WorldWideScience

Sample records for personal health choices

  1. Influence of worldview on health care choices among persons with chronic pain.

    Science.gov (United States)

    Buck, Tina; Baldwin, Carol M; Schwartz, Gary E

    2005-06-01

    The aim of this research was to examine relationships between the Pepperian worldviews of people with chronic pain and the health care choices that they make. A convenience sample survey was done. University Medical Center Pain Clinic, Tucson, Arizona. Men and women patients (n = 96) with nonmalignant chronic pain. World Hypothesis Scale; Health Care Choice List. Findings indicate that the combination of age and formistic worldview are statistically significant predictors of conventional health care choices by participants in this study. Older patients and persons with a predominantly formistic worldview were less likely to use complementary and alternative medicine (CAM) as a choice among this sample with chronic nonmalignant pain. Borderline significant associations were noted between persons with formistic or mechanistic worldviews and conventional health care choices, and persons with contextualistic, organismic, or equal scores in two worldview categories and CAM health care choices. Although rates of CAM use did not significantly differ from conventional choices, the prevalence rate for CAM use was high (55.2%) based on national findings. Results of this study provide a link to understanding how underlying philosophies can contribute to the reasons people with chronic pain make health care decisions. Further exploration of worldviews might very well contribute to best practices for consumer health care by engaging in communication styles and belief systems consistent with consumers' personal schemas.

  2. Personal health records in the Netherlands: potential user preferences quantified by a discrete choice experiment.

    Science.gov (United States)

    Determann, Domino; Lambooij, Mattijs S; Gyrd-Hansen, Dorte; de Bekker-Grob, Esther W; Steyerberg, Ewout W; Heldoorn, Marcel; Pedersen, Line Bjørnskov; de Wit, G Ardine

    2017-05-01

    To identify groups of potential users based on their preferences for characteristics of personal health records (PHRs) and to estimate potential PHR uptake. We performed a discrete choice experiment, which consisted of 12 choice scenarios, each comprising 2 hypothetical PHR alternatives and an opt-out. The alternatives differed based on 5 characteristics. The survey was administered to Internet panel members of the Dutch Federation of Patients and Consumer Organizations. We used latent class models to analyze the data. A total of 1,443 potential PHR users completed the discrete choice experiment. We identified 3 latent classes: "refusers" (class probability 43%), "eager adopters" (37%), and "reluctant adopters" (20%). The predicted uptake for the reluctant adopters ranged from 4% in the case of a PHR with the worst attribute levels to 68% in the best case. Those with 1 or more chronic diseases were significantly more likely to belong to the eager adopter class. The data storage provider was the most decisive aspect for the eager and reluctant adopters, while cost was most decisive for the refusers. Across all classes, health care providers and independent organizations were the most preferred data storage providers. We identified 3 groups, of which 1 group (more than one-third of potential PHR users) indicated great interest in a PHR irrespective of PHR characteristics. Policymakers who aim to expand the use of PHRs will be most successful when health care providers and health facilities or independent organizations store PHR data while refraining from including market parties. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. School Choice: The Personal and the Political

    Science.gov (United States)

    Shuls, James V.

    2018-01-01

    Enrollment in school choice programs is growing, so is overall support for school choice. Many have analyzed what demographic characteristics impact attitudes towards school choice. This article adds to the literature by exploring the interaction between personal decisions regarding school choice and broader support for school choice programs.…

  4. Pleasure, pursuit of health or negotiation of identity? Personality correlates of food choice motives among young and middle-aged women.

    Science.gov (United States)

    Lindeman, M; Stark, K

    1999-08-01

    The clustering of four food choice motives (health, weight concern, pleasure and ideological reasons) and the relationship between personality and the food choice motives were analysed among young and middle-aged women in two studies. The personality variables included personal strivings, magical beliefs about food, awareness and internalization of thinness pressures, appearance and weight dissatisfaction, depression, self-esteem and symptoms of eating disorders. Study 1 was done with 171 young and middle-aged women. In Study 2, with data provided by 118 senior high-school girls, one cluster of girls who did not regard any of the food choice motives as important was found, otherwise the food choice clusters were fairly similar in both studies. They were labelled as health fosterers, gourmets, ideological eaters, health dieters and distressed dieters. Only the second dieter group, distressed dieters, showed low psychological well-being and symptoms of disordered eating. The results also indicated that ideological food choice motives (i.e. expression of one's identity via food) were best predicted by vegetarianism, magical beliefs about food and health, and personal strivings for ecological welfare and for understanding self and the world. Copyright 1999 Academic Press.

  5. Choosing health, constrained choices.

    Science.gov (United States)

    Chee Khoon Chan

    2009-12-01

    In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.

  6. Doctors' personal health care choices: A cross-sectional survey in a mixed public/private setting

    Directory of Open Access Journals (Sweden)

    Chao David VK

    2008-05-01

    Full Text Available Abstract Background Among Western countries, it has been found that physicians tend to manage their own illnesses and tend not have their own independent family physicians. This is recognized as a significant issue for both physicians and, by extension, the patients under their care, resulting in initiatives seeking to address this. Physicians' personal health care practices in Asia have yet to be documented. Methods An anonymous cross-sectional postal questionnaire survey was conducted in Hong Kong, China. All 9570 medical practitioners in Hong Kong registered with the Hong Kong Medical Council in 2003 were surveyed. Chi-square tests and logistic regression models were applied. Results There were 4198 respondents to the survey; a response rate of 44%. Two-thirds of respondents took care of themselves when they were last ill, with 62% of these self-medicating with prescription medication. Physicians who were graduates of Hong Kong medical schools, those working in general practice and non-members of the Hong Kong College of Family Physicians were more likely to do so. Physician specialty was found to be the most influential reason in the choice of caregiver by those who had ever consulted another medical practitioner. Only 14% chose consultation with a FM/GP with younger physians and non-Hong Kong medical graduates having a higher likelihood of doing so. Seventy percent of all respondents believed that having their own personal physician was unnecessary. Conclusion Similar to the practice of colleagues in other countries, a large proportion of Hong Kong physicians self-manage their illnesses, take self-obtained prescription drugs and believe they do not need a personal physician. Future strategies to benefit the medical care of Hong Kong physicians will have to take these practices and beliefs into consideration.

  7. Does health affect portfolio choice?

    Science.gov (United States)

    Love, David A; Smith, Paul A

    2010-12-01

    A number of recent studies find that poor health is empirically associated with a safer portfolio allocation. It is difficult to say, however, whether this relationship is truly causal. Both health status and portfolio choice are influenced by unobserved characteristics such as risk attitudes, impatience, information, and motivation, and these unobserved factors, if not adequately controlled for, can induce significant bias in the estimates of asset demand equations. Using the 1992-2006 waves of the Health and Retirement Study, we investigate how much of the connection between health and portfolio choice is causal and how much is due to the effects of unobserved heterogeneity. Accounting for unobserved heterogeneity with fixed effects and correlated random effects models, we find that health does not appear to significantly affect portfolio choice among single households. For married households, we find a small effect (about 2-3 percentage points) from being in the lowest of five self-reported health categories. Copyright © 2009 John Wiley & Sons, Ltd.

  8. Personality Influences Career Choice: Sensation Seeking in Professional Musicians

    Science.gov (United States)

    Vuust, Peter; Gebauer, Line; Hansen, Niels Chr.; Jorgensen, Stine Ramsgaard; Moller, Arne; Linnet, Jakob

    2010-01-01

    Despite the obvious importance of deciding which career to pursue, little is known about the influence of personality on career choice. Here we investigated the relation between sensation seeking, a supposedly innate personality trait, and career choice in classical and "rhythmic" students at the academies of music in Denmark. We…

  9. Personality and field of study choice

    NARCIS (Netherlands)

    Humburg, M.

    2014-01-01

    Field of study choice has far-reaching implications for individuals enrolling in university. Field of study choice is strongly linked to the subject matter graduates will specialize in, the kind of work environment they will be working in, and the returns to their skills they can expect once they

  10. Are personal values related to sustainable attribute choice

    OpenAIRE

    Mueller, Simone; Sirieix, Lucie; Remaud, Hervé

    2011-01-01

    Purpose: A cross-cultural study with large representative samples analyses to what degree Schwartz’s personal values and environmental concerns are related to consumers’ choices of wine with sustainable characteristics. Methodology: Across seven countries, the attribute importance and willingness to pay of consumer segments resulting from choice experiments are related to Schwartz’s personal value dimensions and environmental attitudes. Findings: Personal values were only weakly related to re...

  11. The personal health future

    NARCIS (Netherlands)

    Spil, Antonius A.M.; Klein, Richard

    2015-01-01

    Despite several personal health record (PHR) product offerings from major technology sector players over the past years, the notion of tracking and maintaining one׳s personal health information electronically has failed to takeoff among consumers. Accordingly, we explore factors potentially shaping

  12. Salud/Servicios Personales. Libro del Profesor. (Health/Personal Services. Teacher's Guide). B2. CHOICE (Challenging Options in Career Education).

    Science.gov (United States)

    Mid-Hudson Migrant Education Center, New Paltz, NY.

    Written in Spanish, the guide comprises the first grade unit of a career education curriculum developed for migrant students. The guide covers 12 health and personal service occupations--blacksmith, television repairer, hairdresser/barber, day care worker, waitress, gas station attendant, family doctor, ambulance driver/attendant, dietician,…

  13. Medical speciality choice: does personality matter?

    LENUS (Irish Health Repository)

    Lydon, S

    2015-03-01

    There has been increasing interest in the personalities of doctors. This study examined whether personality differed based upon gender, level of training or medical speciality among 200 physicians and 134 medical students. Post-internship doctors scored significantly higher on conscientiousness (p = .001) than those pursuing basic medical training. Among those pursuing basic medical training, females scored significantly higher than males on agreeableness (p < .001) and conscientiousness (p = .001). Among post-internship respondents, females scored significantly higher on agreeableness (p = .004). There were no personality differences between post-internship doctors working in different specialities. However, among those pursuing basic medical training, those interested in person-focused medical specialities scored significantly higher on extraversion (p < .001), conscientiousness (p = .001), and lower on neuroticism (p = .01) than those who had no strong preference. These results suggest that there is no unique personality profile associated with medical practice, or medical speciality. Instead, it appears that medical school may shape personality.

  14. Relationship between personality traits and vocational choice.

    Science.gov (United States)

    Garcia-Sedeño, Manuel; Navarro, Jose I; Menacho, Inmaculada

    2009-10-01

    Summary.-The relationship between occupational preferences and personality traits was examined. A randomly chosen sample of 735 students (age range = 17 to 23 years; 50.5% male) in their last year of high school participated in this study. Participants completed Cattell's Sixteen Personality Factor-5 Questionnaire (16PF-5 Questionnaire) and the Kuder-C Professional Tendencies Questionnaire. Initial hierarchical cluster analysis categorized the participants into two groups by Kuder-C vocational factors: one showed a predilection for scientific or technological careers and the other a bias toward the humanities and social sciences. Based on these groupings, differences in 16PF-5 personality traits were analyzed and differences associated with three first-order personality traits (warmth, dominance, and sensitivity), three second-order factors (extraversion, control, and independence), and some areas of professional interest (mechanical, arithmetical artistic, persuasive, and welfare) were identified. The data indicated that there was congruency between personality profiles and vocational interests.

  15. Putting Health Back Into Health Insurance Choice.

    Science.gov (United States)

    Atanasov, Pavel; Baker, Tom

    2014-08-01

    What are the barriers to voluntary take-up of high-deductible plans? We address this question using a large-scale employer survey conducted after an open-enrollment period in which a new high-deductible plan was first introduced. Only 3% of the employees chose this plan, despite the respondents' recognition of its financial advantages. Employees who believed that the high-deductible plan provided access to top physicians in the area were three times more likely to choose it than employees who did not share this belief. A framed field experiment using a similar choice menu showed that displaying additional financial information did not increase high-deductible plan take-up. However, when plans were presented as identical except for the deductible, respondents were highly likely to choose the high-deductible plan, especially in a two-way choice. These results suggest that informing plan choosers about high-deductible plans' health access provisions may affect choice more strongly than focusing on their financial advantages. © The Author(s) 2014.

  16. Consumers, health insurance and dominated choices.

    Science.gov (United States)

    Sinaiko, Anna D; Hirth, Richard A

    2011-03-01

    We analyze employee health plan choices when the choice set offered by their employer includes a dominated plan. During our study period, one-third of workers were enrolled in the dominated plan. Some may have selected the plan before it was dominated and then failed to switch out of it. However, a substantial number actively chose the dominated plan when they had an unambiguously better choice. These results suggest limitations in the ability of health reform based solely on consumer choice to achieve efficient outcomes and that implementation of health reform should anticipate, monitor and account for this consumer behavior. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Personality and Values as Predictors of Medical Specialty Choice

    Science.gov (United States)

    Taber, Brian J.; Hartung, Paul J.; Borges, Nicole J.

    2011-01-01

    Research rarely considers the combined influence of personality traits and values in predicting behavioral outcomes. We aimed to advance a germinal line of inquiry that addresses this gap by separately and simultaneously examining personality traits and physician work values to predict medical specialty choice. First-year medical students (125…

  18. Personality and Field of Study Choice in University

    Science.gov (United States)

    Humburg, Martin

    2017-01-01

    This paper demonstrates that the Big five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, and emotional stability) measured at age 14 can be linked to field of study choice in university at around age 19. While personality matters less than cognitive skills, such as math ability and verbal ability, for…

  19. The problem of moral choice personality

    Directory of Open Access Journals (Sweden)

    I. A. Kadievskaya

    2014-02-01

    Full Text Available Article is dedicated to the comprehension of the problems of the moral selection of personality. It is substantiated, that the moral consciousness is the complex system, because of which in the society are established the specific rules of interrelations between the people.   The concepts are analyzed: morals, relativity, moral absolutism, general human values, globalization, manipulation by consciousness, spiritual­ moral training. The specific character of the moral relativity, which denies absolute nature, i.e., is established universality and compulsion of morals, emphasizing conditionality and situationality of moral n. Moral absolutism is contradicted to moral relativity. Moral absolutism corresponds to persuasion, that there are absolute standards, which can be used for the permission of questions of morals, and that the specific actions can be correct or incorrect by themselves independent of their context. The two­digit (positive and negative axiological understanding of the phenomenon of globalization, which dually influences our consciousness, spiritual peace and moral selection, is represented. Under the conditions for large­scale information manipulations the translation of moral values as information, modifies their essence. Is shown the role of spiritual­ moral training in the formation, which must be variative and voluntary, allow for the possibility of ideological selection. The moral freedom of each person is manifested in the transformation of moral requirements into the internal needs of personality, into its own persuasions.

  20. Influencers of career choice among allied health students.

    Science.gov (United States)

    Brown-West, A P

    1991-01-01

    This study focused on the factors that influence students' choice of an allied health profession. A survey of 153 students in three allied health programs at the University of Connecticut revealed that "the need to help others," "prestige," "professional autonomy," "opportunities for advancement," "income potential," and "the effect of the specialty on family and personal life," were the major influencers of career choice among allied health students. Only a few students regarded malpractice suits and AIDS as negative influencers. While medical laboratory science majors regarded these as important factors, dietetics and physical therapy majors did not. The article suggests further use of these findings by program directors and career counselors.

  1. The Relationship Between Personality Types and Career Choice of ...

    African Journals Online (AJOL)

    The study was carried out to investigate the Relationship between Personality Types and Career Choice of Secondary School Students in Nigeria. The researchers formulated one research question and one hypothesis to guide the study. The researchers employed two sampling techniques, cluster and random sampling ...

  2. Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children.

    Science.gov (United States)

    Richards, Rickelle; Smith, Chery

    2007-10-01

    In-depth interviews were conducted with homeless children (n=56, aged 6-13 years) in an urban center in Minnesota, USA, to determine factors influencing food choice, food access, and weight status, with interview questions developed using the Social Cognitive Theory. Interview transcripts were coded and then evaluated both collectively and by weight status ( or = 85th percentile=overweight). Forty-five percent of children were overweight. Environmental, parental, and personal factors emerged as common themes influencing food access and choice. Despite children's personal food preferences, homelessness and the shelter environment created restrictive conditions that influenced food choice and access. Shelter rules, lack of adequate storage and cooking facilities, and limited food stores near the shelter, impacted the type and quality of food choices, ultimately affecting hunger, weight status, and perceived health.

  3. Personal health records

    DEFF Research Database (Denmark)

    Kensing, Finn

    2012-01-01

    The paper addresses the complex interplay between patients, healthcare professionals, and technology in relation to the treatment of chronic patients. It reflects on an ongoing interdisciplinary action research project striving to design and implement IT support for communication and collaboration...... in the distributed heterogeneous network of chronic patients and the healthcare professionals that take care of them. An interactive personal health record (PHR) has been designed as part of the project. As such it is part of a trend to find ways to include patients in their own care process. This has been motivated...... by expected health benefits for the patients as well as promises to lead to reduced costs for a burdened healthcare system....

  4. Personality may confound common measures of mate-choice.

    Directory of Open Access Journals (Sweden)

    Morgan David

    Full Text Available The measurement of female mating preferences is central to the study of the evolution of male ornaments. Although several different methods have been developed to assess sexual preference in some standardized way, the most commonly used procedure consists of recording female spatial association with different males presented simultaneously. Sexual preference is then inferred from time spent in front of each male. However, the extent to which the measurement of female mate-choice is related to exploration tendencies has not been addressed so far. In the present study we assessed the influence of variation in exploration tendencies, a trait closely associated to global personality, on the measurement of female mating preference in the zebra finch (Taeniopygia guttata using the widely used four-chamber choice-apparatus. The number of movements performed within both exploration and mate-choice apparatus was consistent within and across the two contexts. In addition, personality explained variation in selectivity, preference strength and consistency. High-exploratory females showed lower selectivity, lower preference scores and displayed more consistent preference scores. Our results suggest that variation in personality may affect the measurement of female mating preference and may contribute to explain existing inconsistencies across studies.

  5. Economic Rationality in Choosing between Short-Term Bad-Health Choices and Longer-Term Good-Health Choices

    Directory of Open Access Journals (Sweden)

    David Campbell

    2013-11-01

    Full Text Available Non-contagious, chronic disease has been identified as a global health risk. Poor lifestyle choices, such as smoking, alcohol, drug and solvent abuse, physical inactivity, and unhealthy diet have been identified as important factors affecting the increasing incidence of chronic disease. The following focuses on the circumstance affecting the lifestyle or behavioral choices of Aboriginal and Torres Strait Islander peoples in remote-/very remote Australia. Poor behavioral choices are the result of endogenous characteristics that are influenced by a range of stressful exogenous variables making up the psychosocial determinants including social disenfranchisement, cultural loss, insurmountable tasks, the loss of volitional control and resource constraints. It is shown that poor behavioral choices can be economically rational; especially under highly stressful conditions. Stressful circumstances erode individual capacity to commit to long-term positive health alternatives such as self-investment in education. Policies directed at removing the impediments and providing incentives to behaviors involving better health choices can lead to reductions in smoking and alcohol consumption and improved health outcomes. Multijurisdictional culturally acceptable policies directed at distal variables relating to the psychosocial determinants of health and personal mastery and control can be cost effective. While the content of this paper is focused on the conditions of colonized peoples, it has broader relevance.

  6. Personal traits underlying environmental preferences: a discrete choice experiment.

    Directory of Open Access Journals (Sweden)

    Mario Soliño

    Full Text Available Personality plays a role in human behavior, and thus can influence consumer decisions on environmental goods and services. This paper analyses the influence of the big five personality dimensions (extraversion, agreeableness, conscientiousness, neuroticism and openness in a discrete choice experiment dealing with preferences for the development of an environmental program for forest management in Spain. For this purpose, a reduced version of the Big Five Inventory survey (the BFI-10 is implemented. Results show a positive effect of openness and extraversion and a negative effect of agreeableness and neuroticism in consumers' preferences for this environmental program. Moreover, results from a latent class model show that personal traits help to explain preference heterogeneity.

  7. Personal awareness and behavioural choices on having a stoma: a qualitative metasynthesis.

    Science.gov (United States)

    Tao, Hui; Songwathana, Praneed; Isaramalai, Sang-Arun; Zhang, Ying

    2014-05-01

    To answer how personal awareness and behavioural choices on having a stoma have been described and interpreted in previous qualitative studies. Over the past two decades, there has been an accumulation of the qualitative studies concerning the experiences of individuals living with a stoma. Synthesising the findings of these studies would be able to improve the understanding among health providers. Qualitative metasynthesis. The literature was obtained through searching CINAHL and PubMed databases for papers published in English, and China National Knowledge Infrastructure database for papers published in Chinese from 1990-March 2012. Sixteen articles were selected using the predefined criteria. Three themes about personal awareness and behavioural choices on having a stoma were identified: altered self, restricted life and overcoming restrictions. The results showed the impacts of having a stoma through the analysis on connections between personal awareness and behavioural choices. Having a stoma means that the individuals have to learn to be aware of and accustomed to changes and restrictions in their everyday lives. The individuals take behavioural efforts to overcome these restrictions involving: deciding on whether to reveal or conceal their stomas to others based on the possibility of being accepted or rejected, using internal resources, seeking and receiving external supports. The description and interpretation on personal awareness and behavioural choices associated with having a stoma is useful for nurses in providing practical, informational and emotional supports to help the individuals successfully adapt to their lives with a stoma. © 2013 John Wiley & Sons Ltd.

  8. Make the healthy choice the easy choice: using behavioral economics to advance a culture of health.

    Science.gov (United States)

    Volpp, K G; Asch, D A

    2017-05-01

    Despite great advances in the science and technology of health care, a large gap separates theoretically achievable advances in health from what individuals and populations actually achieve. Human behavior sits on the final common pathway to so many of our health and health care goals, including the prevention and management of illness and the fostering of wellness. Behavioral economics is a relatively new field offering approaches to supplement many of the conventional approaches to improving health behaviors that rely on education or standard economic theory. While those conventional approaches presume that an educated public will naturally make decisions that optimize personal welfare, approaches derived from behavioral economics harness existing and predictable patterns of behavior that often lead people to make choices against their best interests. By keeping these predictable patterns of behavior in mind when designing health insurance, health care programs or the health-related aspects of everyday life, behavioral economists aim to meet people half-way: no longer asking them to reshape their behavior to something more health promoting, but helping the behavioral patterns they already follow lead them to better health. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Personalism for public health ethics

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2010-06-01

    Full Text Available In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  10. Personalism for public health ethics.

    Science.gov (United States)

    Petrini, Carlo; Gainotti, Sabina; Requena, Pablo

    2010-01-01

    In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  11. Explorations in Personal Health.

    Science.gov (United States)

    Haro, Michael S.; And Others

    This text, designed for college students, is oriented toward the social, emotional, and behavioral aspects of health. Eight health-related topics of major concern for college students were selected for inclusion: (1) interpersonal relationships; (2) coping strategies; (3) sexuality; (4) nutrition; (5) medical care and services; (6) health…

  12. A fair range of choice: justifying maximum patient choice in the British National Health Service.

    Science.gov (United States)

    Wilmot, Stephen

    2007-06-01

    In this paper I put forward an ethical argument for the provision of extensive patient choice by the British National Health Service. I base this argument on traditional liberal rights to freedom of choice, on a welfare right to health care, and on a view of health as values-based. I argue that choice, to be ethically sustainable on this basis, must be values-based and rational. I also consider whether the British taxpayer may be persuadable with regard to the moral acceptability of patient choice, making use of Rawls' theory of political liberalism in this context. I identify issues that present problems in terms of public acceptance of choice, and also identify a boundary issue with regard to public health choices as against individual choices.

  13. Swiss residents' speciality choices – impact of gender, personality traits, career motivation and life goals

    Directory of Open Access Journals (Sweden)

    Abel Thomas

    2006-10-01

    Full Text Available Abstract Background The medical specialities chosen by doctors for their careers play an important part in the development of health-care services. This study aimed to investigate the influence of gender, personality traits, career motivation and life goal aspirations on the choice of medical speciality. Methods As part of a prospective cohort study of Swiss medical school graduates on career development, 522 fourth-year residents were asked in what speciality they wanted to qualify. They also assessed their career motivation and life goal aspirations. Data concerning personality traits such as sense of coherence, self-esteem, and gender role orientation were collected at the first assessment, four years earlier, in their final year of medical school. Data analyses were conducted by univariate and multivariate analyses of variance and covariance. Results In their fourth year of residency 439 (84.1% participants had made their speciality choice. Of these, 45 (8.6% subjects aspired to primary care, 126 (24.1% to internal medicine, 68 (13.0% to surgical specialities, 31 (5.9% to gynaecology & obstetrics (G&O, 40 (7.7% to anaesthesiology/intensive care, 44 (8.4% to paediatrics, 25 (4.8% to psychiatry and 60 (11.5% to other specialities. Female residents tended to choose G&O, paediatrics, and anaesthesiology, males more often surgical specialities; the other specialities did not show gender-relevant differences of frequency distribution. Gender had the strongest significant influence on speciality choice, followed by career motivation, personality traits, and life goals. Multivariate analyses of covariance indicated that career motivation and life goals mediated the influence of personality on career choice. Personality traits were no longer significant after controlling for career motivation and life goals as covariates. The effect of gender remained significant after controlling for personality traits, career motivation and life goals. Conclusion

  14. The Impact of Personal Characteristics on Contraceptive Choices and Use Over 5 years

    Directory of Open Access Journals (Sweden)

    Cathy Carlson PhD, APN

    2016-12-01

    Full Text Available Worldwide, there is an unintended pregnancy rate of 40%. That rate is higher in some areas, such as in the United States—where it is nearly 50%. These pregnancies have potentially negative outcomes for the mother and child that include health, economic, social, and psychological aspects. Long-acting reversible contraceptives (LARCs are highly reliable methods for family planning. Identifying personal characteristics associated with choosing LARCs will better address the unintended pregnancy rates. The purpose of this research project was to evaluate characteristics of adolescents and women at high risk for unintended pregnancies by (a describing the use of a LARC and selected personal characteristics for the years 2009 and 2014 and (b exploring relationships among LARC choice and selected personal characteristics of clients seeking family planning services. A retrospective chart review was conducted on 268 randomly selected records, half of which were each from the years 2009 and 2014. One Midwestern U.S. family planning clinic was the site of the research. The characteristics used in the chart reviews were derived from the literature and Healthy People 2020 goals. Key differences between the years 2009 and 2014 included a significant increase in the number of LARCs prescribed to high-risk women. There was a significant relationship between the choice of a LARC and having used one in the past. Personal characteristics influencing LARC birth control choice included White, Hispanic females, those with a history of a teen pregnancy, those who experienced any previous pregnancy or live birth, and those below the poverty level. The findings indicate the importance of educating clients on LARC options. To foster initial use of a LARC, an application, based on the findings of this study, has been developed that provides individualized choices and education on contraceptive methods including LARCs.

  15. Personality differentially affects individual mate choice decisions in female and male Western mosquitofish (Gambusia affinis).

    Science.gov (United States)

    Chen, Bo-Jian; Liu, Kai; Zhou, Lin-Jun; Gomes-Silva, Guilherme; Sommer-Trembo, Carolin; Plath, Martin

    2018-01-01

    Consistent individual differences in behavioral tendencies (animal personality) can affect individual mate choice decisions. We asked whether personality traits affect male and female mate choice decisions similarly and whether potential personality effects are consistent across different mate choice situations. Using western mosquitofish (Gambusia affinis) as our study organism, we characterized focal individuals (males and females) twice for boldness, activity, and sociability/shoaling and found high and significant behavioral repeatability. Additionally, each focal individual was tested in two different dichotomous mate choice tests in which it could choose between computer-animated stimulus fish of the opposite sex that differed in body size and activity levels, respectively. Personality had different effects on female and male mate choice: females that were larger than average showed stronger preferences for large-bodied males with increasing levels of boldness/activity (i.e., towards more proactive personality types). Males that were larger than average and had higher shoaling tendencies showed stronger preferences for actively swimming females. Size-dependent effects of personality on the strength of preferences for distinct phenotypes of potential mating partners may reflect effects of age/experience (especially in females) and social dominance (especially in males). Previous studies found evidence for assortative mate choice based on personality types or hypothesized the existence of behavioral syndromes of individuals' choosiness across mate choice criteria, possibly including other personality traits. Our present study exemplifies that far more complex patterns of personality-dependent mate choice can emerge in natural systems.

  16. Personality and Health Care Decision-Making Style

    OpenAIRE

    Kathryn E. Flynn; Maureen A. Smith

    2007-01-01

    Using the Wisconsin Longitudinal Study Graduate Survey (N = 5,830), a population-based cohort of older adults (most aged 63–66 years), we explored relationships between five factors of personality and four preference types that account for multiple components of the health care decision-making process (information exchange, deliberation, and selection of treatment choice). After adjustment for personal, health, social, and economic factors, we found that increased conscientiousness and openne...

  17. NUDGING FOR HEALTH: ON PUBLIC POLICY AND DESIGNING CHOICE ARCHITECTURE

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a ‘nudge unit’ with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives. PMID:24081425

  18. Nudging for health: on public policy and designing choice architecture.

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a 'nudge unit' with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives.

  19. Privacy by design in personal health monitoring.

    Science.gov (United States)

    Nordgren, Anders

    2015-06-01

    The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted.

  20. Creating an impersonal NHS? Personalization, choice and the erosion of intimacy.

    Science.gov (United States)

    Owens, John

    2015-02-01

    Personalization - most often understood in terms of granting patients greater opportunity to participate in, and make choices about, the services they receive - has become a key principle guiding reform of the English NHS. This study sets out to explore the relationship between two senses of the term 'personal' within the context of personalization. Firstly, much of the policy literature equates a 'personal' service with one that is responsive to the choices of individual patients. Secondly, the term 'personal' can be thought to refer to the intimate relationships between patients and medical professionals that have typified traditional models of good practice. I combine a review of the relevant academic and policy literature on personalization with a process of conceptual analysis to uncover three arguments, which suggest that personalization based on choice may adversely affect standards of care by eroding the qualities of intimacy at the heart of the care process. Thus, an unintended consequence of the drive for personalization may be the creation of an NHS that is, in an important sense, less personal than it once was. Whilst personalization may deliver many potential benefits, the tension between promoting patient choice and retaining intimate professional-patient relationships ought to be taken seriously. Thus, the task of promoting choice whilst retaining intimacy represents a key policy challenge for advocates of personalization. © 2012 John Wiley & Sons Ltd.

  1. Value-based choice: An integrative, neuroscience-informed model of health goals.

    Science.gov (United States)

    Berkman, Elliot T

    2018-01-01

    Traditional models of health behaviour focus on the roles of cognitive, personality and social-cognitive constructs (e.g. executive function, grit, self-efficacy), and give less attention to the process by which these constructs interact in the moment that a health-relevant choice is made. Health psychology needs a process-focused account of how various factors are integrated to produce the decisions that determine health behaviour. I present an integrative value-based choice model of health behaviour, which characterises the mechanism by which a variety of factors come together to determine behaviour. This model imports knowledge from research on behavioural economics and neuroscience about how choices are made to the study of health behaviour, and uses that knowledge to generate novel predictions about how to change health behaviour. I describe anomalies in value-based choice that can be exploited for health promotion, and review neuroimaging evidence about the involvement of midline dopamine structures in tracking and integrating value-related information during choice. I highlight how this knowledge can bring insights to health psychology using illustrative case of healthy eating. Value-based choice is a viable model for health behaviour and opens new avenues for mechanism-focused intervention.

  2. Health Care Facility Choice and User Fee Abolition: Regression Discontinuity in a Multinomial Choice Setting

    OpenAIRE

    Steven F. Koch; Jeffrey S. Racine

    2013-01-01

    We apply parametric and nonparametric regression discontinuity methodology within a multinomial choice setting to examine the impact of public health care user fee abolition on health facility choice using data from South Africa. The nonparametric model is found to outperform the parametric model both in- and out-of-sample, while also delivering more plausible estimates of the impact of user fee abolition (i.e. the 'treatment effect'). In the parametric framework, treatment effects were relat...

  3. Mostly empty words--what the discourse of "choice" in health care does.

    Science.gov (United States)

    Nordgren, Lars

    2010-01-01

    This paper has two purposes: one is to analyse how the policy of freedom of choice emerged and was formed in the Swedish health care discourse; the second is related to how free choice influences the discourse in health care and how subjects are formed within the field, i.e. what the language of choice in health care does. The research strategy is inspired by a combined theoretical framework borrowed from Michel Foucault's concepts of "discursive formation" and "subjectivization" completed with Judith Butler's concept of performativity. The language of "freedom of choice" calls to mind the rhetoric of promises, i.e. that the patient should be free and responsible, in his or her relation to health care. Since patients seem to be insufficiently informed and supported about the actual benefits of possibilities and limitations associated with the severely restricted reform of free choice, the statements concerning opportunities to make personal health decisions will lose their significance. The advocacy of discourses of freedom of choice seems therefore mostly like empty words, as they are producing weak patients instead of free and empowered people. As the reform was initiated in the beginning of 2000 it is rather fresh. The paper produces insights into the rhetoric of political promises and the limitations of the reform dealing with freedom of choice in health care.

  4. Empowerment and personal assistance - resistance, consumer choice, partnership or discipline?

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Askheim, Ole Petter

    2014-01-01

    to promote active partnership. In this article, we take a closer look at the concept of empowerment and how different approaches capture different relationships between the state and the users of PA. We distinguish between empowerment as a form of resistance, as a form of consumer choice, as co...

  5. Medical students' personal values and their career choices a quarter-century later.

    Science.gov (United States)

    Hojat, M; Brigham, T P; Gottheil, E; Xu, G; Glaser, K; Veloski, J J

    1998-08-01

    A longitudinal study of 391 physicians tested two hypotheses regarding personal values and career choices: that higher preference for social values would be associated with physicians' being more interested in "people-oriented" rather than "technology-oriented" specialties and that higher preference for economic values would be associated with expectations of high income. The physicians (344 men, 47 women) were graduates of Jefferson Medical College in 1974 and 1975 who completed the Allport-Vernon-Lindzey Study of Values during medical school. Analysis showed that physicians currently in the "people-oriented" specialties scored significantly higher on the Social Value scale than their peers in "technology-oriented" specialties. A moderate but statistically significant correlation was found between scores on the Economic Value scale and expectations of higher income. The findings suggest that physicians' personal values are relevant to their career decisions such as specialty choice and expectations of income. The findings have implications with regard to two major issues in the evolving health care system, namely, the distribution of physicians by specialty and cost containment.

  6. VA Personal Health Record Sample Data

    Data.gov (United States)

    Department of Veterans Affairs — My HealtheVet (www.myhealth.va.gov) is a Personal Health Record portal designed to improve the delivery of health care services to Veterans, to promote health and...

  7. factors influencing the choice of health care providing facility among

    African Journals Online (AJOL)

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  8. Modeling the Personal Health Ecosystem.

    Science.gov (United States)

    Blobel, Bernd; Brochhausen, Mathias; Ruotsalainen, Pekka

    2018-01-01

    Complex ecosystems like the pHealth one combine different domains represented by a huge variety of different actors (human beings, organizations, devices, applications, components) belonging to different policy domains, coming from different disciplines, deploying different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. For correctly modeling such systems, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. However, most of the existing standards, specifications and tools for describing, representing, implementing and managing health (information) systems reflect the advancement of information and communication technology (ICT) represented by different evolutionary levels of data modeling. The paper presents a methodology for integrating, adopting and advancing models, standards, specifications as well as implemented systems and components on the way towards the aforementioned ultimate approach, so meeting the challenge we face when transforming health systems towards ubiquitous, personalized, predictive, preventive, participative, and cognitive health and social care.

  9. Differential Health and Social Needs of Older Adults Waitlisted for Public Housing or Housing Choice Vouchers.

    Science.gov (United States)

    Carder, Paula; Luhr, Gretchen; Kohon, Jacklyn

    2016-01-01

    Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV; previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. We conclude with policy implications for housing and health agencies that serve low-income older persons.

  10. Rockin' around the Clock: An Exploratory Study of Music Teachers' Personal Listening Choices

    Science.gov (United States)

    Davis, Virginia Wayman

    2015-01-01

    This study aimed to explore the personal music listening choices of music teachers. Specifically, in which formats do teachers listen to music for personal pleasure, how do they obtain the music they choose, and how frequently do they choose to listen to certain genres of music. Using an online survey, music teachers answered questions about their…

  11. Does personality influence eating styles and food choices? Direct and indirect effects.

    Science.gov (United States)

    Keller, Carmen; Siegrist, Michael

    2015-01-01

    In a random sample (N = 951) from the general population, direct and indirect effects of the Big Five personality traits on eating styles and food choices were examined. Path models revealed that high openness to experience were associated with higher fruit, vegetable and salad and lower meat and soft drink consumption. High agreeableness was associated with low meat consumption. Neuroticism, conscientiousness and extraversion significantly and directly influenced eating styles and significantly indirectly influenced food choices. Conscientiousness mainly promoted fruit consumption by promoting restrained eating and prevented meat consumption by reducing external eating. Conscientiousness prevented consumption of sweet and savory foods, and of sugar-sweetened soft drinks by promoting restrained eating and reducing external eating, and consumption of sweet and savory foods also by reducing emotional eating. Neuroticism promoted consumption of sweet and savory foods by promoting emotional and external eating. Extraversion promoted sweet and savory, meat and soft drink consumption via promoting external eating. Results suggest that neurotic and emotionally unstable individuals seem to adopt counter-regulatory external or emotional eating and eat high-energy dense sweet and savory foods. Highly conscientious individuals adopt regulatory dietary restraint and practice counter-regulatory emotional or external eating less, resulting in more consumption of recommended and less consumption of not recommended food. The higher sociability of extraverted people, which is basically a health beneficial psychological resource, seems to have health-averse effects. Personality traits are stable; however, the resulting more proximal, counter-regulatory eating styles such as emotional or external eating might be more successfully addressed in interventions to prevent overeating and overweight. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty.

