is also considered. The PricewaterhouseCoopers AS (PwC) has carried out the evaluation, commissioned by Enova. PwC has conducted Internet-based surveys and interviewed actors in various roles within the district. PwC concluded that the goals that were set at the input of the program period is reached. Energy results were higher than expected, while there is a trend that Enova have to pay more and more for the projects. The number of applications and projects has remained fairly stable, while projects have been smaller in size and extent. (eb)

  16. Board self-evaluation: the Bayside Health experience.

    Science.gov (United States)

    Duncan-Marr, Alison; Duckett, Stephen J

    2005-08-01

    Board evaluation is a critical component of good governance in any organisation. This paper describes the board self-evaluation process used by Bayside Health, a public health service in Melbourne. The question of how governing boards can assess their performance has received increasing attention over the past decade. In particular, the increasing demand for accountability to shareholders and regulators experienced by corporate sector Boards has resulted in greater scrutiny of board performance, with the market and the balance sheet providing some basis for assessment. Performance evaluation of governing boards in the public sector has been more challenging. Performance evaluation is complex in a sector that is not simply driven by the bottom line, where the stakeholders involve both government and the broader community, and where access to, and the quality and safety of the services provided, are often the major public criteria by which performance may be judged. While some practices from the corporate sector can be applied successfully in the public sector, this is not always the case, and public sector boards such as the Board of Directors of Bayside Health have been developing ways to evaluate and improve their performance.

  17. Labor and health status in economic evaluation of health care. The Health and Labor Questionnaire

    NARCIS (Netherlands)

    van Roijen, L.; Essink-Bot, M. L.; Koopmanschap, M. A.; Bonsel, G.; Rutten, F. F.

    1996-01-01

    A health care program may influence both costs and health effects. We developed the Health and Labor Questionnaire (HLQ), which consists of four modules, to collect data on absence from work, reduced productivity, unpaid labor production, and labor-related problems. We applied the HLQ in several

  18. Training evaluation: a case study of training Iranian health managers.

    Science.gov (United States)

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

    2009-03-05

    The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and

  19. Training evaluation: a case study of training Iranian health managers

    Directory of Open Access Journals (Sweden)

    Butcher Christopher

    2009-03-01

    Full Text Available Abstract Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least

  20. An Interactive Website to Reduce Sexual Risk Behavior: Process Evaluation of TeensTalkHealth

    Science.gov (United States)

    Sieving, Renee E; Terveen, Loren G; Rosser, BR Simon; Kodet, Amy J; Rothberg, Vienna D

    2015-01-01

    Background Different theoretical frameworks support the use of interactive websites to promote sexual health. Although several Web-based interventions have been developed to address sexual risk taking among young people, no evaluated interventions have attempted to foster behavior change through moderated interaction among a virtual network of adolescents (who remain anonymous to one another) and health professionals. Objective The objective was to conduct a summative process evaluation of TeensTalkHealth, an interactive sexual health website designed to promote condom use and other healthy decision making in the context of romantic and sexual relationships. Methods Evaluation data were obtained from 147 adolescents who participated in a feasibility and acceptability study. Video vignettes, teen-friendly articles, and other content served as conversation catalysts between adolescents and health educators on message boards. Results Adolescents’ perceptions that the website encouraged condom use across a variety of relationship situations were very high. Almost 60% (54/92, 59%) of intervention participants completed two-thirds or more of requested tasks across the 4-month intervention. Adolescents reported high levels of comfort, perceived privacy, ease of website access and use, and perceived credibility of health educators. Potential strategies to enhance engagement and completion of intervention tasks during future implementations of TeensTalkHealth are discussed, including tailoring of content, periodic website chats with health educators and anonymous peers, and greater incorporation of features from popular social networking websites. Conclusions TeensTalkHealth is a feasible, acceptable, and promising approach to complement and enhance existing services for youth. PMID:26336157

  1. Chemical and biological evaluation of essential oil from Saussurea costus (Falc.) Lipsch. from Garhwal Himalaya collected at different harvesting periods.

    Science.gov (United States)

    Benedetto, Cristina; D'Auria, Maurizio; Mecca, Marisabel; Prasad, Pratti; Singh, Pramod; Singh, Sandeep; Sinisgalli, Chiara; Milella, Luigi

    2018-02-19

    The purpose of this study is the determination of chemical composition and antioxidant activity of essential oils (EOs) from Saussurea costus (Falc.) Lipsch. Roots have been collected on December of the first plant year (IY) and in April, August and December of the third plant year (I, 6B, D7). A GC analysis was carried out for achieving this purpose. Subsequently, total polyphenol content (TPC) and antioxidant activity measured by DPPH, FRAP and BCB assays were evaluated. Three different statistical methods: Relative Antioxidant Capacity Index (RACI), Pearson's correlation coefficient (r) and PCA, were used to compare results obtained and underline EO relationships. From the results obtained, it was possible to observe how the collection period of the EO, in particular both the month and the year of collection, influences the metabolite profile.

  2. Calcifying discopathy in infancy in the cervical spine: Evaluation of vertebral alterations over a period of time

    Energy Technology Data Exchange (ETDEWEB)

    Urso, S; Colajacomo, M; Migliorini, A; Fassari, F M

    1987-07-01

    CDI in the cervical spine has already been observed and described by many authors, as a well-defined clinico-radiological syndrome with a benign course. The clinical picture is composed of: pain and functional limitation, sometimes with a stiff neck, more rarely slight fever, increase of the erythrocyte sedimentation rate or leukocytosis. The radiographic picture consists of the association of morphological and structural alterations of vertebral bodies adjacent to one or more disc calcifications usually centrally sited, sometimes associated with anterior or posterior herniations. On the basis of the observation of 7 patients, in the 15-year-old range, the authors propose to evaluate the changes of both the vertebral bodies and the discs involved in the disease over a period of time. The repetition of even modest alterations, that persist in time, testify to the involvement of the vertebral growth perhaps, more than the discal alterations connected with the calcification.

  3. What are the new challenges, goals, and tasks of occupational health in China's Thirteenth Five-Year Plan (13th FYP) period?

    Science.gov (United States)

    Wang, Bing; Wu, Chao; Kang, Liangguo; Huang, Lang; Pan, Wei

    2018-03-20

    In recent years, the Chinese government has attached great importance to occupational health under the guidance of people-oriented concept. This paper introduces the current status and future development of occupational health in China's Thirteenth Five-Year Plan (13th FYP) period (2016-2020) to promote the cooperation and exchange on occupational health between China and other countries. We collected statistical data about occupational diseases and information addressing occupational diseases. We included all types of official reports, guidelines, policies, and relevant laws published by the Chinese government. China has carried out a series of strategies and measures to reduce the incidence of occupational diseases, and has made progress in occupational health protection. However, occupational health in China still faces severe conditions and challenges for occupational diseases that have not been prevented and controlled effectively. To actively promote the future development of occupational health during the 13th FYP period, China has issued a series of important policy documents (such as the Plan for a Healthy China 2030, the 13th FYP for Occupational Disease Prevention and Control, and the 13th FYP for Occupational Health Hazard Prevention and Control) in the last two years. The overall situation condition of occupational health in China is still serious. Occupational health in China's 13th FYP period faces a series of challenges, future tasks include plans to add the employer and regulatory levels of occupational health management, and occupational health education and publicity to the current technology-dominated approaches.

  4. Evaluation of Octhylphenol Effect on Development and Survival on Zebra Fish (Danio Rerio During Different Ontogenic Period

    Directory of Open Access Journals (Sweden)

    Gabi Dumitrescu

    2010-05-01

    Full Text Available This paper is part of a complex study of our research collective that studies the toxic effect of the ethinylestradiolum, and some of the polyethoxylated alkylphenols on the growth and reproduction of the Zebra fish (Danio rerio and of the common Carp (Cyprinus carpio. Our study aim was to evaluate the effect of octylphenol on growth and survival of zebra fish, from 21-115 days, and within 21-75 days of life. For this purpose, for each period under study, fishes were divided into three groups of 30 individuals, named: Lot 1 - Control, respectively lots 2 and 3, at which the administrated octylphenol concentrations were of 60 μg L-1, respectively 100 μg L-1. Fishes of the six groups were raised in 30-liters aquariums (30 fish / aquarium. The growth was measured by weighing and biometric measurements (total length, standard length, the length of the head, maximal height, minimal height and the mass of the body, while the surviving rate was established at the end of every period and at the end of the experiment, when we were able to calculate the total number of dead fish. Biometric study of the analysis performed in 75 days, 115 days respectively shows that octylphenol has negative influence on body development, and survival both, the highest percentage of mortality (46,66% was registered at 100 μgL-1 concentration, between 21 -75 days.

  5. Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods

    Science.gov (United States)

    2010-01-01

    Background Schools are key settings for health promotion (HP) but the development of suitable approaches for evaluating HP in schools is still a major topic of discussion. This article presents a research protocol of a program developed to evaluate HP. After reviewing HP evaluation issues, the various possible approaches are analyzed and the importance of a realistic evaluation framework and a mixed methods (MM) design are demonstrated. Methods/Design The design is based on a systemic approach to evaluation, taking into account the mechanisms, context and outcomes, as defined in realistic evaluation, adjusted to our own French context using an MM approach. The characteristics of the design are illustrated through the evaluation of a nationwide HP program in French primary schools designed to enhance children's social, emotional and physical health by improving teachers' HP practices and promoting a healthy school environment. An embedded MM design is used in which a qualitative data set plays a supportive, secondary role in a study based primarily on a different quantitative data set. The way the qualitative and quantitative approaches are combined through the entire evaluation framework is detailed. Discussion This study is a contribution towards the development of suitable approaches for evaluating HP programs in schools. The systemic approach of the evaluation carried out in this research is appropriate since it takes account of the limitations of traditional evaluation approaches and considers suggestions made by the HP research community. PMID:20109202

  6. Aggregation of risk indicators to cardiometabolic and musculoskeletal health in Brazilian adolescents in the periods 2008/09 and 2013/14

    Directory of Open Access Journals (Sweden)

    Anelise R. Gaya

    2018-03-01

    Conclusion: The occurrence of an aggregate risk to the cardiometabolic and musculoskeletal health of Brazilian adolescents increased in the 2008/09 and 2013/14 periods. Regarding gender, an increase in the cardiometabolic and musculoskeletal risk between these periods was observed in girls. As for boys, an increase was observed only in cardiometabolic risk.

  7. A system dynamics evaluation model: implementation of health information exchange for public health reporting.

    Science.gov (United States)

    Merrill, Jacqueline A; Deegan, Michael; Wilson, Rosalind V; Kaushal, Rainu; Fredericks, Kimberly

    2013-06-01

    To evaluate the complex dynamics involved in implementing electronic health information exchange (HIE) for public health reporting at a state health department, and to identify policy implications to inform similar implementations. Qualitative data were collected over 8 months from seven experts at New York State Department of Health who implemented web services and protocols for querying, receipt, and validation of electronic data supplied by regional health information organizations. Extensive project documentation was also collected. During group meetings experts described the implementation process and created reference modes and causal diagrams that the evaluation team used to build a preliminary model. System dynamics modeling techniques were applied iteratively to build causal loop diagrams representing the implementation. The diagrams were validated iteratively by individual experts followed by group review online, and through confirmatory review of documents and artifacts. Three casual loop diagrams captured well-recognized system dynamics: Sliding Goals, Project Rework, and Maturity of Resources. The findings were associated with specific policies that address funding, leadership, ensuring expertise, planning for rework, communication, and timeline management. This evaluation illustrates the value of a qualitative approach to system dynamics modeling. As a tool for strategic thinking on complicated and intense processes, qualitative models can be produced with fewer resources than a full simulation, yet still provide insights that are timely and relevant. System dynamics techniques clarified endogenous and exogenous factors at play in a highly complex technology implementation, which may inform other states engaged in implementing HIE supported by federal Health Information Technology for Economic and Clinical Health (HITECH) legislation.

  8. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Directory of Open Access Journals (Sweden)

    Koehlmoos Tracey P

    2011-07-01

    Full Text Available Abstract Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER. Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis

  9. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Science.gov (United States)

    2011-01-01

    Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

  10. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  11. Effects of shortening the dry period of dairy cows on milk production, energy balance, health, and fertility: A systemtic review

    NARCIS (Netherlands)

    Knegsel, van A.T.M.; Drift, van der S.G.A.; Cermáková, J.; Kemp, B.

    2013-01-01

    A dry period of 6–8 weeks for dairy cows is generally thought to maximise milk production in the next lactation. However, the value of such a long dry period is increasingly questioned. In particular, shortening the dry period shifts milk production from the critical period after calving to the

  12. Evaluation of capacity-building program of district health managers in India: a contextualized theoretical framework.

    Science.gov (United States)

    Prashanth, N S; Marchal, Bruno; Kegels, Guy; Criel, Bart

    2014-01-01

    Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff's perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.

  13. Udder health of dairy cows fed different dietary energy levels after a short or no dry period without use of dry cow antibiotics

    NARCIS (Netherlands)

    Hoeij, van R.J.; Lam, T.J.G.M.; Bruckmaier, R.M.; Dijkstra, J.; Remmelink, G.J.; Kemp, B.; Knegsel, van A.T.M.

    2018-01-01

    Reports on the effects of length of dry period (DP) on udder health of cows that were not treated with dry cow antibiotics are scarce. Additionally, the effects of a reduced dietary energy level for cows with a 0-d DP on udder health have not yet been studied. The aims of this study were (1) to

  14. Efficacy methods to evaluate health communication and marketing campaigns.

    Science.gov (United States)

    Evans, W Douglas; Uhrig, Jennifer; Davis, Kevin; McCormack, Lauren

    2009-06-01

    Communication and marketing are growing areas of health research, but relatively few rigorous efficacy studies have been conducted in these fields. In this article, we review recent health communication and marketing efficacy research, present two case studies that illustrate some of the considerations in making efficacy design choices, and advocate for greater emphasis on rigorous health communication and marketing efficacy research and the development of a research agenda. Much of the outcomes research in health communication and marketing, especially mass media, utilizes effectiveness designs conducted in real time, in the media markets or communities in which messages are delivered. Such evaluations may be impractical or impossible, however, imiting opportunities to advance the state of health communication and marketing research and the knowledge base on effective campaign strategies, messages, and channels. Efficacy and effectiveness studies use similar measures of behavior change. Efficacy studies, however, offer greater opportunities for experimental control, message exposure, and testing of health communication and marketing theory. By examining the literature and two in-depth case studies, we identify advantages and limitations to efficacy studies. We also identify considerations for when to adopt efficacy and effectiveness methods, alone or in combination. Finally, we outline a research agenda to investigate issues of internal and external validity, mode of message presentation, differences between marketing and message strategies, and behavioral outcomes.

  15. Nanofilm-coated long-period fiber grating humidity sensors for corrosion detection in structural health monitoring

    Science.gov (United States)

    Zheng, Shijie; Zhu, Yinian; Krishnaswamy, Sridhar

    2011-04-01

    Long-period gratings (LPGs) have shown their significant promising applications in sensors owing to the attractive features that they posses such as small size, immunity for electromagnetic interference, geometric versatility, multiplexing capability, and resistance to corrosive and hazardous environments. Recent researches have revealed that LPGs written on the standard optical fibers could be used as a powerful sensing platform for structural health monitoring. In this work, we inscribe LPGs into SMF-28 optical fiber by focused-beam CO2 laser, demonstrating as a refractive index sensor for nondestructive chemical detections in the civil infrastructures. Although evanescent-field based LPG sensors have been applied in quantitatively monitoring chemical analytes including moisture, chloride, and corrosion by-product, etc., the sensitivity, selectivity, and response time as well as thermo-stability of such sensors are still the issues for some special purposes. In order to improve those characteristics of the sensors, we propose two types of nano-film to be coated in grating region by electrostatic self-assembly (ESA) deposition processing. The primary coating does not affect on LPG transmission parameters such as resonance wavelength and its intensity that can be used for sensing, but it increases the sensitivity to refractive index change of surrounding material. The secondary coating is for selectively absorption of analyte molecule of interest. Response time of the nanofilm-coated LPG sensor is dependent on the analyte absorption and de-absorption rates as well as the thicknesses of the coating materials, which is also investigated. Multi-channel sensor system is being designed to monitor different analytes simultaneously, which is continuing to further explore the monitoring of structural health conditions through in situ measurements of corrosion in the concrete structures.

  16. Assessment of nuclear tests consequences for biota and population health for period after the test site shutting down

    International Nuclear Information System (INIS)

    Bigaliev, A.B.

    2001-01-01

    In 1993 by the 'Nevada-Semej' International Anti-Nuclear Movement the Scientific Committee 'Radiation, Ecology, Heath' was created by the initiative of thr movement Leader - O.O.Sulejnenov. The committee jointed the energies of scientists - biologists, radio-biologists, physicians, radiologists, physicists and other specialists. In the Scientific Committee the Expert Councils for conducting the independent assessment of radiation influence on the natural environment and population health have been organized. The scientists and specialists have been took part in data systematization on radiation situation, dose loads on the Semipalatinsk test site population on the base of archival materials analysis, published papers and own data of studies. One may note, that currently the ecological map of site territory radiation contamination was developed,But these data are evaluative only and its demand clarification

  17. Hanford Site storm water comprehensive site compliance evaluation report for the reporting period July 1, 1996 through June 30, 1997

    International Nuclear Information System (INIS)

    Perkins, C.J.

    1997-01-01

    On September 9, 1992, the US Environmental Protection Agency (EPA) issued General Permit No. WA-R-00-OOOF, Authorization to Discharge Under the National Pollutant Discharge Elimination System (NPDES) for Storm Water Discharges Associated with Industrial Activity to the US Department of Energy, Richland Operations Office (RL). RL submitted a Notice of Intent to comply with this permit to EPA in conformance with the General Permit requirements on October 1, 1992. On February 14, 1994, EPA issued a Storm Water General Permit Coverage Notice and assigned WA-R-00-Al7F as the Hanford Site's National Pollutant Discharge Elimination System (NPDES) storm water permit number. The Hanford Site Storm Water Pollution Prevention Plan (SWPPP) (WHC 1996a) was certified by J. E Rasmussen, Director Environmental Assurance, RL, on September 24, 1996, in compliance with Part IV.B(i) of the General Permit. As required by General Permit No. WA-R-00-OOOF (WA-R-00-Al7F), Section IV, Part D, Section 4.c, an annual report must be developed by RL and retained on site to verify that the requirements listed in the General Permit are being implemented. The previous Hanford Site Storm Plater Comprehensive Site Compliance Evaluation Report (WHC 1996b) addressed the period from July 1995 through June 1996. This document fulfills the requirement to prepare an annual report and contains the results of inspections of the storm water outfalls listed in the SWPPP (WHC 1996a). This report also describes the methods used to conduct the 1100 Storm Plater Comprehensive Site Compliance Evaluation (SWCSCE) as required in Part IV, Section D.4.c in the General Permit; summarizes the results of the compliance evaluation; and documents significant leaks and spills. The reporting year for this SWCSCE report is July 1, 1996 through June 30, 1997

  18. Improving occupational health care for construction workers: a process evaluation.

    Science.gov (United States)

    Boschman, Julitta S; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2013-03-11

    To evaluate the process of a job-specific workers' health surveillance (WHS) in improving occupational health care for construction workers. From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0-10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Programme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect

  19. Economic evaluation of occupational health and safety programmes in health care.

    Science.gov (United States)

    Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

    2015-10-01

    Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Building research and evaluation capacity in population health: the NSW Health approach.

    Science.gov (United States)

    Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

    2016-02-01

    Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84

  1. Pilot evaluation of the text4baby mobile health program

    Directory of Open Access Journals (Sweden)

    Evans William Douglas

    2012-11-01

    Full Text Available Abstract Background Mobile phone technologies for health promotion and disease prevention have evolved rapidly, but few studies have tested the efficacy of mobile health in full-fledged programs. Text4baby is an example of mobile health based on behavioral theory, and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health, health care beliefs, practices, and behaviors in order to improve clinical outcomes. The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign. Methods We conducted a randomized pilot evaluation study. All participants were pregnant women first presenting for care at the Fairfax County, Virginia Health Department. We randomized participants to enroll in text4baby and receive usual health care (intervention, or continue simply to receive usual care (control. We then conducted a 24-item survey by telephone of attitudes and behaviors related to text4baby. We surveyed participants at baseline, before text4baby was delivered to the intervention group, and at follow-up at approximately 28 weeks of baby’s gestational age. Results We completed 123 baseline interviews in English and in Spanish. Overall, the sample was predominantly of Hispanic origin (79.7% with an average age of 27.6 years. We completed 90 follow-up interviews, and achieved a 73% retention rate. We used a logistic generalized estimating equation model to evaluate intervention effects on measured outcomes. We found a significant effect of text4baby intervention exposure on increased agreement with the attitude statement “I am prepared to be a new mother” (OR = 2.73, CI = 1.04, 7.18, p = 0.042 between baseline and follow-up. For those who had attained a high school education or greater, we observed a significantly higher overall agreement to attitudes against alcohol consumption during pregnancy (OR = 2.80, CI = 1.13, 6.90, p = 0.026. We also observed a

  2. Association of changes among body condition score during the transition period with NEFA and BHBA concentrations, milk production, fertility, and health of Holstein cows.

    Science.gov (United States)

    Barletta, R V; Maturana Filho, M; Carvalho, P D; Del Valle, T A; Netto, A S; Rennó, F P; Mingoti, R D; Gandra, J R; Mourão, G B; Fricke, P M; Sartori, R; Madureira, E H; Wiltbank, M C

    2017-12-01

    Our objective was to evaluate the association between body condition score (BCS) change during the transition period with fertility, non-esterified fatty acids (NEFA) and beta-hydroxybutyrate (BHBA) concentrations, milk yield, and health problems of Holstein cows in a retrospective cohort study. Holstein cows (n = 232) were assessed for BCS (5 point scale; 0.25 point increments) and had blood collected at 21 and 7 d before, on the day of, and 7 and 21 d after calving. Blood samples were assayed for NEFA and BHBA concentrations. All cows received a timed artificial insemination (TAI) at 65 ± 3 days in milk (DIM) following a Presynch-Ovsynch protocol with a progesterone implant during the Ovsynch protocol. Cows were grouped based on BCS change after calving as to whether they: 1) lost (L), 2) maintained (M), or 3) gained (G) BCS. Data were analyzed by logistic regression with GLIMMIX and ANOVA with repeated measures using the MIXED procedures of SAS. Both NEFA and BHBA concentrations after calving differed (P fertility, and occurrence of health problems during the lactation. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A Logic Model for Evaluating the Academic Health Department.

    Science.gov (United States)

    Erwin, Paul Campbell; McNeely, Clea S; Grubaugh, Julie H; Valentine, Jennifer; Miller, Mark D; Buchanan, Martha

    2016-01-01

    Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.

  4. Constructive eHealth evaluation: lessons from evaluation of EHR development in 4 Danish hospitals.

    Science.gov (United States)

    Høstgaard, Anna Marie Balling; Bertelsen, Pernille; Nøhr, Christian

    2017-04-20

    Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented. A case study evaluation of the EHR development process in the North Denmark Region was conducted from 2004 to 2010. The population consisted of clinicians, IT professionals, administrators, and vendors. The study involved 4 hospitals in the region. Data were collected using questionnaires, observations, interviews, and insight gathered from relevant documents. The evaluation showed a need for a) Early involvement of clinicians, b) The best possible representation of clinicians, and c) Workload reduction for those involved. The consequences of not providing this were a lack of ownership of decisions and negative attitudes towards the clinical benefits related to these decisions. Further, the result disclosed that by following the above recommendations, and by providing feedback to the 4 actor groups, the physicians' involvement was improved. As a result they took ownership of decisions and gained a positive attitude to the clinical benefits. The CeHEM has proven successful in formative evaluation of EHR development and can point at important issues that need to be taken care of by management

  5. [Outcomes evaluation of the school staff health promotion project].

    Science.gov (United States)

    Woynarowska-Sołdan, Magdalena

    This article presents selected outcomes of a 3-year project "Health promotion of school staff in health-promoting schools," as well as the achievements and difficulties in its implementation. The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62-93%) and the physical and social environment of the school (50-92%). Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2):187-200. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  6. Outcomes evaluation of the school staff health promotion project

    Directory of Open Access Journals (Sweden)

    Magdalena Woynarowska-Sołdan

    2016-04-01

    Full Text Available Background: This article presents selected outcomes of a 3-year project “Health promotion of school staff in health-promoting schools,” as well as the achievements and difficulties in its implementation. Material and Methods: The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Results: Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62–93% and the physical and social environment of the school (50–92%. Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. Conclusions: The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2:187–200

  7. Evaluation of Healthy Lifestyle Behaviors in Health Care Workers

    Directory of Open Access Journals (Sweden)

    Meltem Yalcinkaya

    2007-12-01

    Full Text Available This research was conducted as a descriptive study for the purpose of determining the healthy lifestyle behaviors of health care workers employed at university and state hospitals in Afyon and Denizli. There were 1779 health care personnel in the sample who were employed at university and state hospitals in Afyon and Denizli. It was planned conducted the research on the entire population however some health care workers did not want to participate a total of 316 health care workers were included in the study sample. Data were collected between 15 June-15 Agust 2006 using a demografik questionnaire form and the Healthy Lifestyle Behaviors Scale. In the evaluation data gained, Number-percentage calculations, t-test, One Way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. This study was determined that 84.5% of the health care workers were nurses, 55.7% were in the 20-30 year old age group, 75.0% were married, 39.2% worked on surgical units, 69.6% ate regular meals, only 22.8% were interested in sports, 61.1% did not smoke cigarettes. A statistically significant difference was found health care workers between for age group, gender, educational level, years of employment, hospital unit where they worked, status of eating regular meals, status of being interested in sports, use of alcohol, hospital where employed and the health care workers' healthy lifestyle behaviors (p<0.05. For development health care behaviors lifestyle the main factor which is avoid risk behavior life. Healt care workers must play an important role on the issue. [TAF Prev Med Bull 2007; 6(6.000: 409-420

  8. Evaluation of Healthy Lifestyle Behaviors in Health Care Workers

    Directory of Open Access Journals (Sweden)

    Meltem Yalcinkaya

    2007-12-01

    Full Text Available This research was conducted as a descriptive study for the purpose of determining the healthy lifestyle behaviors of health care workers employed at university and state hospitals in Afyon and Denizli. There were 1779 health care personnel in the sample who were employed at university and state hospitals in Afyon and Denizli. It was planned conducted the research on the entire population however some health care workers did not want to participate a total of 316 health care workers were included in the study sample. Data were collected between 15 June-15 Agust 2006 using a demografik questionnaire form and the Healthy Lifestyle Behaviors Scale. In the evaluation data gained, Number-percentage calculations, t-test, One Way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. This study was determined that 84.5% of the health care workers were nurses, 55.7% were in the 20-30 year old age group, 75.0% were married, 39.2% worked on surgical units, 69.6% ate regular meals, only 22.8% were interested in sports, 61.1% did not smoke cigarettes. A statistically significant difference was found health care workers between for age group, gender, educational level, years of employment, hospital unit where they worked, status of eating regular meals, status of being interested in sports, use of alcohol, hospital where employed and the health care workers' healthy lifestyle behaviors (p<0.05. For development health care behaviors lifestyle the main factor which is avoid risk behavior life. Healt care workers must play an important role on the issue. [TAF Prev Med Bull. 2007; 6(6: 409-420

  9. Can complex health interventions be evaluated using routine clinical and administrative data? - a realist evaluation approach.

    Science.gov (United States)

    Riippa, Iiris; Kahilakoski, Olli-Pekka; Linna, Miika; Hietala, Minni

    2014-12-01

    Interventions aimed at improving chronic care typically consist of multiple interconnected parts, all of which are essential to the effect of the intervention. Limited attention has been paid to the use of routine clinical and administrative data in the evolution of these complex interventions. The purpose of this study is to examine the feasibility of routinely collected data when evaluating complex interventions and to demonstrate how a theory-based, realist approach to evaluation may increase the feasibility of routine data. We present a case study of evaluating a complex intervention, namely, the chronic care model (CCM), in Finnish primary health care. Issues typically faced when evaluating the effects of a complex intervention on health outcomes and resource use are identified by using routine data in a natural setting, and we apply context-mechanism-outcome (CMO) approach from the realist evaluation paradigm to improve the feasibility of using routine data in evaluating complex interventions. From an experimentalist approach that dominates the medical literature, routine data collected from a single centre offered a poor starting point for evaluating complex interventions. However, the CMO approach offered tools for identifying indicators needed to evaluate complex interventions. Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange. © 2014 John Wiley & Sons, Ltd.

  10. Evaluation of two communication strategies to improve udder health management.

    Science.gov (United States)

    Jansen, J; Renes, R J; Lam, T J G M

    2010-02-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

  11. Women in post-trafficking services in moldova: diagnostic interviews over two time periods to assess returning women's mental health

    Directory of Open Access Journals (Sweden)

    Gorceag Lilia T

    2011-04-01

    found to have co-morbid PTSD or other forms of anxiety and depression immediately post-return should be offered evidenced-based mental health treatment for at least the standard 12-month period of rehabilitation.

  12. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-09-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia.

  13. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia. (Tsunoda, M.)

  14. Evaluation of the perioperative period of orthotopic liver transplantation with veno-venous bypass and without it

    Directory of Open Access Journals (Sweden)

    D. A. Levit

    2017-01-01

    Full Text Available Orthotopic liver transplantation (OLT is the only treatment for many patients with end-stage chronic liver diseases. In patients with complete vena cava inferior (VCI cross-clamping veno-venous bypass (VVB is either used or not depending on the indications. The case management of the patient with complete VCI cross-clamping depends on the initial state of the recipient and the transplant team’s opinion.Aim. To compare the perioperative period of OLT depending on the method to conduct the main stage of the surgery: with the use of veno-venous bypass and without it with complete VCI cross-clamping.Materials and methods. In Group 1 (n = 20, OLT was performed without VVB with complete VCI cross-clamping; in Group 2 (n = 26, the surgery was conducted with veno-venous bypass. Patients in both groups were similar in age (46.15 ± 10.22 and 47.3 ± 9.29, respectively, in severity of the disease: Child-Pugh (10.15 ± 1.42 and 10.19 ± 2.45, MELD 16.47 ± 4.41 and 15.8 ± 4.95.Results. We determined and evaluated hemodynamic parameters, oxygen transport, the quantitative and qualitative infusion composition, urine output, characteristics of the postoperative period.Conclusion. Our data show that changes in hemodynamic and oxygen transport are associated with reperfusion syndrome and do not depend on the method of transplantation. At the same time, it reduces the blood loss, time of surgery, and the duration of postoperative mechanical ventilation and stay in the ICU after liver transplantation in patients without veno-venous bypass.

  15. Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study.

    Science.gov (United States)

    Kako, Jun; Morita, Tatsuya; Yamaguchi, Takuhiro; Sekimoto, Asuko; Kobayashi, Masamitsu; Kinoshita, Hiroya; Ogawa, Asao; Zenda, Sadamoto; Uchitomi, Yosuke; Inoguchi, Hironobu; Matsushima, Eisuke

    2018-02-01

    To clarify the duration required for dyspnea to return to baseline severity after fan therapy, to evaluate whether fan-to-legs therapy or no fan therapy would be a suitable control therapy, and to investigate changes in patients' face surface temperature after fan therapy. In this pilot study, all participants received 3 interventions in the following order: no fan, fan to legs, and fan to face. Participants used a fan for 5 minutes, and they scored their dyspnea at 10-minute intervals for 60 minutes or until the score had returned to its baseline value, whichever occurred first. Nine patients with advanced cancer admitted to a palliative care unit were included; they had dyspnea at rest and rated its severity as at least 3 points on a 0- to 10-point numerical rating scale. Descriptive statistics and the Wilcoxon signed rank test were used to analyze the data. All patients completed the study. Of the 9 participants, 6 experienced a clinical benefit from using a fan to their faces. Of these patients, only 2 participants' (2 of 6) dyspnea scores returned to baseline by the end of the 60-minute assessment period after exposure to fan-to-face therapy. In fan-to-legs and no fan settings, there was no change in the dyspnea scores. There were significant differences between the baseline face surface temperature and that after fan-to-face and fan-to-legs settings. When using a crossover design to investigate the effect of fan therapy on dyspnea, 1 hour is an insufficient washout period.

  16. Evaluation of the Coca-Cola company travel health kit.

    Science.gov (United States)

    Harper, Lynne A; Bettinger, Julie; Dismukes, Roberta; Kozarsky, Phyllis E

    2002-01-01

    The Coca-Cola travel health kit has been used for about one decade for international travelers and required evaluation to see if the items contained were appropriate for the employees. Two hundred thirty-four travelers were sampled and filled out a voluntary survey including questions about demographic information, travel history, and usage and value of the contents of the travel health kit. One hundred eighty-one surveys were returned; 65% of the respondents were male, and the majority of travelers were between the ages of 36 and 45 years. The most useful items were analgesics and medications used for gastrointestinal problems. In general, the items identified as being the least useful were those requiring specialized use by a medical practitioner, such as needles and syringes. Suggestions of items to be added to the kit included vitamins, cough drops, sleep aids, and eye drops. A surprising result that Coca-Cola employees expressed the desire for brand name rather than generic items. Evaluation of the Coca-Cola Company travel health kit revealed it to be very useful to most corporate travelers. Suggestions that were made will be taken into consideration in designing a new kit, and consideration is being given to whether a basic travel health kit should be provided to which travelers can add other items depending on their personal needs.

  17. [Evaluation of the mental health system in Mexico: where is it headed?].

    Science.gov (United States)

    Berenzon Gorn, Shoshana; Saavedra Solano, Nayelhi; Medina-Mora Icaza, María Elena; Aparicio Basaurí, Víctor; Galván Reyes, Jorge

    2013-04-01

    Evaluate some of the key indicators that characterize the Mexican mental health system using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). The strategy for examining the WHO-AIMS indicators included: (i) a review of documentary sources; (ii) application of the questionnaire; and (iii) group work with a team of experts using the consensus technique. To facilitate collection of the data, a questionnaire was prepared in which the indicators were turned into simple questions. The people gathering the data were trained, and the activity was monitored. It was found that, of the total budget for health, only 2% is allocated for mental health, and, of that share, 80% is used in the operation of psychiatric hospitals. The pivotal point for mental health care is in the psychiatric hospital; there are very few psychiatric units in the general hospitals, few residential establishments, and few services targeted specifically to care for children and adolescents. Access is limited because of the centralized health care system, with the majority of establishments located in the large cities. Only 30% of primary care services have protocols for the evaluation and treatment of mental disorders. Finally, in the mental health facilities, the ratios of psychiatrists, other physicians, nurses, and psychologists per 100 000 population are 1.6, 1.3, 3.4, and 1.5, respectively. More funding will be needed in order to bridge the gap between the mental health burden and the budget allocated for its care, and resources will need to be used more rationally, with the first level of care becoming the pivot. In addition, it will be necessary to increase the number of specialists, offer periodic in-service training for personnel at the first level of care, and enlist greater participation by the rest of society.

  18. [Health evaluation of fine particulate matter in indoor air].