    Science.gov (United States)

    Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko

    2018-03-27

    Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with

  13. Specialty choice preference of medical students according to personality traits by Five-Factor Model.

    Science.gov (United States)

    Kwon, Oh Young; Park, So Youn

    2016-03-01

    The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  14. Specialty choice preference of medical students according to personality traits by Five-Factor Model

    Directory of Open Access Journals (Sweden)

    Oh Young Kwon

    2016-03-01

    Full Text Available Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods: A questionnaire survey of Year 4 medical students (n=110 in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Results: Of the 110 eligible medical students, 105 (95.4% response rate completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010 and more Openness students preferred medical departments to others (p=0.031. Personal interest was the significant motivational factors in more Openness students (p=0.003 and Conscientiousness students (p=0.003. Conclusion: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  15. Measuring the loss of consumer choice in mandatory health programmes using discrete choice experiments.

    Science.gov (United States)

    Parkinson, Bonny; Goodall, Stephen; Norman, Richard

    2013-04-01

    Economic evaluation of mandatory health programmes generally do not consider the utility impact of a loss of consumer choice upon implementation, despite evidence suggesting that consumers do value having the ability to choose. The primary aim of this study was to explore whether the utility impact of a loss of consumer choice from implementing mandatory health programmes can be measured using discrete choice experiments (DCEs). Three case studies were used to test the methodology: fortification of bread-making flour with folate, mandatory influenza vaccination of children, and the banning of trans-fats. Attributes and levels were developed from a review of the literature. An orthogonal, fractional factorial design was used to select the profiles presented to respondents to allow estimation of main effects. Overall, each DCE consisted of 64 profiles which were allocated to four versions of 16 profiles. Each choice task compared two profiles, one being voluntary and the other being mandatory, plus a 'no policy' option, thus each respondent was presented with eight choice tasks. For each choice task, respondents were asked which health policy they most preferred and least preferred. Data was analysed using a mixed logit model with correlated coefficients (200 Halton draws). The compensating variation required for introducing a programme on a mandatory basis (versus achieving the same health impacts with a voluntary programme) that holds utility constant was estimated. Responses were provided by 535 participants (a response rate of 83 %). For the influenza vaccination and folate fortification programmes, the results suggested that some level of compensation may be required for introducing the programme on a mandatory basis. Introducing a mandatory influenza vaccination programme required the highest compensation (Australian dollars [A$] 112.75, 95 % CI -60.89 to 286.39) compared with folate fortification (A$18.05, 95 % CI -3.71 to 39.80). No compensation was

  16. Framing choice: The origins and impact of consumer rhetoric in US health care debates.

    Science.gov (United States)

    Lee, Nancy S

    2015-08-01

    This paper examines the origins of consumerist discourse in health care from a communication perspective via a historical textual analysis of health writing in popular magazines from 1930 to 1949. The focus is on Consumers Union's Consumer Reports and the American Medical Association's lay health magazine, Hygeia. Findings from Consumer Reports show that the consumer movement of the 1930s-40s staunchly advocated for universal health insurance. Whereas consumer rights language nowadays tends towards individual choice and personal responsibility, consumerism in health care during that era articulated ideas about consumer citizenship, framing choice and responsibility in collectivist terms and health care as a social good. This paper also illuminates the limits and weaknesses of a central tenet in consumerism-freedom of choice-by analyzing stories in Hygeia about the doctor-patient relationship. A textual analysis finds that the AMA's justification in the 1930s-40s against socialized medicine, i.e., the freedom to choose a doctor, was in practice highly controlled by the medical profession. Findings show that long before the rhetoric of the "empowered consumer" became popular, some patients exercised some choice even in an era when physicians achieved total professional dominance. But these patients were few and tend to occupy the upper socioeconomic strata of US society. In reality choice was an illusion in a fee-for-service era when most American families could not afford the costs of medical care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Influence of Eysenckian Personality Traits in Choice of Specialization by Young Omani Doctors

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Alawi

    2017-07-01

    Full Text Available Objectives:The role of personality in occupational specialty choices has been explored in many parts of the world. To our knowledge, there is a dearth of such studies in the Arab/Islamic population and Oman is no exception. This study aimed to explore the relationship between personality traits and specialty choice among residents of Oman Medical Specialty Board (OMSB. Methods: A cross-sectional study was carried out among Omani resident physicians working under OMSB. The Eysenck Personality Questionnaire–Revised was employed to quantify personality subtypes (e.g., psychoticism, extraversion, and neuroticism. Specialties were categorized as surgical, medical, and diagnostics as per standard of North American medical specialties. A total of 255 residents in 17 medical specialties participated in the study (m = 40.4%; f = 59.6% of 300 eligible subjects giving a response rate of 85.0%. Results: Respondents who had chosen surgical specialties scored significantly higher on the psychoticism subscale than those who had opted for medical and diagnostic specialties. As for individual specialties, orthopedic respondents had statistically significant higher mean scores on psychoticism and neuroticism compared to radiologists and psychiatrists who scored the lowest in the two personality traits, respectively. Conclusions: This study found statistically significant associations between personality traits and choices of specialty by young Omani doctors. We recommend more detailed studies that examine further psychological and cultural variables that are likely to affect the choices of specializations by young Omani professionals in both medical and non-medical fields.

  18. Influence of Eysenckian Personality Traits in Choice of Specialization by Young Omani Doctors.

    Science.gov (United States)

    Al-Alawi, Mohammed; Al-Sinawi, Hamed; Al-Husseini, Salim; Al-Adawi, Samir; Panchatcharam, Sathiya Murthi; Khan, Sahar; Jeyaseelan, Lakshmanan

    2017-07-01

    The role of personality in occupational specialty choices has been explored in many parts of the world. To our knowledge, there is a dearth of such studies in the Arab/Islamic population and Oman is no exception. This study aimed to explore the relationship between personality traits and specialty choice among residents of Oman Medical Specialty Board (OMSB). A cross-sectional study was carried out among Omani resident physicians working under OMSB. The Eysenck Personality Questionnaire-Revised was employed to quantify personality subtypes (e.g., psychoticism, extraversion, and neuroticism). Specialties were categorized as surgical, medical, and diagnostics as per standard of North American medical specialties. A total of 255 residents in 17 medical specialties participated in the study (m = 40.4%; f = 59.6%) of 300 eligible subjects giving a response rate of 85.0%. Respondents who had chosen surgical specialties scored significantly higher on the psychoticism subscale than those who had opted for medical and diagnostic specialties. As for individual specialties, orthopedic respondents had statistically significant higher mean scores on psychoticism and neuroticism compared to radiologists and psychiatrists who scored the lowest in the two personality traits, respectively. This study found statistically significant associations between personality traits and choices of specialty by young Omani doctors. We recommend more detailed studies that examine further psychological and cultural variables that are likely to affect the choices of specializations by young Omani professionals in both medical and non-medical fields.

  19. Discrete Choice Experiments in Public Health

    NARCIS (Netherlands)

    Veldwijk, J.

    2015-01-01

    One approach to improve public health is to implement preventive programs that have been proven effective and cost-effective. For any preventive program to be successful, it is of paramount importance that a large majority of the target population participates. Unfortunately, it is not self-evident

  20. Five on one side: personal and social information in spatial choice.

    Science.gov (United States)

    Brown, Michael F; Saxon, Marie E; Bisbing, Teagan; Evans, Jessica; Ruff, Jennifer; Stokesbury, Andrew

    2015-03-01

    To examine whether the outcome of a rat's own choices ("personal information") and the choice behavior of another rat ("social information") can jointly control spatial choices, rats were tested in an open field task in which they searched for food. For the rats of primary interest (Subject Rats), the baited locations were all on one side of the arena, but the specific locations baited and the side on which they occurred varied over trials. The Subject Rats were sometimes tested together with an informed "Model" rat that had learned to find food in the same five locations (all on the same side of the arena) on every trial. Unintended perceptual cues apparently controlled spatial choices at first, but when perceptual cues to food location were not available, choices were controlled by both personal information (allowing the baited side of the arena to be determined) and social information (allowing baited locations to be determined more precisely). This shows that control by personal and social information are not mutually exclusive and supports the view that these two kinds of information can be used flexibly and adaptively to guide spatial choices. This article is part of a Special Issue entitled: tribute to Tom Zentall. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. FastStats: Older Persons' Health

    Science.gov (United States)

    ... Whooping Cough or Pertussis Family Life Marriage and Divorce Health Care and Insurance Access to Health Care ... tables 10, 11 [PDF – 4.4 MB] Leading causes of death among persons aged 65 and over ...

  2. Professional Aspirations among Pre-Service Teachers: Personal Responsibility, Time Perspectives, and Career Choice Satisfaction

    Science.gov (United States)

    Eren, Altay

    2017-01-01

    Exploring the direct and indirect effects of pre-service teachers' sense of personal responsibility on their professional aspirations through affective (i.e., career choice satisfaction) and cognitive (i.e., time perspectives) variables may enable teacher educators and policy makers to better describe the factors influencing teacher development in…

  3. The Effect of General Creative Personality and Freedom of Task Choice on Adolescents' Social Creativity

    Science.gov (United States)

    Gu, Chuanhua; Hu, Bi Ying; Ngwira, Flemmings Fishani; Jing, Zhi; Zhou, Zongkui

    2016-01-01

    This study investigated the effect of general creative personality and freedom of task choice on the social creativity of adolescents. The results indicated, first, that senior high school students scored higher than junior high school students. Second, girls scored higher than boys on originality, fluency, flexibility, appropriateness, and…

  4. The role of comparison motives in the relationship between personality and comparison level choice

    NARCIS (Netherlands)

    Eggens, L.; Hendriks, A. A. J.; Bosker, R. J.; van der Werf, M. P. C.

    2011-01-01

    This article studied whether the motives for comparison of grades with those of others play a mediating role in the relationship between the Big Five personality traits and the choice of the level of comparison of students. The study was conducted among about 1,500 students in higher education. Of

  5. Personality Trait and Professional Choice among Preservice Teachers in Eastern Kentucky.

    Science.gov (United States)

    Hinton, Samuel; Stockburger, Muriel

    A preliminary study was conducted to examine indicators which tend to reflect relationships between personality traits and professional choice among elementary education students enrolled in the teacher education program in Eastern Kentucky University. Education students in elementary education (N=122) completed the Myers Briggs Type Indicator.…

  6. Demand-driven care and hospital choice. Dutch health policy toward demand-driven care: results from a survey into hospital choice.

    Science.gov (United States)

    Lako, Christiaan J; Rosenau, Pauline

    2009-03-01

    In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician's opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician's advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demand-driven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient's confidence in physician referral and advice.

  7. A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices.

    Science.gov (United States)

    Robinson, Angela; Spencer, Anne; Moffatt, Peter

    2015-04-01

    There has been recent interest in using the discrete choice experiment (DCE) method to derive health state utilities for use in quality-adjusted life year (QALY) calculations, but challenges remain. We set out to develop a risk-based DCE approach to derive utility values for health states that allowed 1) utility values to be anchored directly to normal health and death and 2) worse than dead health states to be assessed in the same manner as better than dead states. Furthermore, we set out to estimate alternative models of risky choice within a DCE model. A survey was designed that incorporated a risk-based DCE and a "modified" standard gamble (SG). Health state utility values were elicited for 3 EQ-5D health states assuming "standard" expected utility (EU) preferences. The DCE model was then generalized to allow for rank-dependent expected utility (RDU) preferences, thereby allowing for probability weighting. A convenience sample of 60 students was recruited and data collected in small groups. Under the assumption of "standard" EU preferences, the utility values derived within the DCE corresponded fairly closely to the mean results from the modified SG. Under the assumption of RDU preferences, the utility values estimated are somewhat lower than under the assumption of standard EU, suggesting that the latter may be biased upward. Applying the correct model of risky choice is important whether a modified SG or a risk-based DCE is deployed. It is, however, possible to estimate a probability weighting function within a DCE and estimate "unbiased" utility values directly, which is not possible within a modified SG. We conclude by setting out the relative strengths and weaknesses of the 2 approaches in this context. © The Author(s) 2014.

  8. Preferences and choices for care and health insurance

    NARCIS (Netherlands)

    Berg, B. van den; Dommelen, P. van; Stam, P.; Laske-Aldershof, T.; Buchmueller, T.; Schut, F.T.

    2008-01-01

    Legislation that came into effect in 2006 has dramatically altered the health insurance system in the Netherlands, placing greater emphasis on consumer choice and competition among insurers. The potential for such competition depends largely on consumer preferences for price and quality of service

  9. Influencers of Career Choice among Allied Health Students.

    Science.gov (United States)

    Brown-West, Anne P.

    1991-01-01

    Major influences on career choice among 153 allied health students were need to help others, prestige, autonomy, and advancement and income potential. Risk of malpractice suits and Acquired Immune Deficiency Syndrome were negative influences for medical laboratory majors, but not for dietetics and physical therapy majors. (SK)

  10. Personality Diagnosis for Personalized eHealth Services

    Science.gov (United States)

    Cortellese, Fabio; Nalin, Marco; Morandi, Angelica; Sanna, Alberto; Grasso, Floriana

    In this paper we present two different approaches to personality diagnosis, for the provision of innovative personalized services, as used in a case study where diabetic patients were supported in the improvement of physical activity in their daily life. The first approach presented relies on a static clustering of the population, with a specific motivation strategy designed for each cluster. The second approach relies on a dynamic population clustering, making use of recommendation systems and algorithms, like Collaborative Filtering. We discuss pro and cons of each approach and a possible combination of the two, as the most promising solution for this and other personalization services in eHealth.

  11. Personal Choices, Personal Power. Career Survival Kit for Teen Education and Employment.

    Science.gov (United States)

    Lindner, A. Frances

    This workbook is one component of the Career Survival Kit prepared for teenage parents in Wisconsin. The workbook is designed to help teen parents identify their choices in preventing another pregnancy. It presents some thoughts about sexual decisions and responsibility. Birth control methods are described to help teens decide the best method for…

  12. Insuring against Health Shocks: Health Insurance and Household Choices

    OpenAIRE

    Liu, Kai

    2015-01-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

  13. Insuring against health shocks: Health insurance and household choices.

    Science.gov (United States)

    Liu, Kai

    2016-03-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Personalized health care: from theory to practice.

    Science.gov (United States)

    Snyderman, Ralph

    2012-08-01

    The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Multiple Personality Domains in Relation to Occupational Choice and Performance among Established Teachers. Research Report. ETS RR-04-41

    Science.gov (United States)

    Emmerich, Walter; Rock, Donald A.; Trapani, Catherine S.

    2004-01-01

    Does personality impact differently on occupational choice and occupational performance? In a study of established teachers, interests, the Five-Factor Model, and attributions were examined in relation to occupational choice and performance. Attributions were assessed using a new instrument designed for teachers. Choice of teaching specialty was…

  16. Age and choice in health insurance: evidence from a discrete choice experiment.

    Science.gov (United States)

    Becker, Karolin; Zweifel, Peter

    2008-01-01

    A uniform package of benefits and uniform cost sharing are elements of regulation inherent in most social health insurance systems. Both elements risk burdening the population with a welfare loss if preferences for risk and insurance attributes differ. This suggests the introduction of more choice in social health insurance packages may be advantageous; however, it is widely believed that this would not benefit the elderly.A representative telephone survey of 1000 people aged >24 years living in the German- and French-speaking parts of Switzerland was conducted. Participants were asked to compare the status quo (i.e. their current insurance contract) with ten hypothetical alternatives. In addition, participants were asked questions concerning utilization of healthcare services; overall satisfaction with the healthcare system, insurer and insurance policy; and a general preference for new elements in the insurance package. Socioeconomic variables surveyed were age, sex, total household income, education (seven categories ranging from primary school to university degree), place of residence, occupation, and marital status. To examine the relationship between age and willingness to pay (WTP) for additional options in Swiss social health insurance.A representative telephone survey of 1000 people aged >24 years living in the German- and French-speaking parts of Switzerland was conducted. Participants were asked to compare the status quo (i.e. their current insurance contract) with ten hypothetical alternatives. In addition, participants were asked questions concerning utilization of healthcare services; overall satisfaction with the healthcare system, insurer and insurance policy; and a general preference for new elements in the insurance package. Socioeconomic variables surveyed were age, sex, total household income, education (seven categories ranging from primary school to university degree), place of residence, occupation, and marital status. A discrete choice

  17. Personal health monitoring - exploiting the power of the personal telephone.

    Science.gov (United States)

    Hannan, Amir

    2015-11-01

    Many health issues that we currently face are related to our lifestyle choices. Educating patients can help them to make better informed health decisions. The internet and smartphones, mobile telephones that perform many of the functions of a computer, are becoming more accessible to the majority of the population. Applications on smartphones and professional health websites can signpost patients to trusted information and allow them to co-produce records. Empowering patients, staff and organizations through enabling access to records and understanding, building a partnership trust and the use of social media can enable people to do more and hopefully improve outcomes. In this article, I describe the steps we have taken to facilitate such interactions within our own primary care practice and the response of patients to these initiatives. © The Author(s) 2015.

  18. Test person operated 2-Alternative Forced Choice Audiometry compared to traditional audiometry

    DEFF Research Database (Denmark)

    Schmidt, Jesper Hvass; Brandt, Christian; Christensen-Dalsgaard, Jakob

      Background: With a newly developed technique, hearing thresholds can be estimated with a system operated by the test persons themselves. This technique is based on the 2 Alternative Forced Choice paradigm known from the psychoacoustic research theory. Test persons can operate the system very......-likelihood and up-down methods has proven effective and reliable even under suboptimal test settings. In non-optimal testing conditions i.e. as a part of a hearing conservation programme the headphone Sennheiser HDA-200 has been used as it contains hearing protection. This test-method has been validated......-retest studies of 2AFC audiometry are comparable to test-retest results known from traditional audiometry under standard clinical settings.   Conclusions 2 Alternative Forced Choice audiometry can be a reliable alternative to traditional audiometry especially under certain circumstances, where it can...

  19. Valuing Individuals? Preferences and Health Choices of Physical Exercise

    OpenAIRE

    Aboagye, Emmanuel

    2017-01-01

    The efficacy of physical exercise for the prevention and treatment of non-specific low back pain (LBP) is well documented, but little is known about how individuals value specific components of physical exercise, such as the type and design or the intensity and frequency of exercise. Other factors that influence individual differences in health choices and adherence are associated with individuals? attitudes toward and likelihood of performing recommended exercise regimens. Current evidence s...

  20. Serotonin enhances the impact of health information on food choice.

    Science.gov (United States)

    Vlaev, Ivo; Crockett, Molly J; Clark, Luke; Müller, Ulrich; Robbins, Trevor W

    2017-06-01

    Serotonin has been implicated in promoting self-control, regulation of hunger and physiological homeostasis, and regulation of caloric intake. However, it remains unclear whether the effects of serotonin on caloric intake reflect purely homeostatic mechanisms, or whether serotonin also modulates cognitive processes involved in dietary decision making. We investigated the effects of an acute dose of the serotonin reuptake inhibitor citalopram on choices between food items that differed along taste and health attributes, compared with placebo and the noradrenaline reuptake inhibitor atomoxetine. Twenty-seven participants attended three sessions and received single doses of atomoxetine, citalopram, and placebo in a double-blind randomised cross-over design. Relative to placebo, citalopram increased choices of more healthy foods over less healthy foods. Citalopram also increased the emphasis on health considerations in decisions. Atomoxetine did not affect decision making relative to placebo. The results support the hypothesis that serotonin may influence food choice by enhancing a focus on long-term goals. The findings are relevant for understanding decisions about food consumption and also for treating health conditions such as eating disorders and obesity.

  1. Communication choices of the uninsured: implications for health marketing.

    Science.gov (United States)

    Dutta, Mohan Jyoti; King, Andy J

    2008-01-01

    According to published scholarship on health services usage, an increasing number of Americans do not have health insurance coverage. The strong relationship between insurance coverage and health services utilization highlights the importance of reaching out to the uninsured via prevention campaigns and communication messages. This article examines the communication choices of the uninsured, documenting that the uninsured are more likely to consume entertainment-based television and are less likely to read, watch, and listen to information-based media. It further documents the positive relationship between interpersonal communication, community participation, and health insurance coverage. The entertainment-heavy media consumption patterns of the uninsured suggests the relevance of developing health marketing strategies that consider entertainment programming as an avenue for reaching out to this underserved segment of the population.

  2. My Health, My Choice, My Future Preconception Health

    Centers for Disease Control (CDC) Podcasts

    2012-10-01

    Preconception health means taking care of your own health now so you’ll be healthy for yourself and your future baby.  Created: 10/1/2012 by National Center on Birth Defects and Developmental Disabilities (NCBDDD).   Date Released: 10/1/2012.

  3. Health concern, food choice motives, and attitudes toward healthy eating: the mediating role of food choice motives.

    Science.gov (United States)

    Sun, Yu-Hua Christine

    2008-07-01

    This study addresses how various health concerns might influence not only consumers' food choice motives but also consumers' subsequent attitudes toward healthy eating. This study expects that those consumers with greater health concerns would have different food choice motives and better attitudes toward healthy eating. A self-completion questionnaire was used to gather information. Participants, a random sample of 500 undergraduate students from a national university in Taipei, Taiwan, provided a total of 456 usable questionnaires, representing a valid response rate of 91%. The average age of the respondents at the time of the survey was 21 years and 63% of respondents were females. The relationship between health concern and healthy eating attitudes was confirmed. The relationship between health concern of developing diseases and attitudes toward healthy eating was fully mediated by food choice motives. However, the relationship between calorie consumption health concern and healthy eating attitudes was only partially mediated by food choice motives. Implications of these findings are discussed.

  4. The Influence of Purchasing Context and Reversibility of Choice on Consumer Responses Toward Personalized Products and Standardized Products.

    Science.gov (United States)

    Choi, Jieun; Lee, Doo-Hee; Taylor, Charles R

    2016-04-01

    Existing research on personalization has found that consumers generally prefer personalized products over standardized ones. This study argued that consumer preference for personalized products is dependent on purchasing context and reversibility of choice. Results of an experiment conducted in this study found that consumers preferred personalized products when purchasing an item for personal use but preferred standardized products when purchasing an item as a gift. However, the effects of purchasing context were negated when consumers were given the assurance that personalized products could be returned (reversibility of choice); when presented with reversibility of choice, consumers preferred personalized products over standardized products regardless of purchasing context. Theoretical and managerial implications of these results were discussed. © The Author(s) 2016.

  5. The Personal Health Technology Design Space

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Frost, Mads

    2016-01-01

    . To enable designers to make informed and well-articulated design decision, the authors propose a design space for personal health technologies. This space consists of 10 dimensions related to the design of data sampling strategies, visualization and feedback approaches, treatment models, and regulatory......Interest is increasing in personal health technologies that utilize mobile platforms for improved health and well-being. However, although a wide variety of these systems exist, each is designed quite differently and materializes many different and more or less explicit design assumptions...

  6. Professional choice self-efficacy: predicting traits and personality profiles in high school students

    Directory of Open Access Journals (Sweden)

    Rodolfo Augusto Matteo Ambiel

    2016-01-01

    Full Text Available Abstract This study aimed to verify the predictive capacity of the Big Five personality factors related to professional choice self-efficacy, as well as to draw a personality profile of people with diverse self-efficacy levels. There were 308 high school students participating, from three different grades (57.5 % women, from public and private schools, average 26.64 years of age. Students completed two instruments, Escala de Autoeficácia para Escolha Profissional (Professional Choice Self-efficacy Scale and Bateria Fatorial de Personalidade (Factorial Personality Battery. Results were obtained using multiple regression analysis, analysis of variance with repeated measures profile and Cohen’s d to estimate the effect size of differences. Results showed that Extraversion, Agreeableness and Conscientiousness were the main predictors of self-efficacy. Differences from medium to large were observed between extreme groups, and Extraversion and Conscientiousness were the personality factors that better distinguish people with low and high levels of self-efficacy. Theses results partially corroborate with the hypothesis. Results were discussed based on literature and on the practical implications of the results. New studies are proposed.

  7. Motives underlying food choice: dentists, porters and dietary health promotion.

    Science.gov (United States)

    Crossley, M L; Khan, S N

    2001-08-25

    Differences in dental decay and disease amongst socioeconomic groups are thought to derive, in part, from variations in dietary practices and differences in education. The aim of this exploratory study was to examine whether differences in motivating factors affecting food choice could be found in a comparison of two groups at very different ends of the social spectrum: dentists and porters/cleaners. A convenience sample of 100 people (51 porters/cleaners and 49 dentists) working in the dental school at a university in the North West of England were approached to interview face-to-face and complete the Food Choice Questionnaire (FCQ), a previously validated measure designed to assess nine main factors relevant to peoples' food choices. A sample size of 100 was chosen because it was adequate to test validity (using a two-group Chi-square test with a 0.050 two sided significance). Findings were analysed using independent sample t-test and multiple linear regression. Results indicated significant differences between porters/cleaners and dentists in terms of their motives for food choice on six of the nine FCQ factors. These included convenience (p motivational factors affecting food choice between different social groups is important to dental practitioners who are being taught to play an increasing role in health promotion. If dental practitioners are to partake meaningfully in such a role, it is necessary for them to be aware not only of their own motives in food selection, but also of the way in which those motives may differ from those of their clients.

  8. Trust, choice and power in mental health care: experiences of patients with psychosis.

    Science.gov (United States)

    Laugharne, Richard; Priebe, Stefan; McCabe, Rose; Garland, Natasha; Clifford, Damian

    2012-09-01

    Trust, choice and power are critical issues in clinical practice, public policies and a post-modern understanding of mental health care. We aimed to investigate the experiences and attitudes of patients with psychosis in relation to trust, choice and power. We conducted 20 in-depth interviews with patients with psychotic disorders in care of NHS services. The interviews were subjected to thematic analysis. Patients discussed aspects of their care in terms of dimensions that enhance or undermine trust, choice and power. Two interpretive themes emerged from this data. First, patients perceive the need for a shifting balance of power, according to the severity of their illness and their own experience of care, but feel that threats of coercion and neglect disable them. Second, they appreciate the expertise of clinicians, but particularly value 'the personal touch' that goes beyond this expertise, including personal disclosure about their own lives, common acts of kindness and conversation outside clinical matters. Patients view trust as a two-way process with responsibility shared between patient and clinician. The active involvement of patients with psychosis in their individual care may be strengthened, particularly when they are not acutely ill and have more experience of their illness. While patients value expertise and respect in interactions with clinicians, they also appreciate a 'personal touch', which may go beyond current notions of professionalism.

  9. Rather unspectacular: design choices in National Health Service glasses

    Directory of Open Access Journals (Sweden)

    Dr Joanne Gooding

    2017-04-01

    Full Text Available This article considers the design and production of spectacles in Britain following the introduction of standardised frame styles under the National Health Service. NHS spectacles were provided as a functional, durable medical appliance to be delivered cost-effectively and there was no explicit concern for fashion or the patient experience. The actions of the government and professional bodies greatly affected the trade in eyewear and thus restricted opportunities for innovative design and consumer choice. Within the range of state regulation frames there was no active concern for ‘design’ in terms of appearance and it was only through the purchase of private frames that significant choice and variety in eyewear could be attained. The scope for the public to select a more fashionable frame whilst receiving an element of state aid was through the purchase of NHS hybrid private frames.

  10. Effect of nutrition label format and product assortment on healthfulness of food choice

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica; Grunert, Klaus G; van Trijp, Hans

    2013-01-01

    This study aims to find out whether front-of-pack nutrition label formats influence the healthfulness of consumers’ food choices and important predictors of healthful choices, depending on the size of the choice set that is made available to consumers. The predictors explored were health motivati...... the results revealed no consistent differences in the effects between the formats, they indicate that manipulating choice sets by including healthier options is an effective strategy to increase the healthfulness of food choices........ The results showed that food choices were more healthful in the extended 20-product (vs. 10-product) choice set and that this effect is stronger than a random choice would produce. The formats colour coding and texts, particularly colour coding in Germany, increased the healthfulness of product choices when...

  11. "Choice Set" for health behavior in choice-constrained settings to frame research and inform policy: examples of food consumption, obesity and food security.

    Science.gov (United States)

    Dover, Robert V H; Lambert, Estelle V

    2016-03-16

    Using the nexus between food consumption, food security and obesity, this paper addresses the complexity of health behavior decision-making moments that reflect relational social dynamics in context-specific dialogues, often in choice-constrained conditions. A pragmatic review of literature regarding social determinants of health in relation to food consumption, food security and obesity was used to advance this theoretical model. We suggest that health choice, such as food consumption, is based on more than the capacity and volition of individuals to make "healthy" choices, but is dialogic and adaptive. In terms of food consumption, there will always be choice-constrained conditions, along a continuum representing factors over which the individual has little or no control, to those for which they have greater agency. These range from food store geographies and inventories and food availability, logistical considerations such as transportation, food distribution, the structure of equity in food systems, state and non-government food and nutrition programs, to factors where the individual exercises a greater degree of autonomy, such as sociocultural foodways, family and neighborhood shopping strategies, and personal and family food preferences. At any given food decision-making moment, many factors of the continuum are present consciously or unconsciously when the individual makes a decision. These health behavior decision-making moments are mutable, whether from an individual perspective, or within a broader social or policy context. We review the construct of "choice set", the confluence of factors that are temporally weighted by the differentiated and relationally-contextualized importance of certain factors over others in that moment. The choice transition represents an essential shift of the choice set based on the conscious and unconscious weighting of accumulated evidence, such that people can project certain outcomes. Policies and interventions should avoid

  12. Employee choice of flexible spending account participation and health plan.

    Science.gov (United States)

    Hamilton, Barton H; Marton, James

    2008-07-01

    Despite the fact that flexible spending accounts (FSAs) are becoming an increasingly popular employer-provided health benefit, there has been very little empirical study of FSA use among employees at the individual level. This study contributes to the literature on FSAs using a unique data set that provides three years of employee-level-matched benefits data. Motivated by the theoretical model of FSA choice presented in Cardon and Showalter (J. Health Econ. 2001; 20(6):935-954), we examine the determinants of FSA participation and contribution levels using cross-sectional and random-effect two-part models. FSA participation and health plan choice are also modeled jointly in each year using conditional logit models. We find that, even after controlling for a number of other demographic characteristics, non-whites are less likely to participate in the FSA program, have lower contributions conditional on participation, and have a lower probability of switching to new lower cost share, higher premium plans when they were introduced. We also find evidence that choosing health plans with more expected out-of-pocket expenses is correlated with participation in the FSA program. Copyright (c) 2007 John Wiley & Sons, Ltd.

  13. Personal responsibility in oral health: ethical considerations.

    Science.gov (United States)

    Albertsen, Andreas

    2012-11-30

    Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor oral health. These factors affect people's oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people responsible. They also commit people who support the idea of personal responsibility in oral health to supporting the idea of societal responsibility for mitigating the effects of factors that diminish people's responsibility and increase the available information and knowledge in the population.

  14. Personality, treatment choice and satisfaction in patients with localized prostate cancer

    International Nuclear Information System (INIS)

    Block, Craig A.; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R.

    2007-01-01

    Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n=74), XRT (n=73), or BTX (n=72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P=NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P=NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process. (author)

  15. Personality, treatment choice and satisfaction in patients with localized prostate cancer.

    Science.gov (United States)

    Block, Craig A; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R

    2007-11-01

    Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process.

  16. Can Health and Environmental Concerns Meet in Food Choices?

    Directory of Open Access Journals (Sweden)

    Alessia Cavaliere

    2014-12-01

    Full Text Available The objective of the study is to analyze if there is a relationship between health and environmental sustainability concerns in food choices. We used data of 300 Italian consumers collected through a vis-à-vis survey. We performed cross-tabulations and chi-square tests for a selected set of variables measuring both types of concerns, segmenting the sample by age, gender and education. Our results suggest that the association between health and environmental concerns is often statistically significant, though we observe a high variable specificity of the associations. Socio-demographic conditions seem to play a role in determining the association between the two concerns, with middle-aged and/or highly-educated respondents showing a stronger association between health and environmental concerns.

  17. Is Variability in Mate Choice Similar for Intelligence and Personality Traits? Testing a Hypothesis about the Evolutionary Genetics of Personality

    Science.gov (United States)

    Stone, Emily A.; Shackelford, Todd K.; Buss, David M.

    2012-01-01

    This study tests the hypothesis presented by Penke, Denissen, and Miller (2007a) that condition-dependent traits, including intelligence, attractiveness, and health, are universally and uniformly preferred as characteristics in a mate relative to traits that are less indicative of condition, including personality traits. We analyzed…

  18. Requirements and Solutions for Personalized Health Systems.

    Science.gov (United States)

    Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

    2017-01-01

    Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

  19. Career Choice and Longevity in U.S. Psychiatric-Mental Health Nurses.

    Science.gov (United States)

    Alexander, Robbi K; Diefenbeck, Cynthia A; Brown, Carlton G

    2015-06-01

    The demand for mental health services in the United States taxes the existing care continuum and is projected to increase as federal initiatives such as the Affordable Care Act and mental health parity improve access to, and coverage for, mental health services. Quality health care providers, such as psychiatric-mental health nurses, are needed to bolster the mental health system. Prior research has focused on the unpopularity of psychiatric nursing as a career choice for nursing students. The purpose of this study is to understand how seasoned psychiatric nurses came to choose and remain in the specialty; descriptive phenomenology is used. In a face-to-face interview, eight registered nurses described their experiences with psychiatric nursing as a student, their entry into psychiatric nursing, and factors related to their longevity in the specialty. Giorgi's Existential Phenomenological Research Method was employed to analyze the interview data. Three themes emerged related to career choice: Interest Developed Prior to or While in Nursing School, Personal Relevance, and Validation of Potential. Three themes emerged related to retention: Overcoming Stereotypes to Develop Career Pride, Positive Team Dynamics, and Remaining Hopeful. Nurse educators play an important role in identifying talent, validating capability, enhancing interest, and increasing students' confidence to pursue a psychiatric nursing career, while nursing administrators and clinical specialists play a key role in retention. Findings also stimulate pertinent questions surrounding the long-term viability of the psychiatric-mental health nursing specialty.

  20. Security and privacy issues of personal health.

    Science.gov (United States)

    Blobel, Bernd; Pharow, Peter

    2007-01-01

    While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

  1. Insurance choice and tax-preferred health savings accounts.

    Science.gov (United States)

    Cardon, James H; Showalter, Mark H

    2007-03-01

    We develop an infinite horizon utility maximization model of the interaction between insurance choice and tax-preferred health savings accounts. The model can be used to examine a wide range of policy options, including flexible spending accounts, health savings accounts, and health reimbursement accounts. We also develop a 2-period model to simulate various implications of the model. Key results from the simulation analysis include the following: (1) with no adverse selection, use of unrestricted health savings accounts leads to modest welfare gains, after accounting for the tax revenue loss; (2) with adverse selection and an initial pooling equilibrium comprised of "sick" and "healthy" consumers, introducing HSAs can, but does not necessarily, lead to a new pooling equilibrium. The new equilibrium results in a higher coinsurance rate, an increase in expected utility for healthy consumers, and a decrease in expected utility for sick consumers; (3) with adverse selection and a separating equilibrium, both sick and healthy consumers are better off with a health savings account; (4) efficiency gains are possible when insurance contracts are explicitly linked to tax-preferred health savings accounts.

  2. Micro-Marketing Healthier Choices: Effects of Personalized Ordering Suggestions on Restaurant Purchases

    Science.gov (United States)

    Bedard, Kelly; Kuhn, Peter

    2014-01-01

    We study the effects of the Nutricate receipt, which makes personalized recommendations to switch from unhealthy to healthier items at a restaurant chain. We find that the receipts shifted the mix of items purchased towards the healthier alternatives. For example, the share of adult main dishes requesting “no sauce” increased by 6.8 percent, the share of kids’ meals with apples (instead of fries) rose by 7.0 percent and the share of breakfast sandwiches without sausage increased by 3.8 percent. The results illustrate the potential of emerging information technologies, which allow retailers to tailor product marketing to individual consumers, to generate healthier choices. PMID:25544398

  3. Product samples stimulate choice of unfamiliar healthful food products.

    Science.gov (United States)

    Schickenberg, B; van Assema, P; Brug, J; de Vries, N K

    2011-08-01

    The purpose of this study was to assess whether the availability of a product sample of an unfamiliar low-fat or fruit and vegetable products stimulates choice for this product among food neophobic young adults. The study had a 2 (experimental vs. control group) by 4 (low-fat bread spread, low-fat cheese, fruit juice, fruit and vegetable juice) between subjects design with a pre-and post-experiment questionnaire. The study was conducted in restaurant rooms of several educational institutions in the Netherlands among a convenience sample of 197 food neophobic young adults aged 17-25 years. A small bite or sip-sized sample of the target product was provided as an intervention. The effect measure was choice of either an unfamiliar healthful food product or a traditional food product. Offering a sample of an unfamiliar healthful food product resulted in 51% of the participants in the experimental group choosing this product vs. 36.4% in the control group. Providing food product samples seems to be a promising strategy in healthy diet promotion programs for food neophobic young adults to increase first-time trial of unfamiliar low-fat and fruit and vegetable products. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Investigation of lifestyle choices of individuals following a vegan diet for health and ethical reasons.