    Science.gov (United States)

    2008-11-01

    When evaluating the health effects of indoor air fine particulate matter, the indoor dynamics as well as the physical, chemical and biological properties of fine particles have to be considered. The indoor air fraction PM2.5 largely stems from outdoor air. Accordingly, the German Working Group on Indoor Guideline Values of the Federal Environmental Agency and the States' Health Authorities also recommends WHO's (2006) 24-hour mean guideline value of 25 microg PM2,5 per cubic meter for indoor air evaluation. In contrast to PM2.5, coarse particles (PM10) in schools, kindergartens and dwellings show much higher indoor air concentrations. Additional sources indoors have to be assumed. Because of the different composition of indoor air compared to outdoor air and due to the lack of dose-response relationships of coarse particles in indoor air, the health effects of indoor air PM10 can not be evaluated yet. Sufficient and consistent ventilation is an indispensable basis to reduce PM concentrations in indoor spaces. Furthermore, known sources of PM indoors should be detected consequently and subsequently minimized.

  19. Genetic merit for fertility traits in Holstein cows: IV. Transition period, uterine health, and resumption of cyclicity.

    Science.gov (United States)

    Moore, S G; Fair, T; Lonergan, P; Butler, S T

    2014-05-01

    The objective of this study was to monitor the dry matter intake (DMI), metabolic status, uterine health, and resumption of cyclicity in cows with similar genetic merit for milk production traits but with either good (Fert+) or poor genetic merit (Fert-) for fertility traits. Twenty-six cows were enrolled in the study and data are reported for 15 Fert+ and 10 Fert- cows that completed the study. All cows received a total mixed ration diet during early lactation and were turned out to pasture in late spring. Dry matter intake was recorded daily from wk -2 to 5 relative to parturition. Blood metabolites and metabolic hormones were measured from wk -2 to 8 relative to parturition. Milk production, body condition score, and body weight until wk 35 of lactation are reported. To monitor uterine health, vaginal mucus was scored weekly on a scale of 0 (no pus) to 3 (≥ 50% pus) from parturition to wk 8 and uterine polymorphonuclear neutrophil count was measured at wk 3 and 6 postpartum. Prepartum DMI was similar between genotypes, but Fert+ cows had significantly greater DMI than Fert- cows (19.7 vs. 16.8 kg of dry matter/d) during the postpartum period. Energy balance at wk 1 was significantly greater in Fert+ cows than in Fert- cows [2.3 vs. -1.12 unité fourragère lait (UFL)/d]. The Fert+ cows had significantly greater daily milk solids production (1.89 vs. 1.74 kg/d) and tended to have greater daily milk yield (24.2 vs. 22.3 kg/d). The Fert+ cows had significantly greater mean circulating insulin-like growth factor-I (102.62 vs. 56.85 ng/mL) and tended to have greater mean circulating insulin (3.25 vs. 2.62 μIU/mL) compared with Fert- cows from wk -2 to 8 relative to parturition. Mean circulating glucose (3.40 vs. 3.01 mmol/L) concentrations were significantly greater in Fert+ cows compared with Fert- cows from wk -2 to 3 relative to parturition. The Fert+ cows maintained significantly greater mean body condition score throughout lactation compared with Fert- cows

  20. Evaluation of computerized health management information system for primary health care in rural India

    Directory of Open Access Journals (Sweden)

    Singh Satyavir

    2010-11-01

    Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

  1. An evaluation of Spanish and English on-line information sources regarding pregnancy, birth and the postnatal period.

    Science.gov (United States)

    Artieta-Pinedo, Isabel; Paz-Pascual, Carmen; Grandes, Gonzalo; Villanueva, Gemma

    2018-03-01

    the aim of this study is to evaluate the quality of web pages found by women when carrying out an exploratory search concerning pregnancy, childbirth, the postpartum period and breastfeeding. a descriptive study of the first 25 web pages that appear in the search engines Google, Yahoo and Bing, in October 2014 in the Basque Country (Spain), when entering eight Spanish words and seven English words related to pregnancy, childbirth, the postpartum period, breastfeeding and newborns. Web pages aimed at healthcare professionals and forums were excluded. The reliability was evaluated using the LIDA questionnaire, and the contents of the web pages with the highest scores were then described. a total of 126 web pages were found using the key search words. Of these, 14 scored in the top 30% for reliability. The content analysis of these found that the mean score for "references to the source of the information" was 3.4 (SD: 2.17), that for "up-to-date" was 4.30 (SD: 1.97) and the score for "conflict of interest statement" was 5.90 (SD: 2.16). The mean for web pages created by universities and official bodies was 13.64 (SD: 4.47), whereas the mean for those created by private bodies was 11.23 (SD: 4.51) (F (1,124)5.27. p=0.02). The content analysis of these web pages found that the most commonly discussed topic was breastfeeding, followed by self-care during pregnancy and the onset of childbirth. in this study, web pages from established healthcare or academic institutions were found to contain the most reliable information. The significant number of web pages found in this study with poor quality information indicates the need for healthcare professionals to guide women when sourcing information online. As the origin of the web page has a direct effect on reliability, the involvement of healthcare professionals in the use, counselling and generation of new technologies as an intervention tool is increasingly essential. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. [A 6-year evaluation of dyslipidemia in a health center: Importance of improvement actions].

    Science.gov (United States)

    Antón-García, F; Correcher-Salvador, E; Rodríguez-Lagos, F A; González-Caminero, S

    2014-01-01

    Dyslipidemia, especially an increased LDL-cholesterol, has been shown to be one of the most important risk factors in the genesis of coronary involvement. The prevalence of dyslipidemias in Spain is high. The objective of this study is to assess the progress of dyslipidemic patients in our health center over a 6-year period, and see if there has been any improvement in its control after the presentation of the evaluation of the first 3 years, as well as an updated dyslipidemia protocol. Assessment Period 1 (2006-2008): 267 patients with dyslipidemia. Assessment Period 2 (2009-2011): 222 patients, excluding exitus and address changes. age, sex, personal history of CVD, vascular risk factors, lipids, drug treatment, risk levels, and percentages of CV control objectives. Mean age was 66.2 years (SD 13.4), 66.3% women. Period 1-Period 2: Total cholesterol: 221.9-196.6 mg/dl (P=.000); LDL-cholesterol: 147.9-115.8 mg/dl (P=.000). In high risk patients, therapeutic targets: 14-50.5% (P=.024); medium risk: 35-68.1% (P=.038); low risk: 44-68.2% (P=NS). Pharmacotherapy 68-77% (P=.000). Changing treatment: 30-43% (P=.001). Adherence: 75-86% (P=.003). Untreated high risk: 15.4-16.3% (P=NS). There was a significant improvement in Period 2, especially in high-risk patients, after presenting the results of the evaluation for Period 1 and with the updated dyslipidemia protocol. There are high risk patients without lipid-lowering treatment to be detected and reviewed. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. Using ISO 25040 standard for evaluating electronic health record systems.

    Science.gov (United States)

    Oliveira, Marília; Novaes, Magdala; Vasconcelos, Alexandre

    2013-01-01

    Quality of electronic health record systems (EHR-S) is one of the key points in the discussion about the safe use of this kind of system. It stimulates creation of technical standards and certifications in order to establish the minimum requirements expected for these systems. [1] In other side, EHR-S suppliers need to invest in evaluation of their products to provide systems according to these requirements. This work presents a proposal of use ISO 25040 standard, which focuses on the evaluation of software products, for define a model of evaluation of EHR-S in relation to Brazilian Certification for Electronic Health Record Systems - SBIS-CFM Certification. Proposal instantiates the process described in ISO 25040 standard using the set of requirements that is scope of the Brazilian certification. As first results, this research has produced an evaluation model and a scale for classify an EHR-S about its compliance level in relation to certification. This work in progress is part for the acquisition of the degree of master in Computer Science at the Federal University of Pernambuco.

  4. Practice-centred evaluation and the privileging of care in health information technology evaluation.

    Science.gov (United States)

    Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

    2014-06-05

    Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these

  5. Evolution of a multilevel framework for health program evaluation.

    Science.gov (United States)

    Masso, Malcolm; Quinsey, Karen; Fildes, Dave

    2017-07-01

    A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination. These components of the evaluation framework fit into a matrix structure, and cells within the matrix are supported by relevant evaluation tools. The development of the framework has been influenced by feedback from various stakeholders, existing knowledge of the evaluators and the literature on health promotion and implementation science. Over the years, the framework has matured and is generic enough to be useful in a wide variety of circumstances, yet specific enough to focus data collection, data analysis and the presentation of findings.

  6. Web usage data as a means of evaluating public health messaging and outreach.

    Science.gov (United States)

    Tian, Hao; Brimmer, Dana J; Lin, Jin-Mann S; Tumpey, Abbigail J; Reeves, William C

    2009-12-21

    The Internet is increasingly utilized by researchers, health care providers, and the public to seek medical information. The Internet also provides a powerful tool for public health messaging. Understanding the needs of the intended audience and how they use websites is critical for website developers to provide better services to the intended users. The aim of the study was to examine the utilization of the chronic fatigue syndrome (CFS) website at the Centers for Disease Control and Prevention (CDC). We evaluated (1) CFS website utilization, (2) outcomes of a CDC CFS public awareness campaign, and (3) user behavior related to public awareness campaign materials and CFS continuing medical education courses. To describe and evaluate Web utilization, we collected Web usage data over an 18-month period and extracted page views, visits, referring domains, and geographic locations. We used page views as the primary measure for the CFS awareness outreach effort. We utilized market basket analysis and Markov chain model techniques to describe user behavior related to utilization of campaign materials and continuing medical education courses. The CDC CFS website received 3,647,736 views from more than 50 countries over the 18-month period and was the 33rd most popular CDC website. States with formal CFS programs had higher visiting density, such as Washington, DC; Georgia; and New Jersey. Most visits (71%) were from Web search engines, with 16% from non-search-engine sites and 12% from visitors who had bookmarked the site. The public awareness campaign was associated with a sharp increase and subsequent quick drop in Web traffic. Following the campaign, user interest shifted from information targeting consumer basic knowledge to information for health care professionals. The market basket analysis showed that visitors preferred the 60-second radio clip public service announcement over the 30-second one. Markov chain model results revealed that most visitors took the

  7. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang

    2006-01-01

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area

  8. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area.

  9. A general procedure to evaluate many-body spin operator amplitudes from periodic calculations: application to cuprates

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Iberio de P R [Departament de Quimica Fisica and Institut de Quimica Teorica i Computacional (IQTCUB), Universitat de Barcelona and Parc CientIfic de Barcelona, C/ MartI i Franques 1, E-08028 Barcelona (Spain); Calzado, Carmen J [Departamento de Quimica Fisica, Universidad de Sevilla, C/ Prof. GarcIa Gonzalez s/n, E-41012 Sevilla (Spain); Malrieu, Jean-Paul [IRSAMC, Laboratoire de Physique Quantique, Universite Paul Sabatier, 118 Route de Narbonne, F-31062 Toulouse-Cedex (France); Illas, Francesc [Departament de Quimica Fisica and Institut de Quimica Teorica i Computacional (IQTCUB), Universitat de Barcelona and Parc CientIfic de Barcelona, C/ MartI i Franques 1, E-08028 Barcelona (Spain)

    2007-10-15

    A general procedure is presented which permits the form of an extended spin Hamiltonian to be established for a given magnetic solid and the magnitude of its terms to be evaluated from spin polarized, Hartree-Fock or density functional calculations carried out for periodic models. The computational strategy makes use of a general mapping between the energy of pertinent broken-symmetry solutions and the diagonal terms of the spin Hamiltonian in a local representation. From this mapping it is possible to determine not only the amplitude of the well-known two-body magnetic coupling constants between near-neighbor sites, but also the amplitudes of four-body cyclic exchange terms. A scrutiny of the on-site spin densities provides additional information and control of the many broken-symmetry solutions which can be found. The procedure is applied to the La{sub 2}CuO{sub 4}, Sr{sub 2}CuO{sub 2}F{sub 2}, Sr{sub 2}CuO{sub 2}Cl{sub 2} and Ca{sub 2}CuO{sub 2}Cl{sub 2} square lattices and the SrCu{sub 2}O{sub 3} ladder compound. It is shown that a proper description of the magnetic structure of these compounds requires that two- and four-body terms are explicitly included in the spin Hamiltonian. The implications for the interpretation of recent experiments are discussed.

  10. Evaluation of international recruitment of health professionals in England.

    Science.gov (United States)

    Young, Ruth; Noble, Jenny; Mahon, Ann; Maxted, Mairead; Grant, Janet; Sibbald, Bonnie

    2010-10-01

    To explore whether a period of intensive international recruitment by the English National Health Service (NHS) achieved its objectives of boosting workforce numbers and to set this against the wider costs, longer-term challenges and questions arising. A postal survey of all pre-2006 NHS providers, Strategic Health Authorities and Deans of Postgraduate Medical Education obtained information on 284 (45%) organizations (142 completed questionnaires). Eight subsequent case studies (74 interviews) covered medical consultant, general practitioner, nurse, midwife and allied health professional recruitment. Most respondents had undertaken or facilitated international recruitment between 2001 and 2006 and believed that it had enabled them to address immediate staff shortages. Views on longer-term implications, such as recruit retention, were more equivocal. Most organizations had made only a limited value-for-money assessment, balancing direct expenditure on overseas recruitment against savings on temporary staff. Other short and long-term transaction and opportunity costs arose from pressures on existing staff, time spent on induction/pastoral support, and human resource management and workforce planning challenges. Though recognized, these extensive 'hidden costs' for NHS organizations were harder to assess as were the implications for source countries and migrant staff. The main achievement of the intensive international recruitment period from a UK viewpoint was that such a major undertaking was seen through without major disruption to NHS services. The wider costs and challenges meant, however, that large-scale international recruitment was not sustainable as a solution to workforce shortages. Should such approaches be attempted in future, a clearer upfront appraisal of all the potential costs and implications will be vital.

  11. 29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

    Science.gov (United States)

    2010-07-01

    ... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

  12. [Ethic evaluation of sexual health programs on adolescence].

    Science.gov (United States)

    Jara Rascón, José; Alonso Sandoica, Esmeralda

    2011-01-01

    In public health services, the interest in sexuality seems to turning from traditional topics such as potential treatments for male erectile dysfunction, psychosomatic disorders, the control of premature ejaculation and contraception. Instead, an increasingly prominent role is being given to prevention strategies carried out by means of campaigns or through sexual health programme sin schools. The different teaching strategies that underlie these programmes, which in many cases lack social consensus but are often promoted by international organizations such as WHO or UNESCO, reveal not only divergent ethical conceptions and worldviews on the meaning of sexuality, but also conflicting starting points, means and goals, focusing either on barrier-contraceptive methods or on sexual abstinence and personal responsibility. There is therefore a pressing need to understand the scientific evidence underlying each educational approach and the ethical postulates of each pedagogical proposal. This paper presents an outline of a six-point adolescent sexuality education program, which is respectful of individuals' ethical convictions. Given that few works on preventive medicine issues include an ethical evaluation of the steps followed in their development, this article also proposes a systematic evaluation of strategies for sexual health in the community that is developed through four steps verifying the following aspects: 1) the accuracy of information, 2) the level of evidence, 3) efficiency and 4) non-maleficence about the target population of each health program. The methodology used in these sexual health programs is another aspect that will verify their ethical consistence or, conversely, their absence of ethical values. We emphasize the duty of designers of programme for children not to carry then out against the will of their parents or tutors, and not conceal sensitive and relevant information.

  13. Health risk evaluation of certain compounds found in contaminated soil

    International Nuclear Information System (INIS)

    Dock, L.; Victorin, K.; Vahter, M.; Ahlborg, U.G.

    1991-01-01

    As part of a redevelopment plan for an old gas works site in Stockholm, the Institute of Environmental Medicine (IEM) at the Karolinska Institute was asked to evaluate the health risks associated with exposure to coal tar, containing polycyclic aromatic hydrocarbons (PAH), phenols, cyanides, sulfur compounds, arsenic, lead, cadmium and mercury in soil and to suggest guide line values for these compounds in residential areas. Our health risk evaluation was limited to possible effects following direct exposure to contaminated soil. Indirect exposure, i.e. through contaminated ground water or home-grown vegetables, was not considered, nor were effects on building material. The routes of exposure considered were ingestion, dermal contact and inhalation of soil dust. Small children were considered the primary risk group. The critical health effect associated with dermal exposure to PAH in soil is skin cancer. Ingestion of phenols, cyanides and sulphur compounds may cause acute health effects. Recommended guide line values for these contaminants were generally obtained by dividing the lowest observed effect levels with appropriate safety factors. The metals considered may cause both acute and chronic health effects. The guide line values for cadmium and mercury in soil were set based on a maximum intake through ingestion of soil corresponding to 10% of the provisional tolerable weekly intake levels (PTWI) set by FAO/WHO. For arsenic, the guide line value corresponds to 5% of the PTWI-value for a child. The suggested guide line level for lead was based on studied on the association between soil lead concentration and blood lead levels in children. The suggested guide line level for lead in soil may increase the blood-lead in a child by less than 10%. (31 refs.) (au)

  14. Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

    Science.gov (United States)

    Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi

    2018-02-20

    While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

  15. Conceptual framework for development of comprehensive e-health evaluation tool.

    Science.gov (United States)

    Khoja, Shariq; Durrani, Hammad; Scott, Richard E; Sajwani, Afroz; Piryani, Usha

    2013-01-01

    The main objective of this study was to develop an e-health evaluation tool based on a conceptual framework including relevant theories for evaluating use of technology in health programs. This article presents the development of an evaluation framework for e-health programs. The study was divided into three stages: Stage 1 involved a detailed literature search of different theories and concepts on evaluation of e-health, Stage 2 plotted e-health theories to identify relevant themes, and Stage 3 developed a matrix of evaluation themes and stages of e-health programs. The framework identifies and defines different stages of e-health programs and then applies evaluation theories to each of these stages for development of the evaluation tool. This framework builds on existing theories of health and technology evaluation and presents a conceptual framework for developing an e-health evaluation tool to examine and measure different factors that play a definite role in the success of e-health programs. The framework on the horizontal axis divides e-health into different stages of program implementation, while the vertical axis identifies different themes and areas of consideration for e-health evaluation. The framework helps understand various aspects of e-health programs and their impact that require evaluation at different stages of the life cycle. The study led to the development of a new and comprehensive e-health evaluation tool, named the Khoja-Durrani-Scott Framework for e-Health Evaluation.