    Science.gov (United States)

    Radnitz, Cynthia; Beezhold, Bonnie; DiMatteo, Julie

    2015-07-01

    The proportion of individuals choosing to follow a vegan diet has increased in recent years. The choice is made for different reasons, primarily concern for animals (ethics) and health, which may impact both specific food choices and other lifestyle behaviors linked to health outcomes. To determine the extent to which the reason for following a vegan diet was associated with health behaviors, we conducted an online survey recruiting an international sample of 246 individuals who reported adhering to a vegan diet. We hypothesized that compared to those following the diet for ethical reasons, those doing so for health reasons would consume foods with higher nutritional value and engage in other healthier lifestyle behaviors. Our hypotheses were partially supported in that those citing health reasons (n = 45) reported eating more fruit (U = 3503.00, p = 0.02) and fewer sweets (U = 3347.00, p vegan diets on health, they should be taken into account when studying persons following a vegan diet. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. [Health status of elderly persons in Korea].

    Science.gov (United States)

    Choi, Y H; Kim, M S; Byon, Y S; Won, J S

    1990-12-01

    This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychological and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practitioners working in Kungsang-Buk-Do, Kyngsang-Nam-Do, Jonla Buk-Do, and Kyung Ki-Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climatization functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows: 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliability indicated by a Cronbach = 0.97793. 2. Average score of the subjects physical health status was 4,054 in a 5 point likert scale, mental-emotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status; physical health status was the

  6. The internet of things for personalized health.

    Science.gov (United States)

    Schreier, Günter

    2014-01-01

    Advances in information and communications technologies (ICT) enable new personalized health care concepts which are often characterized by four "P" terms, i.e. personalized, predictive, preventive and participatory. However, real world implementations of the complete 4P spectrum hardly exist today. The Internet of Things (IoT) has been defined as an extension to the current Internet that enables pervasive communication between the physical and the virtual world. Smart devices and enabling elements like Near Field Communication (NFC) and Radio Frequency Identification (RFID) technology already exist and increasingly will be a mainstream element of our lives. This future vision paper attempts to assess if and how the Internet of Things for personalized health (IoT4pH) can help to facilitate the 4P healthcare paradigm and discusses related challenges and opportunities.

  7. School Ethos and Personal, Social, Health Education

    Science.gov (United States)

    Brown, Jackie; Busfield, Robert; O'Shea, Alison; Sibthorpe, Joanne

    2011-01-01

    This paper will discuss research undertaken within a London borough in 2009 that aimed to examine how Personal, Social, Health and Economic education (PSHE) was perceived and delivered. The ethos of schools was incorporated into the enquiry as a key determinate of both perception and delivery of PSHE. The findings are presented with particular…

  8. Consumer preferences for health and nonhealth outcomes of health promotion: results from a discrete choice experiment.

    Science.gov (United States)

    Alayli-Goebbels, Adrienne F G; Dellaert, Benedict G C; Knox, Stephanie A; Ament, André J H A; Lakerveld, Jeroen; Bot, Sandra D M; Nijpels, G; Severens, J L

    2013-01-01

    Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change. A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week. With the exception of "time cost per week" and "start point of future health state," all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes "endurance," "days with sufficient relaxation," and "future health state value" had the greatest impact on consumer choices. The "life expectancy" attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade. Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All

  9. PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

    Directory of Open Access Journals (Sweden)

    Budi Hidayat

    2012-11-01

    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  10. Contingent valuation method applied to survey on personal preferences on choice of electric power source

    International Nuclear Information System (INIS)

    Takahashi, Reiko; Nakagome, Yoshihiro

    2004-01-01

    A Survey was conducted on personal preferences regarding their choice of electric power source to verify the applicability of Contingent Valuation Method (CVM) to such analysis. The survey was carried out on local and urban inhabitants in two steps, first by mail and thereafter by direct interview. A choice of four typical forms of power source was presented: nuclear, coal, hydro and green power; and the question was asked whether the respondent would be willing to pay additional charge for specifying their preferable power source. The mail survey indicated more than half of the respondents hold some willingness to pay either for disuse of nuclear power or expansion of green power. The interview survey revealed various complex motives lying behind their answers. Consequently, it was found that their preference is significantly correlated to their personal image or knowledge of power sources, their thinking or attitude toward energy conservation, their sense of consumption and their private view of life. It is concluded that CVM is pertinently applicable to quantitative analysis of individual opinions, particularly in terms of their motivation to participate in national energy issues. A number of modifications, however, should be required to be brought to the survey design in order to ensure smooth application in practice. (author)

  11. Sources of Inspiration: The role of significant persons in young people's choice of science in higher education

    Science.gov (United States)

    Sjaastad, Jørgen

    2012-07-01

    The objectives of this article were to investigate to which extent and in what ways persons influence students' choice of science, technology, engineering, and mathematics (STEM) in tertiary education, and to assess the suitability of an analytical framework for describing this influence. In total, 5,007 Norwegian STEM students completed a questionnaire including multiple-choice as well as open-ended questions about sources of inspiration for their educational choice. Using the conceptualisation of significant persons suggested by Woelfel and Haller, the respondents' descriptions of parents and teachers are presented in order to elaborate on the different ways these significant persons influence a STEM-related educational choice. Parents engaged in STEM themselves are models, making the choice of STEM familiar, and they help youngsters define themselves through conversation and support, thus being definers. Teachers are models by displaying how STEM might bring fulfilment in someone's life and by giving pupils a positive experience with the subjects. They help young people discover their STEM abilities, thus being definers. Celebrities are reported to have minor influence on STEM-related educational choices. Both qualitative and quantitative analyses indicate that interpersonal relationships are key factors in order to inspire and motivate a choice of STEM education. Implications for recruitment issues and for research on interpersonal influence are discussed. It is suggested that initiatives to increase recruitment to STEM might be aimed at parents and other persons in interpersonal relationships with youth as a target group.

  12. Valuing Individuals' Preferences and Health Choices of Physical Exercise.

    Science.gov (United States)

    Aboagye, Emmanuel

    2017-06-01

    The efficacy of physical exercise for the prevention and treatment of non-specific low back pain (LBP) is well documented, but little is known about how individuals value specific components of physical exercise, such as the type and design or the intensity and frequency of exercise. Other factors that influence individual differences in health choices and adherence are associated with individuals' attitudes toward and likelihood of performing recommended exercise regimens. Current evidence shows that efficacy is similar among exercise interventions, but their features vary widely. Thus it may be difficult for clinicians to discriminate between available options in clinical practice. Considering the many challenges in determining the form of exercise best suited to the individual patient, this commentary discusses some of the practical methods that could be used to elicit individual preference for recommended health care interventions. Such methods have the advantage of providing more information for health care decision making, particularly with regard to exercise interventions for LBP. This commentary also advocates for the use of patient preference in health care decisions.

  13. The Role of Personality in Relation to Gender Differences in School Subject Choices in Pre-University Education

    NARCIS (Netherlands)

    Korpershoek, H.; Kuyper, H.; Van der Werf, M.P.C.

    2012-01-01

    Boys and girls to some extent differ in personality characteristics while they also prefer different school subjects in secondary education. This study has attempted to unravel the relations among gender, personality, and students' subject choices. The study was based on a sample of 1,740 9th grade

  14. Taxing unhealthy choices: The complex idea of liberal egalitarianism in health.

    Science.gov (United States)

    Albertsen, Andreas

    2016-05-01

    Under the heading of liberal egalitarianism, Cappelen and Norheim present a novel approach regarding how we are to assess health disadvantages reflecting people's choices. It seeks to uphold a commitment to principles of responsibility and egalitarianism, while avoiding objections that such theories fail for humanitarian, liberal or fairness reasons. The approach draws a line between those of such diseases which are life-threatening, costly to treat relative to income or undermining important political capabilities and those which are not. For the latter kind, their approach allows for co-payment, whereas the former requires a different measure. Here, the authors maintain that unhealthy choices should be taxed and treatment offered equally to everyone without further cost. While this is an interesting approach, it faces important difficulties. It consists of two elements, which can come into tension with each other when concerns for severity of disease and personal responsibility recommend the employment of different elements. Furthermore, as it stands, the approach is incomplete because it seems unable to address important non-monetary shortages, such as the organ shortage. Finally, it is not apparent how the approach is able to address the significant ways in which social circumstances influences people's choices in health and their ability to stay healthy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. The Emergence of Personalized Health Technology.

    Science.gov (United States)

    Allen, Luke Nelson; Christie, Gillian Pepall

    2016-05-10

    Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end.

  16. Why Even the Logic of Re-Defined Choice May Still Contradict the Logic of Care in Public Health Systems?

    Directory of Open Access Journals (Sweden)

    Marianna Fotaki

    2013-01-01

    Full Text Available I would like to thank Dr. Benjamin Ewert (1 for his commentary on my short paper ‘Is patient choice the future of health care systems?’ (2 for three reasons. First, because I take heart from his support for my key thesis about the need to replace simplistic economic constructs underlying policy assumptions to explain how patients make health-related decisions in real life. Second, because it gives me the opportunity to, on the one hand, clarify my arguments on how health users’ embeddedness in social relations and patients’ multiple identities and personal circumstances influence these decisions; and to elaborate on the role of trust in this processes in more detail on the other hand. Third, because Dr. Ewert’s contribution helped me re-think issues concerning the importance of patient choice in the context of new challenges that public health systems face such as the threat to free and universal provision of health care services. Although I fully agree with the rejection of the obsolete conception of choice that tends to dominate current policy debates, I do believe that his conviction concerning the inescapability of choice requires some further qualifications. This stems from the recognition of users expressed desire to trade off choice against other more important attributes of health care which have to do with their values and norms originating in the ethics of care, and which makes provision of health services possible. Let me now explicate in brief these three points of agreement before presenting my ultimate disclaimer in the conclusion of this response to Dr. Ewert’s comment. On the first point concerning the inadequacy of economic models as a guide for public health policy, without repeating the arguments expressed eloquently in the commentary, I would like to reiterate that these are at odds with reality because a simple notion of preference which underlies the idea of consumerist choice fails to account for the host of

  17. Five-Factor Personality Scale on Career Choice Regarding Accounting Profession: A Study About Business Department Students

    Directory of Open Access Journals (Sweden)

    Şuayyip Doğuş DEMİRCİ

    2015-01-01

    Full Text Available Accounting profession emerges as an important career choice for students of business administration department. By this study, the role of personality traits and some other factors on career choices regarding accountancy profession of 3rd and 4th degree undergraduate students of Business Department at the stage of discovering their careers was tried to be determined. For this purpose, survey as one of data collection techniques was applied and quantitative research methods have been utilized. In order to identify the personality traits of participants, five-factor personality scale was used. As a result of conducted statistical analysis, there were found significant differences in career choices regarding accountancy profession according to average monthly income of family, grade point average, whether having knowledge about profession, whether being interested in accounting courses of individual and responsibility dimension of personality.

  18. Effects of providing personalized feedback of child's obesity risk on mothers' food choices using a virtual reality buffet.

    Science.gov (United States)

    McBride, C M; Persky, S; Wagner, L K; Faith, M S; Ward, D S

    2013-10-01

    Providing personalized genetic-risk feedback of a child's susceptibility to adult-onset health conditions is a topic of considerable debate. Family health history (FHH), specifically parental overweight/obesity status, is a useful assessment for evaluating a child's genetic and environmental risk of becoming obese. It is unclear whether such risk information may influence parents' efforts to reduce their child's risk of obesity. To evaluate whether telling mothers the magnitude of their child's risk of becoming obese based on personal FHH influenced food choices for their young child from a virtual reality-based buffet restaurant. Overweight/obese mothers of a child aged 4-5 years who met eligibility criteria (N=221) were randomly assigned to one of three experimental arms, which emphasized different health information: arm 1, food safety control (Control); arm 2, behavioral-risk information (BRI) alone or arm 3, behavioral-risk information plus personal FHH-based risk assessment (BRI+FHH). Mothers donned a head-mounted display to be immersed in a virtual restaurant buffet, where they selected virtual food and beverages as a lunch for their child. Mothers who were randomized to BRI+FHH filled the index child's plate with an average of 45 fewer calories than those in the Control arm (Prisk message (that is, only one overweight parent). The influence of communicating a child's inherited risk of obesity on mothers' feeding practices may vary by the risk level conveyed. High-risk messages may best be coupled with strategies to increase mother's perceptions that efforts can be undertaken to reduce risk and build requisite behavioral skills to reduce risk.

  19. Toward a personal health society in cardiology.

    Science.gov (United States)

    Fayn, Jocelyne; Rubel, Paul

    2010-03-01

    In this paper, we present a new generation of health services that has emerged due to the development of advanced information and communication technology (ICT) solutions, like the Enhanced Personal, Intelligent, and Mobile system for Early Detection and Interpretation of Cardiac Syndromes (EPI-MEDICS). It is a personal self-care system that allows any citizen to self-record high-quality ECGs on demand with a smart portable device, which is endowed with powerful ICT capabilities: self-adaptive embedded intelligence, mobile health record management support on SmartMedia card, embedded Web server, and wireless communication. The EPI-MEDICS solution design also provides ambient, intelligent, and pervasive computing services offering any citizen a ubiquitous, reliable, and efficient management of his/her own cardiac status. A multicentric evaluation performed in Europe with a series of device prototypes and the performance assessment of the original methods of signal synthesis that were designed to guarantee a high interoperability level of the recorded data within the clinical practice, as well as of the decision-support methodologies that were developed for an early detection of life-threatening myocardial ischemia and arrhythmia, at home or anywhere, demonstrate the pertinence of going toward a personal health society in cardiology, which still yields the highest mortality rate in industrialized countries.

  20. Micro-marketing healthier choices: effects of personalized ordering suggestions on restaurant purchases.

    Science.gov (United States)

    Bedard, Kelly; Kuhn, Peter

    2015-01-01

    We study the effects of the Nutricate receipt, which makes personalized recommendations to switch from unhealthy to healthier items at a restaurant chain. We find that the receipts shifted the mix of items purchased toward the healthier alternatives. For example, the share of adult main dishes requesting "no sauce" increased by 6.8 percent, the share of kids' meals with apples (instead of fries) rose by 7.0 percent and the share of breakfast sandwiches without sausage increased by 3.8 percent. The results illustrate the potential of emerging information technologies, which allow retailers to tailor product marketing to individual consumers, to generate healthier choices. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Personal Health Records: A Systematic Literature Review.

    Science.gov (United States)

    Roehrs, Alex; da Costa, Cristiano André; Righi, Rodrigo da Rosa; de Oliveira, Kleinner Silva Farias

    2017-01-06

    Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients' health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health

  2. [School choice and vocational guidance for schoolchildren with chronic diseases and other health problems].

    Science.gov (United States)

    Lancić, Franciska; Majski-Cesarec, Slavenka; Musil, Vera

    2010-09-01

    By following a child's growth, development, and health, school medicine specialist can see opportunities for career choice. Special attention is needed for schoolchildren with chronic diseases and developmental difficulties, because of limited occupation choices. Studies report 10 % to 15 % prevalence of chronic diseases among schoolchildren. Parents and children should be informed about child's limitations before career choice. It would be helpful for the students to develop interests for occupations that are not contraindicated for their condition. Physical examination gives an insight into the psycho-physical abilities of an eighth-grade primary school student for further education. During examination, counselling and vocational guidance is provided for all students with chronic diseases and other health problems. All procedures are oriented to personal abilities and preferences. The aim of this study was to analyse the reasons for vocational guidance in the Varazdin County of Croatia. It included eighth-grade students from ten primary schools from 1998/99 to 2007/08. Of 4939 students, 458 (9.3 %) with chronic diseases and health difficulties were referred to vocational guidance. Of these, 41.3 % were referred due to mental and behavioural disorders. These students were assessed and received a recommendation for at least two occupations. Forty-eight students (10.5 %) did not follow the recommendation.In a coordinated effort, school physicians, vocational guidance experts, and school and local authorities should secure enrollment of students with chronic diseases and health difficulties in secondary schools and follow their development and education to provide them the best available career opportunities.

  3. Comparisons among three types of generalist physicians: Personal characteristics, medical school experiences, financial aid, and other factors influencing career choice.

    Science.gov (United States)

    Xu, G; Veloski, J J; Barzansky, B; Hojat, M; Diamond, J; Silenzio, V M

    1996-01-01

    A national survey of family physicians, general internists, and general pediatricians was conducted in the US to examine differences among the three groups of generalists physicians, with particular regard to the factors influencing their choice of generalist career. Family physicians were more likely to have made their career decision before medical school, and were more likely to have come from inner-city or rural areas. Personal values and early role models play a very important role in influencing their career choice. In comparison, a higher proportion of general internists had financial aid service obligations and their choice of the specialty was least influenced by personal values. General pediatricians had more clinical experiences either in primary care or with underserved populations, and they regarded medical school experiences as more important in influencing their specialty choice than did the other two groups. Admission committees may use these specialty-related factors to develop strategies to attract students into each type of generalist career.

  4. Does attention to health labels predict a healthy food choice? An eye-tracking study

    NARCIS (Netherlands)

    Fenko, Anna; Nicolaas, Iris; Galetzka, Mirjam

    2018-01-01

    Visual attention to health labels can indicate a subsequent healthy food choice. This study looked into the relative effects of Choices logos and traffic light labels on consumers’ visual attention and food choice. A field experiment using mobile eye-tracking was conducted in a Dutch university

  5. The food choice kaleidoscope. A framework for structured description of product, place and person as sources of variation in food choices.

    Science.gov (United States)

    Jaeger, Sara R; Bava, Christina M; Worch, Thierry; Dawson, John; Marshall, David W

    2011-04-01

    Despite a wide range of research approaches already being used to study eating and drinking, this complex aspect of human activity lacks conceptualisation and methodology for structured description of food choices. This paper introduces a metaphoric framework--the food choice kaleidoscope--as an approach to such inquiry. It conceptualises individual food choice events (or eating occasions) as being shaped by three main factors--product, person and place--and provides a descriptive approach through which patterns and variability in food choice events can be observed. The factors can be studied separately or in combination to reveal the joint influence of product, place and/or person factors. The approach is 'data hungry' and requires information about large numbers of eating occasions obtained for a variety of foods/beverage in a variety of situations. Using information about ∼5800 eating occasions obtained from 25 New Zealand women who self-completed 24-h recall diaries, the kaleidoscopic approach is illustrated. The data are analysed in relation to 30 food/beverage categories and 37 contextual (or 'place') variables, and at the level of individual participants. Results are presented that document: product-to-product variability in who eats/drinks what and where/how it is consumed; place-to-place variation in what is consumed and by whom; and person-to-person variability in what is consumed and where/how it is consumed. The most significant insight to emerge is the considerable heterogeneity that is hidden beneath the average patterns, and that average values may be inappropriate/irrelevant for this type of data. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Effects of nutrition label format and product assortment on the healthfulness of food choice.

    Science.gov (United States)

    Aschemann-Witzel, Jessica; Grunert, Klaus G; van Trijp, Hans C M; Bialkova, Svetlana; Raats, Monique M; Hodgkins, Charo; Wasowicz-Kirylo, Grazyna; Koenigstorfer, Joerg

    2013-12-01

    This study aims to find out whether front-of-pack nutrition label formats influence the healthfulness of consumers' food choices and important predictors of healthful choices, depending on the size of the choice set that is made available to consumers. The predictors explored were health motivation and perceived capability of making healthful choices. One thousand German and Polish consumers participated in the study that manipulated the format of nutrition labels. All labels referred to the content of calories and four negative nutrients and were presented on savoury and sweet snacks. The different formats included the percentage of guideline daily amount, colour coding schemes, and text describing low, medium and high content of each nutrient. Participants first chose from a set of 10 products and then from a set of 20 products, which was, on average, more healthful than the first choice set. The results showed that food choices were more healthful in the extended 20-product (vs. 10-product) choice set and that this effect is stronger than a random choice would produce. The formats colour coding and texts, particularly colour coding in Germany, increased the healthfulness of product choices when consumers were asked to choose a healthful product, but not when they were asked to choose according to their preferences. The formats did not influence consumers' motivation to choose healthful foods. Colour coding, however, increased consumers' perceived capability of making healthful choices. While the results revealed no consistent differences in the effects between the formats, they indicate that manipulating choice sets by including healthier options is an effective strategy to increase the healthfulness of food choices. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Parental Mate Choice Manipulation Tactics: Exploring Prevalence, Sex and Personality Effects

    Directory of Open Access Journals (Sweden)

    Menelaos Apostolou

    2014-07-01

    Full Text Available Parents and children are genetically related but not genetically identical, which means that their genetic interests overlap but also diverge. In the area of mating, this translates into children making mate choices that are not in the best interest of their parents. Parents may then resort to manipulation in order to influence their children's mating decisions in a way that best promotes the former's interests. This paper attempts to identify the structure of manipulation tactics that parents employ on their daughters and sons, as well as on their daughters' and sons' mates, and also to estimate their prevalence. On the basis of the structure of the derived tactics, four hypotheses are tested: Mothers are more willing than fathers to use manipulation tactics; parents are willing to use more manipulation on their daughters than on their sons; the personality of parents predicts the use of tactics on their children and on their children's mates; and the personality of children and of children's mates predicts the use of tactics on them. Evidence from two independent studies provides support for the first three hypotheses, but mixed support for the fourth hypothesis. The implications of these findings are further discussed.

  8. Applying the health action process approach (HAPA) to the choice of health products: An exploratory study

    DEFF Research Database (Denmark)

    Krutulyte, Rasa; Grunert, Klaus G.; Scholderer, Joachim

    This paper presents the results of a qualitative pilot study that aimed to uncovering Danish consumers' motives for choosing health food. Schwarzer's (1992) health action process approach (HAPA) was applied to understand the process by which people chose health products. The research focused...... on the role of the behavioural intention predictors such as risk perception, outcome expectations and self-efficacy. The model has been proved to be a useful framework for understanding consumer choosing health food and is substantial in the further application of dietary choice issues....

  9. THE FACTORS OF OCCUPATIONAL CHOICE OF PERSONS WITH CHRONIC SPINAL CORD INJURY IN THE REPUBLIC OF SLOVENIA

    Directory of Open Access Journals (Sweden)

    Alenka FIDLER

    2017-10-01

    Full Text Available Introduction In the past, most persons with chronic spinal cord injury (SCI retired, but today these persons enter the labor market largely. The opportunities offered by the environment, the available resources and the social contexts of living contribute to self-awareness and to the various career opportunities of an individual with chronic SCI. Objectives: The purpose of the research was to determine the effects on the choice of the occupation of the people with chronic SCI. Methods: The study relies on descriptive and causal-non-experimental methods of empirical pedagogical research. The sample consists of 127 persons with genetic and acquired SCI aged 19 to 70. Results: The research findings indicate that the desired occupation is inaccessible for almost half of the respondents due to the SCI. The occupational choice is affected by an important fact that persons with SCI would accomplish the education successfully. However, there are also factors related to the accessibility and adjustment of an educational institution and a workplace. Among the socialization factors that influence the choice of enrolment in an educational institution or in occupational choice is the acceptance of their disability, the respect for the necessary adjustments by teachers and peers, the support of their families and the possibility of an assistant to overcome their architectural barriers. Conclusion: If we want to increase the employment of people with SCI, the implementation of modern career guidance which emphasis one’s personality, life situation and its prospects for the future is necessary.

  10. Improving comfort and health with personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor

    2004-01-01

    The thermal environment and air quality in buildings affects occupants¿ health, comfort and performance. The heating, ventilating and air-conditioning (HVAC) of buildings today is designed to provide a uniform room environment. However, large individual differences exist between occupants in regard...... existing knowledge on performance of personalized ventilation (PV) and on human response to it. The airflow interaction in the vicinity of the human body is analysed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

  11. Building the national health information infrastructure for personal health, health care services, public health, and research

    Directory of Open Access Journals (Sweden)

    Detmer Don E

    2003-01-01

    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  12. The Cow in the Room: Public Knowledge of the Links Between Dietary Choices and Health and Environmental Impacts

    Directory of Open Access Journals (Sweden)

    Andrew W Joyce

    2008-01-01

    Full Text Available Issue Addressed: This paper describes results of a survey comparing people’s knowledge of health and environmental impacts of dietary choices. Dietary choice is one of the key ways in which individuals can reduce their environmental impact in relation to water use and greenhouse gas emissions but this may not be widely known amongst the public due to limited press coverage.Methods: A street intercept survey was conducted asking open ended questions on how people can help the environment, maintain or improve health and basic demographics. The sample size was 107 with a refusal rate of 51%.Results: Only 3.2% of the sample made a link between dietary choice and environmental impact whereas 85.6% of the sample referred to dietary choice in relation to personal health. Transport options and keeping active were popular responses to both health and environmental categories.Conclusions: It seems that very few people are aware that the livestock sector is the second largest contributor to equivalent greenhouse gas emissions and one of the largest users of fresh water. Reduction in red meat consumption could have both important positive health and environmental impacts.

  13. Personal values underlying ethnic food choice: Means-end evidence for Japanese food

    Directory of Open Access Journals (Sweden)

    Yeong S. Tey

    2018-03-01

    Full Text Available Background: Ethnic cuisines are increasingly popular in global food markets. This study identifies the personal values underlying Malaysian consumers' decision making with respect to Japanese food. Methods: A total of 134 Malaysian consumers were interviewed and analyzed using means-end chain methodology. Results: Our findings indicate that Japanese food is chosen for the values that the attribute “tasty” can help achieve, not for that attribute per se. Conclusion: Identified values primarily related to longevity, meaningful life-style and sense of accomplishment. The identification of these connections is an important step in understanding why a particular ethnic food is favored by foreign consumers. Our findings could be helpful to restaurateurs in meeting marketing strategies with consumer values and policymakers when designing health campaigns. Keywords: Attributes, Japanese food, Means-end chain, Personal values, Product attributes, Cognition

  14. Personal vis-a-vis social responsibility for disparities in health status: An issue of justice.

    Science.gov (United States)

    Jha, Ayan; Dobe, Madhumita

    2016-01-01

    Health inequities are disparities which can be avoided through rational actions on the part of policymakers. Such inequalities are unnecessary and unjust and may exist between and within nations, societies, and population groups. Social determinants such as wealth, income, occupation, education, gender, and racial/ethnic groups are the principal drivers of this inequality since they determine the health risks and preventive behaviors, access to, and affordability of health care. Within this framework, there is a debate on assigning a personal responsibility factor over and above societal responsibility to issues of ill health. One school of philosophy argues that when individuals are worse-off than others for no fault of their own, it is unjust, as opposed to health disparities that arise due to avoidable personal choices such as smoking and drug addiction for which there should (can) be a personal responsibility. Opposing thoughts have pointed out that the relative socioeconomic position of an individual dictates how his/her life may progress from education to working conditions and aging, susceptibility to diseases and infirmity, and the consequences thereof. The existence of a social gradient in health outcomes across populations throughout the world is a testimony to this truth. It has been emphasized that assuming personal responsibility for health in public policy-making can only have a peripheral place. Instead, the concept of individual responsibility should be promoted as a positive concept of enabling people to gain control over the determinants of health through conscious, informed, and healthy choices.

  15. Choice, deliberation, violence: Mental capacity and criminal responsibility in personality disorder.

    Science.gov (United States)

    Pickard, Hanna

    2015-01-01

    Personality disorder is associated with self-harm and suicide, as well as criminal offending and violence towards others. These behaviours overlap when the means chosen to self-harm or attempt suicide put others at risk. In such circumstances, an individual's mental state at one and the same time may be deemed to meet the conditions for criminal responsibility, and to warrant involuntary hospital admission. I explore this tension in how people with personality disorder are treated at the hands of the criminal and civil law respectively in England and Wales: they may be deemed sufficiently mentally well to be punished for their crimes, but not deemed sufficiently mentally well to retain the right to make their own decisions about matters of serious importance to their own lives, including whether or not to continue them. The article divides into four sections. After introducing this tension, Section 2 sketches the nature of personality disorder and the psychology underlying self-directed and other-directed violence. Section 3 addresses the questions of whether people with personality disorder who are violent, whether towards self or others, typically meet the conditions for criminal responsibility and mental capacity respectively, considering in particular whether their underlying desires and values, or their emotional distress, affect their mental capacity to make treatment decisions. Section 4 then considers what we might do to address the tension, within the confines of current legislation. Drawing on The Review of the Mental Health Act 1983, I argue that we are ethically justified in involuntarily admitting to hospital people with personality disorder who pose a serious risk to themselves only if we simultaneously undertake to offer genuine help for their future, in the form of appropriate treatment, social support, and better life opportunities - a provision which, as things stand in England and Wales, is sorely lacking. Copyright © 2015. Published by Elsevier

  16. Choice, deliberation, violence: Mental capacity and criminal responsibility in personality disorder

    Science.gov (United States)

    Pickard, Hanna

    2015-01-01

    Personality disorder is associated with self-harm and suicide, as well as criminal offending and violence towards others. These behaviours overlap when the means chosen to self-harm or attempt suicide put others at risk. In such circumstances, an individual's mental state at one and the same time may be deemed to meet the conditions for criminal responsibility, and to warrant involuntary hospital admission. I explore this tension in how people with personality disorder are treated at the hands of the criminal and civil law respectively in England and Wales: they may be deemed sufficiently mentally well to be punished for their crimes, but not deemed sufficiently mentally well to retain the right to make their own decisions about matters of serious importance to their own lives, including whether or not to continue them. The article divides into four sections. After introducing this tension, Section 2 sketches the nature of personality disorder and the psychology underlying self-directed and other-directed violence. Section 3 addresses the questions of whether people with personality disorder who are violent, whether towards self or others, typically meet the conditions for criminal responsibility and mental capacity respectively, considering in particular whether their underlying desires and values, or their emotional distress, affect their mental capacity to make treatment decisions. Section 4 then considers what we might do to address the tension, within the confines of current legislation. Drawing on The Review of the Mental Health Act 1983, I argue that we are ethically justified in involuntarily admitting to hospital people with personality disorder who pose a serious risk to themselves only if we simultaneously undertake to offer genuine help for their future, in the form of appropriate treatment, social support, and better life opportunities — a provision which, as things stand in England and Wales, is sorely lacking. PMID:25997380

  17. [Personal health records: the case of the Personal Health Folder of Catalonia (Spain)].

    Science.gov (United States)

    Saigí, Francesc; Cerdá Calafat, Ismael; Guanyabens Calvet, Joan; Carrau Vidal, Elisenda

    2012-01-01

    The aims of this study were to explore the possibilities of the Personal Health Folder and to identify the gap between the potential applications of this tool and what it offers through the Internet. The Personal Health Folder is presented, a project linked to the Shared Medical Record of Catalonia (Spain), which provides citizens with an access point to information about their health insurance, customized and supported by information and communication technologies. The project was carried out by the Ministry of Health of the Government of Catalonia (Generalitat de Catalunya) and data were gathered through an anonymous survey. The results were critical to obtain information on the suitability of the published data and on the expectations of a tool aimed at the general population. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana

    Directory of Open Access Journals (Sweden)

    Micheal Kofi Boachie

    2016-03-01

    Full Text Available Background In early 2012, National Health Insurance Scheme (NHIS members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs and direction of association of such factors with the choice of PPP. Methods Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63% and doctors (39.92%, distance or proximity (49.60%, provider reputation (39.52%, waiting time (39.92, additional charges (37.10%, and recommendations (48.79% were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027, availability of doctors (-1.82, additional charges (-2.14 and reputation (-2.09 were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59, waiting time (1.45, residence (-2.62, gender (-2.89, and reputation (-2.69 were statistically significant at 1% level. Presence of additional charges (-1.29 was statistically significant at 5% level. Conclusion Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by

  19. The Role of Wealth and Health in Insurance Choice: Bivariate Probit Analysis in China

    Directory of Open Access Journals (Sweden)

    Yiding Yue

    2014-01-01

    Full Text Available This paper captures the correlation between the choices of health insurance and pension insurance using the bivariate probit model and then studies the effect of wealth and health on insurance choice. Our empirical evidence shows that people who participate in a health care program are more likely to participate in a pension plan at the same time, while wealth and health have different effects on the choices of the health care program and the pension program. Generally, the higher an individual’s wealth level is, the more likelihood he will participate in a health care program; but wealth has no effect on the participation of pension. Health status has opposite effects on choices of health care programs and pension plans; the poorer an individual’s health is, the more likely he is to participate in health care programs, while the better health he enjoys, the more likely he is to participate in pension plans. When the investigation scope narrows down to commercial insurance, there is only a significant effect of health status on commercial health insurance. The commercial insurance choice and the insurance choice of the agricultural population are more complicated.

  20. Choice of Personal Assistance Services Providers by Medicare Beneficiaries Using a Consumer-Directed Benefit: Rural-Urban Differences

    Science.gov (United States)

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Van Nostrand, Joan F.; Eggert, Gerald M.

    2010-01-01

    Purpose: To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. Methods: The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19…

  1. "Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme

    Science.gov (United States)

    Hassan, Nedim

    2017-01-01

    Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

  2. HealthATM: personal health cyberinfrastructure for underserved populations.

    Science.gov (United States)

    Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

    2011-05-01

    There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

  3. An XML-based framework for personalized health management.

    Science.gov (United States)

    Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo

    2006-01-01

    This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.

  4. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    Science.gov (United States)

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

  5. Complexity of Choice: Teachers' and Students' Experiences Implementing a Choice-Based Comprehensive School Health Model

    Science.gov (United States)

    Sulz, Lauren; Gibbons, Sandra; Naylor, Patti-Jean; Wharf Higgins, Joan

    2016-01-01

    Background: Comprehensive School Health models offer a promising strategy to elicit changes in student health behaviours. To maximise the effect of such models, the active involvement of teachers and students in the change process is recommended. Objective: The goal of this project was to gain insight into the experiences and motivations of…

  6. Valuing Health Using Time Trade-Off and Discrete Choice Experiment Methods: Does Dimension Order Impact on Health State Values?

    Science.gov (United States)

    Mulhern, Brendan; Shah, Koonal; Janssen, Mathieu F Bas; Longworth, Louise; Ibbotson, Rachel

    2016-01-01

    Health states defined by multiattribute instruments such as the EuroQol five-dimensional questionnaire with five response levels (EQ-5D-5L) can be valued using time trade-off (TTO) or discrete choice experiment (DCE) methods. A key feature of the tasks is the order in which the health state dimensions are presented. Respondents may use various heuristics to complete the tasks, and therefore the order of the dimensions may impact on the importance assigned to particular states. To assess the impact of different EQ-5D-5L dimension orders on health state values. Preferences for EQ-5D-5L health states were elicited from a broadly representative sample of members of the UK general public. Respondents valued EQ-5D-5L health states using TTO and DCE methods across one of three dimension orderings via face-to-face computer-assisted personal interviews. Differences in mean values and the size of the health dimension coefficients across the arms were compared using difference testing and regression analyses. Descriptive analysis suggested some differences between the mean TTO health state values across the different dimension orderings, but these were not systematic. Regression analysis suggested that the magnitude of the dimension coefficients differs across the different dimension orderings (for both TTO and DCE), but there was no clear pattern. There is some evidence that the order in which the dimensions are presented impacts on the coefficients, which may impact on the health state values provided. The order of dimensions is a key consideration in the design of health state valuation studies. Copyright © 2016. Published by Elsevier Inc.

  7. Health outcomes are about choices and values: an economic perspective on the health outcomes movement.

    Science.gov (United States)

    Shiell, A

    1997-01-01

    The aim of the health outcomes movement is to reorientate health services so that the spotlight shines less on what is done and more on what is achieved. The health outcomes movement, thus far, has been most successful in addressing what appear to be technical questions relating to the measurement and analysis of health outcomes and in placing their routine use on the agenda of clinical practice and health services planning. If there is one lesson to be drawn from an economic perspective, however, it is that health outcomes are about values and not just technicalities. The need to make choices forces one to consider whether what is achieved is also what is most valued. The success of health service delivery, be it at a clinical, planning or systems level, must therefore be measured against agreed objectives. It follows that time must be taken to establish what patients and the community want from their health services and what each is prepared to give up to achieve its ends. Value judgements are unavoidable. The challenge lies not in measuring the outcomes of health interventions but in deciding what the objectives of the health system ought to be.

  8. Association between personality traits and future choice of specialisation among Swedish doctors: a cross-sectional study.

    Science.gov (United States)

    Bexelius, Tomas S; Olsson, Caroline; Järnbert-Pettersson, Hans; Parmskog, Malin; Ponzer, Sari; Dahlin, Marie

    2016-08-01

    Medical students' choice of their future specialty is influenced by several factors, including working conditions and type of patient relations. The aim of this study was to investigate the association between the choice of specialty and personality traits. This is a cross-sectional questionnaire-based study of 399 alumni from Karolinska Institutet Medical School who were assumed to undergo specialty training at the time of the survey in 2013. The Big Five Inventory was used to assess the personality traits extraversion, agreeableness, conscientiousness, neuroticism and openness to experience. Medical specialties were categorised as primary care, psychiatry, internal medicine and surgical and hospital service specialties. Adjustments were made for demographic factors and the method of selection for medical school admission. The response rate was 72% (n=289, of which 262 were in training to become specialists). Among these, surgeons scored lower in agreeableness than physicians in primary care, internal medicine and hospital services. Psychiatrists and hospital service physicians showed lower conscientiousness compared with surgeons. We found distinctive differences in personality traits between medical specialties even after adjusting for other potential explanatory variables. Since there are differences between specialties, for example, surgeons and psychiatrists, this supports previous findings that personality may affect medical students' specialty choice also in a Swedish setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Emotion regulation choice in female patients with borderline personality disorder: Findings from self-reports and experimental measures.

    Science.gov (United States)

    Sauer, Christina; Sheppes, Gal; Lackner, Helmut Karl; Arens, Elisabeth A; Tarrasch, Ricardo; Barnow, Sven

    2016-08-30

    Emotion dysregulation is a core feature of borderline personality disorder (BPD). So far, many studies have tested the consequences of the implementation of certain emotion regulation (ER) strategies, but there have been no investigations about ER choices in BPD. Thus, the aim of this study was to investigate habitual ER choices by self-report questionnaires and experimentally by testing the preference to select between distraction and reappraisal when facing different emotional intensities (high vs. low) and contents (borderline-specific vs. unspecific negative) in patients with BPD (n=24) compared with clinical controls (patients with major depression, n=19) and a healthy control group (n=32). Additionally, heart rate (HR) responses were continuously assessed. Main results revealed that both patient groups showed maladaptive self-reported ER choice profiles compared with HC. We found, however, no differences between the groups in the choice of distraction and reappraisal on the behavioral level and in HR responses. In BPD, within-group analyses revealed a positive correlation between symptom severity and the preference for distraction under high-intensity borderline-specific stimuli. Our findings provide preliminary evidence of ER choices in BPD and show the robustness of the choice effect in patients with affective disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Personality-matching habitat choice, rather than behavioural plasticity, is a likely driver of a phenotype-environment covariance.

    Science.gov (United States)

    Holtmann, Benedikt; Santos, Eduardo S A; Lara, Carlos E; Nakagawa, Shinichi

    2017-10-11

    An emerging hypothesis of animal personality posits that animals choose the habitat that best fits their personality, and that the match between habitat and personality can facilitate population differentiation, and eventually speciation. However, behavioural plasticity and the adjustment of behaviours to new environments have been a classical explanation for such matching patterns. Using a population of dunnocks ( Prunella modularis ), we empirically tested whether personality or behavioural plasticity is responsible for the non-random distribution of shy and bold individuals in a heterogeneous environment. We found evidence for bold individuals settling in areas with high human disturbance, but also that birds became bolder with increasing age. Importantly, personality primarily determines the distribution of individuals, and behavioural adjustment over time contributes very little to the observed patterns. We cannot, however, exclude a possibility of very early behavioural plasticity (a type of developmental plasticity) shaping what we refer to as 'personality'. Nonetheless, our findings highlight the role personality plays in shaping population structure, lending support to the theory of personality-mediated speciation. Moreover, personality-matching habitat choice has important implications for population management and conservation. © 2017 The Author(s).

  11. Health care professionals’ perception of security of personal health devices

    Directory of Open Access Journals (Sweden)

    Ondiege B

    2017-04-01

    Full Text Available Brian Ondiege, Malcolm Clarke Department of Computer Science, College of Engineering, Design and Physical Sciences, Brunel University London, UK Abstract: With the rapid advances in the capabilities of telehealth devices and their increasing connection to the Internet, security is becoming an issue of major concern. Therefore, the perceptions of the health care professionals regarding security are of interest, as the patients trust them to make informed decisions on issues concerning their privacy, data, and health. Eight health care professionals were interviewed to determine their perceptions and knowledge of security in health care. The research further examines one specific aspect of security which is considered of significant concern: the authenticity of a device being from the actual manufacturer and not a counterfeit. This research proposes device registration together with digital signatures and one-time passwords to address the issue of counterfeit remote patient-monitoring devices and identify and authenticate the user of the device. Keywords: telehealth security, health care professionals’ perception, personal health device, authentication

  12. Taxing Unhealthy Choices: The complex idea of Liberal Egalitarianism in Health

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2016-01-01

    Under the heading of liberal egalitarianism, Cappelen and Norheim present a novel approach regarding how we are to assess health disadvantages reflecting people's choices. It seeks to uphold a commitment to principles of responsibility and egalitarianism, while avoiding objections that such theor......Under the heading of liberal egalitarianism, Cappelen and Norheim present a novel approach regarding how we are to assess health disadvantages reflecting people's choices. It seeks to uphold a commitment to principles of responsibility and egalitarianism, while avoiding objections......, it is not apparent how the approach is able to address the significant ways in which social circumstances influences people's choices in health and their ability to stay healthy....

  13. Consent for use of personal information for health research: Do people with potentially stigmatizing health conditions and the general public differ in their opinions?

    Directory of Open Access Journals (Sweden)

    Schwartz Lisa

    2009-07-01

    Full Text Available Abstract Background Stigma refers to a distinguishing personal trait that is perceived as or actually is physically, socially, or psychologically disadvantageous. Little is known about the opinion of those who have more or less stigmatizing health conditions regarding the need for consent for use of their personal information for health research. Methods We surveyed the opinions of people 18 years and older with seven health conditions. Participants were drawn from: physicians' offices and clinics in southern Ontario; and from a cross-Canada marketing panel of individuals with the target health conditions. For each of five research scenarios presented, respondents chose one of five consent choices: (1 no need for me to know; (2 notice with opt-out; (3 broad opt-in; (4 project-specific permission; and (5 this information should not be used. Consent choices were regressed onto: demographics; health condition; and attitude measures of privacy, disclosure concern, and the benefits of health research. We conducted focus groups to discuss possible reasons for observed consent choices. Results We observed substantial variation in the control that people wish to have over use of their personal information for research. However, consent choice profiles were similar across health conditions, possibly due to sampling bias. Research involving profit or requiring linkage of health information with income, education, or occupation were associated with more restrictive consent choices. People were more willing to link their health information with biological samples than with information about their income, occupation, or education. Conclusions The heterogeneity in consent choices suggests individuals should be offered some choice in use of their information for different types of health research, even if limited to selectively opting-out. Some of the implementation challenges could be designed into the interoperable electronic health record. However, many

  14. Voice and choice in health care in England: understanding citizen responses to dissatisfaction.

    Science.gov (United States)

    Dowding, Keith; John, Peter

    2011-01-01

    Using data from a five-year online survey the paper examines the effects of relative satisfaction with health services on individuals' voice-and-choice activity in the English public health care system. Voice is considered in three parts – individual voice (complaints), collective voice voting and participation (collective action). Exercising choice is seen in terms of complete exit (not using health care), internal exit (choosing another public service provider) and private exit (using private health care). The interaction of satisfaction and forms of voice and choice are analysed over time. Both voice and choice are correlated with dissatisfaction with those who are unhappy with the NHS more likely to privately voice and to plan to take up private health care. Those unable to choose private provision are likely to use private voice. These factors are not affected by items associated with social capital – indeed, being more trusting leads to lower voice activity.

  15. That's a Different Kind of Person' - Spatial Connotations and Partner Choice

    NARCIS (Netherlands)

    Haandrikman, Karen; Hutter, Inge

    2012-01-01

    The paper investigates the process of partner choice and the specific role of geographical distance in this process. This focus on the spatial component is a unique and new approach to address the topic. By adopting a qualitative approach, the decision-making process preceding partner choice is

  16. Is Man Free to Make Choices for Health?

    Science.gov (United States)

    Douglass, Joseph H.

    2010-01-01

    This paper is reformatted and reprinted as part of the 40th Anniversary of the American Journal of Health Education. (originally School Health Review) Health Education--Our Heritage series. The original article appeared in the inaugural issue of School Health Review (Volume 1, September 1969, pp. 4-8). At the time, Joseph H. Douglass, Ph.D., was…

  17. Consumer choice of social health insurance in managed competition.

    NARCIS (Netherlands)

    Kerssens, J.J.; Groenewegen, P.P.

    2003-01-01

    Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  18. Tobacco industry use of personal responsibility rhetoric in public relations and litigation: disguising freedom to blame as freedom of choice.

    Science.gov (United States)

    Friedman, Lissy C; Cheyne, Andrew; Givelber, Daniel; Gottlieb, Mark A; Daynard, Richard A

    2015-02-01

    We examined the tobacco industry's rhetoric to frame personal responsibility arguments. The industry rarely uses the phrase "personal responsibility" explicitly, but rather "freedom of choice." When freedom of choice is used in the context of litigation, the industry means that those who choose to smoke are solely to blame for their injuries. When used in the industry's public relations messages, it grounds its meaning in the concept of liberty and the right to smoke. The courtroom "blame rhetoric" has influenced the industry's larger public relations message to shift responsibility away from the tobacco companies and onto their customers. Understanding the rhetoric and framing that the industry employs is essential to combating this tactic, and we apply this comprehension to other industries that act as disease vectors.

  19. A Comparison of the Nomological Networks Associated With Forced-Choice and Likert Formats of the Narcissistic Personality Inventory.

    Science.gov (United States)

    Miller, Joshua D; Gentile, Brittany; Carter, Nathan T; Crowe, Michael; Hoffman, Brian J; Campbell, W Keith

    2018-01-01

    The Narcissistic Personality Inventory (NPI) is one of the most popular measures of narcissism. However, its use of a forced-choice response set might negatively affect some of its psychometric properties. The purpose of this research was to compare a Likert version of the NPI, in which only the narcissistic response of each pair was given, to the original NPI, in 3 samples of participants (N = 1,109). To this end, we compared the nomological networks of the forced-choice and Likert formats of the NPI in relation to alternative measures of narcissism, narcissistic personality disorder, entitlement, self-esteem, general personality traits (reported by self and informants), interpersonal styles, and general pathological traits included in the DSM-5. The Likert format NPI-total and subscales-manifested similar construct validity to the original forced-choice format across all criteria with only minor differences that seem to be due mainly to the increased reliability and variability found in the Likert NPI Entitlement/Exploitativeness subscale. These results provide evidence that a version of the NPI that employs a Likert format can justifiably be used in place of the original.

  20. Can health care providers recognize a fibromyalgia personality?

    NARCIS (Netherlands)

    Da Silva, J.A.P.; Jacobs, J.W.G.; Branco, J.; Canaipa, R.; Gaspar, M.F.; Griep, E.N.; van Helmond, T.; Oliveira, P.J.; Zijlstra, T.R.; Geenen, R.

    2017-01-01

    OBJECTIVES: To determine if experienced health care providers (HCPs) can recognise patients with fibromyalgia (FM) based on a limited set of personality items, exploring the existence of a FM personality. METHODS: From the 240-item NEO-PI-R personality questionnaire, 8 HCPs from two different

  1. MyPHRMachines : lifelong personal health records in the cloud

    NARCIS (Netherlands)

    Van Gorp, P.M.E.; Comuzzi, M.; Soda, P.; Tortorella, F.

    2012-01-01

    Personal Health Records (PHRs) should remain the lifelong property of patients and should be showable conveniently and securely to selected caregivers. Regarding interoperability, current solutions for PHRs focus on standard data exchange formats and transformations to move data across health

  2. Consumer choice of social health insurance in managed competition

    NARCIS (Netherlands)

    Kerssens, Jan J.; Groenewegen, Peter P.

    2003-01-01

    Objective To promote managed competition in Dutch health insurance, the insured are now able to change heaith insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  3. Personal health records: Consumer attitudes toward privacy and security of their personal health information.

    Science.gov (United States)

    Lafky, Deborah Beranek; Horan, Thomas A

    2011-03-01

    Personal health record (PHR) systems are a subject of intense interest in the move to improve healthcare accessibility and quality. Although a number of vendors continue to put forward PHR systems, user-centered design research has lagged, and it has not been clear what features are important to prospective PHR users. Here, we report on a user-centered design study that combines qualitative and quantitative approaches to investigate several dimensions relevant to PHR design, and to look at the effect of health status on user needs. The results indicate that health status, especially disability and chronic illness, is relevant to PHR design. Further, the results provide empirical evidence about the role of privacy and security in users' attitudes toward PHR use. The exact nature of these attitudes differs from widely held perceptions about consumer values in healthcare information management. © The Author(s) 2011.

  4. Are consumers influenced in their food choice by health labels?

    DEFF Research Database (Denmark)

    Boztug, Yasemin; Juhl, Hans Jørn; Elshiewy, Ossama

    focus on consumer attention to labels and very few studies concentrate on effects on actual purchase behavior. In this study we report the results from an analysis of scanner data provided by a large UK retailer and the conclusion is that GDA label introduction does not have the expected consequences......Front of pack (FOP) nutrition labeling has received extensive political attention within the last years. The European Commission is proposing to make FOP nutrition labeling mandatory in order to guide consumers to make healthier food choices. Most of the studies of the effects on nutrition labeling...

  5. Examining the Concept of Choice in Sexual Health Interventions for Young People

    Science.gov (United States)

    Spencer, Grace; Doull, Marion; Shoveller, Jean A.

    2014-01-01

    Concepts of choice are often drawn upon within sexual health promotion discourses to encourage young people to take "responsibility" for and promote their own sexual health and reproductive control. A systematic literature search using predefined inclusion criteria identified peer-reviewed articles focusing on sexual health interventions…

  6. Application of ubiquitous computing in personal health monitoring systems.

    Science.gov (United States)

    Kunze, C; Grossmann, U; Stork, W; Müller-Glaser, K D

    2002-01-01

    A possibility to significantly reduce the costs of public health systems is to increasingly use information technology. The Laboratory for Information Processing Technology (ITIV) at the University of Karlsruhe is developing a personal health monitoring system, which should improve health care and at the same time reduce costs by combining micro-technological smart sensors with personalized, mobile computing systems. In this paper we present how ubiquitous computing theory can be applied in the health-care domain.

  7. Reproductive health choices for young adults with sickle cell disease or trait: randomized controlled trial immediate posttest effects.

    Science.gov (United States)

    Wilkie, Diana J; Gallo, Agatha M; Yao, Yingwei; Molokie, Robert E; Stahl, Christine; Hershberger, Patricia E; Zhao, Zhongsheng; Suarez, Marie L; Labotka, Robert J; Johnson, Bonnye; Angulo, Rigo; Angulo, Veronica; Carrasco, Jesus; Shuey, David; Pelligra, Stephanie; Wang, Edward; Rogers, Dennie T; Thompson, Alexis A

    2013-01-01

    People with sickle cell disease (SCD) or sickle cell trait (SCT) may not have information about genetic inheritance needed for making informed reproductive health decisions. CHOICES is a Web-based, multimedia educational intervention that provides information about reproductive options and consequences to help those with SCD or SCT identify and implement an informed parenting plan. Efficacy of CHOICES compared with usual care must be evaluated. The purpose was to compare immediate posttest effects of CHOICES versus an attention-control usual care intervention (e-Book) on SCD-/SCT-related reproductive health knowledge, intention, and behavior. In a randomized controlled study, we recruited subjects with SCD/SCT from clinics, community settings, and online networks with data collected at sites convenient to the 234 subjects with SCD (n = 136) or SCT (n = 98). Their ages ranged from 18 to 35 years; 65% were women, and 94% were African American. Subjects completed a measure of sickle cell reproductive knowledge, intention, and behavior before and immediately after the intervention. Compared with the e-Book group, the CHOICES group had significantly higher average knowledge scores and probability of reporting a parenting plan to avoid SCD or SCD and SCT when pretest scores were controlled. Effects on intention and planned behavior were not significant. The CHOICES group showed significant change in their intention and planned behavior, whereas the e-Book group did not show significant change in their intention, but their planned behavior differed significantly. Initial efficacy findings are encouraging but warrant planned booster sessions and outcome follow-ups to determine sustained intervention efficacy on reproductive health knowledge, intention, and actual behavior of persons with SCD/SCT.

  8. Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Immediate Posttest Effects

    Science.gov (United States)

    Wilkie, Diana J; Gallo, Agatha M.; Yao, Yingwei; Molokie, Robert E.; Stahl, Christine; Hershberger, Patricia E.; Zhao, Zhongsheng; Suarez, Marie L.; Labotka, Robert J.; Johnson, Bonnye; Angulo, Rigo; Angulo, Veronica; Carrasco, Jesus; Shuey, David; Pelligra, Stephanie; Wang, Edward; Rogers, Dennie T.; Thompson, Alexis A.

    2013-01-01

    Background People with sickle cell disease (SCD) or sickle cell trait (SCT) may not have information about genetic inheritance needed for making informed reproductive health decisions. CHOICES is a web-based, multimedia educational intervention that provides information about reproductive options and consequences to help those with SCD or SCT identify and implement an informed parenting plan. Efficacy of CHOICES compared with usual care must be evaluated. Objective The purpose was to compare immediate posttest effects of CHOICES versus an attention control usual care intervention (e-Book) on SCD/SCT-related reproductive health knowledge, intention, and behavior. Methods In a randomized controlled study, we recruited subjects with SCD/SCT from clinics, community settings, and online networks with data collected at sites convenient to the 234 subjects with SCD (n = 136) or SCT (n = 98) (age ranged from18-35 years, 65% were female, and 94% were African American). Subjects completed a measure of sickle cell reproductive knowledge, intention, and behavior before and immediately after the intervention. Results Compared to the e-Book group, the CHOICES group had significantly higher average knowledge scores and probability of reporting a parenting plan to avoid SCD or SCD and SCT when pretest scores were controlled. Effects on intention and planned behavior were not significant. The CHOICES group showed significant change in their intention and planned behavior; the e-Book group did not show significant change in their intention, but their planned behavior differed significantly. Discussion Initial efficacy findings are encouraging but warrant planned booster sessions and outcome follow-ups to determine sustained intervention efficacy on reproductive health knowledge, intention, and actual behavior of persons with SCD/SCT. PMID:23995469

  9. Personal Responsibility in Oral Health: Ethical Considerations

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2012-01-01

    Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people r...

  10. Personal health record systems and their security protection.

    Science.gov (United States)

    Win, Khin Than; Susilo, Willy; Mu, Yi

    2006-08-01

    The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.

  11. Taking the sweetness out of the 'Share a Coke' marketing campaign: the influence of personalized labelling on elementary school children's bottled drink choices.

    Science.gov (United States)

    McDarby, F; O'Hora, D; O'Shea, D; Byrne, M

    2018-01-01

    Drink personalization (featuring names on bottle labels) has been used by soft drink companies to make their drinks attractive to children, potentially increasing consumption. To date, no publically available research has evaluated the influence of personalization on children's drink choices. To determine (i) whether personalizing bottled drinks influences children's drink choices; (ii) whether it is comparably effective in promoting healthy and unhealthy drinks and (iii) whether drink choices are affected by self-esteem, body mass index and parental factors. Children aged 8-13 years (N = 404) were randomly assigned to one of three drink labeling conditions: Prime Healthy, Prime Unhealthy and Control. All participants selected one beverage from 12 options, comprising six healthy and unhealthy drinks. Personalizing healthy drinks increased choice of healthy drinks (OR, 2.21; 95% CI, 1.24-4.00), and personalizing unhealthy drinks reduced choice of healthy drinks (OR, 0.35; 95% CI, 0.15-.0.75). Higher self-esteem predicted choosing own-named drinks (OR = 1.08, 95% CI, 1.00-1.18; p = .049). Children's drink choices are influenced by personalizing drink bottles. Tighter regulation of this marketing strategy for soft drinks may reduce children choice of these drinks. Personalization may also be used to encourage children to choose healthy drinks. © 2016 World Obesity Federation.

  12. Personal health records: retrieving contextual information with Google Custom Search.

    Science.gov (United States)

    Ahsan, Mahmud; Seldon, H Lee; Sayeed, Shohel

    2012-01-01

    Ubiquitous personal health records, which can accompany a person everywhere, are a necessary requirement for ubiquitous healthcare. Contextual information related to health events is important for the diagnosis and treatment of disease and for the maintenance of good health, yet it is seldom recorded in a health record. We describe a dual cellphone-and-Web-based personal health record system which can include 'external' contextual information. Much contextual information is available on the Internet and we can use ontologies to help identify relevant sites and information. But a search engine is required to retrieve information from the Web and developing a customized search engine is beyond our scope, so we can use Google Custom Search API Web service to get contextual data. In this paper we describe a framework which combines a health-and-environment 'knowledge base' or ontology with the Google Custom Search API to retrieve relevant contextual information related to entries in a ubiquitous personal health record.

  13. Consumer attitudes about health care acquired infections: a German survey on factors considered important in the choice of a hospital.

    Science.gov (United States)

    Vonberg, Ralf-Peter; Sander, Carsten; Gastmeier, Petra

    2008-01-01

    Most patients are free in their choice of hospital for nonemergency admissions. In a nationwide survey in 1000 German households, we interviewed randomly chosen persons (age 14 and older) by phone about what they consider important when choosing a hospital. A standardized questionnaire was used. Additionally, question order was randomized prior to each interview. Demographic data included age, gender, education, and previous admissions to hospitals. Categories that might influence the choice of hospital included "distance to hospital," "friendly staff," "staff-to-patient ratio," "cleanliness," "nosocomial infection rate," "own experiences," "friend's opinion," and "facility's reputation in public media." General cleanliness, low nosocomial infection rates, and friendly staff proved to be the most important issues in our study. In contrast, the reputation of the health care facility in the public media was much less important. It seems that kindness and basic hygiene measures, both quite inexpensive factors, are key issues for patients.

  14. Medical student experiences in prison health services and social cognitive career choice: a qualitative study.

    Science.gov (United States)

    Brooker, Ron; Hu, Wendy; Reath, Jennifer; Abbott, Penelope

    2018-01-02

    One of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve. Amongst the most medically underserved groups of society are people in prison and those with a history of incarceration. In this study we examined the experiences of medical students undertaking General Practice placements in a prison health service. We used the theoretical framework of the Social Cognitive Career Theory (SCCT) to explore the potential of these placements to influence the career choices of medical students. Questionnaire and interview data were collected from final year students, comprising pre and post placement questionnaire free text responses and post placement semi-structured interviews. Data were analysed using inductive thematic analysis, with reference to concepts from the SCCT Interest Model to further develop the findings. Clinical education delivered in a prison setting can provide learning that includes exposure to a wide variety of physical and mental health conditions and also has the potential to stimulate career interest in an under-served area. While students identified many challenges in the work of a prison doctor, increased confidence (SCCT- Self-Efficacy) occurred through performance success within challenging consultations and growth in a professional approach to prisoners and people with a history of incarceration. Positive expectations (SCCT- Outcome Expectations) of fulfilling personal values and social justice aims and of achieving public health outcomes, and a greater awareness of work as a prison doctor, including stereotype rejection, promoted student interest in working with people in contact with the criminal justice system. Placements in prison health services can stimulate student interest in working with prisoners and ex-prisoners by either consolidating pre-existing interest or expanding interest into a field they had not

  15. Considering consumer choice in the economic evaluation of mandatory health programmes: a review.

    Science.gov (United States)

    Parkinson, Bonny; Goodall, Stephen

    2011-08-01

    Governments are increasing their focus on mandatory public health programmes following positive economic evaluations of their impact. This review aims to examine whether loss of consumer choice should be included in economic evaluations of mandatory health programmes (MHP). A systematic literature review was conducted to identify economic evaluations of MHP, whether they discuss the impact on consumer choice and any methodological limitations. Overall 39 economic evaluations were identified, of which 10 discussed the loss of consumer choice and 6 attempted to place a value on the loss of consumer choice. Methodological limitations included: measuring the marginal cost of compliance, unavailability of price elasticity estimates, the impact of income effects, double counting health impacts, biased willingness-to-pay responses, and "protest" responses. Overall it was found that the inclusion of the loss of consumer choice rarely impacted on the final outcome of the study. The impact of MHP on the loss of consumer choice has largely been ignored in economic evaluations. Its importance remains uncertain due to its infrequent inclusion and significant methodological limitations. Further research regarding which methodology is best for valuing the loss of consumer choice and whether it is important to the final implementation decision is warranted. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Morocco's policy choices to achieve Universal health coverage ...

    African Journals Online (AJOL)

    Morocco's health system remains weak in spite of the improvement of other development indicators in the last ten years. Health remains one of the major challenges to lower the social disparities that are the priority for the authorities. Despite the goodwill of all stakeholders, significant reforms implemented respond only ...

  17. Inequality in health versus inequality in lifestyle choices

    Directory of Open Access Journals (Sweden)

    Arnstein Øvrum

    2015-10-01

    Full Text Available Repeated Norwegian cross-sectional data for the period 2005 to 2011 are used to compare sources of inequality in health, as represented by self-assessed health and obesity, with sources of inequality in lifestyles that are central to the production of health, as represented by physical activity, cigarette smoking and dietary behavior. Sources of overall inequality and socioeconomic inequality in these lifestyle and health indicators are compared by estimating probit models, and by decomposing the explained part of the associated Gini and concentration indices with respect to education and income. As potential sources of inequality, we consider education, income, occupation, age, gender, marital status, psychological traits and childhood circumstances. Our results suggest that sources of inequality in health are not necessarily representative of sources of inequality in underlying lifestyles. While education is generally an important source of overall inequality in both lifestyles and health, income is unimportant in all lifestyle indicators except physical activity. In several cases, education and income are clearly outranked by other factors in terms of explaining overall inequality, such as gender in eating fruits and vegetables and age in fish consumption. These results suggest that it is important to decompose both overall inequality and socioeconomic inequality in different lifestyle and health indicators. In indicators where other factors than education and income are clearly most important, policy makers should consider to target these factors to efficiently improve overall population health.

  18. The economics of choice: lessons from the U.S. health-care market.

    Science.gov (United States)

    Hanoch, Yaniv; Rice, Thomas

    2011-03-01

    The English health-care system is moving towards increasing consumers' choice. Following economic thinking, it is assumed that such a policy will improve quality, enhance patient satisfaction and reduce health disparities. Indeed, the English health-care system has already built the necessary infrastructure to increase patients' choice. Before expanding the range of choices further, however, it is important that policy makers be aware of the limitations and hurdles that such a policy contains. Here, we highlight these limitations by drawing on the influential work of Kenneth Arrow, who has argued that we cannot treat the health-care market as if it was just another market, and the ideas of Herbert Simon, who questioned whether people had sufficient cognitive abilities to make effective choices in an information-rich environment. In the light of these two strands of thought, we review evidence suggesting that many older adults have low (health) literacy levels, raising concerns over their ability to obtain, process and understand medical-related information, with its increasing complexity, associated risks and emotional involvement. We also discuss recent findings from the United States highlighting the difficulties older users of health-care face with a wide range of prescription drug insurance plans from which to choose. Thus, learning from the experience of health-care systems where choice is abundant could help any health system interested in extending patients' choice to better target the domains where more choice could be beneficial and possibly avoid those where it could be detrimental. © 2010 Blackwell Publishing Ltd.

  19. Discrete choice experiments to measure consumer preferences for health and healthcare.

    Science.gov (United States)

    Viney, Rosalie; Lancsar, Emily; Louviere, Jordan

    2002-08-01

    To investigate the impact of health policies on individual well-being, estimate the value to society of new interventions or policies, or predict demand for healthcare, we need information about individuals' preferences. Economists usually use market-based data to analyze preferences, but such data are limited in the healthcare context. Discrete choice experiments are a potentially valuable tool for elicitation and analysis of preferences and thus, for economic analysis of health and health programs. This paper reviews the use of discrete choice experiments to measure consumers' preferences for health and healthcare. The paper provides an overview of the approach and discusses issues that arise when using discrete choice experiments to assess individuals' preferences for health and healthcare.

  20. Responsibility for health: personal, social, and environmental.

    Science.gov (United States)

    Resnik, D B

    2007-08-01

    Most of the discussion in bioethics and health policy concerning social responsibility for health has focused on society's obligation to provide access to healthcare. While ensuring access to healthcare is an important social responsibility, societies can promote health in many other ways, such as through sanitation, pollution control, food and drug safety, health education, disease surveillance, urban planning and occupational health. Greater attention should be paid to strategies for health promotion other than access to healthcare, such as environmental and public health and health research.

  1. A Concept Analysis of Personalized Health Care in Nursing.

    Science.gov (United States)

    Han, Claire Jungyoun

    2016-01-01

    The purpose of the study is to identify the concept of personalized health care in nursing and to address future direction in person-centered nursing care. Personalized health care has attracted increased attention in the twenty-first century. As more and more preclinical studies are focusing on cost-effective and patient-centered care, there also has been an identified need for a personalized health care in nursing. Yet the term lacks clear definition and interests among healthcare professionals. Rodgers' strategy for concept analysis was used in this analysis. A literature review for 1960-2014 was conducted for the following keywords: nursing care, personalized, and health care. The analysis demonstrates that personalized health care in nursing is an intangible asset, including explicit attributes (interprofessional collaboration and individualized care approach) and implicit attributes (managing personal vulnerabilities: molecular-based health information and self-health-seeking behaviors). The result of this analysis provides a guide for further conceptual and empirical research and clinical practice in the personalized healthcare era. This concept analysis represents an effort to describe the attributes of a concept regarded as representing an important feature of nursing care and to promote discourse that will enhance maturation of the concept into one that is established with clearly delineated characteristics. © 2015 Wiley Periodicals, Inc.

  2. Can a Discrete Choice Experiment contribute to person-centred healthcare?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2015-01-01

    In person-centred decision making the relative importance of the considerations that matter to the person is elicited and combined, at the point of decision, with the best estimates available on the performance of the available options on those criteria. Whatever procedure is used to implement...... this in a clinical decision, average preferences emerging from group or subgroup research cannot contribute directly, since they can have only a statistical relationship with the preferences of the individual person. The precise relationship is knowable by eliciting those of the individual concerned, but there would...... of how this could happen, the ambiguity often arising from the use and positioning of the apostrophe in the words persons and patients. Only when the person opts out of preference provision and asks to be treated as ‘average’, can the results of a DCE have clinical relevance in genuinely person...

  3. Does personality predict health and well-being? A metasynthesis.

    Science.gov (United States)

    Strickhouser, Jason E; Zell, Ethan; Krizan, Zlatan

    2017-08-01

    To derive a robust and comprehensive estimate of the overall relation between Big Five personality traits and health variables using metasynthesis (i.e., second-order meta-analysis). Thirty-six meta-analyses, which collectively provided 150 meta-analytic effects from over 500,000 participants, met criteria for inclusion in the metasynthesis. Information on methodological quality as well as the type of health outcome, unreliability adjustment, population sampled, health outcome source, personality source, and research design was extracted from each meta-analysis. An unweighted model was used to aggregate data across meta-analyses. When entered simultaneously, the Big Five traits were moderately associated with overall health (multiple R = .35). Personality-health relations were larger when examining mental health outcomes than physical health outcomes or health-related behaviors and when researchers adjusted for measurement unreliability, used self-report as opposed to other-report Big Five scales, or focused on clinical as opposed to nonclinical samples. Further, effects were larger among agreeableness, conscientiousness, and neuroticism than extraversion or openness to experience. This metasynthesis provides among the most compelling evidence to date that personality predicts overall health and well-being. In addition, it may inform research on the mechanisms by which personality impacts health as well as research on the structure of personality. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Economic rationality and health and lifestyle choices for people with diabetes.

    Science.gov (United States)

    Baker, Rachel Mairi

    2006-11-01

    Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality, which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality, in a health context. Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on a factor analysis of the results of a card sorting procedure undertaken by 27 adult respondents with type 2 diabetes in Newcastle upon Tyne, UK. These factors were then compared with the rationality framework and the appropriateness of an extended model of economic rationality as a means of better understanding health and lifestyle choices was assessed. Taking a wider rational choice perspective, choices which are rendered irrational within a narrow-biomedical or strictly instrumental model, can be understood in terms of a coherent rationale, grounded in the accounts of respondents. The implications of these findings are discussed in terms of rational choice theory and diabetes management and research.

  5. Career choices for public health: cohort studies of graduates from UK medical schools.

    Science.gov (United States)

    Goldacre, Michael J; Laxton, Louise; Lambert, Trevor W; Webster, Premila

    2011-12-01

    The aim of this paper is to describe UK-trained doctors' early intentions about seeking careers in public health and their eventual speciality destinations. Analysis of longitudinal studies of medical graduates from all UK medical schools in selected year-of-qualification cohorts from 1974 to 2008; data collected by postal questionnaires at various times after qualifying; and selection, for this paper, of doctors who expressed an early preference for a career in public health and/or who eventually practised in it. Of all doctors eventually practising in public health, for whom we had early choices, public health had been the unreserved first choice of 8% (10/125) in their first post-qualification year, 27% (33/122) in their third year and 59% (51/86) in their fifth year. Including first choices for public health 'tied' with an equal preference for a different speciality, and doctors' second and third choices for public health, 19% (24/125) of practising public health doctors had considered public health as a possible career in their first post-graduation year, 41% (50/122) in the third and 83% (71/86) in the fifth year. Comparisons with other specialities show that doctors in public health chose their speciality relatively late after qualification.

  6. Does personal experience affect choice-based preferences for wildfire protection programs?

    Science.gov (United States)

    Armando González-Cabán; Thomas P. Holmes; John B. Loomis; José J. Sánchez

    2013-01-01

    In this paper, we investigate homeowner preferences and willingness to pay for wildfire protection programs using a choice experiment with three attributes: risk, loss, and cost. A phone-mail-phone survey was used to collect data from homeowners predominantly living in medium and high wildfire risk communities in Florida. We tested three hypotheses: (1) homeowner...

  7. The effect of personal experience on choice-based preferences for wildfire protection programs

    Science.gov (United States)

    Tom Holmes; Armando Gonzalez-Caban; John Loomis; Jose Sanchez

    2013-01-01

    In this paper, we investigate homeowner preferences and willingness to pay for wildfire protection programs using a choice experiment with three attributes: risk, loss and cost. Preference heterogeneity among survey respondents was examined using three econometric models and risk preferences were evaluated by comparing willingness to pay for wildfire protection...

  8. Effect of personalized nutrition on health-related behavior change: evidence from the Food4Me randomized controlled trial

    Science.gov (United States)

    Background - Optimal nutritional choices are linked with better health but most current interventions to improve diet have limited effect. We tested the hypothesis that providing personalized nutrition (PN) advice based on collected information on individual diet and lifestyle, phenotype or genotype...

  9. The role of involvement in the choice of foods with nutrition and health claims

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    Claims are gaining in importance as a tool of communication in the growing sector of health-related foods. In order to target the right consumers, it is crucial to determine their key characteristics. A realistically designed choice experiment aims at analysing the role of various determinants...... of choice for foods with claims. Logistic regression reveals that while product-involvement plays only a minor role, health-related food-involvement appears to be a better explanatory factor than e.g. sociodemographic variables. It is concluded that items measuring the latter type of involvement might...... be helpful for practical market research in the area of health-related foods....

  10. Impact of comorbidity on the individual's choice of primary health care provider

    DEFF Research Database (Denmark)

    Zielinski, Andrzej; Håkansson, Anders; Beckman, Anders

    2011-01-01

    a public instead of private PHC provider increased with higher age and comorbidity level of the individuals. It is suggested that using a measure of comorbidity can help us understand more about the chronically ill individual's choice of health care provider. This would be of importance when health care......Abstract Objective. This study examined whether age, gender, and comorbidity were of importance for an individual's choice of listing with either a public or a private primary health care (PHC) practice. Design and setting. The study was a register-based closed cohort study in one private and one...... policy-makers decide on reimbursement system or organization of PHC....

  11. Using Personal Water Footprints to Identify Consumer Food Choices that Influence the Conservation of Local Water Resources

    Science.gov (United States)

    Marrin, D. L.

    2015-12-01

    As the global demand for water and food escalates, the emphasis is on supply side factors rather than demand side factors such as consumers, whose personal water footprints are dominated (>90%) by food. Personal footprints include the water embedded in foods that are produced locally as well as those imported, raising the question of whether local shifts in people's food choices and habits could assist in addressing local water shortages. The current situation in California is interesting in that drought has affected an agriculturally productive region where a substantial portion of its food products are consumed by the state's large population. Unlike most agricultural regions where green water is the primary source of water for crops, California's arid climate demands an enormous volume of blue water as irrigation from its dwindling surface and ground water resources. Although California exports many of its food products, enough is consumed in-state so that residents making relatively minor shifts their food choices could save as much local blue water as their implementing more drastic reductions in household water use (comprising food group on both a caloric and gravimetric basis. Another change is wasting less food, which is a shared responsibility among consumers, producers and retailers; however, consumers' actions and preferences ultimately drive much of the waste. Personal water footprints suggest a role for individuals in conserving local water resources that is neither readily obvious nor a major focus of most conservation programs.

  12. The Essence of Man’s Future as a Personal Choice of the Individual

    Directory of Open Access Journals (Sweden)

    Julia Chala

    2014-07-01

    Full Text Available This article analyzes nature and possibility of determining a man of future. The basis learned in the article can serve as a basis of the question of human nature. An author emphasizes that the question of a person’s future stems from the philosophy of education and can be learned on the basis of philosophical anthropology. Representatives of the last one, as the author notes, for a long time have been studying the nature of man, trying to synthesize knowledge of different sciences. It is noted that the main feature of the human being is to be able to make mindful choice and to take responsibility for its consequences. The article illustrates the capabilities of a normal choice for future generations. The works of the classical representatives of German philosophical and anthropological school, and the ideas of Kiev school of philosophy, as well as the documents of a general importance as the Declaration of Independence served as the materials of the research woer. The work itself is based on the principle of reflection upon the general theses. This paper learns the main ideas of human nature and analyses the impact of law on the provision of human capabilities and the choice in common. The suggestion is made of the necessity of emotions, feelings and sensations as the basis of human choice. The author concludes that the main task of philosophy of education is to preserve and ensure the man of future to make its mindful choise.The choice that is based on the rational thinking as well as on the emotional impulse

  13. Consultations for women's health problems: factors influencing women's choice of sex of general practitioner.

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Bakker, D.H. de; Bensing, J.M.