  16. Ethics reflection groups in community health services: an evaluation study.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2015-04-17

    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

  17. Role of PAHO/WHO in eHealth Capacity Building in the Americas: Analysis of the 2011–2015 period

    Directory of Open Access Journals (Sweden)

    David Novillo-Ortiz

    Full Text Available Political will and adoption of measures toward the use of eHealth have been steadily increasing, facilitating mobilization of resources necessary to adopt and implement digital services that will make it possible to improve access, expand coverage, and increase financial efficiency of health care systems. Adoption of the Strategy and Plan of Action on eHealth of the Pan American Health Organization (PAHO in 2011 by all Member States in the Region of the Americas has led the Region to major progress in this regard, including the following: creation of knowledge networks and development of information sources, establishment of eHealth sustainability models, support for development of electronic health records, promotion of standards on health data and related technologies that ensure exchange of information, use of mobile devices to improve health, and improvement in quality of care through telemedicine. This article details the main actions carried out by PAHO with regard to eHealth, specifically by the office of Knowledge Management, Bioethics, and Research in the 2011-2015 period (first period of implementation of the PAHO eHealth strategy and plan of action, which include research and capacity-building activities, development of technical guidelines, and formation of knowledge networks.

  18. An evaluation of the quality of IMCI assessments among IMCI trained health workers in South Africa.

    Directory of Open Access Journals (Sweden)

    Christiane Horwood

    Full Text Available BACKGROUND: Integrated Management of Childhood Illness (IMCI is a strategy to reduce mortality and morbidity in children under 5 years by improving case management of common and serious illnesses at primary health care level, and was adopted in South Africa in 1997. We report an evaluation of IMCI implementation in two provinces of South Africa. METHODOLOGY/PRINCIPAL FINDINGS: Seventy-seven IMCI trained health workers were randomly selected and observed in 74 health facilities; 1357 consultations were observed between May 2006 and January 2007. Each health worker was observed for up to 20 consultations with sick children presenting consecutively to the facility, each child was then reassessed by an IMCI expert to determine the correct findings. Observed health workers had been trained in IMCI for an average of 32.2 months, and were observed for a mean of 17.7 consultations; 50/77(65% HW's had received a follow up visit after training. In most cases health workers used IMCI to assess presenting symptoms but did not implement IMCI comprehensively. All but one health worker referred to IMCI guidelines during the period of observation. 9(12% observed health workers checked general danger signs in every child, and 14(18% assessed all the main symptoms in every child. 51/109(46.8% children with severe classifications were correctly identified. Nutritional status was not classified in 567/1357(47.5% children. CONCLUSION/SIGNIFICANCE: Health workers are implementing IMCI, but assessments were frequently incomplete, and children requiring urgent referral were missed. If coverage of key child survival interventions is to be improved, interventions are required to ensure competency in identifying specific signs and to encourage comprehensive assessments of children by IMCI practitioners. The role of supervision in maintaining health worker skills needs further investigation.

  19. Epidemiological Study of Mammary Tumors in Female Dogs Diagnosed during the Period 2002-2012: A Growing Animal Health Problem

    Science.gov (United States)

    Salas, Yaritza; Márquez, Adelys; Diaz, Daniel; Romero, Laura

    2015-01-01

    Epidemiological studies enable us to analyze disease behavior, define risk factors and establish fundamental prognostic criteria, with the purpose of studying different types of diseases. The aim of this study was to determine the epidemiological characteristics of canine mammary tumors diagnosed during the period 2002-2012. The study was based on a retrospective study consisting of 1,917 biopsies of intact dogs that presented mammary gland lesions. Biopsies were sent to the Department of Pathology FMVZ-UNAM diagnostic service. The annual incidence of mammary tumors was 16.8%: 47.7% (benign) and 47.5% (malignant). The highest number of cases was epithelial, followed by mixed tumors. The most commonly diagnosed tumors were tubular adenoma, papillary adenoma, tubular carcinoma, papillary carcinoma, solid carcinoma, complex carcinoma and carcinosarcoma. Pure breeds accounted for 80% of submissions, and the Poodle, Cocker Spaniel and German Shepherd were consistently affected. Adult female dogs (9 to 12 years old) were most frequently involved, followed by 5- to 8-year-old females. Some association between breeds with histological types of malignant tumors was observed, but no association was found between breeds and BN. Mammary tumors in intact dogs had a high incidence. Benign and malignant tumors had similar frequencies, with an increase in malignant tumors in the past four years of the study. Epithelial tumors were more common, and the most affected were old adult females, purebreds and small-sized dogs. Mammary tumors in dogs are an important animal health problem that needs to be solved by improving veterinary oncology services in Mexico. PMID:25992997

  20. [Evaluation of new and emerging health technologies. Proposal for classification].

    Science.gov (United States)

    Prados-Torres, J D; Vidal-España, F; Barnestein-Fonseca, P; Gallo-García, C; Irastorza-Aldasoro, A; Leiva-Fernández, F

    2011-01-01

    Review and develop a proposal for the classification of health technologies (HT) evaluated by the Health Technology Assessment Agencies (HTAA). Peer review of AETS of the previous proposed classification of HT. Analysis of their input and suggestions for amendments. Construction of a new classification. Pilot study with physicians. Andalusian Public Health System. Spanish HTAA. Experts from HTAA. Tutors of family medicine residents. HT Update classification previously made by the research team. Peer review by Spanish HTAA. Qualitative and quantitative analysis of responses. Construction of a new and pilot study based on 12 evaluation reports of the HTAA. We obtained 11 thematic categories that are classified into 6 major head groups: 1, prevention technology; 2, diagnostic technology; 3, therapeutic technologies; 4, diagnostic and therapeutic technologies; 5, organizational technology, and 6, knowledge management and quality of care. In the pilot there was a good concordance in the classification of 8 of the 12 reports reviewed by physicians. Experts agree on 11 thematic categories of HT. A new classification of HT with double entry (Nature and purpose of HT) is proposed. APPLICABILITY: According to experts, the classification of the work of the HTAA may represent a useful tool to transfer and manage knowledge. Moreover, an adequate classification of the HTAA reports would help clinicians and other potential users to locate them and this can facilitate their dissemination. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  1. [Evaluating training programs on occupational health and safety: questionnaire development].

    Science.gov (United States)

    Zhou, Xiao-Yan; Wang, Zhi-Ming; Wang, Mian-Zhen

    2006-03-01

    To develop a questionnaire to evaluate the quality of training programs on occupational health and safety. A questionnaire comprising five subscales and 21 items was developed. The reliability and validity of the questionnaire was tested. Final validation of the questionnaire was undertaken in 700 workers in an oil refining company. The Cronbach's alpha coefficients of the five subscales ranged from 0.6194 to 0.6611. The subscale-scale Pearson correlation coefficients ranged from 0.568 to 0.834 . The theta coefficients of the five subscales were greater than 0.7. The factor loadings of the five subscales in the principal component analysis ranged from 0.731 to 0.855. Use of the questionnaire in the 700 workers produced a good discriminability, with excellent, good, fair and poor comprising 22.2%, 31.2%, 32.4% and 14.1 respectively. Given the fact that 18.7% of workers had never been trained and 29.7% of workers got one-off training only, the training program scored an average of 57.2. The questionnaire is suitable to be used in evaluating the quality of training programs on occupational health and safety. The oil refining company needs to improve training for their workers on occupational health and safety.

  2. Design and evaluation of the ONC health information technology curriculum.

    Science.gov (United States)

    Mohan, Vishnu; Abbott, Patricia; Acteson, Shelby; Berner, Eta S; Devlin, Corkey; Hammond, William E; Kukafka, Rita; Hersh, William

    2014-01-01

    As part of the Heath Information Technology for Economic and Clinical Health (HITECH) Act, the Office of the National Coordinator for Health Information Technology (ONC) implemented its Workforce Development Program, which included initiatives to train health information technology (HIT) professionals in 12 workforce roles, half of them in community colleges. To achieve this, the ONC tasked five universities with established informatics programs with creating curricular materials that could be used by community colleges. The five universities created 20 components that were made available for downloading from the National Training and Dissemination Center (NTDC) website. This paper describes an evaluation of the curricular materials by its intended audience of educators. We measured the quantity of downloads from the NTDC site and administered a survey about the curricular materials to its registered users to determine use patterns and user characteristics. The survey was evaluated using mixed methods. Registered users downloaded nearly half a million units or components from the NTDC website. We surveyed these 9835 registered users. 1269 individuals completed all or part of the survey, of whom 339 identified themselves as educators (26.7% of all respondents). This paper addresses the survey responses of educators. Successful aspects of the curriculum included its breadth, convenience, hands-on and course planning capabilities. Several areas were identified for potential improvement. The ONC HIT curriculum met its goals for community college programs and will likely continue to be a valuable resource for the larger informatics community in the future.

  3. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-04-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully.

  4. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully. (Ueda, J.)

  5. An empirical evaluation of landscape energetic models: Mallard and American black duck space use during the non-breeding period

    Science.gov (United States)

    Beatty, William S.; Webb, Elisabeth B.; Kesler, Dylan C.; Naylor, Luke W.; Raedeke, Andrew H.; Humburg, Dale D.; Coluccy, John M.; Soulliere, G.

    2015-01-01

    Bird conservation Joint Ventures are collaborative partnerships between public agencies and private organizations that facilitate habitat management to support waterfowl and other bird populations. A subset of Joint Ventures has developed energetic carrying capacity models (ECCs) to translate regional waterfowl population goals into habitat objectives during the non-breeding period. Energetic carrying capacity models consider food biomass, metabolism, and available habitat to estimate waterfowl carrying capacity within an area. To evaluate Joint Venture ECCs in the context of waterfowl space use, we monitored 33 female mallards (Anas platyrhynchos) and 55 female American black ducks (A. rubripes) using global positioning system satellite telemetry in the central and eastern United States. To quantify space use, we measured first-passage time (FPT: time required for an individual to transit across a circle of a given radius) at biologically relevant spatial scales for mallards (3.46 km) and American black ducks (2.30 km) during the non-breeding period, which included autumn migration, winter, and spring migration. We developed a series of models to predict FPT using Joint Venture ECCs and compared them to a biological null model that quantified habitat composition and a statistical null model, which included intercept and random terms. Energetic carrying capacity models predicted mallard space use more efficiently during autumn and spring migrations, but the statistical null was the top model for winter. For American black ducks, ECCs did not improve predictions of space use; the biological null was top ranked for winter and the statistical null was top ranked for spring migration. Thus, ECCs provided limited insight into predicting waterfowl space use during the non-breeding season. Refined estimates of spatial and temporal variation in food abundance, habitat conditions, and anthropogenic disturbance will likely improve ECCs and benefit conservation planners

  6. A multi-method approach to evaluate health information systems.

    Science.gov (United States)

    Yu, Ping

    2010-01-01

    Systematic evaluation of the introduction and impact of health information systems (HIS) is a challenging task. As the implementation is a dynamic process, with diverse issues emerge at various stages of system introduction, it is challenge to weigh the contribution of various factors and differentiate the critical ones. A conceptual framework will be helpful in guiding the evaluation effort; otherwise data collection may not be comprehensive and accurate. This may again lead to inadequate interpretation of the phenomena under study. Based on comprehensive literature research and own practice of evaluating health information systems, the author proposes a multimethod approach that incorporates both quantitative and qualitative measurement and centered around DeLone and McLean Information System Success Model. This approach aims to quantify the performance of HIS and its impact, and provide comprehensive and accurate explanations about the casual relationships of the different factors. This approach will provide decision makers with accurate and actionable information for improving the performance of the introduced HIS.

  7. [Measurement and health economic evaluation of informal care].

    Science.gov (United States)

    Zrubka, Zsombor

    2017-09-01

    Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.

  8. Understanding mental health through reading selected literature sources: an evaluation.

    Science.gov (United States)

    McKie, A; Gass, J P

    2001-04-01

    The increasing use of the humanities in nurse education provides an alternative means of facilitating students' understanding of health issues. In part, this contributes to a critique of rationalist-technological approaches to education where knowledge is reduced to abstract, discernable and measured units. A more communal approach to education recognises the place of interpretation as part of learning and, within this, the significance of dialogue, identity, tradition, attachment and partnership. The reading of works of literature is one way in which the reader interprets texts in a multiplicity of ways in order to more fully understand the 'real' world. Mental health offers particular opportunities for literary descriptions. The evaluation of a learning unit within a mental health nursing branch programme where students read a number of works of literature is outlined. Results indicate a variety of student responses to use of such an approach. The authors assert the usefulness of these approaches in encouraging deeper understanding of complex issues faced in mental health nursing practice. At the same time, however, careful consideration is given to the place of such approaches within the overall philosophy of a curriculum programme. Copyright 2001 Harcourt Publishers Ltd.

  9. Evaluating health effects of transport interventions methodologic case study.

    Science.gov (United States)

    Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

    2006-08-01

    There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

  10. An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

    Science.gov (United States)

    Palermo, C; Hughes, R; McCall, L

    2010-06-01

    Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P work time allocated to preventive work post-intervention. Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

  11. Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

    Science.gov (United States)

    Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

    2018-01-05

    Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. ©Rebecca Schnall, Hwayoung Cho, Jianfang Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 05.01.2018.

  12. [Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

    Science.gov (United States)

    Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

    2011-04-01

    The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Evaluation of trickle-bed air biofilter performance under periodic stressed operating conditions as a function of styrene loading.

    Science.gov (United States)

    Kim, Daekeun; Cai, Zhangli; Sorial, George A

    2005-02-01

    Trickle-bed air biofilters (TBABs) are suitable for treating volatile organic compounds (VOCs) at a significantly high practical loading because of their controlled environmental conditions. The application of TBAB for treating styrene-contaminated air under periodic backwashing and cyclical nonuse periods at a styrene loading of 0.64-3.17 kg chemical oxygen demand (COD)/m3 x day was the main focus of this study. Consistent long-term efficient performance of TBAB strongly depended on biomass control. A periodic in situ upflow with nutrient solution under media fluidization, that is, backwashing, was approached in this study. Two different nonuse periods were employed to simulate a shutdown for equipment repair or during weekends and holidays. The first is a starvation period without styrene loading, and the second is a stagnant period, which reflects no flow passing through the biofilter. For styrene loadings up to 1.9 kg COD/m3 x day, removal efficiencies consistently above 99% were achieved by conducting a coordinated biomass control strategy, that is, backwashing for 1 hr once per week. Under cyclical nonuse periods for styrene loadings up to 1.27 kg COD/m3 x day, stable long-term performance of the biofilter was maintained at more than 99% removal without employing backwashing. No substantial impact of nonuse periods on the biofilter performance was revealed. However, a coordinated biomass control by backwashing subsequently was unavoidable for attaining consistently high removal efficiency at a styrene loading of 3.17 kg COD/m3 x day. As styrene loading was increased, reacclimation of the biofilter to reach the 99% removal efficiency following backwashing or the nonuse periods was delayed. After the non-use periods, the response of the biofilter was a strong function of the biomass in the bed. No significant difference between the effects of the two different nonuse periods on TBAB performance was observed during the study period.

  14. Discounting in the economic evaluation of health care interventions.

    Science.gov (United States)

    Krahn, M; Gafni, A

    1993-05-01

    Do economic theories that underlie discounting have specific implications for program evaluation in health? In this study, both the contemporary practice and the theoretical foundations of discounting are reviewed. The social discount rate controversy is considered, and the two major concepts (i.e., opportunity cost and time preference) involved in the formulation of a social discount rate are outlined. Also described are the arguments for discounting proposed by thinkers in non-economic disciplines. Finally, the implications of choosing a discount rate for evaluation of individual health care programs are considered. It is argued that the conventional practice of discounting all health care programs at a rate of 5% may not consistently reflect societal or individual preference. Specific recommendations arising from this paper are: 1) given the considerable disagreement at the theoretical level as to the appropriate social discount rate, analysts should be specific about what theoretical approach underlies their choice of rate, especially when the analytic result is sensitive to the discount rate; 2) the discount rate chosen should be appropriate for the perspective of the analysis (social vs. individual vs. institutional, etc.); 3) when appropriate, measures should be taken to avoid double discounting, because some health related outcome measures already incorporate individuals' time preference; and 4) it is suggested that the political process may serve as the appropriate means of reflecting social values in the choice of a discount rate. In addition, the authors argue that a consensus conference approach, with political participation, offers a flexible, pragmatic, and explicit way of synthesizing the empirical, normative, and ethical considerations that underlie choice of a discount rate.

  15. Exploring the role of health literacy in the evaluation of online health information: Insights from a mixed-methods study.

    Science.gov (United States)

    Diviani, Nicola; van den Putte, Bas; Meppelink, Corine S; van Weert, Julia C M

    2016-06-01

    To gain new insights into the relationship between health literacy and evaluation of online health information. Using a mixed-methods approach, forty-four semi-structured interviews were conducted followed by a short questionnaire on health literacy and eHealth literacy. Qualitative and quantitative data were merged to explore differences and similarities among respondents with different health literacy levels. Thematic analysis showed that most respondents did not question the quality of online health information and relied on evaluation criteria not recognized by existing web quality guidelines. Individuals with low health literacy, despite presenting higher eHealth literacy scores, appeared to use less established criteria and to rely more heavily on non-established ones compared to those with high health literacy. Disparities in evaluation ability among people with different health literacy might be related to differences in awareness of the issue and to the use of different evaluation criteria. Future research should quantitatively investigate the interplay between health literacy, use of established and non-established criteria, and ability to evaluate online health information. Communication and patient education efforts should aim to raise awareness on online health information quality and to promote use of established evaluation criteria, especially among low health literate citizens. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Mobile personal health records: an evaluation of features and functionality.

    Science.gov (United States)

    Kharrazi, Hadi; Chisholm, Robin; VanNasdale, Dean; Thompson, Benjamin

    2012-09-01

    To evaluate stand-alone mobile personal health record (mPHR) applications for the three leading cellular phone platforms (iOS, BlackBerry, and Android), assessing each for content, function, security, and marketing characteristics. Nineteen stand-alone mPHR applications (8 for iOS, 5 for BlackBerry, and 6 for Android) were identified and evaluated. Main criteria used to include mPHRs were: operating standalone on a mobile platform; not requiring external connectivity; and covering a wide range of health topics. Selected mPHRs were analyzed considering product characteristics, data elements, and application features. We also reviewed additional features such as marketing tactics. Within and between the different mobile platforms attributes for the mPHR were highly variable. None of the mPHRs contained all attributes included in our evaluation. The top four mPHRs contained 13 of the 14 features omitting only the in-case-of emergency feature. Surprisingly, seven mPHRs lacked basic security measures as important as password protection. The mPHRs were relatively inexpensive: ranging from no cost to $9.99. The mPHR application cost varied in some instances based on whether it supported single or multiple users. Ten mPHRs supported multiple user profiles. Notably, eight mPHRs used scare tactics as marketing strategy. mPHR is an emerging health care technology. The majority of existing mPHR apps is limited by at least one of the attributes considered for this study; however, as the mobile market continues to expand it is likely that more comprehensive mPHRs will be developed in the near future. New advancements in mobile technology can be utilized to enhance mPHRs by long-term patient empowerment features. Marketing strategies for mPHRs should target specific subpopulations and avoid scare tactics. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. [Evaluation of immunosuppressive treatment on homocystein levels in patients after kidney transplantation during a 2 year observation period].

    Science.gov (United States)

    Aksamit, Dariusz; Janda, Katarzyna; Kuźniewski, Marek; Krzanowski, Marcin; Ignacak, Ewa; Betkowska-Prokop, Alina; Chowaniec, Eve; Sułowicz, Wladysław

    2012-01-01

    The aim of the study was to evaluate the influence of the type of prescribed immunosuppression: cyclosporine A (CsA) vs. tacrolimus (Tac) on remote homocystein levels in patients (pts) after kidney transplantation (Ktx). The study included 51 pts (17 F, 34 M) aged 15 to 62 years (mean 38.1) after cadaver Ktx. The mean observation period equaled 21.2 months (6 -24); while total observation period was 90 personlyears. Before Ktx, 46 pts were treated with maintenance hemodialysis (HD), while 5 by peritoneal dialysis (PD). After Ktx, patients had immunosuppression prescribed according to the following schemes: prednisone (P) + CsA + azathioprine (AZA) - 12 pts; P + CsA + mycophenolate mofetil (MMF) -26 pts; P + Tac + MMF - 11 pts; and P + Tac + AZA - 2 pts. Hcy level was measured using high performance liquid chromatography (HPLC). Serum creatinine level was measured by standard method using the Hitachi 917 analyzer. Creatinine clearance was calculated based on the Cockcroft-Gault formula. Patient's blood was drawn before Ktx and 3, 6, 9, 12,15, 18, 21 and 24 months post procedure. Delayed graft function (DGF) after Ktx was diagnosed in 29 pts (56.9%) and this group required from 4 to 28 HD sessions (mean 14 sessions). Hcy level did not significantly differ between pts requiring (29 pts) and not requiring (22 pts) HD treatment after Ktx. It was also noted that the number of performed HD sessions did not significantly correlate with Hcy levels 24 months after Ktx (R =0.04, p=0.81). No relationship was found (non-parametric Spearman test) between the drop in Hcy level 3 months after Ktx as compare with value before Ktx and ischemia time (R=0.09, p=0.49), number of compatible HLA A and B (R=0.07, p=0.63), and DR antigens (R=0.09, p=0.51). Decrease in Hcy level (before Ktx and 24 months after Ktx) did not significantly correlate with the above parameters, respectively: R=-0.14, p=0.40; R=0.06, p=0.73; R=0.12, p=0.45; R=0.11, p=0.50. Decrease in Hcy level (before Ktx and 3

  18. Comparison of two heuristic evaluation methods for evaluating the usability of health information systems.

    Science.gov (United States)

    Khajouei, Reza; Hajesmaeel Gohari, Sadrieh; Mirzaee, Moghaddameh

    2018-04-01

    In addition to following the usual Heuristic Evaluation (HE) method, the usability of health information systems can also be evaluated using a checklist. The objective of this study is to compare the performance of these two methods in identifying usability problems of health information systems. Eight evaluators independently evaluated different parts of a Medical Records Information System using two methods of HE (usual and with a checklist). The two methods were compared in terms of the number of problems identified, problem type, and the severity of identified problems. In all, 192 usability problems were identified by two methods in the Medical Records Information System. This was significantly higher than the number of usability problems identified by the checklist and usual method (148 and 92, respectively) (p information systems. The results demonstrated that the checklist method had significantly better performance in terms of the number of identified usability problems; however, the performance of the usual method for identifying problems of higher severity was significantly better. Although the checklist method can be more efficient for less experienced evaluators, wherever usability is critical, the checklist should be used with caution in usability evaluations. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Allied health research positions: a qualitative evaluation of their impact.

    Science.gov (United States)

    Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

    2017-02-06

    Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health

  20. An Exploratory Investigation of the Periodic Performance Evaluation Processes for Marketing Faculty: A Comparison of Doctoral-Granting and Non-Doctoral-Granting Universities

    Science.gov (United States)

    Shepherd, C. David; Carley, Susan S.; Stuart, Randy S.

    2009-01-01

    Whether a first entrant into the academic job market or a seasoned professional, career outcomes for marketing educators depend heavily on the evaluation process used at their institutions. This research explores the periodic performance evaluation process for marketing faculty members using data collected from a national sample of marketing…

  1. Health system guidance appraisal--concept evaluation and usability testing.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-05

    Health system guidance (HSG) provides recommendations aimed to address health system challenges. However, there is a paucity of methods to direct, appraise, and report HSG. Earlier research identified 30 candidate criteria (concepts) that can be used to evaluate the quality of HSG and guide development and reporting requirements. The objective of this paper was to describe two studies aimed at evaluating the importance of these 30 criteria, design a draft HSG appraisal tool, and test its usability. This study involved a two-step survey process. In step 1, respondents rated the 30 concepts for appropriateness to, relevance to, and priority for health system decisions and HSG. This led to a draft tool. In step 2, respondents reviewed HSG documents, appraised them using the tool, and answered a series of questions. Descriptive analyses were computed. Fifty participants were invited in step 1, and we had a response rate of 82 %. The mean response rates for each concept within each survey question were universally favorable. There was also an overall agreement about the need for a high-quality tool to systematically direct the development, appraisal, and reporting of HSG. Qualitative feedback and a consensus process by the team led to refinements to some of the concepts and the creation of a beta (draft) version of the HSG tool. In step 2, 35 participants were invited and we had a response rate of 74 %. Exploratory analyses showed that the quality of the HSGs reviewed varied as a function of the HSG item and the specific document assessed. A favorable consensus was reached with participants agreeing that the HSG items were easy to understand and easy to apply. Moreover, the overall agreement was high for the usability of the tool to systematically direct the development (85 %), appraisal (92 %), and reporting (81 %) of HSG. From this process, version 1.0 of the HSG appraisal tool was generated complete with 32 items (and their descriptions) and 4 domains. The final

  2. One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal

    Directory of Open Access Journals (Sweden)

    Ana Gloria Fonseca

    2018-03-01

    Full Text Available The increasing occurrence of human cysticercosis, a zoonotic neglected disease, is challenging the traditional prevention and control paradigm and calling for One Health (OH solutions in industrialized countries. OH solutions for health interventions are increasingly being used to capture expected and unexpected outcomes across people, animals, and the environment. The Network for Evaluation of One Health (NEOH proposes an evidence-based framework, relying on systems and mixed methods approaches to evaluate the One Health-ness. In this case study, this tool is used to evaluate the design of the Observatory of Taeniasis and Cysticercosis, as an example of intersectorial collaboration for surveillance in Portugal. The OH Initiative (drivers and expected outcomes and its system (boundaries, aim, dimensions, actors, and stakeholders were described. The different aspects of this Initiative were scored with values from 0 (=no OH approach to 1 (=perfect OH approach. The OH index was 0.31. Its OH ratio is 1.98. Overall scores were as follows: OH thinking 0.75; OH planning 0.60; OH working 0.60; OH sharing 0.35; OH learning 0.50; and systemic organization 0.50. Operational levels of the Initiative are the main strengths, indicating a comprehensive multidimensional innovative approach and transdisciplinarity. Critical issues in the supporting infrastructure were observed, related to communication, learning and organizational gaps in the project, with the evaluation being conducted as the project is being designed and implemented. The strengths and weaknesses detected may be used to refine the Initiative. This case study therefore exemplifies and supports OH assessment also for ongoing projects, at design and early implementation stages for guiding and guaranteeing an OH-oriented perspective.

  3. Advancing the use of performance evaluation in health care

    DEFF Research Database (Denmark)

    Traberg, Andreas; Jacobsen, Peter

    2014-01-01

    Purpose – The purpose of this paper is to develop a framework for health care performance evaluation that enables decision makers to identify areas indicative of corrective actions. The framework should provide information on strategic pro-/regress in an operational context that justifies the need...... unit, where operational decision makers have been struggling with extensive amounts of performance information. Research limitations/implications – The implementation of the framework in a single case in a public and highly political environment restricts the generalizing potential. The authors...

  4. [Evaluation of the organization of health services as a strategy for the prevention and control of visceral leishmaniasis].

    Science.gov (United States)

    Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da

    2016-01-01

    to evaluate the organization of health services as a strategy for the prevention and control of visceral leishmaniasis (VL) in Ribeirão das Neves, Minas Gerais, Brazil, from 2010 to 2012. this was a case study evaluation of the degree of implementation of a strategy for the integration of health care services, control of zoonosis and epidemiological surveillance; it consisted of observing the work process, interviewing health professionals and analysing secondary data from information systems. implementation was partially adequate (84%); in terms of structure, the human resources component had the worst evaluation (64%) whilst in terms of work process, evaluation was 80% for reorganization of care and 77% for surveillance; in the period 2010-2012 there was a 20% increase in reported cases of VL and a 20% reduction in the time interval between reporting a case and starting treatment. the strategy contributed to the improvement of the organization of VL prevention and control actions.

  5. Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study.

    Directory of Open Access Journals (Sweden)

    Lelia H Chaisson

    Full Text Available Tuberculosis (TB remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda.We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC: performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks' duration.The performance feedback evaluation included 1,446 adults; 838 (58% were evaluated during the pre-intervention period and 608 (42% during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p<0.001 increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47% were evaluated during the pre-intervention period and 1,043 (53% during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, p<0.001 increase in the proportion of patients receiving ISTC-adherent care.Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.

  6. Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study.

    Science.gov (United States)

    Chaisson, Lelia H; Katamba, Achilles; Haguma, Priscilla; Ochom, Emmanuel; Ayakaka, Irene; Mugabe, Frank; Miller, Cecily; Vittinghoff, Eric; Davis, J Lucian; Handley, Margaret A; Cattamanchi, Adithya

    2015-01-01

    Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks' duration. The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, pISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, pISTC-adherent care. Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.

  7. A systematic evaluation of payback of publicly funded health and health services research in Hong Kong

    Directory of Open Access Journals (Sweden)

    Chong Doris SY

    2007-07-01

    Full Text Available Abstract Background The Health and Health Services Research Fund (HHSRF is dedicated to support research related to all aspects of health and health services in Hong Kong. We evaluated the fund's outcomes and explored factors associated with the translation of research findings to changes in health policy and provider behaviour. Methods A locally suitable questionnaire was developed based on the "payback" evaluation framework and was sent to principal investigators of the completed research projects supported by the fund since 1993. Research "payback" in six outcome areas was surveyed, namely knowledge production, use of research in the research system, use of research project findings in health system policy/decision making, application of the research findings through changed behaviour, factors influencing the utilization of research, and health/health service/economic benefits. Results Principal investigators of 178 of 205 (87% completed research projects returned the questionnaire. Investigators reported research publications in 86.5% (mean = 5.4 publications per project, career advancement 34.3%, acquisition of higher qualifications 38.2%, use of results in policy making 35.4%, changed behaviour in light of findings 49.4%, evidence of health service benefit 42.1% and generated subsequent research in 44.9% of the projects. Payback outcomes were positively associated with the amount of funding awarded. Multivariate analysis found participation of investigators in policy committees and liaison with potential users were significantly associated with reported health service benefit (odds ratio [OR]participation = 2.86, 95% confidence interval [CI] 1.28–6.40; ORliaison = 2.03, 95% CI 1.05–3.91, policy and decision-making (ORparticipation = 10.53, 95% CI 4.13–26.81; ORliaison = 2.52, 95% CI 1.20–5.28, and change in behavior (ORparticipation = 3.67, 95% CI 1.53–8.81. Conclusion The HHSRF has produced substantial outcomes and compared

  8. Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study.

    Science.gov (United States)

    Dyson, Michele P; Newton, Amanda S; Shave, Kassi; Featherstone, Robin M; Thomson, Denise; Wingert, Aireen; Fernandes, Ricardo M; Hartling, Lisa

    2017-09-01

    Health care providers value ready access to reliable synthesized information to support point-of-care decision making. Web-based communities, facilitated by the adoption of social media tools such as Facebook, Twitter, and YouTube, are increasingly being used for knowledge dissemination, bridging the gap between knowledge generation and synthesis and knowledge implementation. Our objective was to implement and evaluate a structured social media strategy, using multiple platforms, to disseminate Cochrane Child Health evidence to health care providers caring for children. Our social media strategy had three components: daily "tweets" using the Cochrane Child Health Twitter account, weekly WordPress blog posts, and a monthly journal club on Twitter ("tweet chat"). Each tweet, blog, and journal club shared Cochrane evidence on a child health topic. We evaluated the strategy through (1) Twitter and blog site analytics, (2) traceable link (Bitly) statistics, (3) Altmetric.com scores for promoted evidence, and (4) participant feedback. We also tracked the resources required to write the blog, tweet content, and manage the strategy. The 22-week social media strategy ran between November 2014 and April 2015. We created 25 blog posts, sent 585 tweets, and hosted 3 tweet chats. Monthly blog visits and views and Twitter account followers increased over time. During the study period, the blog received 2555 visitors and 3967 page views from a geographically diverse audience of health care providers, academics, and health care organizations. In total, 183 traceable Bitly links received 3463 clicks, and the Twitter account gained 469 new followers. The most visited and viewed blog posts included gastrointestinal topics (lactose avoidance), research on respiratory conditions (honey for cough and treatments for asthma), and maternal newborn care (skin-to-skin contact). On Twitter, popular topics were related to public health (vaccination) and pain management. We collected Altmetric

  9. Environmental consultancy: dancing bee bioindicators to evaluate landscape health

    Directory of Open Access Journals (Sweden)

    Margaret Jane Couvillon

    2015-05-01

    Full Text Available Here we explore how waggle dance decoding may be applied as a tool for ecology by evaluating the benefits and limitations of the methodology compared to other existing ways to evaluate the honey bees’ use of the landscape. The honey bee foragers sample and report back on large areas (c. 100km2. Because honey bees perform dances only for the most profitable resources, these data provide spatial information about the availability of good quality forage for any given time. We argue that dance decoding provides information for a wide range of ecological, conservation, and land management issues. In this way, one species and methodology gives us a novel measure of a landscape’s profitability and health that may be widely relevant, not just for honey bees, but for other flower-visiting insects as well.

  10. Diagnostic evaluation of dementia in the secondary health care sector

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Andersen, Birgitte Bo; Kessing, Lars Vedel

    2009-01-01

    BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia...... diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable...... completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence...

  11. Exploring the role of health literacy in the evaluation of online health information: Insights from a mixed-methods study

    NARCIS (Netherlands)

    Diviani, N.; van den Putte, B.; Meppelink, C.S.; van Weert, J.C.M.

    Objective To gain new insights into the relationship between health literacy and evaluation of online health information. Methods Using a mixed-methods approach, forty-four semi-structured interviews were conducted followed by a short questionnaire on health literacy and eHealth literacy.

  12. Evaluating health care interventions in the European Union.

    Science.gov (United States)

    McDaid, David; Cookson, Richard

    2003-02-01

    This paper examines the current state of evaluations of health care interventions in the European Union, from the identification and commissioning of research through to its impact on policy and practice. Material is drawn from a survey conducted for the ASTEC project as well as a review of literature. Although the use of evaluative research has increased substantially in the last decade, both the pace of change and preferred research methodologies employed differ markedly. Much research still concentrates on issues of safety, efficacy and effectiveness, although there is evidence of an increasing emphasis on cost-effectiveness. Many countries are beginning to introduce systems linking economic evaluation to the decision-making process, while networks for the exchange of information continue to evolve. Research capacity in the public sector, although improving, is uneven, in part due to the uncertainty over long term career prospects and competition from industry. Capacity building measures should in particular ensure that dissemination expertise is strengthened, and that more emphasis is placed on developing receptor capacity within different stakeholder groups. Linking knowledge production to changes in practice remains a key challenge. Further research on implementation and impact assessment is required, to help demonstrate the value of evaluations on both policy and practice.