    1994-01-01

    AIM. This study set out to examine the degree to which women choose to visit a woman doctor for women's health problems and the determinants of this choice. The differences between women and men doctors with regard to treating women's health problems were also studied. METHOD. Data from the Dutch

  14. Determinants of patient choice of health care providers: a scoping review.

    NARCIS (Netherlands)

    Victoor, A.; Delnoij, D.M.J.; Friele, R.D.; Rademakers, J.J.D.J.M.

    2012-01-01

    Background: In several North-Western European countries, a demand driven health care system has been implemented that stresses the importance of patient choice of health care providers. Patients are assumed to actively choose the best provider with the lowest costs. This selection prompts providers

  15. What Is a Personal Health Record (PHR)?

    Science.gov (United States)

    ... patient identification number, address, phone number, and social security number. Your health insurance company receives your health information through the claims provided by the patient accounts/billing department at your healthcare facility. The ...

  16. How to Create a Personal Health Record

    Science.gov (United States)

    ... for managing your health Surgeon General's Family Health History Initiative More PHR Success Stories I learned that a PHR saves time, energy, and money. And it saved my life! A woman's Facebook PHR saved her life In The Blogs Get ...

  17. Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health

    Directory of Open Access Journals (Sweden)

    Nir Eyal

    2013-01-01

    Full Text Available In many countries around the world, including Iran, obesity is reaching epidemic proportions. Doctors have recently taken, or expressed support for, an extreme ‘personal responsibility for health’ policy against obesity: refusing services to obese patients. This policy may initially seem to improve patients’ incentives to fight obesity. But turning access to medical services into a benefit dependent on health improvement is a bad policy. It conditions the very aid that patients need in order to become healthier or success in becoming healthier. Whatever else we may think of personal responsibility for health policies, this particular one is absurd. Unfortunately, quite a few personal responsibility for health policies use similar absurd conditioning. They mistakenly use ‘carrots’ or ‘sticks’ for adherence the basic means to the same health outcomes that they seek to promote. This perspective proposes the following rule of thumb: any conditional incentive for healthy choice should be in a currency other than the basic means to that healthy choice.

  18. From HIV prevention to reproductive health choices: HIV/AIDS ...

    African Journals Online (AJOL)

    In South Africa, the private sector has responded to the HIV epidemic by providing treatment in the form of highly active antiretroviral therapy (HAART). The private sector has paved the way for policy and treatment regimens, while the public sector has reviewed health-systems capacity and the political will to provide ...

  19. Salt Matters: Preserving Choice, Protecting Health (Short Version)

    Centers for Disease Control (CDC) Podcasts

    2011-02-01

    This video presents information about salt as a major contributor to high blood pressure, heart disease, and stroke.  Created: 2/1/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division for Heart Disease and Stroke Prevention (DHDSP).   Date Released: 2/1/2011.

  20. Salt Matters: Preserving Choice, Protecting Health (Long Version)

    Centers for Disease Control (CDC) Podcasts

    2011-02-01

    This video presents information about salt as a major contributor to high blood pressure, heart disease, and stroke.  Created: 2/1/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division for Heart Disease and Stroke Prevention (DHDSP).   Date Released: 4/20/2011.

  1. Health and wellness characteristics of persons with traumatic brain injury.

    Science.gov (United States)

    Braden, Cynthia A; Cuthbert, Jeffrey P; Brenner, Lisa; Hawley, Lenore; Morey, Clare; Newman, Jody; Staniszewski, Kristi; Harrison-Felix, Cynthia

    2012-01-01

    To describe health and wellness characteristics of persons with TBI living in the community, compare to other disability populations and evaluate the associations between health-related constructs. Observational. Outpatient rehabilitation hospital and a Veterans Affairs Medical Centre. Seventy-four community-dwelling adults with moderate-to-severe TBI. None. Health Promoting Lifestyle Profile II (HPLP-II), Self Rated Abilities Health Practices Scale (SRAHP), Barriers to Health Promoting Activities for Disabled Scale (BHPAD), Medical Outcomes Study 12-Item Health Status Survey Short Form (SF-12), Personal Resource Questionnaire-adapted (PRQ-a), Perceived Wellness Survey (PWS), Diener Satisfaction with Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O). Health-promoting behaviours, self-efficacy and barriers to health were comparable to other disability populations. Perceived health status, participation and life satisfaction were decreased. Measures of health promotion and self-efficacy were positively associated with perceived mental health status, life satisfaction and participation. Barriers to healthy activities were negatively associated with health promotion, self-efficacy and perceived mental health status. Health and wellness status was below desired levels for the study cohort, and comparable to other disability populations. Better understanding of associations among health-related constructs is needed. Continued research on conceptually-based health and wellness interventions for persons with TBI is recommended.

  2. Personality Accounts for the Connection Between Volunteering and Health.

    Science.gov (United States)

    King, Hannah R; Jackson, Joshua J; Morrow-Howell, Nancy; Oltmanns, Thomas F

    2015-09-01

    Existing literature has shown that volunteering is related to better physical and mental health outcomes. The purpose of this study is to examine whether personality traits and volunteering are independent predictors of physical and mental health. The current study utilizes data from the St. Louis Personality and Aging Network (SPAN), a representative sample of community-based adults between the ages of 55 and 64. Using hierarchical linear regressions, we test whether volunteering is a significant predictor of both physical and mental health while controlling for personality traits. We find that volunteering is not significantly related to either physical or mental health while controlling for personality traits. We also find that lower neuroticism is related to better physical functioning and mental health, whereas higher extraversion is related to better mental health. These results indicate that volunteering may be related to health outcomes because of the personality characteristics of volunteers, not the volunteering experience in and of itself. Future longitudinal studies are needed to further explore the relationship between personality, volunteering, and health. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. What characterizes persons with poor mental health?

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Davidsen, Michael; Kjøller, Mette

    2014-01-01

    analysed by means of logistic regression models. Results: Men and women with poor mental health are characterized by being single, having a long-term illness, not being able to rely on help from others in case of illness and by feeling that family and friends demand too much of them. Men with poor mental...... health were further characterized by being a heavy smoker, and having a BMI below 25. Women with poor mental health were further characterized by being 16-44 years old and sedentary in leisure time. CONCLUSIONS THE PREVALENCE OF POOR MENTAL HEALTH IS HIGHER AMONG WOMEN THAN MEN, AND DIFFERENT FACTORS...... CHARACTERIZE MEN AND WOMEN WITH POOR MENTAL HEALTH THE PRESENT FINDINGS SUPPORT THE NOTION THAT BOTH SOCIO-DEMOGRAPHICS AND LIFESTYLE FACTORS ARE INDEPENDENTLY RELATED WITH POOR MENTAL HEALTH WE SUGGEST TAKING INTO ACCOUNT ALL THESE AREAS OF LIFE WHEN PLANNING ACTIVITIES TO PREVENT POOR MENTAL HEALTH AND WHEN...

  4. Using a Discrete Choice Conjoint Experiment to Engage Stakeholders in the Design of an Outpatient Children's Health Center.

    Science.gov (United States)

    Cunningham, Charles E; Niccols, Alison; Rimas, Heather; Robicheau, Randi; Anderson, Colleen; DeVries, Bart

    2017-10-01

    To engage users in the design of a regional child and youth health center. The perspective of users should be an integral component of a patient-centered, evidence-based approach to the design of health facilities. We conducted a discrete choice conjoint experiment (DCE), a method from marketing research and health economics, as a component of a strategy to engage users in the preconstruction planning process. A sample of 467 participants (290 staff and 177 clients or community stakeholders) completed the DCE. Latent class analysis identified three segments with different design preferences. A group we termed an enhanced design (57%) segment preferred a fully featured facility with personal contacts at the start of visits (in-person check-in, personal waiting room notification, volunteer-assisted wayfinding, and visible security), a family resource center with a health librarian, and an outdoor playground equipped with covered heated pathways. The self-guided design segment (11%), in contrast, preferred a design allowing a more independent use of the facility (e.g., self-check-in at computer kiosks, color-coded wayfinding, and a self-guided family resource center). Designs affording privacy and personal contact with staff were important to the private design segment (32%). The theme and decor of the building was less important than interactive features and personal contacts. A DCE allowed us to engage users in the planning process by estimating the value of individual design elements, identifying segments with differing views, informing decisions regarding design trade-offs, and simulating user response to design options.

  5. Identifying the role of different personality traits on the relationship between stress and food choice

    OpenAIRE

    Trew, Marissa

    2014-01-01

    Research shows that high levels of stress correlate with higher consumption of high- fat and high-sugar snack-type foods, particularly amongst women. However, it has been observed that not all individuals are vulnerable to this pattern of ‘stress-related’ eating. Both stress and dietary habits have been strongly correlated with specific personality traits but previous research has neglected to observe whether personality traits significantly affect correlations between perceived stress and ty...

  6. Employee choice of consumer-driven health insurance in a multiplan, multiproduct setting.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger; Christianson, Jon B

    2004-08-01

    To determine who chooses a Consumer-Driven Health Plan (CDHP) in a multiplan, multiproduct setting, and, specifically, whether the CDHP attracts the sicker employees in a company's risk pool. We estimated a health plan choice equation for employees of the University of Minnesota, who had a choice in 2002 of a CDHP and three other health plans--a traditional health maintenance organization (HMO), a preferred provider organization (PPO), and a tiered network product based on care systems. Data from an employee survey were matched to information from the university's payroll system. Chronic illness of the employee or family members had no effect on choice of the CDHP, but such employees tended to choose the PPO. The employee's age was not related to CDHP choice. Higher-income employees chose the CDHP, as well as those who preferred health plans with a national provider panel that includes their physician in the panel. Employees tended to choose plans with lower out-of-pocket premiums, and surprisingly, employees with a chronic health condition themselves or in their family were more price-sensitive. This study provides the first evidence on who chooses a CDHP in a multiplan, multiproduct setting. The CDHP was not chosen disproportionately by the young and healthy, but it did attract the wealthy and those who found the availability of providers more appealing. Low out-of-pocket premiums are important features of health plans and in this setting, low premiums appeal to those who are less healthy.

  7. Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

    Science.gov (United States)

    Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

    2015-11-01

    to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

    Science.gov (United States)

    Kaufmann, Cornel; Schmid, Christian; Boes, Stefan

    2017-09-01

    The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study.

    Science.gov (United States)

    Ali, Habiba I; Jarrar, Amjad H; Abo-El-Enen, Mostafa; Al Shamsi, Mariam; Al Ashqar, Huda

    2015-05-28

    Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

  10. The military health system's personal health record pilot with Microsoft HealthVault and Google Health.

    Science.gov (United States)

    Do, Nhan V; Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. The pilot project included 250 beneficiary users. Approximately 73.2% of users were Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR. Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.

  11. The economic burden of personality disorders in mental health care

    NARCIS (Netherlands)

    Soeteman, D.I.; Hakkaart-van Roijen, L.; Verheul, R.; Busschbach, J.J.V.

    2008-01-01

    Objective: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The

  12. Issues in Worksite Health Promotion: A Personal Viewpoint.

    Science.gov (United States)

    Shephard, Roy J.

    2002-01-01

    Attempts to change employees' personal behavior to promote a healthy workplace raise ethical and professional questions. Needs for successful wellness programs must be balanced against individual rights to remain unhealthy. The paper discusses potential fiscal benefits of wellness programs, ethics of motivation, personal responsibility for health,…

  13. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

  14. Communicating healthier food choice : food composition data, front-of-pack nutrition labelling and health claims.

    OpenAIRE

    Hodgkins, Charo E.

    2016-01-01

    Background: Food composition data, front-of-pack nutrition labelling and nutrition and health claims have an important role to play in the development of appropriate policy, regulation and public health interventions ultimately aimed at reducing the burden of diet-related chronic disease. The overarching aim of this thesis is to explore whether the communication of healthier food choice through front-of-pack (FOP) nutrition labelling and health claims can be enhanced by the development of con...

  15. Personality traits predict perceived health-related quality of life in persons with multiple sclerosis.

    Science.gov (United States)

    Zarbo, Ignazio Roberto; Minacapelli, Eleonora; Falautano, Monica; Demontis, Silvia; Carpentras, Giovanni; Pugliatti, Maura

    2016-04-01

    Personality traits can affect health-related quality of life (HRQoL) in different disorders. In multiple sclerosis (MS), personality traits can determine patients' willingness to take on more risky treatment options, predispose to neuropsychiatric symptoms and affect coping strategies. We investigated the role of personality traits as possible predictors of HRQoL in a large cohort of persons with MS (PwMS). In total, 253 consecutively recruited PwMS were screened for intellectual deficits with Raven Colour Progressive Matrices (RCPM), state anxiety with STAI-X1 and major depression on a clinical basis. PwMS' self-perceived mental and physical health status was measured with the 36-Item Short Form Health Survey (SF-36), and the personality profile with the Eysenck Personality Questionnaire (EPQ-R). The correlation between HRQoL and personality traits was investigated by means of analysis of variance, adjusting for possible confounders. Of the 253 MS patients, 195 (F:M=2.75), aged 41.7±10.2 years were included in the analysis. The variance of SF-36 mental and physical composite score was largely explained by extraversion and neuroticism. Our data confirm that PwMS' HRQoL is largely influenced by personality traits, which may therefore act as predictors of perceived quality of life and should be included in clinical and experimental settings focusing on HRQoL. © The Author(s), 2015.

  16. Potential and challenges of body area networks for personal health.

    Science.gov (United States)

    Penders, Julien; van de Molengraft, Jef; Brown, Lindsay; Grundlehner, Bernard; Gyselinckx, Bert; Van Hoof, Chris

    2009-01-01

    This paper illustrates how body area network technology may enable new personal health concepts. A BAN technology platform is presented, which integrates technology building blocks from the Human++ research program on autonomous wireless sensors. Technology evaluation for the case of wireless sleep staging and real-time arousal monitoring is reported. Key technology challenges are discussed. The ultimate target is the development of miniaturized body sensor nodes powered by body-energy, anticipating the needs of emerging personal health applications.

  17. What health plans do people prefer? The trade-off between premium and provider choice.

    Science.gov (United States)

    Determann, Domino; Lambooij, Mattijs S; de Bekker-Grob, Esther W; Hayen, Arthur P; Varkevisser, Marco; Schut, Frederik T; Wit, G Ardine de

    2016-09-01

    Within a healthcare system with managed competition, health insurers are expected to act as prudent buyers of care on behalf of their customers. To fulfil this role adequately, understanding consumer preferences for health plan characteristics is of vital importance. Little is known, however, about these preferences and how they vary across consumers. Using a discrete choice experiment (DCE) we quantified trade-offs between basic health plan characteristics and analysed whether there are differences in preferences according to age, health status and income. We selected four health plan characteristics to be included in the DCE: (i) the level of provider choice and associated level of reimbursement, (ii) the primary focus of provider contracting (price, quality, social responsibility), (iii) the level of service benefits, and (iv) the monthly premium. This selection was based on a literature study, expert interviews and focus group discussions. The DCE consisted of 17 choice sets, each comprising two hypothetical health plan alternatives. A representative sample (n = 533) of the Dutch adult population, based on age, gender and educational level, completed the online questionnaire during the annual open enrolment period for 2015. The final model with four latent classes showed that being able to choose a care provider freely was by far the most decisive characteristic for respondents aged over 45, those with chronic conditions, and those with a gross income over €3000/month. Monthly premium was the most important choice determinant for young, healthy, and lower income respondents. We conclude that it would be very unlikely for half of the sample to opt for health plans with restricted provider choice. However, a premium discount up to €15/month by restricted health plans might motivate especially younger, healthier, and less wealthy consumers to choose these plans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Health, personal responsibility, and distributive justice

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    explains why we have justice-based reasons to reduce social inequality in health. In my second article I investigate and (partly) object to a suggestion put forward by Shlomi Segall, according to which we should exchange the notion of responsibility with a notion of Reasonable Avoidability in the luck...... responsibility is generally impossible. I argue, nonetheless, that this approach is plausible. In my fourth and final article I proceed under the assumption that responsibility is possible. I examine the relation between responsibility (for one’s own health condition) and cost-responsibility (for health care...

  19. The use of discrete choice experiments to inform health workforce policy: a systematic review.

    Science.gov (United States)

    Mandeville, Kate L; Lagarde, Mylene; Hanson, Kara

    2014-09-01

    Discrete choice experiments have become a popular study design to study the labour market preferences of health workers. Discrete choice experiments in health, however, have been criticised for lagging behind best practice and there are specific methodological considerations for those focused on job choices. We performed a systematic review of the application of discrete choice experiments to inform health workforce policy. We searched for discrete choice experiments that examined the labour market preferences of health workers, including doctors, nurses, allied health professionals, mid-level and community health workers. We searched Medline, Embase, Global Health, other databases and grey literature repositories with no limits on date or language and contacted 44 experts. Features of choice task and experimental design, conduct and analysis of included studies were assessed against best practice. An assessment of validity was undertaken for all studies, with a comparison of results from those with low risk of bias and a similar objective and context. Twenty-seven studies were included, with over half set in low- and middle-income countries. There were more studies published in the last four years than the previous ten years. Doctors or medical students were the most studied cadre. Studies frequently pooled results from heterogeneous subgroups or extrapolated these results to the general population. Only one third of studies included an opt-out option, despite all health workers having the option to exit the labour market. Just five studies combined results with cost data to assess the cost effectiveness of various policy options. Comparison of results from similar studies broadly showed the importance of bonus payments and postgraduate training opportunities and the unpopularity of time commitments for the uptake of rural posts. This is the first systematic review of discrete choice experiments in human resources for health. We identified specific issues relating

  20. Frequently Asked Questions about Personal Health Records

    Science.gov (United States)

    ... kept by your health plan, contact the plan’s customer service department. Ask for an "authorization for the ... and healthcare provider have a confidential relationship. However, access to parents may be permitted in ...

  1. Health on impulse: when low self-control promotes healthy food choices.

    Science.gov (United States)

    Salmon, Stefanie J; Fennis, Bob M; de Ridder, Denise T D; Adriaanse, Marieke A; de Vet, Emely

    2014-02-01

    Food choices are often made mindlessly, when individuals are not able or willing to exert self-control. Under low self-control, individuals have difficulties to resist palatable but unhealthy food products. In contrast to previous research aiming to foster healthy choices by promoting high self-control, this study exploits situations of low self-control, by strategically using the tendency under these conditions to rely on heuristics (simple decision rules) as quick guides to action. More specifically, the authors associated healthy food products with the social proof heuristic (i.e., normative cues that convey majority endorsement for those products). One hundred seventy-seven students (119 men), with an average age of 20.47 years (SD = 2.25) participated in the experiment. This study used a 2 (low vs. high self-control) × 2 (social proof vs. no heuristic) × 2 (trade-off vs. control choice) design, with the latter as within-subjects factor. The dependent variable was the number of healthy food choices in a food-choice task. In line with previous studies, people made fewer healthy food choices under low self-control. However, this negative effect of low self-control on food choice was reversed when the healthy option was associated with the social proof heuristic. In that case, people made more healthy choices under conditions of low self-control. Low self-control may be even more beneficial for healthy food choices than high self-control in the presence of a heuristic. Exploiting situations of low self-control is a new and promising method to promote health on impulse. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  2. Beauty Or Health? A Personal View

    OpenAIRE

    Riji, Haliza Mohd

    2006-01-01

    This paper deals with the question of beauty and health in women. It discusses changing definitions of beauty as a result of influences from the entertainment, beauty and health product industries. Advertisements are seen to be major players in defining beauty through promotion of cosmetic, skin, hair and slimming products. Concerns relating to beauty become inculcated in girls through the process of socialisation as they mature into womanhood. The media plays a significant role in portraying...

  3. Background Noise Acceptance and Personality Factors Involved in Library Environment Choices by College Students

    Science.gov (United States)

    Gordon-Hickey, Susan; Lemley, Trey

    2012-01-01

    For decades, academic libraries made efforts to provide study environments differing in acoustic environment. The present study aimed to provide an evidence basis for this practice by comparing background noise acceptance and personality factors of two groups of college-aged students self identified as preferring quiet or background noise when…

  4. Personality Traits' Effects on Self-Efficacy and Outcome Expectations for High School Major Choice

    Science.gov (United States)

    Brown, Dikla; Cinamon, Rachel Gali

    2016-01-01

    The current study focuses on the contribution of the Big Five personality traits to the development of self-efficacy and outcome expectations regarding selection of a high school major among 368 Israeli adolescents (Mage = 16.07, SD = 0.41). Structural equation analyses showed that higher levels of conscientiousness and extraversion and lower…

  5. The relation between specialty choice of psychology students and their interests, personality, and cognitive abilities

    NARCIS (Netherlands)

    Wicherts, J.M.; Vorst, H.C.M.

    2010-01-01

    The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology

  6. The Relation between Specialty Choice of Psychology Students and Their Interests, Personality, and Cognitive Abilities

    Science.gov (United States)

    Wicherts, Jelte M.; Vorst, Harrie C. M.

    2010-01-01

    The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology were on average more extraverted than students of…

  7. Health risk perception, optimistic bias, and personal satisfaction.

    Science.gov (United States)

    Bränström, Richard; Brandberg, Yvonne

    2010-01-01

    To examine change in risk perception and optimistic bias concerning behavior-linked health threats and environmental health threats between adolescence and young adulthood and how these factors related to personal satisfaction. In 1996 and 2002, 1624 adolescents responded to a mailed questionnaire. Adolescents showed strong positive optimistic bias concerning behaviorlinked risks, and this optimistic bias increased with age. Increase in optimistic bias over time predicted increase in personal satisfaction. The capacity to process and perceive potential threats in a positive manner might be a valuable human ability positively influencing personal satisfaction and well-being.

  8. Flying personal planes: modeling the airport choices of general aviation pilots using stated preference methodology.

    Science.gov (United States)

    Camasso, M J; Jagannathan, R

    2001-01-01

    This study employed stated preference (SP) models to determine why general aviation pilots choose to base and operate their aircraft at some airports and not others. Thirteen decision variables identified in pilot focus groups and in the general aviation literature were incorporated into a series of hypothetical choice tasks or scenarios. The scenarios were offered within a fractional factorial design to establish orthogonality and to preclude dominance in any combination of variables. Data from 113 pilots were analyzed for individual differences across pilots using conditional logit regression with and without controls. The results demonstrate that some airport attributes (e.g., full-range hospitality services, paved parallel taxiway, and specific types of runway lighting and landing aids) increase pilot utility. Heavy airport congestion and airport landing fees, on the other hand, decrease pilot utility. The importance of SP methodology as a vehicle for modeling choice behavior and as an input into the planning and prioritization process is discussed. Actual or potential applications include the development of structured decision-making instruments in the behavioral sciences and in human service programs.

  9. Health promotion messages: the role of social presence for food choices.

    Science.gov (United States)

    Bittner, Jenny V; Kulesz, Micaela M

    2015-04-01

    We investigated whether social presence cues encourage consumers to self-regulate and select healthier food products. In the first experiment, workers completed food choices in an e-commerce environment. After the activation of health-related goals, they saw a social presence cue and were asked to choose between healthy and unhealthy food options. The analyses revealed main effects of social presence and health goal activation on food choices. These effects were additive, such that the combination of social presence and health goals induced significantly healthier choices compared with the control group. The second experiment further examined social presence cues that were presented on a menu. The results showed significant effects on food choices and on the perceived self-regulatory success in dieting. These findings indicate that social presence cues could be employed to increase healthful eating and, furthermore, that it may be useful to co-activate multiple cues in health promotion messages. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Patient choice and mobility in the UK health system: internal and external markets.

    Science.gov (United States)

    Dusheiko, Mark

    2014-01-01

    The National Health Service (NHS) has been the body of the health care system in the United Kingdom (UK) for over 60 years and has sought to provide the population with a high quality service free of user charges for most services. The information age has seen the NHS rapidly transformed from a socialist, centrally planned and publicly provided system to a more market based system orientated towards patients as consumers. The forces of globalization have provided patients in the UK with greater choice in their health care provision, with NHS treatment now offered from any public or approved private provider and the possibility of treatment anywhere in the European Economic Area (EEA) or possibly further. The financial crisis, a large government deficit and austerity public spending policies have imposed a tight budget constraint on the NHS at a time of increasing demand for health care and population pressure. Hence, further rationing of care could imply that patients are incentivised to seek private treatment outside the constraints of the NHS, where the possibility of much greater choice exists in an increasingly globally competitive health care market. This chapter examines the evidence on the response of patients to the possibilities of increased choice and mobility within the internal NHS and external overseas health care markets. It also considers the relationships between patient mobility, health care provision and health policy. Patients are more mobile and willing to travel further to obtain better care outcomes and value for money, but are exposed to greater risk.

  11. [Preferences of the powdered spices choice to the meal by professionally working persons in relation to the innovative changes in their manufacturing].

    Science.gov (United States)

    Bortnowska, Grazyna; Kałuzna-Zajaczkowska, Justyna

    2011-01-01

    The objective of this study was to evaluate preferences and frequency choice of commercially available powdered spices, applied to the dishes prepared at home by professionally working persons as well as factors which determine the acceptance of innovative changes in relation to the number and type of components used for their manufacturing. It was shown that above 80% mixtures of spices contained except vegetable spices also other flavourings, spice-products and functional additives but mostly monosodium glutamate (MSG) and sodium chloride. The respondents mostly accepted multicomponent powdered spices, manufactured with the application of new technologies which permitted creation original tastes and next their health-promoting role as well as convenience in use however, without changes in recipe. The women declared that to the dishes prepared at home usually applied herb spices. Conversely, the men mostly liked and often chose spices with savoury and distinctive taste and most willingly multicomponent ones which were suitable for flavour improvement of many dishes.

  12. Personalizing health care: feasibility and future implications.

    Science.gov (United States)

    Godman, Brian; Finlayson, Alexander E; Cheema, Parneet K; Zebedin-Brandl, Eva; Gutiérrez-Ibarluzea, Inaki; Jones, Jan; Malmström, Rickard E; Asola, Elina; Baumgärtel, Christoph; Bennie, Marion; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Diogene, Eduardo; Ferrario, Alessandra; Fürst, Jurij; Garuoliene, Kristina; Gomes, Miguel; Harris, Katharine; Haycox, Alan; Herholz, Harald; Hviding, Krystyna; Jan, Saira; Kalaba, Marija; Kvalheim, Christina; Laius, Ott; Lööv, Sven-Ake; Malinowska, Kamila; Martin, Andrew; McCullagh, Laura; Nilsson, Fredrik; Paterson, Ken; Schwabe, Ulrich; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Tomek, Dominik; Vlahovic-Palcevski, Vera; Voncina, Luka; Wladysiuk, Magdalena; van Woerkom, Menno; Wong-Rieger, Durhane; Zara, Corrine; Ali, Raghib; Gustafsson, Lars L

    2013-08-13

    Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer's perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

  13. Applying Health Locus of Control and Latent Class Modelling to food and physical activity choices affecting CVD risk.

    Science.gov (United States)

    Grisolía, José M; Longo, Alberto; Hutchinson, George; Kee, Frank

    2015-05-01

    Health Locus of Control (HLC) classifies our beliefs about the connection between our actions and health outcomes (Skinner, 1996) into three categories: "internal control", corresponding to health being the result of an individual's effort and habits; "control by powerful others", whereby health depends on others, such as doctors; and "chance control", according to which health depends on fate and chance. Using Choice Experiments we investigate the relationship between HLC and willingness to change lifestyle, in terms of eating habits, physical activity and associated cardiovascular disease risk, in a 384 person sample representative of the 40-65 aged population of Northern Ireland administered between February and July 2011. Using latent class analysis we identify three discrete classes of people based on their HLC: the first class is sceptical about their capacity to control their health and certain unhealthy habits. Despite being unsatisfied with their situation, they are reluctant to accept behaviour changes. The second is a group of individuals unhappy with their current situation but willing to change through exercise and diet. Finally, a group of healthy optimists is identified, who are satisfied with their current situation but happy to take more physical activity and improve their diet. Our findings show that any policy designed to modify people's health related behaviour should consider the needs of this sceptical class which represents a considerable proportion of the population in the region. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The application of defaults to optimize parents' health-based choices for children.

    Science.gov (United States)

    Loeb, Katharine L; Radnitz, Cynthia; Keller, Kathleen; Schwartz, Marlene B; Marcus, Sue; Pierson, Richard N; Shannon, Michael; DeLaurentis, Danielle

    2017-06-01

    Optimal defaults is a compelling model from behavioral economics and the psychology of human decision-making, designed to shape or "nudge" choices in a positive direction without fundamentally restricting options. The current study aimed to test the effectiveness of optimal (less obesogenic) defaults and parent empowerment priming on health-based decisions with parent-child (ages 3-8) dyads in a community-based setting. Two proof-of-concept experiments (one on breakfast food selections and one on activity choice) were conducted comparing the main and interactive effects of optimal versus suboptimal defaults, and parent empowerment priming versus neutral priming, on parents' health-related choices for their children. We hypothesized that in each experiment, making the default option more optimal will lead to more frequent health-oriented choices, and that priming parents to be the ultimate decision-makers on behalf of their child's health will potentiate this effect. Results show that in both studies, default condition, but not priming condition or the interaction between default and priming, significantly predicted choice (healthier vs. less healthy option). There was also a significant main effect for default condition (and no effect for priming condition or the interaction term) on the quantity of healthier food children consumed in the breakfast experiment. These pilot studies demonstrate that optimal defaults can be practicably implemented to improve parents' food and activity choices for young children. Results can inform policies and practices pertaining to obesogenic environmental factors in school, restaurant, and home environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. A Scalable Framework to Detect Personal Health Mentions on Twitter.

    Science.gov (United States)

    Yin, Zhijun; Fabbri, Daniel; Rosenbloom, S Trent; Malin, Bradley

    2015-06-05

    Biomedical research has traditionally been conducted via surveys and the analysis of medical records. However, these resources are limited in their content, such that non-traditional domains (eg, online forums and social media) have an opportunity to supplement the view of an individual's health. The objective of this study was to develop a scalable framework to detect personal health status mentions on Twitter and assess the extent to which such information is disclosed. We collected more than 250 million tweets via the Twitter streaming API over a 2-month period in 2014. The corpus was filtered down to approximately 250,000 tweets, stratified across 34 high-impact health issues, based on guidance from the Medical Expenditure Panel Survey. We created a labeled corpus of several thousand tweets via a survey, administered over Amazon Mechanical Turk, that documents when terms correspond to mentions of personal health issues or an alternative (eg, a metaphor). We engineered a scalable classifier for personal health mentions via feature selection and assessed its potential over the health issues. We further investigated the utility of the tweets by determining the extent to which Twitter users disclose personal health status. Our investigation yielded several notable findings. First, we find that tweets from a small subset of the health issues can train a scalable classifier to detect health mentions. Specifically, training on 2000 tweets from four health issues (cancer, depression, hypertension, and leukemia) yielded a classifier with precision of 0.77 on all 34 health issues. Second, Twitter users disclosed personal health status for all health issues. Notably, personal health status was disclosed over 50% of the time for 11 out of 34 (33%) investigated health issues. Third, the disclosure rate was dependent on the health issue in a statistically significant manner (P<.001). For instance, more than 80% of the tweets about migraines (83/100) and allergies (85

  16. Communication beetwen health workers and laringectomic person

    OpenAIRE

    Milanović, Nataša; Momić, Jelena; Rošić, Mladenka; Sabatti, Lara

    2016-01-01

    Speach is basic simbolic and comunication activity, process of making vocal signs. Many illnesses can partially or totaly unable the speach. For patient who underwent total laryngectomy, speaking is unabled what makes comunication difficult. New state leads to many psychological and social problems. However, with improvement in medicine and continuous education of health providers, today this problem can be solved.

  17. Perceptions of Healthful Eating and Influences on the Food Choices of Appalachian Youth

    Science.gov (United States)

    Swanson, Mark; Schoenberg, Nancy E.; Davis, Rian; Wright, Sherry; Dollarhide, Kaye

    2013-01-01

    Objective: Patterns of overweight and obesity have an unequal geographic distribution, and there are elevated rates in Appalachia. Perceptions of Appalachian youth toward healthful eating and influences on food choice were examined as part of formative research to address these disparities. Methods: Eleven focus groups, averaging 6 youth (n = 68)…

  18. Great expectations: patient choice as a lever for change in health care.

    NARCIS (Netherlands)

    Friele, R.D.

    2011-01-01

    The introduction of market forces in the Dutch health care system is partially based on assumptions regarding patients' behavior. They are expected to actively choose their care providers. Their choices may work as a lever for change. When asked, most patients say that they find it very important to

  19. Health conditions and support needs of persons living in residential ...

    African Journals Online (AJOL)

    Background. Intellectual disability (ID) is a relatively high-incidence disability, with an increased risk of poor physical and mental health. Persons with ID also have lifelong support needs that must be met if they are to achieve an acceptable quality of life. Little is known about these health conditions and support needs in the ...

  20. Personal Health Records: Design considerations for the South African context

    CSIR Research Space (South Africa)

    Mxoli, A

    2014-09-01

    Full Text Available A Personal Health Record (PHR) is a set of internet-based tools that allow individuals to create, store and coordinate their lifelong health information in one place making it available to relevant parties. It typically contains the individual’s...

  1. personal characteristics and compliance to health education among

    African Journals Online (AJOL)

    Global Journal

    2016-10-08

    Oct 8, 2016 ... This study investigated personal characteristics (individual factors) ... Three research questions and one hypothesis were formulated to ... Literature ... good nutrition, exercise, clothing and travel during ... health education, she must be aware of the benefits of ..... International Journal for Women's Health.

  2. 21 CFR 1250.35 - Health of persons handling food.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Health of persons handling food. 1250.35 Section 1250.35 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION INTERSTATE CONVEYANCE...

  3. How the health belief model helps the tobacco industry: individuals, choice, and "information".

    Science.gov (United States)

    Balbach, Edith D; Smith, Elizabeth A; Malone, Ruth E

    2006-12-01

    To analyse trial and deposition testimony of tobacco industry executives to determine how they use the concepts of "information" and "choice" and consider how these concepts are related to theoretical models of health behaviour change. We coded and analysed transcripts of trial and deposition testimony of 14 high-level executives representing six companies plus the Tobacco Institute. We conducted an interpretive analysis of industry executives' characterisation of the industry's role as information provider and the agency of tobacco consumers in making "choices". Tobacco industry executives deployed the concept of "information" as a mechanism that shifted to consumers full moral responsibility for the harms caused by tobacco products. The industry's role was characterised as that of impartial supplier of value-free "information", without regard to its quality, accuracy and truthfulness. Tobacco industry legal defences rely on assumptions congruent with and supported by individual rational choice theories, particularly those that emphasise individual, autonomous decision-makers. Tobacco control advocates and health educators must challenge the industry's preferred framing, pointing out that "information" is not value-free. Multi-level, multi-sectoral interventions are critical to tobacco use prevention. Over-reliance on individual and interpersonal rational choice models may have the effect of validating the industry's model of smoking and cessation behaviour, absolving it of responsibility and rendering invisible the "choices" the industry has made and continues to make in promoting the most deadly consumer product ever made.

  4. Beauty Or Health? A Personal View.

    Science.gov (United States)

    Riji, Haliza Mohd

    2006-01-01

    This paper deals with the question of beauty and health in women. It discusses changing definitions of beauty as a result of influences from the entertainment, beauty and health product industries. Advertisements are seen to be major players in defining beauty through promotion of cosmetic, skin, hair and slimming products. Concerns relating to beauty become inculcated in girls through the process of socialisation as they mature into womanhood. The media plays a significant role in portraying the meaning of beauty through its representation of women. These influences largely influence and alter women's perceptions of their body image and in trying to meet the goals of beauty as represented by the media. This may result in dissatisfaction with their body image. Advertisements can encourage women to indulge in smoking as a fashionable trend or opt for plastic surgery in attempts to acquire beauty. This paper concludes with implications of the issues relating to changing perceptions of beauty and suggests recommendations.

  5. Differences in Waiting List Prioritization Preferences of Occupational Therapists, Elderly People, and Persons With Disabilities: A Discrete Choice Experiment.