  13. Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

    Science.gov (United States)

    Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

    2013-01-01

    this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics

  14. The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

    Directory of Open Access Journals (Sweden)

    Annemarie Ruijsbroek

    Full Text Available Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run.With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008 and intervention period (mid 2008-2013-14 in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme.Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes.We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

  15. The Effect of Centering Pregnancy versus Traditional Prenatal Care Models on Improved Adolescent Health Behaviors in the Perinatal Period.

    Science.gov (United States)

    Trotman, Gylynthia; Chhatre, Gayatri; Darolia, Renuka; Tefera, Eshetu; Damle, Lauren; Gomez-Lobo, Veronica

    2015-10-01

    To determine if the CenteringPregnancy model of prenatal care improves maternal health behaviors in adolescent pregnancy. We conducted a retrospective chart review comparing 150 pregnant adolescents who received prenatal care between 2008 to 2012 with CenteringPregnancy to those receiving care in traditional prenatal care models with either multiprovider or single-provider visits. Outcome measures included weight gain during pregnancy, compliance to prenatal care appointments, infant feeding method, postpartum follow up and contraceptive use postpartum. A χ(2) analysis was used to compare outcomes between the 3 groups at a 2-tailed α of .05. Fifty individuals were evaluated in each group. Adolescents in the CenteringPregnancy group were more likely to comply with prenatal and postpartum visits and to meet the 2009 Institute of Medicine gestational weight guidelines for weight gain in pregnancy than were adolescents in either multiprovider (62.0% vs 38.0%, P = .02) or single-provider (62.0% vs 38.0%, P = .02) groups. The CenteringPregnancy group was also more likely to solely breastfeed compared with adolescents in the multiprovider group (40.0% vs 20.0%, P = .03) and include breastfeeding in addition to bottle-feeding compared with both multiprovider (32.0% vs 14.0%, P = .03) and single-provider (32.0% vs 12.0%, P = .03) patient groups. Additionally, the CenteringPregnancy group had increased uptake of long-acting reversible contraception and were less likely to suffer from postpartum depression. CenteringPregnancy Prenatal Care program aids in compliance to prenatal visits, appropriate weight gain, increased uptake of highly effective contraception, and breastfeeding among adolescent mothers. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Evaluation of Forest Health Conditions using Unmanned Aircraft Systems (UAS)

    Science.gov (United States)

    Hatfield, M. C.; Heutte, T. M.

    2016-12-01

    US Forest Service Alaska Region Forest Health Protection (FHP) and University of Alaska Fairbanks, Alaska Center for Unmanned Aircraft Systems Integration (ACUASI) are evaluating capability of Unmanned Aerial Systems (UAS) to monitor forest health conditions in Alaska's Interior Region. In July 2016, the team deployed UAS at locations in the Tanana Valley near Fairbanks in order to familiarize FHP staff with capabilities of UAS for evaluating insect and disease damage. While many potential uses of UAS to evaluate and monitor forest health can be envisioned, this project focused on use of a small UAS for rapid assessment of insect and disease damage. Traditional ground-based methods are limited by distance from ground to canopy and inaccessibility of forest stands due to terrain conditions. Observation from fixed-wing aircraft provide a broad overview of conditions but are limited by minimum safe flying altitude (500' AGL) and aircraft speed ( 100 mph). UAS may provide a crucial bridge to fill in gaps between ground and airborne methods, and offer significant cost savings and greater flexibility over helicopter-based observations. Previous uses of UAS for forest health monitoring are limited - this project focuses on optimizing choice of vehicle, sensors, resolution and area scanned from different altitudes, and use of visual spectrum vs NIR image collection. The vehicle selected was the ACUASI Ptarmigan, a small hexacopter (based on DJI S800 airframe and 3DR autopilot) capable of carrying a 1.5 kg payload for 15 min for close-range environmental monitoring missions. Sites were chosen for conditions favorable to UAS operation and presence of forest insect and disease agents including spruce broom rust, aspen leaf miner, birch leaf roller, and willow leafblotch miner. A total of 29 flights were conducted with 9000+ images collected. Mission variables included camera height, UAS speed, and medium- (Sony NEX-7) vs low-resolution (GoPro Hero) cameras. Invaluable

  17. Amiata donkey milk chain: animal health evaluation and milk quality

    Directory of Open Access Journals (Sweden)

    Giuseppe Ragona

    2016-08-01

    Full Text Available This study presents an investigation of Amiata donkey health and quality of milk for human consumption. Thirty-one lactating dairy jennies were examined. The following samples were collected: faecal samples from the rectum of animals for parasitological examination; cervical swabs for the detection of bacteria causing reproductive disorders; and blood samples for serological diagnosis of main zoonotic (Brucella spp., Leptospira spp. and donkey abortion agents (Brucella spp., Leptospira spp., Salmonella abortus equi, Equine viral arterithis virus, Equine herpesvirus type 1. In addition, individual milk samples were collected and analysed for mastitis- causing pathogens and milk quality. Regarding animal health, we detected a high prevalence of strongyle parasites in donkeys. It is very important to tackle parasitic diseases correctly. Selective control programmes are preferable in order to reduce anthelmintic drug use. For dairy donkeys, withdrawal periods from anthelmintic drugs need to be carefully managed, in accordance with EU and national regulations. The isolation of Staphylococcus aureus in milk highlights the importance of preventing contamination during milking, by adopting appropriate hygiene and safety practices at a farm level. Lysozyme activity was high compared to cow’s milk, contributing to the inhibitory activity against certain bacteria. Donkey milk was characterised by high lactose content, low caseins, low fat, higher levels of unsaturated fatty acids compared to ruminant milks. Unsaturated fatty acids and omega 3 fatty acids in particular have become known for their beneficial health effect, which is favourable for human diet. These characteristics make it suitable for infants and children affected by food intolerance/ allergies to bovine milk proteins and multiple food allergies as well as for adults with dyslipidemias. It is also recommended to prevent cardiovascular diseases.

  18. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

    Science.gov (United States)

    Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

    2006-11-01

    All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

  19. Health economic evaluations of medical devices in the People's Republic of China: A systematic literature review.

    Science.gov (United States)

    Zhang, Rongrong; Modaresi, Farhang; Borisenko, Oleg

    2015-01-01

    The objective of this study is to identify and review the methodological quality of health economic evaluations of medical devices performed in the People's Republic of China. To our knowledge, no such investigations have been performed to date. A systematic literature review involving searches of Medline, Medline In-Process, the National Health Service Economic Evaluation Database, the Cost-Effectiveness Analysis Registry of the Tufts Medical Center, and the Wanfang Database was performed. The search spanned the period from 1990 to 2013. Studies on health economic evaluations of medical devices, in-vitro diagnostics, procedures, and the use of medical devices in Chinese health care settings were included. Full-text articles and conference abstracts in English and Chinese were included. Fifty-seven publications were included, 26 (46%) of which were in English and 31 (54%) of which were in Chinese. The included publications covered a wide range of clinical areas, such as surgery (n=23, 40%), screening (n=9, 16%), imaging use (n=6, 11%), kidney intervention (n=4, 7%), and nine other technological areas. Most of the studies (n=31, 54%) were cost analyses. Among the others, 13 (50%) studies used modeling, and another 13 (50%) were within-trial evaluations. Among studies that used modeling, eleven (85%) conducted sensitivity analyses, six of which had one-way sensitivity analysis, whereas one conducted both one-way and two-way sensitivity analyses; four of these eleven modeling-based analyses included probabilistic sensitivity analyses. The incremental cost-effectiveness ratio was reported in ten (18%) studies, eight of which were screening studies. The remaining two modeling studies were in areas of imaging and oncology. This study indicates that there are major limitations and deficiencies in the health economic evaluations on medical devices performed in the People's Republic of China. Further efforts are required from different stakeholders - academic, governmental

  20. Contextual factors in maternal and newborn health evaluation: a protocol applied in Nigeria, India and Ethiopia.

    Science.gov (United States)

    Sabot, Kate; Marchant, Tanya; Spicer, Neil; Berhanu, Della; Gautham, Meenakshi; Umar, Nasir; Schellenberg, Joanna

    2018-01-01

    , but also because contextual data was not available for the precise units of analysis or time periods of interest. We would advise others to consider integrating contextual factors within other data collection activities, and to conduct regular reviews of maternal and newborn health policies. This approach and the learnings from its application could help inform the development of guidelines for the collection and use of contextual factors in public health evaluation.

  1. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    Science.gov (United States)

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, pscorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  2. Evaluation of a Quality Improvement Resource for Public Health Practitioners.

    Science.gov (United States)

    Porterfield, Deborah S; Marcial, Laura H; Brown, Stephen; Throop, Cynthia; Pina, Jamie

    Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.

  3. Chromium supplementation alters the performance and health of feedlot cattle during the receiving period and enhances their metabolic response to a lipopolysaccharide challenge

    Science.gov (United States)

    Crossbred steers (n = 180; 230 +/- 6 kg) were fed during a 56-d receiving period to determine if supplementing chromium (Cr; KemTRACE®brandChromiumPropionate0.04%, Kemin Industries) would improve feedlot performance and health of newly-received cattle. A completely randomized block design (36 pens; ...

  4. Periodic bacterial control with peracetic acid in a recirculating aquaculture system and its long-term beneficial effect on fish health

    DEFF Research Database (Denmark)

    Liu, Dibo; Straus, David L.; Pedersen, Lars-Flemming

    2017-01-01

    improve fish health. In the present study, a periodic microbial control was performed in a RAS with 16 tanks stocked with mirror carp (Cyprinus carpio) for 3months. Half of the fish culture tanks were treated with 1mgL−1 peracetic acid (PAA) twice per week, while the other half remained untreated...

  5. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    Science.gov (United States)

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  6. 29 CFR 1960.79 - Self-evaluations of occupational safety and health programs.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Self-evaluations of occupational safety and health programs. 1960.79 Section 1960.79 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH... AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs...

  7. Comparing the risk associated with psychosocial work conditions and health behaviours on incident hypertension over a nine-year period in Ontario, Canada.

    Science.gov (United States)

    Smith, Peter M; Mustard, Cameron A; Lu, Hong; Glazier, Richard H

    2013-01-07

    Hypertension is an increasingly important health concern in Canada. This paper examines the risks associated with psychosocial working conditions compared to health behaviours on the risk of hypertension over a 9-year period in Ontario, Canada. We used data from Ontario respondents to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Information Plan database covering physician services and the Canadian Institute for Health Information database for hospital admissions. We focused on labour market participants aged 35 to 60, who had not been previously diagnosed with hypertension, were not self-employed, and were working more than 10 hours per week, more than 20 weeks in the previous 12 months (N = 6,611). Subjects were followed for a nine-year period to ascertain incidence of hypertension. Low job control was associated with an increased risk of hypertension among men, but not among women. The population attributable fraction associated with low job control among males was 11.8% in our fully adjusted model. There was no consistent pattern of increased risk of hypertension across different levels of health behaviours. Primary prevention efforts to reduce the incidence of hypertension predominantly target modifiable health behaviours. Evidence from this longitudinal cohort suggests that modifiable characteristics of the work environment should also be considered in the design of cardiovascular disease prevention programs, in particular for male labour market participants.

  8. Prevention of birth defects in the pre-conception period: knowledge and practice of health care professionals (nurses and doctors in a city of Southern Brazil

    Directory of Open Access Journals (Sweden)

    Flávia Romariz Ferreira

    2015-10-01

    Full Text Available Background: Some congenital defects can be prevented in the pregestational stage. However, many health professionals are not prepared to provide counselling to couples regarding the same. Objective: This study aimed to assess the performance of doctors and nurses from a primary health-care unit in Florianopolis, Brazil, in preventing birth defects in the preconception period based on the recommendations of the Control Center of Disease Prevention. Materials and Methods: This descriptive cross sectional study was performed at a tertiary referral center. In this study, a semi-structured questionnaire was provided to 160 health professionals comprising doctors and nurses who were actively involved in providing primary health care in family health programs. The non-parametric Chi-square (χ2 test was used to analyse the data obtained through multiple choice questions. Results: Our results showed that although 81.9% of health professionals provided health-care assistance based on protocols, and only 46.2% professionals were aware of the presence of the topic in the protocol. Of the recommendations provided by the Control Center of Disease Prevention, the use of folic acid was the most prescribed. However, this prescription was not statistically different between nurses and doctors (P=0.85. Conclusion: This study identified the fragile nature in these professional’s knowledge about the prevention of birth defects in pre-conception period, as evidenced by the inconsistency in their responses.

  9. EVALUATION CRITERIA OF INNOVATIVE SOCIAL INVESTMENT PROJECTS IN HEALTH CARE

    Directory of Open Access Journals (Sweden)

    Vadim Aleksandrovich Lomazov

    2013-11-01

    Full Text Available Purpose: analysis of key indicators and creation of evaluation criteria of innovative socio-economic investment projects in healthcare, implemented on the basis of public-private partnerships.Methodology: there has been performed comprehensive assessment of specialized socio-economic projects in health sector taking into consideration interests of participants in the project (public and private, main aspects (medical, social, economic, scientific and innovative, and assessment components (presumable effectiveness or risk during implementation of the project. The degree of relative importance of the factors considered in each level, and the levels themselves are determined by experts with the help of paired comparisons method. The values of the project indicators are estimated against nonuniform grading scale, both the results of direct measurements and expert information being used.Results: There has been suggested an approach and a procedure for evaluating projects based on the allocation of interests, issues and evaluation components of the project as sub-criteria levels of the hierarchy analysis method; there has been developed research prototype of information analysis system for assessment of projects on the basis of the proposed approach.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-48

  10. Barriers and facilitators to smoking cessation in pregnancy and in the post-partum period: The health care professionals' perspective.

    Science.gov (United States)

    Naughton, Felix; Hopewell, Sarah; Sinclair, Lesley; McCaughan, Dorothy; McKell, Jennifer; Bauld, Linda

    2018-05-15

    Health care professionals and the health care environment play a central role in protecting pregnant and post-partum women and their infants from smoking-related harms. This study aimed to better understand the health professional's perspective on how interactions between women, health care professionals, and the environment influence how smoking is managed. Semi-structured interviews and focus groups. Data were from 48 health care staff involved in antenatal or post-partum care at two UK sites, including midwives, obstetricians, health visitors, GPs, pharmacists, service commissioners, and Stop Smoking Service (SSS) advisors and managers. Thematic analysis was guided by a social-ecological framework (SEF). Themes were divided across three SEF levels and represented factors connected to the management of smoking in the health care context and the beliefs and behaviour of pregnant or post-partum smokers. Organizational level: Service reconfigurations, 'last resort' nicotine replacement therapy prescribing policies, and non-mandatory training were largely negative factors. There were mixed views on opt-out referral pathways and positive views on carbon monoxide monitoring. Interpersonal level: Protection of client-professional relationships often inhibited frank discussions about smoking, and weak interservice relationships affected SSS referral motivation and quality. Individual level: Professionals felt community midwives had primary responsibility for managing smoking, although midwives felt underskilled doing this. Midwives' perceived priority for addressing smoking was influenced by the demands from unrelated organizational initiatives. Opportunities to improve clinical support for pregnant smokers exist at organizational, interservice, and health care professional levels. Interactions between levels reflect the importance of simultaneously addressing different level-specific barriers to smoking cessation in pregnancy. Statement of contribution What is already

  11. Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

    Science.gov (United States)

    Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

    2015-04-17

    Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

  12. Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students.

    Science.gov (United States)

    Braun, Hannan M; Garcia-Grossman, Ilana R; Quiñones-Rivera, Andrea; Deutsch, Madeline B

    2017-02-01

    Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge. Students participated in a 10-session, lunch-hour elective course during the spring of 2015. To evaluate impact, course participants completed pre-, immediately post-, and 3-month postcourse questionnaires, including a previously validated nine-item transphobia scale, to determine the course's effect on knowledge, attitudes, and beliefs about transgender health. Forty-six students completed the pre- and immediately postelective questionnaire (74% response rate). Compared with pre-elective surveys, immediately postelective scores demonstrated increased knowledge in most domains and reduced transphobia. Specific knowledge domains with improvements included terminology, best practices for collecting gender identity, awareness of the DSM-V gender dysphoria diagnosis, medications used for gender affirmation, and relevant federal policies. A previously validated transphobia scale was found to have good reliability in the current sample. This elective course led to positive short-term changes in measures of multiple knowledge domains and reduced measures of transphobia among health profession students. Further study is needed to assess the long-term impact. Our methods and findings, including the demonstration of reliability of a previously validated nine-item transphobia scale, serve as formative data for the future development of theory-based transgender medicine curricula and measures.

  13. The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program

    Directory of Open Access Journals (Sweden)

    Baik-Lin Eun

    2010-03-01

    Full Text Available Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors&#8212;for example, good mental health, balanced nutrition, and more exercise.

  14. Occurrence Probabilities of Wet and Dry Periods in Southern Italy through the SPI Evaluated on Synthetic Monthly Precipitation Series

    Directory of Open Access Journals (Sweden)

    Tommaso Caloiero

    2018-03-01

    Full Text Available The present article investigates dry and wet periods in a large area of the Mediterranean basin. First, a stochastic model was applied to a homogeneous database of monthly precipitation values of 46 rain gauges in five regions of southern Italy. In particular, after estimating the model parameters, a set of 104 years of monthly precipitation for each rain gauge was generated by means of a Monte Carlo technique. Then, dry and wet periods were analyzed through the application of the standardized precipitation index (SPI over 3-month and 6-month timespan (short-term and 12-month and 24-month period (long-term. As a result of the SPI application on the generated monthly precipitation series, higher occurrence probabilities of dry conditions than wet conditions have been detected, especially when long-term precipitation scales are considered.

  15. Applying the AHP in Health Economic Evaluations of New Technology.

    NARCIS (Netherlands)

    Hummel, J. Marjan; Steuten, Lotte Maria Gertruda; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

    2011-01-01

    Much research in health care is devoted to health economical modelling. Even though the Analytic Hierarchy Process (AHP) is increasingly being applied in health care, its value to health economical modelling is still unrecognized. We explored the value of using AHP-derived results in a health

  16. [A quality evaluation tableau for health institutions: an educational tool].

    Science.gov (United States)

    Moll, Marie Christine; Decavel, Frédérique; Merlet, Christine

    2009-09-01

    For a few years, health institutions have had to comply with the certification and the need to establish the new governance. Thanks to the accreditation version 2 (obtained in 2005), the elaboration of the hospital project (adopted in October, 2006) and the organization in poles since 2006, the quality oriented management became a priority axis at the University Hospital of Angers. The strategic adaptation to quality requirements leads to develop the hospital management, more especially at the level of the clinical, medico technical and administrative poles. The elements of the hospital project including the part about the quality, risk and evaluation aim at being adapted by every pole according to the level of its project. This adaptation which is imposed to each pole manager requires a practical and educational accompaniment allowing at the same time to realize a diagnosis of the progress of the quality approach, a measure of the impact of the global impregnation within the institution and a comparison between pole. A eight axis dashboard with criteria and a user guide were developed from certification ISO 9001, the EFQM manual and the certification manual version 2 of the Healthcare High Authorities. The criteria are transcribed in an EXCEL grid ready to use. Succeeding in estimating your own quality system means that you demonstrate the maturity of the quality approach. The results of this evaluation confirmed those of the certification. The dashboard is a management structuring tool at the service of the multidisciplinary team. Two considerations emerge from these results: First of all, for the hospital top management, the axes to be improved emerge as a priority to determine and target the next annual action plans. The results also allow to support the auto evaluation for the certification version 2010 planned in January of the same year. It is a pragmatic tool which allows auto evaluation and comparison to estimate the pole performances. It is a strategic

  17. A cross-sectional analysis of barriers to health-care seeking among medical students across training period

    Directory of Open Access Journals (Sweden)

    Vikas Menon

    2017-01-01

    Full Text Available Background and Aims: Very little information is available on how needs and perceptions to service utilization may change with duration of medical training. Our objective was to compare the self-reported barriers to health-care seeking for mental and physical health services separately between 1st year and final year medical students. Methods: In this cross-sectional study, we invited all medical students of the concerned cohorts to complete a prevalidated checklist and 28-item self-reported questionnaire about perceived barriers to health-care seeking. The questionnaire had separate items pertaining to usage of mental and physical health-care services. Results: The response rate of the 1st year and final year cohorts were 83.8% and 86.6%, respectively. Lack of time, unawareness about where to seek help, cost issues, and fear of future academic jeopardy were more common concerns among 1st year students to the usage of mental health services (odds ratio [OR] 0.27, 0.45,0.09, and 0.49, respectively whereas issues of stigma were more commonly reported by final year students for using mental health services (OR = 2.87. In contrast, the barriers in using physical health services were broadly comparable between the two cohorts. Conclusion: Differences exist between medical students in various years of training particularly with regard to self-reported barriers and perceptions particularly about using mental health-care services. This may have key implications for designing and delivery of service provisions in this group.

  18. St. John Health integrating new corporate identity, brand. Brand/logo to be rolled out over two-year period.

    Science.gov (United States)

    Rees, Tom

    2003-01-01

    St. John Health, Warren, Mich., is integrating a new corporate identity and brand strategy for its network of nine wholly-owned and two affiliated hospital, along with more than 100 physician offices and specialty centers in southeast Michigan. "A new identity is a great rallying cry. It automatically says. 'We have a new mission. We have a new system. We are reaching new people,'" said Eunice O'Loughlan, VP, corporate communications for St. John Health.

  19. Evaluation of a public health newsletter intended for travel agents.

    Science.gov (United States)

    Provost, Sylvie

    2003-01-01

    Travel agents are in a key position to encourage travelers to seek consultation in travel clinics. Since the beginning of the year 2000, a newsletter specifically designed to sensitize travel agents to travel health has been published by the public health authorities and distributed to all travel agencies in Quebec. This study was undertaken to evaluate the utilization and appreciation of the newsletter by travel agents and its impact on preventive practices. During the autumn of 2001, a cross-sectional descriptive survey was carried out among travel agencies in Quebec. Data were collected using a self-administered questionnaire sent by fax with a postal follow-up. A total of 252 of the 950 travel agencies contacted (27%) answered our questionnaire. In all, 78% of respondents said their agency receives the newsletter. Among these agencies, the majority of respondents considered that the subjects discussed in the newsletter are interesting (often or in general: 96%), that the subjects and preventive recommendations for travel destinations are useful in the travel agent's practice (often or in general: 89%), and generally presented in an adequate way (96%). According to the respondents, the newsletter encouraged them, often or very often, to inform travelers about travel-related health problems (70%) or to recommend a consultation in a travel clinic (63%). The impact of the newsletter on the recommendation to consult was greater among agents having more than 10 years' experience (odds ratio [OR] 3.2). When asked about the best way to send them the newsletter, only 31% identified bulk mailing, which was the current mode of distribution. Satisfaction rate with the newsletter appears to be high among respondents who receive it. However, the low response rate to the survey may indicate that as a whole, the travel agents' interest in the newsletter is mitigated. Despite the limitations of this study, the results will allow us to modify some aspects of the publication

  20. 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. ...

  1. Consequences of dry period length and dietary energy source on physiological health variables in dairy cows and calves

    NARCIS (Netherlands)

    Mayasari, Nova

    2017-01-01

    During the transition period, dairy cows experience a negative energy balance (NEB) caused by the high energy requirement for milk yield, while feed intake is limited. Severity of the NEB has been associated with an increased incidence of metabolic disorders and infectious

  2. Evaluation of Existing and New Periodic Tables of the Elements for the Chemistry Education of Blind Students

    Science.gov (United States)

    Fantin, Dennis; Sutton, Marc; Daumann, Lena J.; Fischer, Kael F.

    2016-01-01

    As a symbol of the power and majesty of science, the periodic table has inspired many scientists-to-be to investigate the deep secrets of nature through the study of chemistry. In the spirit of inclusion, blind students too deserve and need to have their curiosity about the inner workings of nature stimulated through greater exposure to this…

  3. Evaluation of the knowledge regarding prevention of cervical cancer among women from a Health Unit

    Directory of Open Access Journals (Sweden)

    Ernandes Gonçalves Dias

    2015-07-01

    Full Text Available Background and objectives: Cervical cancer is a disease with high degree of morbidity and mortality, but has early detection by performing screening test which allows healing. This study aimed to evaluate the knowledge regarding prevention of Cervical Cancer among women in a Basic Health Unit in Minas Gerais. Methods: This is a study descriptive with approach qualitative with 44 women. Was used as the data collection instrument of a semistructured script consisting of subjective questions. Data were collected between March April 2014. Results: The women had age of 40-57 years old, 33 (75% were married, 43(97,73% had children, 20 (45,45% had incomplete primary education, 36 (81,82% were responsible for all financial income of the family and lived with up to the minimum wage. As for the Pap smear, considered important, however showed little clarity as to the meaning of prevention. Performed the test as means of prevention and early diagnosis of Cervical Cancer. Among women who did not perform the preventive the cause was discouragement. Conclusion: We conclude that although the Pap smear be offered for free, there is still women who do not have adequate knowledge about the same and not makes periodically, fitting to health services intensify health education programs to seeking to raise awareness about the importance of regular practice of the Pap smear. Keywords: Cervix Uteri. Uterine Cervical Neoplasms. Health centers.

  4. A Tentative Study on the Evaluation of Community Health Service Quality*

    Science.gov (United States)

    Ma, Zhi-qiang; Zhu, Yong-yue

    Community health service is the key point of health reform in China. Based on pertinent studies, this paper constructed an indicator system for the community health service quality evaluation from such five perspectives as visible image, reliability, responsiveness, assurance and sympathy, according to service quality evaluation scale designed by Parasuraman, Zeithaml and Berry. A multilevel fuzzy synthetical evaluation model was constructed to evaluate community health service by fuzzy mathematics theory. The applicability and maneuverability of the evaluation indicator system and evaluation model were verified by empirical analysis.

  5. Evidence-based Heuristics for Evaluating Demands on eHealth Literacy and Usability in a Mobile Consumer Health Application.

    Science.gov (United States)

    Monkman, Helen; Griffith, Janessa; Kushniruk, Andre W

    2015-01-01

    Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.

  6. Embedding Mental Health Support in Schools: Learning from the Targeted Mental Health in Schools (TaMHS) National Evaluation

    Science.gov (United States)

    Wolpert, Miranda; Humphrey, Neil; Belsky, Jay; Deighton, Jessica

    2013-01-01

    The Targeted Mental Health in Schools (TaMHS) programme was a nationwide initiative that funded mental health provision in schools for pupils at risk of or already experiencing mental health problems. The implementation, impact and experience of this programme was evaluated using quantitative and qualitative methodology involving three main…

  7. Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs : What Broader Non-Health Outcomes Matter Most?

    NARCIS (Netherlands)

    Benning, Tim M; Alayli-Goebbels, Adrienne F G; Aarts, Marie-Jeanne; Stolk, Elly; de Wit, G Ardine; Prenger, Rilana; Braakman-Jansen, Louise M A; Evers, Silvia M A A

    2015-01-01

    BACKGROUND: Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of

  8. Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?

    NARCIS (Netherlands)

    Benning, Tim M.; Alayli-Goebbels, Adrienne F.G.; Aarts, Marie-Jeanne; Stolk, Elly; de Wit, G. Ardine; Prenger, Hendrikje Cornelia; Braakman-Jansen, Louise Marie Antoinette; Evers, Silvia M.A.A.

    2015-01-01

    Background Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of

  9. Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation

    DEFF Research Database (Denmark)

    Rolander, B.; Jonker, D.; Winkel, Jørgen

    2013-01-01

    ' working conditions, health and productivity during a 5-year period. In 2003 and 2008, 65 dentists responded to questionnaires measuring work conditions and health. Treatment times for patients and productivity were tracked in electronic registers. Paired t-tests showed that the number of treated adult...... patients per dentist increased, and perceived physical working conditions improved while perceived work control and leadership deteriorated. Structural equation modelling showed that physical factors were important for health and productivity. When assessing risks in the work environment, there is a need...... to understand the interaction of effects on working conditions and health due to rationalisations so as to increase the sustainability of production systems. Practioner Summary: Dentistry in Sweden has undergone considerable change. Questionnaire surveys with dentists, undertaken in 2003 and 2008, found...

  10. Countermeasures (iRED, ARED CEVIS, MEC, TVIS, T2, Periodic Fitness Evaluation, BP-ECG, HRM). Critical Readiness Review Increment 23 and 24

    Science.gov (United States)

    Toder, Carly; Gipson, Iona; Conly, Danielle; Nieschwitz, Linda; Perk, Austin

    2010-01-01

    This slide presentation reviews attempts to counteract the effects of being in space. It includes information on the Resistive Exercise Device (RED), the Advanced Resistive Exercise Device (ARED), Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS), Treadmill with Vibration Isolation and Stabilization (TVIS) and periodic fitness evaluation with specific information on BP/ECG, heart rate monitor 2 and data distribution.

  11. Health Hazard Evaluation Report HETA 84-204-1600, Dental Health Associates, Paoli, Pennsylvania. [Nitrous oxide

    Energy Technology Data Exchange (ETDEWEB)

    Crandall, M.S.

    1985-06-01

    Area air and breathing-zone samples were analyzed for nitrous oxide at Dental Health Associates, Paoli, Pennsylvania on August 2, 1984. The evaluation was requested by a dental assistant because of general concern about the extent of nitrous oxide exposure, especially since the office was not equipped with a waste-anesthetic gas-scavenging system. The author recommends installing a waste anesthetic gas scavenging system with a dedicated exhaust. The nitrous oxide delivery and mixing system should be checked for leaks monthly and work practices for handling nitrous oxide should be improved.

  12. Implementation and evaluation of Stanford Health Care direct-care teledermatology program

    Directory of Open Access Journals (Sweden)

    Akhilesh S Pathipati

    2016-07-01

    Full Text Available Introduction: Teledermatology has proven to be an effective means of providing dermatologic care. The existing research has primarily evaluated its usefulness in a consultative model. Few academic centers have evaluated a patient-initiated model, and direct-to-consumer services remain the subject of controversy. Stanford Health Care recently launched a direct-care, patient-initiated teledermatology pilot program. This article evaluates the viability and patient satisfaction with this service. Materials and Methods: During the pilot period, patients were able to seek remote dermatologic care using an eVisit tool in their MyHealth account. Patients initiated the consultation, answered questions regarding their complaint, and uploaded a picture if relevant. A Stanford dermatologist reviewed each eVisit and responded with an assessment and plan. The dermatologist noted whether they were able to make a diagnosis and their level of confidence in it. After the study, 10 patients participated in a focus group to provide feedback on the service. Results: In all, 38 patients sought care during the pilot period. A dermatologist was able to make a diagnosis in 36 of 38 (95% cases, with an average confidence level of 7.9 of 10. The average time to consultation was 0.8 days. Patients indicated high levels of satisfaction with the service although they had suggestions for improvement. Discussion: Patients provided clinically useful images and information in a direct-care teledermatology model. Such services allow dermatology providers to increase access while maintaining high-quality care in an academic medical center. Further research is needed on standalone services that cannot integrate encounters with the patient’s existing medical record.

  13. EVALUATION OF MICROLEAKAGE DEGREE IN COMPOSITE RESIN RESTORATIONS BY COMPARING TWO ADHESIVES SYSTEMS AFTER DIFFERENT AGING PERIODS

    OpenAIRE

    Falconí-Borja, Gabriela Marina; Molina-Pule, Carla Grimaneza; Velásquez-Ron, Byron Vinicio; Armas-Vega, Ana del Carmen

    2016-01-01

    ABSTRACT Introduction: the clinical success of adhesive systems is based on the use of a responsible for creating microporosity in the dental structure acid and arises assess in vitro the degree of microfiltration in direct restorations with cavities class V where two adhesive systems differently used composition and at different periods of time. Methods: in the cervical third of 60 third molars extracted by therapeutic indication performed by diamond instruments, two cavities one on the ...

  14. Evaluation of the collection of periodical publications pertaining to CIDN (Nuclear Information and Documentation Center): Part I

    International Nuclear Information System (INIS)

    Contreras, T.J.

    1994-01-01

    The main purpose of this paper is to identify the lacks of the collection of periodical publications pertaining to CIDN as a function of the information needs of the researching community, considering that the research roles are in changing process. The library services of alert, selective dissemination of information, and interlibrary loan are analyzed. The results attained in the first stage of this study will help to take decisions about the titles that is necessary to put into the discard. (Author)

  15. The methodology of comparative evaluation of ruble and foreign currency loans in the pre-crisis period

    Directory of Open Access Journals (Sweden)

    Chamov Aleksey Nikolaevich

    2016-04-01

    Full Text Available In the article the author considers a problem of an optimal way of borrowing during the pre-crisis period (deciding between ruble and foreign currency borrowings. It is obvious that during the period of stable economic growth, when currency pair rate (for example, ruble - USA dollar doesn't change significntly, the lower interest rate of foreign currency loans makes them a cheaper way of borrowing. But during a crisis an abrupt growth of currency pair rate can make foreign currency loan a more expensive way of borrowing (as compared to ruble loan. The author suggests a scenario-based method of decision making about an optimal way of borrowing during a pre-crisis period, which affords to calculate a threshold meaning of currency pair rate, after which a foreign currency loan becomes more expensive. Application of the method is illustrated on the example of a situation in a telecommunication sector in Russian Federation during currency crisis of 2014. A detailed analysis if the situation in the sector in the last pre-crisis year (2013 is provided. Structures of debt burdens of the leading companies (Vimpelcom, MTS and Megafon are considered. Percent shares of currency loans, shares of borrowing types and according interest rates are provided. In the conclusion of the article some specific aspects of application of suggested method and potential ways of its improvement are considered.

  16. Effect of concentrate supplementation during the dry period on colostrum quality and effect of colostrum feeding regimen on passive transfer of immunity, calf health, and performance.

    Science.gov (United States)

    Dunn, A; Ashfield, A; Earley, B; Welsh, M; Gordon, A; McGee, M; Morrison, S J

    2017-01-01

    The objectives were to evaluate the effect of (1) supplementing concentrates to multiparous Holstein cows during the dry period on colostral and milk immunoglobulin G (IgG) concentration; and (2) feeding calves colostrum at either 5 or 10% of their body weight (BW) on passive transfer of immunity, health, and performance. Holstein multiparous cows (n=37) were assigned to 1 of 2 nutritional treatments during an 8-wk dry period: (1) offered ad libitum grass silage only (GS) or (2) offered ad libitum access to the same grass silage plus concentrate [total mixed ration in a 75:25 dry matter (DM) ratio], providing a mean concentrate DM intake of 3.0kg/cow per day (GSC). Both treatment groups were offered identical levels of mineral and vitamin supplementation. Calves from these cows were weighed immediately after birth and fed either 5% (5BW) or 10% (10BW) of their BW in colostrum from their own dams within 2.5h of birth. Calves in the 10BW group received their second feed of colostrum from first-milking colostrum. Concentrate supplementation during the dry period had no effect on colostral IgG concentration, first-milking IgG yield, or fat, protein, and lactose contents. However, cows in GSC produced a greater mean milk yield over the first 8 milkings compared with cows in the GS group. Concentrate supplementation had no effect on calf BW or BW gain, serum IgG, or apparent efficiency of absorption (AEA) at 24h after birth. However, offspring from the GSC group had fewer cases of enteritis during the first 56d of life compared with offspring from the GS group. Calves in the 10BW group had greater mean serum IgG concentration for the first 3d following birth; however, at 24h after birth, we observed no treatment effect on AEA. The rate of enteritis was greater for calves in the 5BW treatment compared with 10BW. The colostrum-feeding regimen had no effect on BW gain or on the incidence of pneumonia among calf treatment groups. In conclusion, concentrate supplementation

  17. The effects of menopausal health training for spouses on women's quality of life during menopause transitional period.