    Science.gov (United States)

    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie Ehrmann

    2018-01-01

    To compare the preferences of occupational therapists, elderly people, and adults with disabilities regarding prioritization criteria for occupational therapy waiting lists in home care. Discrete choice experiment survey. Survey mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons. A sample (N=714) of home-based occupational therapists (n=241), elderly persons from a bank of research participants (n=226), and adults with physical disabilities recruited through community organizations (n=247). Not applicable. The dependent variable was whether the referral scenario was prioritized or not in each question. The results were analyzed through logistic regression using conditional logit models. Prioritization preferences differed between groups (Ppeople who had a few falls (odds ratio vs no falls, 48.7), whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (odds ratio vs no difficulty entering and exiting the home, 30.8 for elderly people and 16.8 for persons with disabilities.) CONCLUSIONS: Our results highlight the gap between the priorities of home-based occupational therapists and their target clientele. Although further inquiry is needed to inform priority setting, the findings emphasize the importance of public or patient involvement in decisions on waiting list prioritization. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine

    Science.gov (United States)

    Chapman, Benjamin P.; Roberts, Brent; Duberstein, Paul

    2011-01-01

    We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine. PMID:21766032

  7. BEAUTY OR HEALTH? A PERSONAL VIEW

    Directory of Open Access Journals (Sweden)

    Haliza Mohd Riji

    2006-01-01

    Full Text Available This paper deals with the question of beauty and health in women. It discusses changing definitions of beauty as a result of influences from the entertainment, beauty and health product industries. Advertisements are seen to be major players in defining beauty through promotion of cosmetic, skin, hair and slimming products. Concerns relating to beauty become inculcated in girls through the process of socialisation as they mature into womanhood. The media plays a significant role in portraying the meaning of beauty through its representation of women. These influences largely influence and alter women’s perceptions of their body image and in trying to meet the goals of beauty as represented by the media. This may result in dissatisfaction with their body image. Advertisements can encourage women to indulge in smoking as a fashionable trend or opt for plastic surgery in attempts to acquire beauty. This paper concludes with implications of the issues relating to changing perceptions of beauty and suggests recommendations.

  8. Prioritising health service innovation investments using public preferences: a discrete choice experiment.

    Science.gov (United States)

    Erdem, Seda; Thompson, Carl

    2014-08-28

    Prioritising scarce resources for investment in innovation by publically funded health systems is unavoidable. Many healthcare systems wish to foster transparency and accountability in the decisions they make by incorporating the public in decision-making processes. This paper presents a unique conceptual approach exploring the public's preferences for health service innovations by viewing healthcare innovations as 'bundles' of characteristics. This decompositional approach allows policy-makers to compare numerous competing health service innovations without repeatedly administering surveys for specific innovation choices. A Discrete Choice Experiment (DCE) was used to elicit preferences. Individuals chose from presented innovation options that they believe the UK National Health Service (NHS) should invest the most in. Innovations differed according to: (i) target population; (ii) target age; (iii) implementation time; (iv) uncertainty associated with their likely effects; (v) potential health benefits; and, (vi) cost to a taxpayer. This approach fosters multidimensional decision-making, rather than imposing a single decision criterion (e.g., cost, target age) in prioritisation. Choice data was then analysed using scale-adjusted Latent Class models to investigate variability in preferences and scale and valuations amongst respondents. Three latent classes with considerable heterogeneity in the preferences were present. Each latent class is composed of two consumer subgroups varying in the level of certainty in their choices. All groups preferred scientifically proven innovations, those with potential health benefits that cost less. There were, however, some important differences in their preferences for innovation investment choices: Class-1 (54%) prefers innovations benefitting adults and young people and does not prefer innovations targeting people with 'drug addiction' and 'obesity'. Class- 2 (34%) prefers innovations targeting 'cancer' patients only and has

  9. Is Personality Associated with Health Care Use by Older Adults?

    Science.gov (United States)

    Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

    2013-01-01

    Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and

  10. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

    Science.gov (United States)

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2012-05-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

  11. Making healthy choices easy choices: the role of empowerment

    NARCIS (Netherlands)

    Koelen, M.A.; Lindström, B.

    2005-01-01

    An important goal of health promotion is to make it easier for people to make healthy choices. However, this may be difficult if people do not feel control over their environment and their personal circumstances. An important concept in relation to this is empowerment. Health professionals are

  12. Wise Choices? The Economics Discourse of a High School Economics and Personal Finance Course

    Science.gov (United States)

    Sober, Tamara Leigh

    2017-01-01

    Today's high school students will face a host of economic problems such as the demise of the social safety net, mounting college student debt, and costly health care plans, as stated in the rationale for financial literacy provided by the Council for Economic Education's National Standards for Financial Literacy. These problems are compounded by…

  13. Can decision biases improve insurance outcomes? An experiment on status quo bias in health insurance choice.

    Science.gov (United States)

    Krieger, Miriam; Felder, Stefan

    2013-06-19

    Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

  14. Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

    Science.gov (United States)

    Krieger, Miriam; Felder, Stefan

    2013-01-01

    Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure. PMID:23783222

  15. What should primary health care practitioners know about factors influencing young people’s food choices?

    Directory of Open Access Journals (Sweden)

    Louise Holmberg

    2010-04-01

    Full Text Available BackgroundTo identify factors that determine the nature and extent ofyoung consumers trust in food; sources of information whichinfluence young consumer food choices; and how trustimpacts on young people’s food choices.MethodIn-depth qualitative research interviews were conducted withyoung women and men, who are the primary food purchasersin their household (n=8ResultsFood choices of young adults were generally determined bycost and convenience. The overall perception was thatAustralian food regulation was effective and therefore, foodsafety need not be questioned. Health including long termhealth, although considered, was not central in food choicebehaviour. Trustworthy nutrition information sourcesincluded family and friends. While food labels were used theywere considered scientific and complex. The media and thefood industry were deemed to be untrustworthy informationsources.ConclusionCost and convenience were major determinants of foodchoice in this group of young people who generally lacked areflexive capacity with regards to food safety and health. Afailure to prioritise health raises questions regarding theengagement of young people in public health initiatives, andshould be of interest to primary health care practitioners.These data suggest that general practitioners should beaware that cost and convenience may take priority overhealth issues for young people. Further research isrequired to confirm the findings of this small study, withfuture studies aiming to include young people fromvarying socio-demographic backgrounds in order to gain amore comprehensive view of young people’s trust infood.

  16. Using contingent choice methods to assess consumer preferences about health plan design.

    Science.gov (United States)

    Marquis, M Susan; Buntin, Melinda Beeuwkes; Kapur, Kanika; Yegian, Jill M

    2005-01-01

    American insurers are designing products to contain health care costs by making consumers financially responsible for their choices. Little is known about how consumers will view these new designs. Our objective is to examine consumer preferences for selected benefit designs. We used the contingent choice method to assess willingness to pay for six health plan attributes. Our sample included subscribers to individual health insurance products in California, US. We used fitted logistic regression models to explore how preferences for the more generous attributes varied with the additional premium and with the characteristics of the subscriber. High quality was the most highly valued attribute based on the amounts consumers report they are willing to pay. They were also willing to pay substantial monthly premiums to reduce their overall financial risk. Individuals in lower health were willing to pay more to reduce their financial risk than individuals in better health. Consumers may prefer tiered-benefit designs to those that involve overall increases in cost sharing. More consumer information is needed to help consumers better evaluate the costs and benefits of their insurance choices.

  17. Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

    Directory of Open Access Journals (Sweden)

    Stefan Felder

    2013-06-01

    Full Text Available Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

  18. What does facial symmetry reveal about health and personality?

    Directory of Open Access Journals (Sweden)

    Švegar Domagoj

    2016-09-01

    Full Text Available Over the last two decades, facial symmetry has been intensively researched. The present article aims to summarize empirical research concerning relations between facial symmetry and health and facial symmetry and personality. A systematic review of the literature shows that facial symmetry is one of the most influential visual markers of attractiveness and health, important for mate selection, while asymmetry can be considered a consequence of an individual’s inability to resist environmental and genetic stressors during development of the organism. However, in spite of evidence suggesting that preferences for facial symmetry are deeply rooted in our evolutionary history, a strong connection between facial symmetry and health is demonstrated only in studies measuring perceived health, while there is only scarce evidence corroborating the link between symmetry and actual health. The interconnections between facial symmetry and personality have not yet been extensively researched. Less than a dozen studies have addressed that issue and they have reached different conclusions. Some evidence suggests that facial symmetry signals personality attributes that indicate good psychological health, while other findings imply that pro-social personality traits negatively correlate with facial symmetry.

  19. Type D personality and health status in cardiovascular disease populations

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Spek, Viola; Pedersen, Susanne S.

    2012-01-01

    Background: Knowledge of the factors associated with individual differences in patient-reported outcomes is essential to identify high-risk patients and improve secondary prevention. Design: In this meta-analysis, we examined the association between Type D personality and the individual differences...... in patient-reported physical and mental health status among cardiovascular patients. Methods: A computerized search of the literature through PUBMED and PsychINFO (from 1995 to May 2011) was performed and prospective studies were selected that analysed the association between Type D personality and health...... status in cardiovascular patients. Two separate meta-analyses were performed for the association of Type D personality with physical and mental health status, respectively. Results: Of all identified studies, ten studies met the selection criteria. The meta-analyses showed that Type D was associated...

  20. The use of biometrics in the Personal Health Record (PHR).

    Science.gov (United States)

    Bonney, Wilfred

    2011-01-01

    The emergence of the Personal Health Record (PHR) has made individual health information more readily accessible to a wide range of users including patients, consumers, practitioners, and healthcare providers. However, increased accessibility of PHR threatens the confidentiality, privacy, and security of personalized health information. Therefore, a need for robust and reliable forms of authentication is of prime concern. The concept of biometric authentication is now highly visible to healthcare providers as a technology to prevent unauthorized access to individual health information. Implementing biometric authentication mechanisms to protect PHR facilitates access control and secure exchange of health information. In this paper, a literature review is used to explore the key benefits, technical barriers, challenges, and ethical implications for using biometric authentication in PHR.

  1. Health and Safety. Supervising: Industrial Relations. The Choice Series #84. A Self Learning Opportunity.

    Science.gov (United States)

    McCall, Matthew S.

    This student guide is intended to assist persons employed as supervisors in understanding and practicing principles of occupational health and safety. Discussed in the first three sections are the following topics: health and safety at work (causes of accidents, ways of dealing with and reporting accidents, procedures for preventing accidents and…

  2. Consumer-Choice Health plan (second of two parts). A national-health-insurance proposal based on regulated competition in the private sector.

    Science.gov (United States)

    Enthoven, A C

    1978-03-30

    Medical costs are straining public finances. Direct economic regulation will raise costs, retard beneficial innovation and be increasingly burdensome to physicians. As an alternative, I suggest that the government change financial incentives by creating a system of competing health plans in which physicians and consumers can benefit from using resources wisely. Main proposals consist of changed tax laws, Medicare and Medicaid to subsidize individual premium payments by an amount based on financial and predicted medical need, as well as subsidies usable only for premiums in qualified health insurance or delivery plans operating under rules that include periodic open enrollment, community rating by actuarial category, premium rating by market area and a limit on each person's out-of pocket costs. Also, efficient systems should be allowed to pass on the full savings to consumers. Finally, incremental changes should be made in the present system to alter it fundamentally, but gradually and voluntarily. Freedom of choice for consumers and physicians should be preserved.

  3. Interoperable eHealth Platform for Personalized Smart Services

    DEFF Research Database (Denmark)

    Mihaylov, Mihail Rumenov; Mihovska, Albena Dimitrova; Kyriazakos, Sofoklis

    2015-01-01

    personalized context-aware applications to serve the user's needs. This paper proposes the use of advised sensing, context-aware and cloud-based lifestyle reasoning to design an innovative eHealth platform that supports highly personalized smart services to primary users. The architecture of the platform has...... been designed in accordance with the interoperability requirements and standards as proposed by ITU-T and Continua Alliance. In particular, we define the interface dependencies and functional requirements needed, to allow eCare and eHealth vendors to manufacture interoperable sensors, ambient and home...

  4. [Being personal: the development of community psychiatric mental health nursing].

    Science.gov (United States)

    Shiau, Shu-Jen; Lee, Shu-Hong

    2009-08-01

    Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process.

  5. Equity, empowerment and choice: from theory to practice in public health.

    Science.gov (United States)

    Ratna, Jalpa; Rifkin, Susanb

    2007-05-01

    The purpose of this article is to illustrate how a framework that links equity and empowerment to improved health outcomes for those who live in poverty can be a useful tool for planning and managing health programmes. Using the work of Amartya Sen, Susan Rifkin has developed a framework described in the acronym CHOICE. The article applies the framework to two case studies from Kenya seeking to reduce the disease burdens of malaria and HIV/AIDS. The article examines how the process of pursuing equity and empowerment either supports the positive health outcomes identified as objectives and/or strengthens these outcomes.

  6. Associations between causal attributions and personal stigmatizing attitudes in untreated persons with current mental health problems.

    Science.gov (United States)

    Stolzenburg, Susanne; Freitag, Simone; Schmidt, Silke; Schomerus, Georg

    2018-02-01

    Past research has shown that among the general public, certain causal explanations like biomedical causes are associated with stronger desire for social distance from persons with mental illness. Aim of this study was to find out how different causal attributions of persons with untreated mental health problems regarding their own complaints are associated with stigmatizing attitudes, anticipated self-stigma when seeking help and perceived stigma-stress. Altogether, 207 untreated persons with a current depressive syndrome were interviewed. Biomedical causes, but also belief in childhood trauma or unhealthy behavior as a cause of the problem, were associated with stronger personal stigma and with more stigma-stress. Similarities and differences to findings among the general population and implications for future research are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Social value and individual choice: The value of a choice-based decision-making process in a collectively funded health system.

    Science.gov (United States)

    Espinoza, Manuel Antonio; Manca, Andrea; Claxton, Karl; Sculpher, Mark

    2018-02-01

    Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Personality traits and dysfunctional construal of online health promotion messages.

    Science.gov (United States)

    Lee, Yaeeun; Kurtz, John E

    2017-10-20

    With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated. A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires. Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog. This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study.

  9. Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

    Science.gov (United States)

    Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

    2017-01-01

    We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

  10. Health, Supportive Environments, and the Reasonable Person Model

    Science.gov (United States)

    Stephen Kaplan; Rachel Kaplan

    2003-01-01

    The Reasonable Person Model is a conceptual framework that links environmental factors with human behavior. People are more reasonable, cooperative, helpful, and satisfied when the environment supports their basic informational needs. The same environmental supports are important factors in enhancing human health. We use this framework to identify the informational...

  11. Personality affects aspects of health-related quality of life in parkinson's disease via psychological coping strategies

    DEFF Research Database (Denmark)

    Whitworth, Stephanie R.; Loftus, Andrea M.; Skinner, Timothy C.

    2013-01-01

    , choice of coping strategy, and their subsequent effect on HRQoL remains unclear. OBJECTIVE: The objective of this study was to examine whether personality (neuroticism and extraversion) indirectly affects HRQoL through the use of specific psychological coping strategies. Methods: One hundred and forty......Background: Personality traits influence health-related quality of life (HRQoL) in Parkinson's disease (PD). Further, an individual's personality traits can influence the strategies they use to cope with a particular stressful situation. However, in PD, the interplay between personality traits...... for gender, age at diagnosis, and age at testing, the emotion-focused coping strategy of escape-avoidance was significantly correlated with neuroticism and certain aspects of HRQoL (cognitive impairment and social support). This suggests that neurotic personality traits may negatively impact on some aspects...

  12. Valuing health risk in agriculture: a choice experiment approach to pesticide use in China.

    Science.gov (United States)

    Jin, Jianjun; Wang, Wenyu; He, Rui; Gong, Haozhou

    2017-07-01

    This paper presents a choice experiment approach to investigate farmers' valuations for health risk changes associated with pesticide use in Anqiu County, China. An empirical comparison on the disparity between farmers' willingness to pay (WTP) for a health risk reduction and willingness to accept (WTA) for the same risk increase is also conducted. Respondents were randomly assigned into the WTP group or the WTA group. Four attributes (health consequence, baseline risk, risk change size, and price) were identified and included. The results show that cancer consequence due to pesticide use decreases the utility of the farmer. A higher baseline risk has a higher WTP to reduce the risk and a higher probability of receiving compensation. If the health risk change size is bigger, it will result in a higher WTP and higher compensation. Household income, education, and age have significant and positive impacts on farmers' WTP. Farmers who are more educated or female are more likely to accept the compensation scheme if health risks increase. The marginal WTA for the same risk change is about two times higher than the marginal WTP. The findings of this study can contribute to the literature comparing people's WTP and WTA in a discrete choice experiment on valuing health risk changes associated with pesticide use.

  13. Embedded Sensor Systems for Health - A Step Towards Personalized Health.

    Science.gov (United States)

    Lindén, Maria; Björkman, Mats

    2018-01-01

    The demography is changing towards older people, and the challenge to provide an appropriate care is well known. Sensor systems, combined with IT solutions are recognized as one of the major tools to handle this situation. Embedded Sensor Systems for Health (ESS-H) is a research profile at Mälardalen University in Sweden, focusing on embedded sensor systems for health technology applications. The research addresses several important issues: to provide sensor systems for health monitoring at home, to provide sensor systems for health monitoring at work, to provide safe and secure infrastructure and software testing methods for physiological data management. The user perspective is important in order to solve real problems and to develop systems that are easy and intuitive to use. One of the overall aims is to enable health trend monitoring in home environments, thus being able to detect early deterioration of a patient. Sensor systems, signal processing algorithms, and decision support algorithms have been developed. Work on development of safe and secure infrastructure and software testing methods are important for an embedded sensor system aimed for health monitoring, both in home and in work applications. Patient data must be sent and received in a safe and secure manner, also fulfilling the integrity criteria.

  14. ?Choice Set? for health behavior in choice-constrained settings to frame research and inform policy: examples of food consumption, obesity and food security

    OpenAIRE

    Dover, Robert V. H.; Lambert, Estelle V.

    2016-01-01

    Objectives Using the nexus between food consumption, food security and obesity, this paper addresses the complexity of health behavior decision-making moments that reflect relational social dynamics in context-specific dialogues, often in choice-constrained conditions. Methods A pragmatic review of literature regarding social determinants of health in relation to food consumption, food security and obesity was used to advance this theoretical model. Results and discussion We suggest that heal...

  15. Personality and the perception of health and happiness.

    Science.gov (United States)

    Cloninger, C Robert; Zohar, Ada H

    2011-01-01

    Health is a state of physical, mental, and social well-being. Personality traits measure individual differences in adaptive functioning and mental health, but little is known about how well personality accounts for health's affective aspects (i.e., "happiness") and its non-affective aspects (i.e., "wellness") in the general population. 1102 volunteer representatives of the Sharon area of Israel completed the Temperament and Character Inventory (TCI), the Positive and Negative Affect Scale (PANAS), the Satisfaction with Life Scale (SWLS), the Multidimensional Scale of Perceived Social Support (PSS), and the subjective health assessment of the General Health Questionnaire (GHQ). Multidimensional personality profiles were used to evaluate the linear and non-linear effects of interactions among dimensions on different aspects of well-being. Self-directedness was strongly associated with all aspects of well-being regardless of interactions with other dimensions. Cooperativeness was strongly associated with perceived social support, and weakly with other aspects of well-being, particularly when Self-directedness was low. Self-transcendence was strongly associated with positive emotions when the influence of the other character dimensions was taken into account. Personality explained nearly half the variance in happiness and more than one-third of the variance in wellness. Our data are cross-sectional and self-reported, so they are subject to personal perceptual bias. The emotional, social, and physical aspects of well-being are interdependent, but specific configurations of TCI Self-directedness, Cooperativeness, and Self-transcendence influence them differentially. Interactions among different combinations of character traits have strong effects on the perception of both wellness and happiness. Copyright © 2010 Elsevier B.V. All rights reserved.

  16. Constrained choices? Linking employees' and spouses' work time to health behaviors.

    Science.gov (United States)

    Fan, Wen; Lam, Jack; Moen, Phyllis; Kelly, Erin; King, Rosalind; McHale, Susan

    2015-02-01

    There are extensive literatures on work conditions and health and on family contexts and health, but less research asking how a spouse or partners' work conditions may affect health behaviors. Drawing on the constrained choices framework, we theorized health behaviors as a product of one's own time and spouses' work time as well as gender expectations. We examined fast food consumption and exercise behaviors using survey data from 429 employees in an Information Technology (IT) division of a U.S. Fortune 500 firm and from their spouses. We found fast food consumption is affected by men's work hours-both male employees' own work hours and the hours worked by husbands of women respondents-in a nonlinear way. The groups most likely to eat fast food are men working 50 h/week and women whose husbands work 45-50 h/week. Second, exercise is better explained if work time is conceptualized at the couple, rather than individual, level. In particular, neo-traditional arrangements (where husbands work longer than their wives) constrain women's ability to engage in exercise but increase odds of men exercising. Women in couples where both partners are working long hours have the highest odds of exercise. In addition, women working long hours with high schedule control are more apt to exercise and men working long hours whose wives have high schedule flexibility are as well. Our findings suggest different health behaviors may have distinct antecedents but gendered work-family expectations shape time allocations in ways that promote men's and constrain women's health behaviors. They also suggest the need to expand the constrained choices framework to recognize that long hours may encourage exercise if both partners are looking to sustain long work hours and that work resources, specifically schedule control, of one partner may expand the choices of the other. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Preferences for working in rural clinics among trainee health professionals in Uganda: a discrete choice experiment.

    Science.gov (United States)

    Rockers, Peter C; Jaskiewicz, Wanda; Wurts, Laura; Kruk, Margaret E; Mgomella, George S; Ntalazi, Francis; Tulenko, Kate

    2012-07-23

    Health facilities require teams of health workers with complementary skills and responsibilities to efficiently provide quality care. In low-income countries, failure to attract and retain health workers in rural areas reduces population access to health services and undermines facility performance, resulting in poor health outcomes. It is important that governments consider health worker preferences in crafting policies to address attraction and retention in underserved areas. We investigated preferences for job characteristics among final year medical, nursing, pharmacy, and laboratory students at select universities in Uganda. Participants were administered a cadre-specific discrete choice experiment that elicited preferences for attributes of potential job postings they were likely to pursue after graduation. Job attributes included salary, facility quality, housing, length of commitment, manager support, training tuition, and dual practice opportunities. Mixed logit models were used to estimate stated preferences for these attributes. Data were collected from 246 medical students, 132 nursing students, 50 pharmacy students and 57 laboratory students. For all student-groups, choice of job posting was strongly influenced by salary, facility quality and manager support, relative to other attributes. For medical and laboratory students, tuition support for future training was also important, while pharmacy students valued opportunities for dual practice. In Uganda, financial and non-financial incentives may be effective in attracting health workers to underserved areas. Our findings contribute to mounting evidence that salary is not the only important factor health workers consider when deciding where to work. Better quality facilities and supportive managers were important to all students. Similarities in preferences for these factors suggest that team-based, facility-level strategies for attracting health workers may be appropriate. Improving facility quality

  18. Preferences for working in rural clinics among trainee health professionals in Uganda: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Rockers Peter C

    2012-07-01

    Full Text Available Abstract Background Health facilities require teams of health workers with complementary skills and responsibilities to efficiently provide quality care. In low-income countries, failure to attract and retain health workers in rural areas reduces population access to health services and undermines facility performance, resulting in poor health outcomes. It is important that governments consider health worker preferences in crafting policies to address attraction and retention in underserved areas. Methods We investigated preferences for job characteristics among final year medical, nursing, pharmacy, and laboratory students at select universities in Uganda. Participants were administered a cadre-specific discrete choice experiment that elicited preferences for attributes of potential job postings they were likely to pursue after graduation. Job attributes included salary, facility quality, housing, length of commitment, manager support, training tuition, and dual practice opportunities. Mixed logit models were used to estimate stated preferences for these attributes. Results Data were collected from 246 medical students, 132 nursing students, 50 pharmacy students and 57 laboratory students. For all student-groups, choice of job posting was strongly influenced by salary, facility quality and manager support, relative to other attributes. For medical and laboratory students, tuition support for future training was also important, while pharmacy students valued opportunities for dual practice. Conclusions In Uganda, financial and non-financial incentives may be effective in attracting health workers to underserved areas. Our findings contribute to mounting evidence that salary is not the only important factor health workers consider when deciding where to work. Better quality facilities and supportive managers were important to all students. Similarities in preferences for these factors suggest that team-based, facility-level strategies for

  19. Medical students’ personal choice for mode of delivery in Santa Catarina, Brazil: a cross-sectional, quantitative study

    Directory of Open Access Journals (Sweden)

    Watanabe Tatiane

    2012-07-01

    Full Text Available Abstract Background The increase in overall rates of cesarean sections (CS in Brazil causes concern and it appears that multiple factors are involved in this fact. In 2009, undergraduate students in the first and final years of medical school at the University of Santa Catarina answered questionnaires regarding their choice of mode of delivery. The aim of the study was to evaluate whether the education process affects decision-making regarding the waay of childbirth preferred by medical students. Methods A cross-sectional, quantitative study was conducted based on data obtained from questionnaires applied to medical students. The questions addressed four different scenarios in childbirth, as follows: under an uneventful pregnancy; the mode of delivery for a pregnant woman under their care; the best choice as a healthcare manager and lastly, choosing the birth of their own child. For each circumstance, there was an open question to explain their choice. Results A total of 189 students answered the questionnaires. For any uneventful pregnancy and for a pregnant woman under their care, 8.46% of the students would opt for CS. As a healthcare manager, only 2.64% of the students would recommend CS. For these three scenarios, the answers of the students in the first year did not differ from those given by students in the sixth year. In the case of the student’s own or a partner’s pregnancy, 41.4% of those in the sixth year and 16.8% of those in the first year would choose a CS. A positive association was found between being a sixth year student and a personal preference for CS according to logistic regression (OR = 2.91; 95%CI: 1.03–8.30. Pain associated with vaginal delivery was usually the reason for choosing a CS. Conclusions A higher number of sixth year students preferred a CS for their own pregnancy (or their partner’s compared to first year students. Pain associated with vaginal delivery was the most common reason given for haven chosen

  20. Associations between Modifiable Health-Risk Behaviors and Personality Types

    Directory of Open Access Journals (Sweden)

    Jon C. Schommer

    2017-05-01

    Full Text Available Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1 the quality of patient-physician relationships, (2 patient-physician communication, and (3 preferred method for receiving information. Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics Panels from March 14-30, 2016. Chi-square analysis was used for making comparisons between categories of personality types and items related to health-risk behaviors. Statistical significance was set at p < 0.05. However, chi-square analysis with large sample sizes (e.g. 10,500 in this study readily yields statistical significance. Practical significance was set at four or more percentage points above or below the overall mean. Results: Regarding objective 1, personality type was associated with all nine health-risk behaviors studied. Personality types within the Experiencer temperament (17% of the U.S. population accounted for 46% of the undesirable scores we computed for health-risk behaviors. The Idealist temperament (17% of population accounted for 32% of the undesirable scores. Conceptualizers (10% of population accounted for 17% of the undesirable scores and Traditionalists (46% of population accounted for 5% of the undesirable scores. Regarding objective 2, the findings showed that personality type was associated with (1 the importance people place on the patient-physician relationship, (2 which characteristics of that relationship are most desirable, (3 desire for

  1. The views of policy influencers and mental health officers concerning the Named Person provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003.

    Science.gov (United States)

    Berzins, Kathryn M; Atkinson, Jacqueline M

    2010-10-01

    The Mental Health (Care and Treatment) (Scotland) Act 2003 introduced the role of the Named Person, who can be nominated by service users to protect their interests if they become subject to compulsory measures and replaces the Nearest Relative. If no nomination is made, the primary carer or nearest relative is appointed the Named Person. The views of professionals involved in the development and implementation of the provisions were unknown. To describe the perceptions of mental health officers and policy makers involved in the development and implementation of the new provisions. Sixteen professionals were interviewed to explore their perceptions of and experiences with the Named Person provisions. Data were analysed using Thematic Analysis. Perceptions of the Named Person provisions were generally favourable but concerns were expressed over low uptake; service users' and carers' lack of understanding of the role; and potential conflict with human rights legislation over choice and information sharing. Legislation should be amended to allow the choice of no Named Person and the prevention of information being shared with the default appointed Named Person. Removal of the default appointment should be considered.

  2. Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

    Science.gov (United States)

    Gibbons, M C

    2013-01-01

    The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

  3. Health and Pleasure in Consumers' Dietary Food Choices: Individual Differences in the Brain's Value System

    Science.gov (United States)

    Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier

    2016-01-01

    Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched. PMID:27428267

  4. A framework linking community empowerment and health equity: it is a matter of CHOICE.

    Science.gov (United States)

    Rifkin, Susan B

    2003-09-01

    This paper presents a framework to explore the relationship between health equity and community empowerment. It traces the progression of the concept of participation to the present term of empowerment and the links among empowerment, equity, and health outcomes. It argues that the relationship can best be described by using the acronym CHOICE (Capacity-building, Human rights, Organizational sustainability, Institutional accountability, Contribution, and Enabling environment). Based on the concept of development as freedom put forward by Nobel Laureate Amartya Sen, the paper describes how each factor illustrates the relationship between equity and empowerment in positive health outcomes, giving appropriate examples. In conclusion, it is suggested that these factors might form the basis of a tool to assess the relationship between equity and empowerment and its impact on health outcomes.

  5. Women, men and public health-how the choice of normative theory affects resource allocation.

    Science.gov (United States)

    Månsdotter, Anna; Lindholm, Lars; Ohman, Ann

    2004-09-01

    Women live longer than men in almost all countries, but men are more privileged in terms of power, influence, resources and probably morbidity. This investigation aims at illustrating how the choice of normative framework affects judgements about the fairness in these sex differences, and about desired societal change. The selected theories are welfare economics, health sector extra-welfarism, justice as fairness and feminist justice. By means of five Swedish proposals aiming at improving the population's health or "sex equity", facts and values are applied to resource allocation. Although we do not claim a specific ethical foundation, it seems to us that the feminist criterion has great potential in public health policy. The overall conclusion is that the normative framework must be explicitly discussed and stated in issues of women's and men's health.

  6. The detrimental impact of maladaptive personality on public mental health : a challenge for psychiatric practice

    OpenAIRE

    Hengartner, Michael Pascal

    2015-01-01

    Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challen...

  7. Surfing the internet for health information: an italian survey on use and population choices.

    Science.gov (United States)

    Siliquini, Roberta; Ceruti, Michele; Lovato, Emanuela; Bert, Fabrizio; Bruno, Stefania; De Vito, Elisabetta; Liguori, Giorgio; Manzoli, Lamberto; Messina, Gabriele; Minniti, Davide; La Torre, Giuseppe

    2011-04-07

    Recent international sources have described how the rapid expansion of the Internet has precipitated an increase in its use by the general population to search for medical information. Most studies on e-health use investigated either through the prevalence of such use and the social and income patterns of users in selected populations, or the psychological consequences and satisfaction experienced by patients with particular diseases. Few studies have been carried out in Europe that have tried to identify the behavioral consequences of Internet use for health-related purposes in the general population.The aims of this study are to provide information about the prevalence of Internet use for health-related purposes in Italy according to demographic and socio-cultural features, to investigate the impact of the information found on health-related behaviors and choices and to analyze any differences based on health condition, self-rated health and relationships with health professionals and facilities. A multicenter survey was designed within six representative Italian cities. Data were collected through a validated questionnaire administered in hospital laboratories by physicians. Respondents were questioned about their generic condition, their use of the Internet and their health behaviors and choices related to Internet use. Data were analyzed using descriptive statistics and logistic regression to assess any differences by socio-demographic and health-related variables. The sample included 3018 individuals between the ages of 18 and 65 years. Approximately 65% of respondents reported using the Internet, and 57% of them reported using it to search for health-related information. The main reasons for search on the Internet were faster access and a greater amount of information. People using the Internet more for health-related purposes were younger, female and affected by chronic diseases. A large number of Internet users search for health information and

  8. Surfing the internet for health information: an italian survey on use and population choices

    Directory of Open Access Journals (Sweden)

    Manzoli Lamberto

    2011-04-01

    Full Text Available Abstract Background Recent international sources have described how the rapid expansion of the Internet has precipitated an increase in its use by the general population to search for medical information. Most studies on e-health use investigated either through the prevalence of such use and the social and income patterns of users in selected populations, or the psychological consequences and satisfaction experienced by patients with particular diseases. Few studies have been carried out in Europe that have tried to identify the behavioral consequences of Internet use for health-related purposes in the general population. The aims of this study are to provide information about the prevalence of Internet use for health-related purposes in Italy according to demographic and socio-cultural features, to investigate the impact of the information found on health-related behaviors and choices and to analyze any differences based on health condition, self-rated health and relationships with health professionals and facilities. Methods A multicenter survey was designed within six representative Italian cities. Data were collected through a validated questionnaire administered in hospital laboratories by physicians. Respondents were questioned about their generic condition, their use of the Internet and their health behaviors and choices related to Internet use. Data were analyzed using descriptive statistics and logistic regression to assess any differences by socio-demographic and health-related variables. Results The sample included 3018 individuals between the ages of 18 and 65 years. Approximately 65% of respondents reported using the Internet, and 57% of them reported using it to search for health-related information. The main reasons for search on the Internet were faster access and a greater amount of information. People using the Internet more for health-related purposes were younger, female and affected by chronic diseases. Conclusions A large

  9. Health-seeking behavior and hospital choice in China's New Cooperative Medical System.

    Science.gov (United States)

    Brown, Philip H; Theoharides, Caroline

    2009-07-01

    Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice.

  10. Seamless personal health information system in cloud computing.

    Science.gov (United States)

    Chung, Wan-Young; Fong, Ee May

    2014-01-01

    Noncontact ECG measurement has gained popularity these days due to its noninvasive and conveniences to be applied on daily life. This approach does not require any direct contact between patient's skin and sensor for physiological signal measurement. The noncontact ECG measurement is integrated with mobile healthcare system for health status monitoring. Mobile phone acts as the personal health information system displaying health status and body mass index (BMI) tracking. Besides that, it plays an important role being the medical guidance providing medical knowledge database including symptom checker and health fitness guidance. At the same time, the system also features some unique medical functions that cater to the living demand of the patients or users, including regular medication reminders, alert alarm, medical guidance, appointment scheduling. Lastly, we demonstrate mobile healthcare system with web application for extended uses, thus health data are clouded into web server system and web database storage. This allows remote health status monitoring easily and so forth it promotes a cost effective personal healthcare system.

  11. Accessibility to health services by persons with disabilities.

    Science.gov (United States)

    Castro, Shamyr Sulyvan; Lefèvre, Fernando; Lefèvre, Ana Maria Cavalcanti; Cesar, Chester Luiz Galvão

    2011-02-01

    To analyze the difficulties in accessibility to health services experienced by persons with disabilities. A qualitative study was performed with individuals who reported having a certain type of disability (paralysis or amputation of limbs; low vision, unilateral or total blindness; low hearing, unilateral or total deafness). A total of 25 individuals (14 women) were interviewed in the city of São Paulo, Southeastern Brazil, between June and August 2007, responding to questions about transportation and accessibility to health services. Collective Subject Discourse was the methodology used to analyze results and analyses were performed with the Qualiquantisoft software. The analysis of discourses on transportation to health services revealed a diversity in terms of the user going to the service alone or accompanied; using a private car, public transportation or ambulance or walking; and requiring different times to arrive at the service. With regard to the difficulties in accessibility to health services, there were reports of delayed service, problems with parking, and lack of ramps, elevators, wheelchairs, doctors and adapted toilets. Individuals with a certain type of disability used various means of transportation, requiring someone to accompany them in some cases. Problems with accessibility to health services were reported by persons with disabilities, contradicting the principle of equity, a precept of the Brazilian Unified Health System.

  12. Nutrition labelling and the choices logo in Israel: positions and perceptions of leading health policy makers.

    Science.gov (United States)

    Gesser-Edelsburg, A; Endevelt, R; Tirosh-Kamienchick, Y

    2014-02-01

    Based on the Social Marketing approach and Diffusion of Innovations Theory that indicates the importance of opinion leaders with respect to the spreading of new ideas, concepts or practices within a community, the present study aimed to examine positions and perceptions of Israeli leading dietitians and health officials regarding nutrition labelling and the Choices logo, before it was launched in Israel in February 2011, as well as how they would communicate it to the public as agents of influence. The study involved in-depth face-to-face and telephone interviews with 15 senior dietitians and Health Ministry officials using semi-structured protocols including questions about nutrition labelling and the Choices logo. The respondents considered that the nutrition facts panels usually found on the backs of packages are too complicated for the average consumer. Simiularly, fronts of packages are cluttered with advertisements and health claims, causing confusion. The study participants would like to see an integrative label on the front of the package to facilitate consumers' decisions. However, the Choices logo raises ethical and social questions about the conflict between corporate interests and public health: (i) the label's relativity versus objectivity; (ii) the consumer's responsibility to create a balanced diet; (iii) the label's credibility; and (iv) bias against companies, products and audiences. The results of the present study highlight the importance of a need for an integrated programme of nutrition promotion, including the use of social marketing based on a cooperative effort between the food industry, regulators and professionals, to recommend changes and adjustments in nutritional front of package labelling with the aim of promoting healthier nutrition consumption. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  13. Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable.

    Science.gov (United States)

    David, Sean P; Johnson, Samuel G; Berger, Adam C; Feero, W Gregory; Terry, Sharon F; Green, Larry A; Phillips, Robert L; Ginsburg, Geoffrey S

    2015-01-01

    Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system. © 2015 Annals of Family Medicine, Inc.