    Science.gov (United States)

    Bahri, Narjes; Yoshany, Nooshin; Morowatisharifabad, Mohammad Ali; Noghabi, Ali Delshad; Sajjadi, Moosa

    2016-02-01

    Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P women in the intervention group was higher 3 months after intervention (P training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.

  18. 26 CFR 1.420-1 - Significant reduction in retiree health coverage during the cost maintenance period.

    Science.gov (United States)

    2010-04-01

    ... sale or other transfer in connection with which the employees of a trade or business of the employer... of the trade or business. (d) Examples. The following examples illustrate the application of this... individuals died in Year 2. During Year 3, Employer W amends its health plan to eliminate coverage for 5...

  19. Online health information search and evaluation: observations and semi-structured interviews with college students and maternal health experts.

    Science.gov (United States)

    Kim, Hyojin; Park, Sun-Young; Bozeman, Ingrid

    2011-09-01

    While the Internet is a popular source of health information, health seekers' inadequate skills to locate and discern quality information pose a potential threat to their healthcare decision-making. We aimed to examine health information search and appraisal behaviours among young, heavy users of the Internet. In study 1, we observed and interviewed 11 college students about their search strategies and evaluation of websites. In study 2, three health experts evaluated two websites selected as the best information sources in study 1. Familiarity with health websites and confidence in search strategies were major factors affecting search and evaluation behaviours. Website quality was mostly judged by aesthetics and peripheral cues of source credibility and message credibility. In contrast to users' favourable website evaluation, the experts judged the websites to be inappropriate and untrustworthy. Our results highlight a critical need to provide young health seekers with resources and training that are specifically geared toward health information search and appraisal. The role of health seekers' knowledge and involvement with the health issue in search effort and success warrants future research. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  20. A framework and case studies for evaluation of enzyme ontogeny in children's health risk evaluation.

    Science.gov (United States)

    Ginsberg, Gary; Vulimiri, Suryanarayana V; Lin, Yu-Sheng; Kancherla, Jayaram; Foos, Brenda; Sonawane, Babasaheb

    2017-01-01

    Knowledge of the ontogeny of Phase I and Phase II metabolizing enzymes may be used to inform children's vulnerability based upon likely differences in internal dose from xenobiotic exposure. This might provide a qualitative assessment of toxicokinetic (TK) variability and uncertainty pertinent to early lifestages and help scope a more quantitative physiologically based toxicokinetic (PBTK) assessment. Although much is known regarding the ontogeny of metabolizing systems, this is not commonly utilized in scoping and problem formulation stage of human health risk evaluation. A framework is proposed for introducing this information into problem formulation which combines data on enzyme ontogeny and chemical-specific TK to explore potential child/adult differences in internal dose and whether such metabolic differences may be important factors in risk evaluation. The framework is illustrated with five case study chemicals, including some which are data rich and provide proof of concept, while others are data poor. Case studies for toluene and chlorpyrifos indicate potentially important child/adult TK differences while scoping for acetaminophen suggests enzyme ontogeny is unlikely to increase early-life risks. Scoping for trichloroethylene and aromatic amines indicates numerous ways that enzyme ontogeny may affect internal dose which necessitates further evaluation. PBTK modeling is a critical and feasible next step to further evaluate child-adult differences in internal dose for a number of these chemicals.

  1. Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators.

    Science.gov (United States)

    Wildman, John; McMeekin, Peter; Grieve, Eleanor; Briggs, Andrew

    2016-11-01

    With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluations of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. We propose a method, combining economic evaluation techniques, that can accommodate health outcomes and outcomes beyond health through the use of a common numeraire. Such economic evaluations can benefit both the public and private sector, firstly by ensuring the efficient allocation of resources. And secondly, by providing information for individuals who, in the market for ALTs, face consumption decisions that are infrequent and for which there may be no other sources of information. We consider these issues in the welfarist, extra-welfarist and capabilities frameworks, which we link to attributes in an individual production model. This approach allows for the valuation of the health component of any such intervention and the valuation of key social care attributes and processes. Finally, we present a set of considerations for evaluators highlighting the key issues that need to be considered in this type of economic evaluation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  2. Evaluar intervenciones sanitarias sin experimentos Evaluating health interventions without experiments

    Directory of Open Access Journals (Sweden)

    M. Vera Hernández

    2003-06-01

    Full Text Available En el presente artículo se revisa la bibliografía reciente en evaluación cuantitativa de intervenciones no experimentales, poniendo especial énfasis en su aplicación a la economía y la gestión sanitarias. En particular, se han descrito las técnicas de matching y de doble diferencia combinada con matching. El parámetro elegido como objeto de la estimación es la ganancia media para los participantes en la intervención, bajo la hipótesis de heterogeneidad en las ganancias no observables que produce la intervención entre los individuos elegibles. Se ha llevado a cabo una exposición no técnica de las metodologías descritas con el espíritu de fomentar al lector una lectura más profunda de la bibliografía relevante.This paper summarizes recent literature on quantitative techniques for the evaluation of non experimental reforms. We closely look at the application of the methods to health economics and health management. The methods of matching and difference in differences combined with matching have been analysed in greatest detail. We have focused our attention on the estimation of the average treatment for the treated as the relevant parameter to be estimated. Along the paper, we have assumed that gains from the reform are heterogeneous in non observable variables across eligible individuals. The methods are described in a non technical manner to motivate further reading.

  3. Evaluating the quality of Internet health resources in pediatric urology.

    Science.gov (United States)

    Fast, Angela M; Deibert, Christopher M; Hruby, Gregory W; Glassberg, Kenneth I

    2013-04-01

    Many patients and their parents utilize the Internet for health-related information, but quality is largely uncontrolled and unregulated. The Health on the Net Foundation Code (HONcode) and DISCERN Plus were used to evaluate the pediatric urological search terms 'circumcision,' 'vesicoureteral reflux' and 'posterior urethral valves'. A google.com search was performed to identify the top 20 websites for each term. The HONcode toolbar was utilized to determine whether each website was HONcode accredited and report the overall frequency of accreditation for each term. The DISCERN Plus instrument was used to score each website in accordance with the DISCERN Handbook. High and low scoring criteria were then compared. A total of 60 websites were identified. For the search terms 'circumcision', 'posterior urethral valves' and 'vesicoureteral reflux', 25-30% of the websites were HONcode certified. Out of the maximum score of 80, the average DISCERN Plus score was 60 (SD = 12, range 38-78), 40 (SD = 12, range 22-69) and 45 (SD = 19, range 16-78), respectively. The lowest scoring DISCERN criteria included: 'Does it describe how the treatment choices affect overall quality of life?', 'Does it describe the risks of each treatment?' and 'Does it provide details of additional sources of support and information?' (1.35, 1.83 and 1.95 out of 5, respectively). These findings demonstrate the poor quality of information that patients and their parents may use in decision-making and treatment choices. The two lowest scoring DISCERN Plus criteria involved education on quality of life issues and risks of treatment. Physicians should know how to best use these tools to help guide patients and their parents to websites with valid information. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. Evaluation in health: participatory methodology and involvement of municipal managers.

    Science.gov (United States)

    Almeida, Cristiane Andrea Locatelli de; Tanaka, Oswaldo Yoshimi

    2016-08-04

    To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators. Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR - Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management. With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user's perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues. Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay invested with greater significance to the local actors

  5. Response of Aspergillus niger Inoculated on Tomatoes Exposed to Vapor Phase Mustard Essential Oil for Short or Long Periods and Sensory Evaluation of Treated Tomatoes

    Directory of Open Access Journals (Sweden)

    Ana Elena Aguilar-González

    2017-01-01

    Full Text Available The inhibitory effect of mustard essential oil (EO in vapor phase against Aspergillus niger was evaluated in vitro and in vivo (in tomatoes. Mold response in tomatoes exposed for short or long periods to selected concentrations of mustard EO was also evaluated. Furthermore, a sensory evaluation was also performed among treated tomatoes and compared with nontreated ones. Minimum inhibitory concentration (MIC for the studied EO was determined by the inverted Petri dish method. MIC for the in vitro and in vivo tests for mustard EO was of 3.08 μL/Lair. In vitro and in vivo results demonstrate the effectiveness of vapors of mustard EO against A. niger. The studied EO contains highly volatile organic compounds with strong inhibitory effects, even when applied for short periods, and can consequently be considered a good alternative to traditional synthetic antimicrobials without detriment of selected sensory attributes.

  6. [IMSS in numbers. Evaluation of the performance of health institutions in Mexico, 2004].

    Science.gov (United States)

    2006-01-01

    The evaluation of health institutions performance in Mexico during 2004 was done using 29 indicators that describe intra-hospital mortality rates, productivity of health services, availability of health resources, quality of care, security, investment and costs of health care and the satisfaction level by users of health services. This exercise describes the efficiency and organization of health services provided by the different health institutions and allows comparing and balancing the performance of each institution. Results indicate the differences in availability of resources, inequity in the financing health care services, and inefficiency in the use of resources but also describe the level of efficacy of certain institutions and the satisfaction level that different users have of health services. The evaluation of the performance of the entire health institutions should provide the means to improve all the process of health care and to increase the quality of care in all health institutions in the country.

  7. Evaluating common de-identification heuristics for personal health information.

    Science.gov (United States)

    El Emam, Khaled; Jabbouri, Sam; Sams, Scott; Drouet, Youenn; Power, Michael

    2006-11-21

    With the growing adoption of electronic medical records, there are increasing demands for the use of this electronic clinical data in observational research. A frequent ethics board requirement for such secondary use of personal health information in observational research is that the data be de-identified. De-identification heuristics are provided in the Health Insurance Portability and Accountability Act Privacy Rule, funding agency and professional association privacy guidelines, and common practice. The aim of the study was to evaluate whether the re-identification risks due to record linkage are sufficiently low when following common de-identification heuristics and whether the risk is stable across sample sizes and data sets. Two methods were followed to construct identification data sets. Re-identification attacks were simulated on these. For each data set we varied the sample size down to 30 individuals, and for each sample size evaluated the risk of re-identification for all combinations of quasi-identifiers. The combinations of quasi-identifiers that were low risk more than 50% of the time were considered stable. The identification data sets we were able to construct were the list of all physicians and the list of all lawyers registered in Ontario, using 1% sampling fractions. The quasi-identifiers of region, gender, and year of birth were found to be low risk more than 50% of the time across both data sets. The combination of gender and region was also found to be low risk more than 50% of the time. We were not able to create an identification data set for the whole population. Existing Canadian federal and provincial privacy laws help explain why it is difficult to create an identification data set for the whole population. That such examples of high re-identification risk exist for mainstream professions makes a strong case for not disclosing the high-risk variables and their combinations identified here. For professional subpopulations with published

  8. Factors associated with smoking relapse in the postpartum period: an analysis of the child health surveillance system data in Southeast England.

    Science.gov (United States)

    Harmer, Clare; Memon, Anjum

    2013-05-01

    There is increasing evidence that a high proportion (47%-63%) of women who quit smoking during pregnancy relapse during the postpartum period. The purpose of this population-based study was to examine the association between selected sociodemographic factors and smoking relapse in the early postpartum period (within the first 6 weeks) in women who had successfully quit smoking during the pregnancy. The study included 512 women resident in East Sussex, United Kingdom, who had quit smoking during the pregnancy. Information on the prevalence of smoking and selected sociodemographic factors and breast feeding at the 6-weeks postpartum review by health visitor was obtained from the Child Health Surveillance System, which records and monitors the health and development of children from birth until school entry. Of the 512 women who had quit smoking during the pregnancy, 238 (46.5%) relapsed in the early postpartum period. In the bivariate analysis, there was an association between deprivation and smoking relapse in the early postpartum period (OR = 5.3, 95% CI: 2.5-11.4), with a significant trend in increasing risk of relapse with increasing level of deprivation (p postpartum period. On the other hand, women who were breast feeding were significantly less likely to relapse (OR = 0.6, 95% CI: 0.4-0.9). Factors associated with early postpartum smoking relapse identified in this study, particularly breast feeding, high parity, and concurrent smoking by partner/other household member(s), may contribute to the development of effective and targeted interventions to maintain smoking cessation in women and their household.

  9. Peculiarities of adaptation reactions in female migrants and health disorders risks occuring after different periods of staying on Moscow region territory

    Directory of Open Access Journals (Sweden)

    N.F. Izmerov

    2017-06-01

    Full Text Available The article gives the results of determining peculiarities which are characteristic for adaptation in female migrants de-pending on a period of their staying in Moscow region. Adaptation was assessed as per variants of functional stress status and functional abilities of circulatory system. We detected that female migrants during their adaptation to impacts exerted by neuro-emotional factors, social-psychological factors, and physical (muscular loads which varied in their intensity and length, had signs of stress syndrome. This syndrome was apparent through physiological parameters, namely increase in index of functional changes in circulatory system, and changes in heart rate variability as per regulatory systems activity parameter (PARS. If female migrants stayed in Moscow region for less than 3 years than the most specific weight of migrants with unsatisfactory adaptation was detected among Russians and it was equal to 36.04%; adaptation mechanisms were strained among Tadjiks women (62.08 %. If they stayed for longer than 3 years, then unsatisfactory adaptation parameter grew among Tadjiks women by 12.4 % and it indicated that the body's functional reserves were mobilized and it could lead to adaptation failure. When ad-aptation was satisfactory, β-adrenoactivity of erythrocytes membranes was within the physiological changes standards regardless of a period of staying. When adaptation mechanisms were strained and adaptation itself was unsatisfactory, the greatest growth in this parameter was detected among Tadjiks women in any period of staying. Preservation of female labor migrants health and prolongation of their working capacity period requires a system of med-ical and social support. Activities aimed at primary prevention of health disorders should include general physical training, tempering, autogenous training, and elimination of hazardous communal and occupational risk factors. Secondary prevention activities are systematic medical

  10. The Atlas of Health and Working Conditions by Occupation. 1. Occupational ranking lists and occupational profiles from periodical occupational health survey data

    NARCIS (Netherlands)

    Broersen, J. P.; van Dijk, F. J.; Weel, A. N.; Verbeek, J. H.

    1995-01-01

    In this article, we describe methods which have been applied in the compilation of the Atlas of Health and Working conditions by Occupation. First, we discuss the need for information systems to identify problems concerning working conditions and health. Such information systems have an exploratory

  11. 29 CFR 1960.11 - Evaluation of occupational safety and health performance.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Evaluation of occupational safety and health performance. 1960.11 Section 1960.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH... AND HEALTH PROGRAMS AND RELATED MATTERS Administration § 1960.11 Evaluation of occupational safety and...

  12. Research on the evaluation system for heat metering and existing residential building retrofits in northern regions of China for the 12th five-year period

    International Nuclear Information System (INIS)

    Xin, Liu; Yan, Ding; Yujia, Tong; Neng, Zhu; Zhe, Tian

    2014-01-01

    On the basis of ERBR (existing residential building retrofit) work in the 11th five-year period, energy efficiency retrofits for old residential buildings have been further promoted in northern regions of China during the 12th five-year period. ERBR projects are capable of not only achieving energy conservation and emissions reductions but also providing warmer rooms for residents during cold winters. Therefore, this project should be continued in northern regions of China following a long-term management mode. With the aim of exploring methods and mechanisms for the evaluation of the retrofit effect, an evaluation method was established with the application of the multi-level expert evaluation method. The evaluation indexes cover the aspects of policy mechanisms, financing modes and technical measures. A rewards and punishment mechanism according to the evaluation system was also suggested. Such an evaluation system can be used as a valuable reference for future implementation of energy efficiency retrofit work. - Highlights: • With the AHPD method, the evaluation system of the ERBR was set up to complete. • There are 29 indicators, including policies, financings and technologies. • Rewards and punishment mechanisms are offered to the ERBR. • For weight value more than 0.06, long-term practice and accumulation are needed

  13. Smoking, health-related quality of life and economic evaluation.

    Science.gov (United States)

    López-Nicolás, Ángel; Trapero-Bertran, Marta; Muñoz, Celia

    2018-06-01

    The economic evaluation of tobacco control policies requires the adoption of assumptions about the impact of changes in smoking status on health-related quality of life (HRQoL). Estimates for such impacts are necessary for different populations. This paper aims to test whether smoking status has an independent effect on HRQoL over and above the effect derived from the increased likelihood of suffering a tobacco related disease, and to calculate utility values for the Spanish population. Using data from the Spanish Encuesta Nacional de Salud of 2011-12, we estimate statistical models for HRQoL as measured by the EQ-5D-5L instrument as a function of smoking status. We include a comprehensive set of controls for biological, clinical, lifestyle and socioeconomic characteristics. Smoking status has an independent, statistically significant effect on HRQoL. However, the size of the effect is small. The typical smoking related diseases, such as lung cancer, are associated with a reduction in HRQoL about 5 times larger than the difference between current smokers and never smokers. Attributing substantive HRQ