  14. Career in mental health still an unlikely career choice for nursing graduates: a replicated longitudinal study.

    Science.gov (United States)

    Stevens, John; Browne, Graeme; Graham, Iain

    2013-06-01

    The lack of qualified mental health nurses is at critical level with the problem likely to worsen as the aging mental health nursing workforce retires. This study investigates the career preferences of undergraduate nursing students by comparing preferences at the start, middle, and end of the Bachelor of Nursing program. The comparison of the cohorts gave an indication of the change in preferences over the intervening years. It replicates research completed in 1992, 1997, and 2001, and develops a profile of nursing career preferences and the rationale underpinning those preferences in a cohort of students (n = 150) who began their Bachelor of Nursing studies in 2007 and completed in 2009. The main findings included that, like the previous studies, mental health nursing is one of the least desirable career choices for most nurses at the start of their course and remains so as they approach graduation. The reasons change but the outcome remains the same. The current system of using the Bachelor of Nursing award to produce mental health nurses in Australia does not encourage nurses to consider a career in mental health nursing. Which begs the question: where will mental health nurses in the future come from? © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  15. Addressing health workforce distribution concerns: a discrete choice experiment to develop rural retention strategies in Cameroon.

    Science.gov (United States)

    Robyn, Paul Jacob; Shroff, Zubin; Zang, Omer Ramses; Kingue, Samuel; Djienouassi, Sebastien; Kouontchou, Christian; Sorgho, Gaston

    2015-03-01

    Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH) is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE) was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, Pimpact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on the analysis of locally relevant, actionable incentives, generated through the involvement of policy-makers at the design stage, this study provides an example of research directly linked to policy action to address a vitally important issue in global health.

  16. A Data Transmission Technique for Personal Health Systems

    Directory of Open Access Journals (Sweden)

    Jih-Fu Tu

    2013-01-01

    Full Text Available We used the modular technique to design a personal health data transmitter (PHDT that is composed of the following components: (1 the core is an embedded signal chip, (2 three kinds of transmutation modules such as USB, RF, and UART, (3 an I2C interface is used to acquire the users data, and (4 through Internet it links to the cloud server to store the personal-health data. By the experiment, we find that the modular manner is feasible, stable of functional, integral, and accurate, while it is exploited to design the PHDT. For the experiment, we present each module algorithm to find that our system is very helpful to people.

  17. A review of physical and mental health in homeless persons.

    Science.gov (United States)

    Martens, W H

    2001-01-01

    To review the physical and mental status in homeless people. A MEDLINE database search covering 5 decades was supplemented by tracing back through references from existing review work. Over 200 articles were extracted, and 106 were selected for review. Homeless persons suffer frequently from physical health problems like tuberculosis, asthma, bronchitis, HIV infection, and as a consequence, they run an increased risk for premature mortality. The prevalence of mental disorders among homeless individuals varies from 80-95% in the USA, Australia, Canada, Norway, and Germany to 25-33% in Ireland and Spain. The most prominent mental disorders among the homeless, which vary from country to country, are depression, affective disorders, substance abuse, psychotic disorders, schizophrenia, and personality disorders. Homelessness is a major public health problem that should have our special interest.

  18. Patients' preferences for primary health care - a systematic literature review of discrete choice experiments.

    Science.gov (United States)

    Kleij, Kim-Sarah; Tangermann, Ulla; Amelung, Volker E; Krauth, Christian

    2017-07-11

    Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research

  19. Colombian drugs policy. The dose for personal and health rights

    Directory of Open Access Journals (Sweden)

    Juan Camilo Fischer Rodríguez

    2013-07-01

    Full Text Available This article is a review of Colombian law on drugs, with special emphasis on the so-called dose for personal and health rights that relate to the use of legal or illegal drugs. A brief contextualization of international treaties on drugs is presented, as well as presenting some cases representing the current debate on trade control measures and use of illegal drugs. The article argues that in the international and Colombian debate there are no homogeneous positions, and the repressive policies towards illegal drug use coexist with approaches from the public health that point to the recognition of the rights of people who use legal or illegal substances.

  20. Are Health State Valuations from the General Public Biased? A Test of Health State Reference Dependency Using Self-assessed Health and an Efficient Discrete Choice Experiment.

    Science.gov (United States)

    Jonker, Marcel F; Attema, Arthur E; Donkers, Bas; Stolk, Elly A; Versteegh, Matthijs M

    2017-12-01

    Health state valuations of patients and non-patients are not the same, whereas health state values obtained from general population samples are a weighted average of both. The latter constitutes an often-overlooked source of bias. This study investigates the resulting bias and tests for the impact of reference dependency on health state valuations using an efficient discrete choice experiment administered to a Dutch nationally representative sample of 788 respondents. A Bayesian discrete choice experiment design consisting of eight sets of 24 (matched pairwise) choice tasks was developed, with each set providing full identification of the included parameters. Mixed logit models were used to estimate health state preferences with respondents' own health included as an additional predictor. Our results indicate that respondents with impaired health worse than or equal to the health state levels under evaluation have approximately 30% smaller health state decrements. This confirms that reference dependency can be observed in general population samples and affirms the relevance of prospect theory in health state valuations. At the same time, the limited number of respondents with severe health impairments does not appear to bias social tariffs as obtained from general population samples. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Health behaviors and personality in burnout: a third dimension

    Directory of Open Access Journals (Sweden)

    Osama M. Mustafa

    2015-09-01

    Full Text Available The high prevalence of burnout among healthcare professionals warrants a thorough examination aimed at improving the current understanding of its predictors and preventive measures. Cecil et al. have underscored the alarming prevalence of burnout among medical students and assessed its association with demographic, lifestyle, and behavioral factors. Of interest, health behaviors were found to be predictive of burnout. The study suggests certain behaviors (such as high physical activity to be protective, and thus, calls for their establishment early in college life to prevent the development of this professionally-disabling mental state. Although the adoption of advisable health behaviors may independently reduce the risk of burnout, recognition of the existence and influence of closely related factors allows for an enhanced understanding and a greater precision for any conclusions to be made. Personality, through deductive and inductive reasoning, is likely to exert significant influence on both the student's behavior and his/her susceptibility to burnout. Thus, with personality representing – in and of itself – a principal model for prediction of burnout risk, controlling for personality traits when addressing health behaviors’ influence per se on burnout is essential.

  2. [Personalized medicine, privatized medicine? legal and public health stakes].

    Science.gov (United States)

    Rial-Sebbag, Emmanuelle

    2014-11-01

    Personalized medicine is booming. It tends to provide a medical management "tailored" for groups of patients, or for one unique patient, but also to identify risk groups to develop public health strategies. In this context, some radicalization phenomenon can emerge, leading to not only personalized medicine but also privatized medicine, which can lead to a capture of the medical public resource. If the "privatization" of medicine is not limited to producing adverse effects, several potentially destabilizing phenomena for patients still remain. First, some objective factors, like the adjustment of scientific prerequisites, are emerging from personalized medicine practices (clinical trial, public health policy) and are interfering with the medical doctor/patient relationship. Another risk emerges for patients concomitantly to their demand for controlling their own health, in terms of patients' security although these risks are not clearly identified and not effectively communicated. These practices, related to a privatized medicine, develop within the healthcare system but also outside, and the government and legislators will have to take into account these new dimensions in drafting their future regulations and policies. © 2014 médecine/sciences – Inserm.

  3. Commercial products that convey personal health information in emergencies.

    Science.gov (United States)

    Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

    2011-12-01

    Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

  4. Assessing the privacy policies in mobile personal health records.

    Science.gov (United States)

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs.

  5. [Health economic consequences of the choice of follicle stimulating hormone alternatives in IVF treatment].

    Science.gov (United States)

    Poulsen, Peter Bo; Højgaard, Astrid; Quartarolo, Jens Piero

    2007-04-02

    There is a choice between two types of hormones for stimulation of the follicles in IVF treatment - recombinant FSH and the urine-derived menotrophin. A literature review by NICE (2004) in the United Kingdom documented that the two types of hormones were equally effective and safe, which is why it was recommended to use the cheaper urine-derived hormone. Based on the EISG study (European and Israeli Study Group), the aim was to analyse the health economic consequences of the choice between the two types of hormone in IVF treatment in Denmark. In a prospective cost-effectiveness analysis (health care sector perspective), menotrophin and recombinant FSH (Gonal-F) were compared. Differences in costs were compared with differences in effects of the two alternatives. The total costs for the average patient are lower when using menotrophin compared with recombinant FSH. Furthermore, the cost per clinical pregnancy was lower with menotrophin compared with recombinant FSH hormone. Menotrophin is therefore less expensive both for the patient as well as for the health care sector. The use of menotrophin instead of recombinant FSH can result in savings of up to DKK 16 million on the drug budget--savings that could finance 1,400 additional IVF cycles. The analysis shows that urine-derived menotrophin is a cost-effective alternative to recombinant FSH with a potential for considerable savings for patients as well as the public drug budget.

  6. Tough luck and tough choices: applying luck egalitarianism to oral health.

    Science.gov (United States)

    Albertsen, Andreas

    2015-06-01

    Luck egalitarianism is often taken to task for its alleged harsh implications. For example, it may seem to imply a policy of nonassistance toward uninsured reckless drivers who suffer injuries. Luck egalitarians respond to such objections partly by pointing to a number of factors pertaining to the cases being debated, which suggests that their stance is less inattentive to the plight of the victims than it might seem at first. However, the strategy leaves some cases in which the attribution of individual responsibility is appropriate (and so, it seems, is asking people to pick up the tab for their choices). One such case is oral health or significant aspects of this. It is appropriate, the paper argues, to hold people responsible for a number of factors that affect their oral health. A luck egalitarian approach inspired by John Roemer can assess whether people have acted responsibly by comparing their choices to those of their peers. A luck egalitarian approach to oral health would recommend prioritizing scarce resources in a responsibility-weighted queuing system and include copayment and general taxation among its measures of financing. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Governing Health Care through Free Choice: Neoliberal Reforms in Denmark and the United States.

    Science.gov (United States)

    Larsen, Lars Thorup; Stone, Deborah

    2015-10-01

    We compare free choice reforms in Denmark and the United States to understand what ideas and political forces could generate such similar policy reforms in radically different political contexts. We analyze the two cases using our own interpretation of neoliberalism as having "two faces." The first face seeks to expand private markets and shrink the public sector; the second face seeks to strengthen the public sector's capacity to govern through incentives and competition. First, we show why these two most-different cases offer a useful comparison to understand similar policy tools. Second, we develop our theoretical framework of the two faces of neoliberalism. Third, we examine Denmark's introduction of a free choice of hospitals in 2002, a policy that for the first time allowed some patients to receive care either in a public hospital outside their local area or in a private hospital. Fourth, we examine the introduction of free choice among private managed care plans into the US Medicare program in 1997. We show how policy makers in both countries used neoliberal reform as a mechanism to make their public health care sectors governable. Fifth, on the basis of our analysis, we draw five lessons about neoliberal policy reforms. Copyright © 2015 by Duke University Press.

  8. Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

    Science.gov (United States)

    Eklund, Mona; Markström, Urban

    2015-11-01

    A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned.

  9. A model of the impact of reimbursement schemes on health plan choice.

    Science.gov (United States)

    Keeler, E B; Carter, G; Newhouse, J P

    1998-06-01

    Flat capitation (uniform prospective payments) makes enrolling healthy enrollees profitable to health plans. Plans with relatively generous benefits may attract the sick and fail through a premium spiral. We simulate a model of idealized managed competition to explore the effect on market performance of alternatives to flat capitation such as severity-adjusted capitation and reduced supply-side cost-sharing. In our model flat capitation causes severe market problems. Severity adjustment and to a lesser extent reduced supply-side cost-sharing improve market performance, but outcomes are efficient only in cases in which people bear the marginal costs of their choices.

  10. Quality choice in a health care market: a mixed duopoly approach.

    Science.gov (United States)

    Sanjo, Yasuo

    2009-05-01

    We investigate a health care market with uncertainty in a mixed duopoly, where a partially privatized public hospital competes against a private hospital in terms of quality choice. We use a simple Hotelling-type spatial competition model by incorporating mean-variance analysis and the framework of partial privatization. We show how the variance in the quality perceived by patients affects the true quality of medical care provided by hospitals. In addition, we show that a case exists in which the quality of the partially privatized hospital becomes higher than that of the private hospital when the patient's preference for quality is relatively high.

  11. Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

    Science.gov (United States)

    Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

    2015-06-01

    The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published

  12. Ambivalent helpers and unhealthy choices: public health practitioners' narratives of Indigenous ill-health.

    Science.gov (United States)

    Kowal, Emma; Paradies, Yin

    2005-03-01

    Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of 'fourth-world' health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia. A thematic analysis of the workshop minutes provided insight into public health practitioners' narratives of Indigenous ill-health. The major themes that emerged included tension between structure and agency and between sameness and difference, and ambivalence surrounding the 'helper' identity of public health practitioners. We suggest that these narratives can be understood as attempts to maintain the moral integrity of both Indigenous people and practitioners. This task is necessitated by the specter of cultural relativism intrinsic to contemporary liberal discourses of multiculturalism that attempt to reconcile the universal rights of the citizen with the special rights of minority groups. We argue that the concepts of self-determination and neocolonialism mark the spaces where universal and particular discourses overlap and clash. Practitioners who seek to escape neocolonialism must inhabit only the discursive space of public health congruent with self-determination, leaving them in a bind common to many postcolonial situations. They must relieve the ill-health of indigenous people without acting upon them; change them without declaring that change is required.

  13. Do nurses' personal health behaviours impact on their health promotion practice? A systematic review.

    Science.gov (United States)

    Kelly, Muireann; Wills, Jane; Sykes, Susie

    2017-11-01

    There is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses' personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services. An integrated systematic review was conducted to determine if nurses' personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted. 31 studies were included in the review. No consistent associations were noted between nurses' weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours. Although it is assumed that nurses' personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence. Copyright

  14. Transfer of information from personal health records: a survey of veterans using My HealtheVet.

    Science.gov (United States)

    Turvey, Carolyn L; Zulman, Donna M; Nazi, Kim M; Wakefield, Bonnie J; Woods, Susan S; Hogan, Timothy P; Weaver, Frances M; McInnes, Keith

    2012-03-01

    Personal health records provide patients with ownership of their health information and allow them to share information with multiple healthcare providers. However, the usefulness of these records relies on patients understanding and using their records appropriately. My HealtheVet is a Web-based patient portal containing a personal health record administered by the Veterans Health Administration. The goal of this study was to explore veterans' interest and use of My HealtheVet to transfer and share information as well as to identify opportunities to increase veteran use of the My HealtheVet functions. Two waves of data were collected in 2010 through an American Customer Satisfaction Index Web-based survey. A random sample of veterans using My HealtheVet was invited to participate in the survey conducted on the My HealtheVet portal through a Web-based pop-up browser window. Wave One results (n=25,898) found that 41% of veterans reported printing information, 21% reported saving information electronically, and only 4% ever sent information from My HealtheVet to another person. In Wave Two (n=18,471), 30% reported self-entering medication information, with 18% sharing this information with their Veterans Affairs (VA) provider and 9.6% sharing with their non-VA provider. Although veterans are transferring important medical information from their personal health records, increased education and awareness are needed to increase use. Personal health records have the potential to improve continuity of care. However, more research is needed on both the barriers to adoption as well as the actual impact on patient health outcomes and well-being.

  15. Improving behavioral realism in hybrid energy-economy models using discrete choice studies of personal transportation decisions

    International Nuclear Information System (INIS)

    Horne, M.; Jaccard, M.; Tiedemann, K.

    2005-01-01

    Hybrid energy-economy models combine top-down and bottom-up approaches to explore behaviorally realistic responses to technology-focused policies. This research uses empirically derived discrete choice models to inform key behavioral parameters in CIMS, a hybrid model. The discrete choice models are estimated for vehicle and commuting decisions from a survey of 1150 Canadians. With the choice models integrated into CIMS, we simulate carbon taxes, gasoline vehicle disincentives, and single occupancy vehicle disincentives to show how different policy levers can motivate technological change. We also use the empirical basis for the choice models to portray uncertainty in technological change, costs, and emissions. (author)

  16. Designing smart analytical data services for a personal health framework.

    Science.gov (United States)

    Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas

    2016-01-01

    Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.

  17. Lifelong pathways to longevity: personality, relationships, flourishing, and health.

    Science.gov (United States)

    Kern, Margaret L; Della Porta, Serenity S; Friedman, Howard S

    2014-12-01

    Building upon decades of research with the lifelong (nine-decade) Terman Life Cycle Study, we present a life pathway model for understanding human thriving that accounts for long-term individual difference in health and longevity, with a particular focus on child personality and adult social relationships. Developing data derived and supplemented from the Terman study (N = 570 males, 451 females), we employed regression and survival analyses to test models of childhood personality predicting adult psychosocial factors (subjective well-being, family relationships, community involvement, subjective achievement, hardships) and subsequent longevity. Child personality differentially related to midlife social relationships, well-being, and hardships. Conscientiousness and good social relationships predicted longer life, whereas subjective well-being was unrelated to mortality risk. Examining multiple life factors across long time periods uncovers important pathways through which personality relates to premature mortality or longevity. Typical stress-and-illness models are untenable and should be replaced with life span trajectory approaches. © 2013 Wiley Periodicals, Inc.

  18. Understanding how transport choices are affected by the environment and health: views expressed in a study on the use of carbon calculators.

    Science.gov (United States)

    Chatterton, T J; Coulter, A; Musselwhite, C; Lyons, G; Clegg, S

    2009-01-01

    To examine the influence that the provision of environmental information might be able to make on personal travel behaviour through analysis of the views of members of the public expressed in a study for the UK Department for Transport on attitudes towards carbon calculator tools. A three-stage qualitative survey taking an ideographic approach to analysing public attitudes to the use of carbon calculator tools in relation to making transport decisions. Interviews and discussion groups with stakeholders, non-users and users providing extensive data that were analysed using the British Market Research Bureau's matrix mapping methodology. Despite considerable awareness of climate change as an issue, personal carbon emissions were not found to have much influence on personal transport choice, which could be seen as being dominated by issues of cost (both in time and money), comfort and convenience. The spatial and temporal dislocation of the cause and effects of climate change make it difficult to link the impacts of personal travel behaviour with specific activities. If environmental- and health-based information is to be provided as a lever to change travel behaviour, it may be necessary to provide information on issues such as local air pollution and personal health impacts in order to link wider benefits with a travel user's self-interest.

  19. Marital Conflict in Older Couples: Positivity, Personality, and Health

    Science.gov (United States)

    Iveniuk, James; Waite, Linda J.; McClintock, Martha K.; Teidt, Andrew D.

    2016-01-01

    We examine the implications of health and personality characteristics for late-life marital conflict, using data from the 2010–11 wave of the National Social Life Health and Aging Project (NSHAP), a nationally representative study with data on both partners in 955 marital and cohabitational dyads. Using these data, we relate characteristics of husbands to characteristics of their wives, and vice versa. Wives with husbands in fair or poor physical health are more likely to report high levels of marital conflict, but the reverse is not true. Similarly, wives report more conflict when their husbands are high on Neuroticism, high on Extraversion, and low on a new measure we call Positivity. Our findings point to noteworthy gender differences between men and women in the associations between individual characteristics and levels of marital conflict. We point to differences between husbands’ and wives’ marital roles as a contributor to these differences. PMID:27274569

  20. Ethnic differences in choices of health information by cancer patients using complementary and alternative medicine: an exploratory study with correspondence analysis.

    Science.gov (United States)

    Kakai, Hisako; Maskarinec, Gertraud; Shumay, Dianne M; Tatsumura, Yvonne; Tasaki, Katsuya

    2003-02-01

    This study examined patterns in the use of health information among Caucasian, Japanese, and non-Japanese Asian Pacific Islander cancer patients in Hawaii and explored the relation of ethnicity and educational level to choices of health information sources. Information from 140 cancer patients, most of whom were users of complementary and alternative medicine (CAM), was analyzed using correspondence analysis. Three clusters of health information pertinent to the three ethnic groups emerged from the data. The results of this study revealed that Caucasian patients preferred objective, scientific, and updated information obtained through medical journals or newsletters from research institutions, telephone information services, and the internet. Japanese patients relied on media and commercial sources including television, newspapers, books, magazines and CAM providers. Non-Japanese Asians and Pacific Islanders used information sources involving person-to-person communication with their physicians, social groups, and other cancer patients. A higher educational level was closely related to a cluster of health information stressing objective, scientific and updated information, while a lower educational level was associated with interpersonally communicated information. The three ethnicity-specific patterns of health information use remained relatively stable at different educational levels, implying that the effect of patients' ethnicity overrides their educational level in shaping their choices of health information. The results of this study indicate the importance of recognizing cancer patients' culturally developed world views when understanding their health information-seeking behavior. For medical practice, these findings indicate the need for healthcare providers to assist cancer patients to obtain accurate health information in a culturally sensitive way.

  1. The Effect of Publicized Quality Information on Home Health Agency Choice.

    Science.gov (United States)

    Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

    2016-12-01

    We examine consumers' use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers' use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers' use of public reports. © The Author(s) 2015.

  2. Consumer Preferences for Health and Nonhealth Outcomes of Health Promotion: Results from a Discrete Choice Experiment

    NARCIS (Netherlands)

    Alayli-Goebbels, A.F.G.; Dellaert, B.G.C.; Knox, S.A.; Ament, A.J.H.A.; Lakerveld, J.; Bot, S.D.M.; Nijpels, G.; Severens, J.L.

    2013-01-01

    Objective: Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their

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

    Science.gov (United States)

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

  4. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    Science.gov (United States)

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2016-01-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

  5. Choosing health: qualitative evidence from the experiences of personal health budget holders.

    Science.gov (United States)

    Davidson, Jacqueline; Baxter, Kate; Glendinning, Caroline; Irvine, Annie

    2013-10-01

    Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. Over 2000 people from 20 pilot sites were recruited to a multi-method evaluation of the personal health budget pilots. A sub-sample of 58 people was selected for qualitative interviews three months after the offer of a budget; 52 were re-interviewed six months later. The purposively selected sample reflected a range of health conditions, locality, age and gender. Personal health budgets were reported to have positive impacts on health, health care and relatives/family. Benefits often extended beyond the condition for which the budget had been awarded. However, interviewees rarely knew the level of their budget; some reported difficulty in agreeing acceptable uses for their budget; and delays could occur in procuring chosen services or equipment. Patients' experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.

  6. Personal Reflection: Reflections on a Family Health History Assignment for Undergraduate Public Health and Nursing Students

    Science.gov (United States)

    Rooks, Ronica N.; Ford, Cassandra

    2013-01-01

    This personal reflection describes our experiences with incorporating the scholarship of teaching and learning and problem-based techniques to facilitate undergraduate student learning and their professional development in the health sciences. We created a family health history assignment to discuss key concepts in our courses, such as health…

  7. Unravelling radiation response: from public health to personalized radiotherapy

    International Nuclear Information System (INIS)

    Manna, Soumen Kanti

    2017-01-01

    Understanding the mechanism underlying response to ionizing radiation exposure is at the heart of radiation biology and its applications. This presentation will showcase how the mass spectrometry-based global profiling helped to identify not only potential age-independent biomarkers of ionizing radiation exposure in mice but also a hitherto unexplored link between DNA repair and polyamine metabolism at an organismal level. It will then provide a glimpse of how a combination of metabolomics and molecular biological tools combined to elucidate the metabolic reprogramming underlying therapeutic resistance of cancer cells. It will then elaborate how an integrated -omics approach could be adopted to understand the heterogeneity in the effects ionizing radiation in the context of development and health. Finally, it will present a framework on how clinicians, epidemiologists and basic researchers can come together to usher in a new era of personalized radiation therapy as well as to develop a paradigm of personalized counter measures against radiation exposure. (author)

  8. Societal Preferences for Funding Orphan Drugs in the United Kingdom: An Application of Person Trade-Off and Discrete Choice Experiment Methods.

    Science.gov (United States)

    Bourke, Siobhan M; Plumpton, Catrin O; Hughes, Dyfrig A

    2018-05-01

    It is unclear whether UK National Health Service (NHS) policies for orphan drugs, which permit funding of non-cost-effective treatments, reflect societal preferences. We conducted person trade-off (PTO) and discrete choice experiment (DCE) among 3950 adults selected to be representative of the UK general population. Experimental design was informed by surveys of patients affected by rare diseases, their caregivers, health care staff, and policymakers. Societal preferences were estimated in relation to treating a common disease, increases in waiting lists, or filling of vacant NHS posts. Results of the DCE were applied to recently licensed orphan drugs. On the basis of equal cost, the majority of respondents to the PTO (54%; 95% confidence interval [CI] 50-59) chose to allocate funds equally between patients treated for rare diseases and those treated for common diseases, with 32% (95% CI 28-36) favoring treating rare diseases over treating common diseases (14%; 95% CI 11-17), which this reduced to 23% (95% CI 20-27) when rare disease treatments were 10 times more expensive. When framed differently, more respondents prioritized not increasing waiting list size (43%; 95% CI 39-48) than to treat rare disease patients (34%; 95% CI 30-38). The DCE indicated a greater preference for treating a common disease over a rare disease. Respondents agreed with five of 12 positive appraisal recommendations for orphan drugs, even if their list price was higher, but preferred the NHS not to fund the remainder. The general public does not value rarity as a sufficient reason to justify special consideration for additional NHS funding of orphan drugs. This has implications regarding the appropriateness of operating higher thresholds of cost-effectiveness. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment

    Science.gov (United States)

    Fowles, Jinnet Briggs; Kind, Elizabeth A; Braun, Barbara L; Bertko, John

    2004-01-01

    Objective To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees. Data Sources/Study Setting A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001. Study Design The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences. Data Collection Methods A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents. Principal Findings The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits

  10. [How do the obese persons perceive their overall health?].

    Science.gov (United States)

    Ríos-Martínez, Blanca P; Rangel-Rodríguez, Gabriela; Pedraza-Moctezuma, Luis G

    2013-01-01

    the purpose was to investigate how the obese person perceives their health in different areas of their life. the SF-36 instrument, which measures various dimensions (social and physical functioning, mental and physical health, bodily pain, limitations due to physical and/or emotional problems, vitality and general health), was applied to 224 patients. It was analyzed whether there were differences between gender, which were channeled to the treatment (surgical and nonsurgical) and the degree of obesity (overweight, obesity and morbid obesity). A descriptive analysis, Student t test, Anova and Tukey t test were used. significant differences (p < 0.05) were found in some dimensions, like tendency to feel tired, exhausted and feeling that their health has been and will continue to deterioration. Women had a worse social and emotional functioning than men; patients with gastric bypass reported more fatigue than patients with gastric band; in regards to the degree of obesity, those who had morbid obesity showed less physical functioning, more pain and worse overall health than those who were just obese. the perception of the obese patients was that their health had deteriorated. Women were more affected in social and emotional functioning than men.

  11. Are personal health records safe? A review of free web-accessible personal health record privacy policies.

    Science.gov (United States)

    Carrión Señor, Inmaculada; Fernández-Alemán, José Luis; Toval, Ambrosio

    2012-08-23

    Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users' concerns regarding the privacy and security of their personal health information. To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users' accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low.

  12. Market implications of new regulations: impact of health and nutrition information on consumer choice

    Energy Technology Data Exchange (ETDEWEB)

    Barreiro-Hurle, J.; Gracia, A.; Magistris, T. de

    2009-07-01

    Consumer concern for health impacts of diet has increased the use of nutritional information and claims by agro-food industry. Under the current European legislation on nutrition and health claims and on nutritional labelling, three type of nutritional information can be provided on food products: nutritional facts panel, nutritional claims and health claims. In this context, the aim of the paper is to assess how much consumers value the provision of three types of nutritional information in a meat product not precisely perceived as healthy, pork Frankfurt sausages, using a choice experiment. The data comes from a survey conducted in two Spanish medium size towns (Zaragoza and Cordoba) during 2007. A mixed logit model is used to estimate the effect of the nutrition information attributes on consumers utility and derive their willingness to pay. Results show that all three nutritional and health information items are valued by consumers, although preferences are heterogeneous. Health claims are significantly higher valued than nutritional attributes (facts panel or claim). Estimated market shares show that the use of any of the available labelling options will obtain significant market success even at prices including premiums above current price levels. (Author)

  13. An Australian discrete choice experiment to value eq-5d health states.

    Science.gov (United States)

    Viney, Rosalie; Norman, Richard; Brazier, John; Cronin, Paula; King, Madeleine T; Ratcliffe, Julie; Street, Deborah

    2014-06-01

    Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n = 1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses. Copyright © 2013 John Wiley & Sons, Ltd.

  14. A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients.

    Science.gov (United States)

    Hoopes, Andrea J; Gilmore, Kelly; Cady, Janet; Akers, Aletha Y; Ahrens, Kym R

    2016-06-01

    Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies. Qualitative analysis of one-on-one interviews. Participants were recruited from 2 urban school-based, primary care centers. Thirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience. Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding. Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches. Participants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs. We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. Accelerating Research Impact in a Learning Health Care System: VA's Quality Enhancement Research Initiative in the Choice Act Era.

    Science.gov (United States)

    Kilbourne, Amy M; Elwy, A Rani; Sales, Anne E; Atkins, David

    2017-07-01

    Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice. With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA's transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act. QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations. QUERI's national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law's further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks. Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health.

  16. Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions

    Science.gov (United States)

    2013-01-01

    Background The idea that behaviour can be influenced at population level by altering the environments within which people make choices (choice architecture) has gained traction in policy circles. However, empirical evidence to support this idea is limited, especially its application to changing health behaviour. We propose an evidence-based definition and typology of choice architecture interventions that have been implemented within small-scale micro-environments and evaluated for their effects on four key sets of health behaviours: diet, physical activity, alcohol and tobacco use. Discussion We argue that the limitations of the evidence base are due not simply to an absence of evidence, but also to a prior lack of definitional and conceptual clarity concerning applications of choice architecture to public health intervention. This has hampered the potential for systematic assessment of existing evidence. By seeking to address this issue, we demonstrate how our definition and typology have enabled systematic identification and preliminary mapping of a large body of available evidence for the effects of choice architecture interventions. We discuss key implications for further primary research, evidence synthesis and conceptual development to support the design and evaluation of such interventions. Summary This conceptual groundwork provides a foundation for future research to investigate the effectiveness of choice architecture interventions within micro-environments for changing health behaviour. The approach we used may also serve as a template for mapping other under-explored fields of enquiry. PMID:24359583

  17. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    Science.gov (United States)

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  18. Leveraging delay discounting for health: Can time delays influence food choice?

    Science.gov (United States)

    Appelhans, Bradley M; French, Simone A; Olinger, Tamara; Bogucki, Michael; Janssen, Imke; Avery-Mamer, Elizabeth F; Powell, Lisa M

    2018-03-15

    Delay discounting, the tendency to choose smaller immediate rewards over larger delayed rewards, is theorized to promote consumption of immediately rewarding but unhealthy foods at the expense of long-term weight maintenance and nutritional health. An untested implication of delay discounting models of decision-making is that selectively delaying access to less healthy foods may promote selection of healthier (immediately available) alternatives, even if they may be less desirable. The current study tested this hypothesis by measuring healthy versus regular vending machine snack purchasing before and during the implementation of a 25-s time delay on the delivery of regular snacks. Purchasing was also examined under a $0.25 discount on healthy snacks, a $0.25 tax on regular snacks, and the combination of both pricing interventions with the 25-s time delay. Across 32,019 vending sales from three separate vending locations, the 25-s time delay increased healthy snack purchasing from 40.1% to 42.5%, which was comparable to the impact of a $0.25 discount (43.0%). Combining the delay and the discount had a roughly additive effect (46.0%). However, the strongest effects were seen under the $0.25 tax on regular snacks (53.7%) and the combination of the delay and the tax (50.2%). Intervention effects varied substantially between vending locations. Importantly, time delays did not harm overall vending sales or revenue, which is relevant to the real-world feasibility of this intervention. More investigation is needed to better understand how the impact of time delays on food choice varies across populations, evaluate the effects of time delays on beverage vending choices, and extend this approach to food choices in contexts other than vending machines. ClinicalTrials.gov, NCT02359916. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

    Science.gov (United States)

    2013-01-01

    Background Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. Methods The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Results Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Conclusions Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness. PMID:23800334

  20. [Mental health service utilization among borderline personality disorder patients inpatient].

    Science.gov (United States)

    Cailhol, L; Thalamas, C; Garrido, C; Birmes, P; Lapeyre-Mestre, M

    2015-04-01

    Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability and impulsivity. Several North American prospective studies support the high level of mental health care utilization in this population. There is little data in other systems of health organization, such as France. Furthermore, little is known on the variables associated with the mental health service utilization among BPD patients. The main objective was to compare the utilization of mental health care among BPD patients, to the general population and patients with another personality disorder (PD) and to describe the demographic and clinical factors associated with the group of patients who use the most health care. A multi-center (5 public and private centers), epidemiological study. Data were collected prospectively (database of an insurance fund covering 80% of the population) and viewed, retrospectively. We used the data collected during the five years previously to the inclusion. Inclusion criteria were age (18-60 years) and membership in the health insurance fund targeted. Patients on legal protection, forced hospitalization, with a chronic psychotic disorder, manic, mental retardation, or not reading French were excluded. First, four groups were composed: BPD, other PD, control groups for PD and other PD. The first two groups were recruited from a screening of inpatients including a self-administered questionnaire (Personality Disorder Questionnaire 4+). Assessment by a psychologist including the Structured Interview for DSM-IV Personality Disorders (SIDP-IV) was given straight to those who had a score above 28. This questionnaire allowed us to distinguish one group of subjects with BPD and a group with other PD (without BPD). Clinical evaluation included Axis I (MINI), Axis II (SIDP-IV), psychopathological features (YSQ-I, DSQ-40), demographic variables and therapeutic alliance (Haq-II). Matched controls (age, sex) composed the 3rd and 4th group (BPD control and

  1. Infrastructure for Personalized Medicine at Partners HealthCare

    Directory of Open Access Journals (Sweden)

    Scott T. Weiss

    2016-02-01

    Full Text Available Partners HealthCare Personalized Medicine (PPM is a center within the Partners HealthCare system (founded by Massachusetts General Hospital and Brigham and Women’s Hospital whose mission is to utilize genetics and genomics to improve the care of patients in a cost effective manner. PPM consists of five interconnected components: (1 Laboratory for Molecular Medicine (LMM, a CLIA laboratory performing genetic testing for patients world-wide; (2 Translational Genomics Core (TGC, a core laboratory providing genomic platforms for Partners investigators; (3 Partners Biobank, a biobank of samples (DNA, plasma and serum for 50,000 Consented Partners patients; (4 Biobank Portal, an IT infrastructure and viewer to bring together genotypes, samples, phenotypes (validated diagnoses, radiology, and clinical chemistry from the electronic medical record to Partners investigators. These components are united by (5 a common IT system that brings researchers, clinicians, and patients together for optimal research and patient care.

  2. The value of personal health record (PHR) systems.

    Science.gov (United States)

    Kaelber, David; Pan, Eric C

    2008-11-06

    Personal health records (PHRs) are a rapidly growing area of health information technology despite a lack of significant value-based assessment.Here we present an assessment of the potential value of PHR systems, looking at both costs and benefits.We examine provider-tethered, payer-tethered, and third-party PHRs, as well as idealized interoperable PHRs. An analytical model was developed that considered eight PHR application and infrastructure functions. Our analysis projects the initial and annual costs and annual benefits of PHRs to the entire US over the next 10 years.This PHR analysis shows that all forms of PHRs have initial net negative value. However, at the end of 10 years, steady state annual net value ranging from$13 billion to -$29 billion. Interoperable PHRs provide the most value, followed by third-party PHRs and payer-tethered PHRs also showing positive net value. Provider-tethered PHRs constantly demonstrating negative net value.

  3. Teaching Healthful Food Choices to Elementary School Students and Their Parents: The Nutrition Detectives[TM] Program

    Science.gov (United States)

    Katz, David L.; Katz, Catherine S.; Treu, Judith A.; Reynolds, Jesse; Njike, Valentine; Walker, Jennifer; Smith, Erica; Michael, Jennifer

    2011-01-01

    Background: The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Methods: Three schools were assigned to receive the Nutrition Detectives[TM] program and…

  4. Accounting for Attribute-Level Non-Attendance in a Health Choice Experiment: Does it Matter?

    Science.gov (United States)

    Erdem, Seda; Campbell, Danny; Hole, Arne Risa

    2015-07-01

    An extensive literature has established that it is common for respondents to ignore attributes of the alternatives within choice experiments. In most of the studies on attribute non-attendance, it is assumed that respondents consciously (or unconsciously) ignore one or more attributes of the alternatives, regardless of their levels. In this paper, we present a new line of enquiry and approach for modelling non-attendance in the context of investigating preferences for health service innovations. This approach recognises that non-attendance may not just be associated with attributes but may also apply to the attribute's levels. Our results show that respondents process each level of an attribute differently: while attending to the attribute, they ignore a subset of the attribute's levels. In such cases, the usual approach of assuming that respondents either attend to the attribute or not, irrespective of its levels, is erroneous and could lead to misguided policy recommendations. Our results indicate that allowing for attribute-level non-attendance leads to substantial improvements in the model fit and has an impact on estimated marginal willingness to pay and choice predictions. Copyright © 2014 John Wiley & Sons, Ltd.

  5. [Empowerment of children and adolescents--the role of personal and social resources and personal autonomy for subjective health].

    Science.gov (United States)

    Erhart, M; Wille, N; Ravens-Sieberer, U

    2008-12-01

    Scientific research on empowerment so far is nearly exclusively focused on the adult population. Nevertheless, it is possible to show a link between empowerment and a) the developmental psychology concepts of resilience, b) autogenetic concepts and c) concepts of risks and resources. This paper aims to study the role of personal, familial and other social resources as well as personal autonomy for subjective health-ratings. A secondary analysis of the health data of 7,000 children and adolescents aged 10-17 years of the German health behaviour in school-aged children (HBSC) study as well as 1,700 children aged 11-17 years of the mental health module (BELLA Study) within the German health interview and examination survey for children and adolescents (KiGGS) was performed. Statistical analyses encompassed analyses of variance and linear regression. Analyses of the HBSC study showed a protective effect for school-class climate as well as parental support, whereby school was associated with fewer self-reported health complaints. Analyses of the BELLA/KiGGS study showed personal, familial and other social resources as well as personal autonomy as unique predictors for a better health-related quality of life (KINDL-R). This was true even if psychological problems were observed. The results confirm the importance of strengthening personal, familial and other social resources as well as the principal importance of personal autonomy for coping with health risks and health impairments. Future research explicitly focussed on empowerment could relate to the role of personal resources within children's and adolescents' contact with the medical and health care system. It can be expected that strengthening personal resources benefits and improves the communication and active participation of children and adolescents within treatment-decision and -evaluation.

  6. Addressing Health Workforce Distribution Concerns: A Discrete Choice Experiment to Develop Rural Retention Strategies in Cameroon

    Directory of Open Access Journals (Sweden)

    Paul Jacob Robyn

    2015-03-01

    Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on

  7. Indivo: a personally controlled health record for health information exchange and communication

    Directory of Open Access Journals (Sweden)

    Crawford William CR

    2007-09-01

    Full Text Available Abstract Background Personally controlled health records (PCHRs, a subset of personal health records (PHRs, enable a patient to assemble, maintain and manage a secure copy of his or her medical data. Indivo (formerly PING is an open source, open standards PCHR with an open application programming interface (API. Results We describe how the PCHR platform can provide standard building blocks for networked PHR applications. Indivo allows the ready integration of diverse sources of medical data under a patient's control through the use of standards-based communication protocols and APIs for connecting PCHRs to existing and future health information systems. Conclusion The strict and transparent personal control model is designed to encourage widespread participation by patients, healthcare providers and institutions, thus creating the ecosystem for development of innovative, consumer-focused healthcare applications.

  8. Is borderline personality disorder only a mental health problem?

    Science.gov (United States)

    Cailhol, Lionel; Francois, Margot; Thalamas, Claire; Garrido, Cécile; Birmes, Philippe; Pourcel, Laure; Lapeyre-Mestre, Maryse; Paris, Joel

    2016-11-01

    Patients with borderline personality disorder (BPD) have been shown to have increased rates of the use of medical services. The objective of this multicentre study was to compare the utilization of physical health services by patients with severe BPD (n = 36) with that of two control groups: one with other personality disorders (PDs) (n = 38) and one with matched subjects randomly selected from the general population (n = 165). Information was drawn from an insurance database collected over a 5-year period. The results showed that the BPD group had a higher mean number of medication prescriptions (377.3 vs. 97.4, p groups with BPD and other PDs. The annual health-care cost for each BPD patient is estimated to be 12 761 euros, of which 17.6% is due to somatic care. In the BPD group, co-morbidity for narcissistic PD (NPD) contributed to the overall use of medications and hospitalization use. Combined with other data, this exploratory study shows that BPD is a medical burden and not just a psychiatric one. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Effect of Motives for Food Choice on Oral Health among Primary School Children in Mangalore: An Analytical Survey.

    Science.gov (United States)

    Mehta, Viral Vijay; Rajesh, Gururaghavendran; Rao, Ashwini; Shenoy, Ramya; Pai, Mithun; Nayak, Vijayendranath

    2017-05-01

    Parents influence children's eating behaviours by making some foods available than others and by acting as models of eating behaviour. Food selected by parents influence general and oral health of their children. Aim of this study was to assess oral health parameters among primary school children and motives for food choice among their parents in Mangalore. A total of 759 primary school children aged 5-10 years, and their parents participated in this study. Motives for food choice among parents of children were evaluated by using Food Choice Questionnaire (FCQ). Oral health status of students was assessed by using World Health Organisation (WHO) Basic Oral Health Assessment Form. Data pertaining to dietary habits and demographics was also collected. Descriptive and inferential statistics along with Pearson's correlation and Binary logistic regression were executed for the present study and level of significance was fixed at pfood choice motives positively influenced dietary patterns and caries experience of their children. Caries experience was less in children whose parents reported higher scores on FCQ. Understanding the barriers, identification of risk factors for poor food choices and targeting interventions might formulate ways by which the desired behaviour can be achieved.

  10. Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany.

    Science.gov (United States)

    Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R

    2017-12-01

    To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Allocating external financing for health: a discrete choice experiment of stakeholder preferences.

    Science.gov (United States)

    Grépin, Karen A; Pinkstaff, Crossley B; Hole, Arne Risa; Henderson, Klara; Norheim, Ole Frithjof; Røttingen, John-Arne; Ottersen, Trygve

    2018-02-01

    Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how much weight should be placed on other country characteristics. Using an online discrete choice experiment designed to elicit preferences over country characteristics to guide decisions about the allocation of external financing for health, we find that stakeholders assign a great deal of importance to health inequalities and the burden of disease but put very little weight on income per capita. We also find considerable variation in preferences across stakeholders, with people from low- and middle-income countries putting more weight on the burden of disease and people from high-income countries putting more weight on health inequalities. These findings suggest that stakeholders put more weight on burden of disease and health inequalities than on income per capita in evaluating which countries should received external financing for health and that that people living in aid recipient may have different preferences than people living in donor countries. Donors may wish to take these differences in preferences in mind if they are reconsidering their aid allocation policies. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Exploring the Role of In-Person Components for Online Health Behavior Change Interventions: Can a Digital Person-to-Person Component Suffice?

    Science.gov (United States)

    Santarossa, Sara; Kane, Deborah; Senn, Charlene Y; Woodruff, Sarah J

    2018-04-11

    The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored. ©Sara Santarossa, Deborah Kane, Charlene Y Senn, Sarah J Woodruff. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.04.2018.

  13. First-Year College Students Increase Food Label-Reading Behaviors and Improve Food Choices in a Personal Nutrition Seminar Course

    Science.gov (United States)

    Tallant, April

    2017-01-01

    Background: Poor dietary behaviors are risk factors for developing chronic diseases that plague public health. Purpose: This study sought to determine the differences in pre and post food label and food choice scores among first-year college students at the beginning and end of the semester. Case analyses were conducted to evaluate individualized…

  14. Mental Health in Rural Caregivers of Persons With Dementia

    Directory of Open Access Journals (Sweden)

    Alexandra J. Werntz

    2015-12-01

    Full Text Available Informal caregiving for dementia is common and often affects caregiver mental health. In addition to typical stressors faced by caregivers of persons with dementia (PWDs, rural caregivers often face additional stressors associated with living in more remote locations; unfortunately, this group is largely understudied. Ninety-three caregiver–PWD dyads completed measures of social support, perceived control, self-efficacy, burden, and cognitive functioning. Measures of PWD activities of daily living and mental functioning were also collected. These variables were hypothesized to predict caregiver self-reported symptoms of depression, anxiety, and stress. Contrary to predictions, only caregiving-related self-efficacy and caregiver burden predicted the caregiver’s mental health. Future interventions for improving rural caregiver self-reported mental health should target cognitions associated with caregiving self-efficacy and caregiver burden. Health care providers for rural families should focus on ways to reduce feelings of caregiver burden and provide caregivers with useful skills and tools for caregiving.

  15. Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment.

    Science.gov (United States)

    Becker, Mackenzie P E; Christensen, Bruce K; Cunningham, Charles E; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Bieling, Peter J; Madsen, Victoria; Chen, Yvonne Y S; Mielko, Stephanie; Zipursky, Robert B

    2016-02-01

    Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation. Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization. Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model. Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

  16. Factors associated with the choice of public health service among nursing students in Thailand.

    Science.gov (United States)

    Sawaengdee, Krisada; Pudpong, Nareerut; Wisaijohn, Thunthita; Suphanchaimat, Rapeepong; Putthasri, Weerasak; Lagarde, Mylene; Blaauw, Duane

    2017-01-01

    Despite the fact that public and private nursing schools have contributed significantly to the Thai health system, it is not clear whether and to what extent there was difference in job preferences between types of training institutions. This study aimed to examine attitudes towards rural practice, intention to work in public service after graduation, and factors affecting workplace selection among nursing students in both public and private institutions. A descriptive comparative cross-sectional survey was conducted among 3349 students from 36 nursing schools (26 public and 10 private) during February-March 2012, using a questionnaire to assess the association between training institution characteristics and students' attitudes, job choices, and intention to work in the public sector upon graduation. Comparisons between school types were done using ANOVA, and Bonferroni-adjusted multiple comparisons tests. Principal component analysis (PCA) was used to construct a composite rural attitude index ( 14 questions). Cronbach's alpha was used to examine the internal consistency of the scales, and ANOVA was then used to determine the differences. These relationships were further investigated through multiple regression. A higher proportion of public nursing students (86.4% from the Ministry of Public Health and 74.1% from the Ministry of Education) preferred working in the public sector, compared to 32.4% of students from the private sector ( p  = public nursing schools were less motivated by financial incentive regarding workplace choices relative to students trained by private institutions. To increase nursing workforce in the public sector, the following policy options should be promoted: 1) recruiting more students with a rural upbringing, 2) nurturing good attitudes towards working in rural areas through appropriate training at schools, 3) providing government scholarships for private students in exchange for compulsory work in rural areas, and 4) providing a

  17. Association of health profession and direct-to-consumer marketing with infant formula choice and switching.

    Science.gov (United States)

    Huang, Yi; Labiner-Wolfe, Judith; Huang, Hui; Choiniere, Conrad J; Fein, Sara B

    2013-03-01

    Infant formula is marketed by health professionals and directly to consumers. Formula marketing has been shown to reduce breastfeeding, but the relation with switching formulas has not been studied. Willingness to switch formula can enable families to spend less on formula. Data are from the Infant Feeding Practices Study II, a United States national longitudinal study. Mothers were asked about media exposure to formula information during pregnancy, receiving formula samples or coupons at hospital discharge, reasons for their formula choice at infant age 1 month, and formula switching at infant ages 2, 5, 7, and 9 months. Analysis included 1,700 mothers who fed formula at infant age 1 month; it used logistic regression and longitudinal data analysis methods to evaluate the association between marketing and formula choice and switching. Most mothers were exposed to both types of formula marketing. Mothers who received a sample of formula from the hospital at birth were more likely to use the hospital formula 1 month later. Mothers who chose formula at 1 month because their doctor recommended it were less likely to switch formula than those who chose in response to direct-to-consumer marketing. Mothers who chose a formula because it was used in the hospital were less likely to switch if they had not been exposed to Internet web-based formula information when pregnant or if they received a formula sample in the mail. Marketing formula through health professionals may decrease mothers' willingness to switch formula. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  18. Relationships Between Activities, Participation, Personal Factors, Mental Health, and Life Satisfaction in Persons With Spinal Cord Injury

    NARCIS (Netherlands)

    van Leeuwen, Christel M.; Post, Marcel W.; Westers, Paul; van der Woude, Lucas H.; de Groot, Sonja; Sluis, Tebbe; Slootman, Hans; Lindeman, Eline

    van Leeuwen CM, Post MW, Westers P, van der Woude LH, de Groot S. Sluis T, Slootman H, Lindeman E. Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury. Arch Phys Med Rehabil 2012;93:82-9. Objective: To clarify

  19. Modeling mental health information preferences during the early adult years: a discrete choice conjoint experiment.

    Science.gov (United States)

    Cunningham, Charles E; Walker, John R; Eastwood, John D; Westra, Henny; Rimas, Heather; Chen, Yvonne; Marcus, Madalyn; Swinson, Richard P; Bracken, Keyna; The Mobilizing Minds Research Group

    2014-04-01

    Although most young adults with mood and anxiety disorders do not seek treatment, those who are better informed about mental health problems are more likely to use services. The authors used conjoint analysis to model strategies for providing information about anxiety and depression to young adults. Participants (N = 1,035) completed 17 choice tasks presenting combinations of 15 four-level attributes of a mental health information strategy. Latent class analysis yielded 3 segments. The virtual segment (28.7%) preferred working independently on the Internet to obtain information recommended by young adults who had experienced anxiety or depression. Self-assessment options and links to service providers were more important to this segment. Conventional participants (30.1%) preferred books or pamphlets recommended by a doctor, endorsed by mental health professionals, and used with a doctor's support. They would devote more time to information acquisition but were less likely to use Internet social networking options. Brief sources of information were more important to the low interest segment (41.2%). All segments preferred information about alternative ways to reduce anxiety or depression rather than psychological approaches or medication. Maximizing the use of information requires active and passive approaches delivered through old-media (e.g., books) and new-media (e.g., Internet) channels.

  20. Employee choice of a high-deductible health plan across multiple employers.

    Science.gov (United States)

    Lave, Judith R; Men, Aiju; Day, Brian T; Wang, Wei; Zhang, Yuting

    2011-02-01

    To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection. Claims and benefit information for 2005-2007 from nine employers in western Pennsylvania first offering HDHP in 2006. We examined plan growth over time, used logistic regression to determine factors associated with choosing an HDHP, and examined the distribution of healthy and sick members across plan types. We linked employees with their dependents to determine family-level variables. We extracted risk scores, covered charges, employee age, and employee gender from claims data. We determined census-level race, education, and income information. Health status, gender, race, and education influenced the type of individual and family policies chosen. In the second year the HDHP was offered, few employees changed plans. Risk segmentation between HDHPs and PPOs existed, but it did not increase. When given a choice, those who are healthier are more likely to select an HDHP leading to risk segmentation. Risk segmentation did not increase in the second year that HDHPs were offered. © Health Research and Educational Trust.

  1. Subjective Age and Health Perceptions of Older Persons: Maintaining the Youthful Bias in Sickness and in Health.

    Science.gov (United States)

    Staats, Sara; And Others

    1993-01-01

    Self-reports of 250 persons over age 50 confirmed increasing bias toward reporting more youthful age as one ages. Optimistic perceptions of health were maintained in older subjects. Results from two subsets of sample (n=48) indicated that youthful and optimistic bias occurred both in older persons with poorer/failing health and in persons in…

  2. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    Science.gov (United States)

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  3. Analysis of College Students' Personal Health Information Activities: Online Survey.

    Science.gov (United States)

    Kim, Sujin; Sinn, Donghee; Syn, Sue Yeon

    2018-04-20

    With abundant personal health information at hand, individuals are faced with a critical challenge in evaluating the informational value of health care records to keep useful information and discard that which is determined useless. Young, healthy college students who were previously dependents of adult parents or caregivers are less likely to be concerned with disease management. Personal health information management (PHIM) is a special case of personal information management (PIM) that is associated with multiple interactions among varying stakeholders and systems. However, there has been limited evidence to understand informational or behavioral underpinning of the college students' PHIM activities, which can influence their health in general throughout their lifetime. This study aimed to investigate demographic and academic profiles of college students with relevance to PHIM activities. Next, we sought to construct major PHIM-related activity components and perceptions among college students. Finally, we sought to discover major factors predicting core PHIM activities among college students we sampled. A Web survey was administered to collect responses about PHIM behaviors and perceptions among college students from the University of Kentucky from January through March 2017. A total of 1408 college students were included in the analysis. PHIM perceptions, demographics, and academic variations were used as independent variables to predict diverse PHIM activities using a principal component analysis (PCA) and hierarchical regression analyses (SPSS v.24, IBM Corp, Armonk, NY, USA). Majority of the participants were female (956/1408, 67.90%), and the age distribution of this population included an adequate representation of college students of all ages. The most preferred health information resources were family (612/1408, 43.47%), health care professionals (366/1408, 26.00%), friends (27/1408, 1.91%), and the internet (157/1408, 11.15%). Organizational or

  4. Measuring the importance of health domains in psoriasis – discrete choice experiment versus rating scales

    Directory of Open Access Journals (Sweden)

    Gutknecht M

    2018-03-01

    Full Text Available Mandy Gutknecht,1 Marthe-Lisa Schaarschmidt,1,2 Marion Danner,3 Christine Blome,1 Matthias Augustin1 1German Center for Health Services Research in Dermatology (CVderm, Institute for Health Services Research in Dermatology and Nursing (IVDP, University Medical Center Hamburg-Eppendorf (UKE, Hamburg, Germany; 2Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany; 3Institute for Health Economics and Clinical Epidemiology (IGKE, University Hospital of Cologne, Cologne, Germany Background: Psoriasis affects different aspects of health-related quality of life (eg, physical, psychological, and social impairments; these health domains can be of different importance for patients. The importance of domains can be measured with the Patient Benefit Index (PBI. This questionnaire weights the achievement of treatment goals by Likert scales (0, “not important at all” to 4, “very important” using the Patient Needs Questionnaire (PNQ. Treatment goals assessed with the PBI have been assigned to five health domains; the importance of each domain can be calculated as the average importance of the respective treatment goals. In this study, the PBI approach of deriving importance weights is contrasted to a discrete choice experiment (DCE, in order to determine the importance of health domains in psoriasis, and to find if the resulting weights will differ when derived from these two methods.Methods: Adult patients with psoriasis completed both questionnaires (PNQ, DCE. The PBI domains were used as attributes in the DCE with the levels “did not help at all”, “helped moderately”, and “helped a lot”.Results: Using DCE, “improving physical functioning” was the most important health domain, followed by “improving psychological well-being”. Using PNQ, these domains were ranked in position two and three following “strengthening confidence in the therapy and in a possible healing”. The latter

  5. Public health and allied career choices for AYUSH graduates in India

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2013-01-01

    Full Text Available Introduction Until the very recent time majority of AYUSH graduates were limited to their own field of study with few exceptions in to the field of public health and allied areas. The reasons could be lack of awareness, unavailability of suitable job opportunity or a sense of insecurity in a relatively new and offbeat domain of work. However more recently, there has been a paradigm shift; with increase in information access, awareness of job opportunities and a great degree of professional and personal satisfaction. This has led to a huge rush of these graduates in to the field of public health and allied areas. Objective ToexplorepublichealthandalliedcareerchoicesforAYUSHgraduateswithspecialreferencetothe scopes and opportunities in each of these fields. Methodology Review based study. Information was obtained by systematic search process using internet based Google, Google Scholar search engines. Discussion The results obtained were pertinent to the domain of public health and allied careers including Public health and related areas such as; Health and Hospital Management, Health Policy, Health Economics, Heath Care Financing, Epidemiology, Medical Sociology, Clinical Research, Pharmaceutical Management etc. it is observed that the placement and job opportunities are much more because of the rapid expansion of health care industry in India with endeavors from public and private stakeholders. There has been a multimillion dollars investment by various national and international donor agencies, pharmaceutical sector, central and state governments and the development partners. Conclusion AYUSH graduates can definitely find this field interesting as well as challenging and job opportunities may not be a problem for the right one.

  6. Using gamification to drive patient’s personal data validation in a Personal Health Record

    Directory of Open Access Journals (Sweden)

    Guido Giunti

    2015-10-01

    Full Text Available Gamification is a term used to describe using game elements in non-game environments to enhance user experience. It has been incorporated with commercial success into several platforms (Linkedin, Badgeville, Facebook this has made some researchers theorize that it could also be used in education as a tool to increase student engagement and to drive desirable learning behaviors on them. While in the past years some game elements have been incorporated to healthcare there is still little evidence on how effective they are. Game elements provide engagement consistent with various theories of motivation, positive psychology (e.g., flow, and also provide instant feedback. Feedback is more effective when it provides sufficient and specific information for goal achievement and is presented relatively close in time to the event being evaluated. Feedback can reference individual progress, can make social comparisons, or can refer to task criteria. Electronic personal health record systems (PHRs support patient centered healthcare by making medical records and other relevant information accessible to patients, thus assisting patients in health self-management. A particularly difficult data set that is often difficult to capture are those regarding social and cultural background information. This data set is not only useful to help better healthcare system management, it is also relevant as it is used for epidemiological and preventive purposes. We used gamified mechanics that involve instant feedback to test if they would increase patient’s personal data validation and completion in our PHR as well as overall PHR use. On our presentation we will describe our results and the story behind them.

  7. Big Five personality and health in adults with and without cancer.

    Science.gov (United States)

    Rochefort, Catherine; Hoerger, Michael; Turiano, Nicholas A; Duberstein, Paul

    2018-01-01

    Personality is associated with health, but examinations in patients with illnesses are lacking. We aimed to determine whether personality-physical health associations differed between community and cancer samples. This cross-sectional study involved 168 participants without cancer, 212 men with prostate cancer, and 55 women with breast cancer. We examined whether the Big Five personality dimensions were associated with health behaviors and multiple health indicators. Higher conscientiousness and lower neuroticism were associated with better health behaviors and health ( r max  = .31), with few differences between community and cancer samples. Findings call for research on the implications of personality in patients with serious illnesses.

  8. Consumer attitudes toward personal health records in a beacon community.

    Science.gov (United States)

    Patel, Vaishali N; Abramson, Erika; Edwards, Alison M; Cheung, Melissa A; Dhopeshwarkar, Rina V; Kaushal, Rainu

    2011-04-01

    To characterize consumers' attitudes about personal health records (PHRs), electronic tools that enable consumers to securely access, manage, and share their health information, in a community participating in health information technology initiatives. Cross-sectional study. A random-digit-dial telephone survey about PHRs was conducted among adult residents of New York State's greater Buffalo region. Multivariate regression analyses identified factors associated with potential PHR use. We obtained a 79% (n = 200) response rate. Many respondents (70%) would potentially use PHRs. Consumers wanted PHRs to incorporate an array of information, including immunization records (89%) and providers visited (88%). They expressed interest in several online activities, including accessing their family members' healthcare information (71%). Potential PHR use was associated with perceptions that PHRs would improve privacy and security of medical information (odds ratio [OR] 4.7; 95% confidence interval [CI] 1.1, 20.1), understanding regarding health (OR 3.7; 95% CI 1.3, 11.1), and overall quality of care (OR 3.6; 95% CI 1.2, 10.6). Potential PHR use was associated with annual household income of more than $30,000 (OR 3.9; 95% CI 1.3, 11.9) and experience looking up health information online (OR 3.0; 95% CI 1.1, 8.1). Consumers expressed great interest in using PHRs and wanted comprehensive PHRs. However, the "digital divide" between those with varying levels of Internet experience and concerns about PHRs’ effect on privacy and security of medical information may limit use. Designing PHRs that incorporate consumer preferences and developing policies that address these barriers may increase consumers' PHR use.

  9. Can personal health record booklets improve cancer screening behaviors?

    Science.gov (United States)

    Newell, Sallie Anne; Sanson-Fisher, Rob William; Girgis, Afaf; Davey, Heather Maree

    2002-01-01

    Despite the widespread use of written health education materials as interventions, relatively few studies have adequately evaluated the effectiveness of such materials on changing healthcare behaviors in the general population. The study consisted of ten matched pairs of small rural towns in New South Wales, Australia, with a total combined population of approximately 25,000 in both the intervention and control group towns. A randomized controlled trial was used. Personal Health Record Booklets (PHRBs) that include the latest evidence-based recommendations for reducing risk of cancer and cardiovascular disease were developed using leading behavioral change theories to maximize effectiveness. The booklets included an explanatory letter, a gender-specific Better Health Booklet, and a gender-specific Better Health Diary. Following a media campaign, the PHRBs were mailed to all residents aged 20 to 60 years (about 12,600 people) in the ten intervention towns. Family practitioners in the intervention towns were recruited to support and encourage people to use the PHRBs. Health Insurance Commission data for Papanicolaou (Pap) tests, mammograms, and skin operations were obtained for 5 years before the intervention, and 3 months and 1 year after the intervention. No significant increases in the rates of Pap tests, mammograms, and skin operations were detected in either short- or long-term follow-ups. While PHRBs may represent an inexpensive, easy-to-produce, and time-efficient method of communicating information to the general population, it appears unlikely that any significant behavioral change will result unless such materials are targeted toward high-risk groups or constitute the first intervention for a particular risk factor.

  10. PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury

    Science.gov (United States)

    2015-04-01

    Award Number: W81XWH-11-2-0129 TITLE: PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury... Brain Injury 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Betty Diamond 5d. PROJECT NUMBER Paul N. Kizakevich 5e. TASK NUMBER E-Mail...and Google App stores.  ActiSleep. PHIT-based sleep diary for data collection in an adolescent sleep and marijuana study. National Institute on Drug

  11. Teens, Food Choice, and Health: How Can a Multi-Method Research Methodology Enhance the Study of Teen Food Choice and Health Messaging?

    OpenAIRE

    Wiseman, Kelleen

    2011-01-01

    This research report compares alternative approaches to analyzing the complex factors that influence teenagers' food choice. Specifically, a multi-method approach-which involves the integration of the qualitative and quantitative research methodoligies, data and analysis-is compared to a single methodological approach, which involves use of either a quantitative or qualitative methodology.

  12. Forced-Choice Assessment of Work-Related Maladaptive Personality Traits: Preliminary Evidence From an Application of Thurstonian Item Response Modeling.

    Science.gov (United States)

    Guenole, Nigel; Brown, Anna A; Cooper, Andrew J

    2018-06-01

    This article describes an investigation of whether Thurstonian item response modeling is a viable method for assessment of maladaptive traits. Forced-choice responses from 420 working adults to a broad-range personality inventory assessing six maladaptive traits were considered. The Thurstonian item response model's fit to the forced-choice data was adequate, while the fit of a counterpart item response model to responses to the same items but arranged in a single-stimulus design was poor. Monotrait heteromethod correlations indicated corresponding traits in the two formats overlapped substantially, although they did not measure equivalent constructs. A better goodness of fit and higher factor loadings for the Thurstonian item response model, coupled with a clearer conceptual alignment to the theoretical trait definitions, suggested that the single-stimulus item responses were influenced by biases that the independent clusters measurement model did not account for. Researchers may wish to consider forced-choice designs and appropriate item response modeling techniques such as Thurstonian item response modeling for personality questionnaire applications in industrial psychology, especially when assessing maladaptive traits. We recommend further investigation of this approach in actual selection situations and with different assessment instruments.

  13. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions.

    Science.gov (United States)

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel; Wilkinson, Mark D

    2013-04-05

    The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this prototype was limited to a single knowledge domain

  14. Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being).

    Science.gov (United States)

    Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo

    2015-01-01

    Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

  15. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions

    Science.gov (United States)

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel

    2013-01-01

    Background The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. Objective The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. Methods We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. Results A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. Conclusions The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this

  16. A Model-Driven Framework to Develop Personalized Health Monitoring

    Directory of Open Access Journals (Sweden)

    Algimantas Venčkauskas

    2016-07-01

    Full Text Available Both distributed healthcare systems and the Internet of Things (IoT are currently hot topics. The latter is a new computing paradigm to enable advanced capabilities in engineering various applications, including those for healthcare. For such systems, the core social requirement is the privacy/security of the patient information along with the technical requirements (e.g., energy consumption and capabilities for adaptability and personalization. Typically, the functionality of the systems is predefined by the patient’s data collected using sensor networks along with medical instrumentation; then, the data is transferred through the Internet for treatment and decision-making. Therefore, systems creation is indeed challenging. In this paper, we propose a model-driven framework to develop the IoT-based prototype and its reference architecture for personalized health monitoring (PHM applications. The framework contains a multi-layered structure with feature-based modeling and feature model transformations at the top and the application software generation at the bottom. We have validated the framework using available tools and developed an experimental PHM to test some aspects of the functionality of the reference architecture in real time. The main contribution of the paper is the development of the model-driven computational framework with emphasis on the synergistic effect of security and energy issues.

  17. Culture of health of a person as a part of physical culture

    OpenAIRE

    A.P. Khalajtsan

    2014-01-01

    Purpose: to determine the general concepts of the theory and methods of physical education. On the basis of their form defining the components of physical culture and personality reflect the place of culture health of individuals among these components. Material: processed more than 40 references. Results: a definition of generalizing concepts of "culture", "health", "physical culture", "culture of health" formulated defining components of physical culture personality: health culture personal...

  18. Career choices in health care: is nursing a special case? A content analysis of survey data.

    Science.gov (United States)

    Miers, Margaret E; Rickaby, Caroline E; Pollard, Katherine C

    2007-09-01

    As demand for nurses and other health professionals continues to outstrip supply it is important to understand what motivates individuals to join a non-medical health profession. The objectives of this study were to investigate students' reasons for choosing a particular nursing specialism, midwifery or other non-medical health profession, and to compare motivation factors across professions, gender, age, level of award, prior qualifications, prior experience and over time. A prospective follow-up study collected survey responses at the beginning and end of pre-qualifying professional programmes. The study took place in one large United Kingdom faculty. The study participants were 775 first-year students undertaking non-medical health professional programmes and 393 qualifying students. An open-ended question was included in a self-completed questionnaire administered at entry and at qualification. Content analysis identified themes. Altruism was the most frequently cited reason for wishing to join a non-medical health profession, followed by personal interest/abilities, professional values/rewards, and prior experience of the area. Students entering nursing were less likely to cite an altruistic motivation than those entering other non-medical health professions (chi(2)=21.61, df=1, pvalues/rewards (chi(2)=20.38, df=8, p=0.009). Students on degree level programmes were more likely to report altruism than those on diploma level courses (chi(2)=17.37, df=1, pvalues/rewards (chi(2)=6.67, p=0.010) decreased over time. Findings suggest that although a service orientation remains a key factor in choosing nursing, students also look for a career which matches their interests and attributes, as well as offering professional values and rewards. Nursing may be in danger of losing service orientated recruits to other non-medical health professions.

  19. Refugees and displaced persons. War, hunger, and public health.

    Science.gov (United States)

    Toole, M J; Waldman, R J

    1993-08-04

    The number of refugees and internally displaced persons in need of protection and assistance has increased from 30 million in 1990 to more than 43 million today. War and civil strife have been largely responsible for this epidemic of mass migration that has affected almost every region of the world, including Europe. Since 1990, crude death rates (CDRs) during the early influx of refugees who crossed international borders have been somewhat lower than CDRs reported earlier among Cambodian and Ethiopian refugees. Nevertheless, CDRs among refugees arriving in Ethiopia, Kenya, Nepal, Malawi, and Zimbabwe since 1990 ranged from five to 12 times the baseline CDRs in the countries of origin. Among internally displaced populations in northern Iraq, Somalia, and Sudan, CDRs were extremely high, ranging from 12 to 25 times the baseline CDRs for the nondisplaced. Among both refugees and internally displaced persons, death rates among children less than 5 years of age were far higher than among older children and adults. In Bangladesh, the death rate in female Rohingya refugees was several times higher than in males. Preventable conditions such as diarrheal disease, measles, and acute respiratory infections, exacerbated often by malnutrition, caused most deaths. Although relief programs for refugees have improved since 1990, the situation among the internally displaced may have worsened. The international community should intervene earlier in the evolution of complex disasters involving civil war, human rights abuses, food shortages, and mass displacement. Relief programs need to be based on sound health and nutrition information and should focus on the provision of adequate shelter, food, water, sanitation, and public health programs that prevent mortality from diarrhea, measles, and other communicable diseases, especially among young children and women.

  20. Is Best-Worst Scaling Suitable for Health State Valuation? A Comparison with Discrete Choice Experiments.

    Science.gov (United States)

    Krucien, Nicolas; Watson, Verity; Ryan, Mandy

    2017-12-01

    Health utility indices (HUIs) are widely used in economic evaluation. The best-worst scaling (BWS) method is being used to value dimensions of HUIs. However, little is known about the properties of this method. This paper investigates the validity of the BWS method to develop HUI, comparing it to another ordinal valuation method, the discrete choice experiment (DCE). Using a parametric approach, we find a low level of concordance between the two methods, with evidence of preference reversals. BWS responses are subject to decision biases, with significant effects on individuals' preferences. Non parametric tests indicate that BWS data has lower stability, monotonicity and continuity compared to DCE data, suggesting that the BWS provides lower quality data. As a consequence, for both theoretical and technical reasons, practitioners should be cautious both about using the BWS method to measure health-related preferences, and using HUI based on BWS data. Given existing evidence, it seems that the DCE method is a better method, at least because its limitations (and measurement properties) have been extensively researched. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. The Influence of Sugar-Sweetened Beverage Health Warning Labels on Parents' Choices.

    Science.gov (United States)

    Roberto, Christina A; Wong, Diandra; Musicus, Aviva; Hammond, David

    2016-02-01

    US states have introduced bills requiring sugar-sweetened beverages (SSBs) to display health warning labels. This study examined how such labels may influence parents and which labels are most impactful. In this study, 2381 demographically and educationally diverse parents participated in an online survey. Parents were randomly assigned to 1 of 6 conditions: (1) no warning label (control); (2) calorie label; or (3-6) 1 of 4 text versions of a warning label (eg, Safety Warning: Drinking beverages with added sugar[s] contributes to obesity, diabetes, and tooth decay). Parents chose a beverage for their child in a vending machine choice task, rated perceptions of different beverages, and indicated interest in receiving beverage coupons. Regression analyses controlling for frequency of beverage purchases were used to compare the no warning label group, calorie label group, and all warning label groups combined. Significantly fewer parents chose an SSB for their child in the warning label condition (40%) versus the no label (60%) and calorie label conditions (53%). Parents in the warning label condition also chose significantly fewer SSB coupons, believed that SSBs were less healthy for their child, and were less likely to intend to purchase SSBs. All P values parents' understanding of health harms associated with overconsumption of such beverages and may reduce parents' purchase of SSBs for their children. Copyright © 2016 by the American Academy of Pediatrics.

  2. [Mental health of homeless persons. Critical review of the Anglo-Saxon literature].

    Science.gov (United States)

    Ducq, H; Guesdon, I; Roelandt, J L

    1997-01-01

    Because the visibility of homeless persons congregating in urban areas has increased since the 1980's, the relationship between homelessness and mental illness has caused more and more concern. A multitude of epidemiological surveys have been organized in Great Britain, Australia, Canada, and mainly in United States, and have attempted to evaluate scientifically the psychiatric morbidity of this population. This literature review reveals disparity of epidemiological methods in assessing the type and extent of mental illness among homeless adults. The lack of consensual definition of homelessness, the choice of different settings in which the research is organized (street, health centres, shelters), and the use of diverse instruments of psychiatric evaluation (diagnosis by clinician, by scale or by structured diagnostic interview) lead to a great disparity of the results. Thus, 1/3 of the homeless adults had prior history of psychiatric hospitalisation. Rates of psychosis range to 70% and it is estimated that 4% to 74% of the homeless persons suffer from affective disorders. Substance abuse disorder remains a problem for a significant number of these individuals, with a high frequency of dual diagnosis. Such divergent data highlight the anglo-saxon debate between those who accuse desinstitutionnalisation as a reason of homelessness, and those who blame the socioeconomic background.

  3. Exploring the impact of word-of-mouth about Physicians' service quality on patient choice based on online health communities.

    Science.gov (United States)

    Lu, Naiji; Wu, Hong

    2016-11-26

    Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians' information, such as Word-of-Mouth (WOM), particularly on physicians' service quality evaluated by other patients. Existing studies from other service domains have proved that WOM impacts consumer choice. However, how patients make a choice based on physicians' WOM has not been studied, particularly with reference to different patient characteristics and by using real data. One thousand eight hundred fifty three physicians' real data were collected from a Chinese online health community. The data were analyzed using ordinary least squares (OLS) method. The study found that functional quality negatively moderated the relationship between technical quality and patient choice, and disease risk moderated the relationship between physicians' service quality and patient choice. Our study recommends that hospital managers need to consider the roles of both technical quality and functional quality seriously. Physicians should improve their medical skills and bedside manners based on the severity and type of disease to provide better service.

  4. Opportunities, Rational Choice, and Self-Control: On the Interaction of Person and Situation in a General Theory of Crime

    Science.gov (United States)

    Seipel, Christian; Eifler, Stefanie

    2010-01-01

    In this article, deviant action is analyzed on the basis of ideas derived from Gottfredson and Hirschi's self-control theory. Presumedly, self-control in interaction with opportunities can explain deviant action. This assumption is elaborated using the concept of high- and low-cost situations from rational choice theory. From this point of view,…

  5. Physician variation in perceived barriers to personal health

    Directory of Open Access Journals (Sweden)

    Rubenfire M

    2012-01-01

    Full Text Available Adam RB Kosteva1, Brian M Salata1, Sangeetha Mahadevan Krishnan2, Michael Howe3, Alissa Weber3, Melvyn Rubenfire2,3, Elizabeth A Jackson2,31Michigan Cardiovascular Research and Reporting Program, 2Division of Cardiovascular Medicine, 3Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USAObjective: Physicians’ personal health habits are associated with their counseling habits regarding physical activity. We sought to examine physicians’ own barriers to a healthy lifestyle by level of training and gender.Methods: Physicians at a major teaching hospital were surveyed regarding their lifestyle habits and barriers to healthy habits. The frequency of reported barriers was examined by years in practice (trainees vs staff physicians and gender.Results: 183 total responses were received. Over 20% of respondents were overweight. Work schedule was cited as the greatest barrier to regular exercise in 70.5% of respondents. Trainees were more likely to cite time constraints or cost as a barrier to a healthy diet compared to staff physicians. Staff physicians were more likely to report the time to prepare healthy foods as a barrier. For both trainees and staff physicians, time was a barrier to regular exercise. For trainees work schedule was a barrier, while both work schedule and family commitments were top barriers cited by staff physicians. Women were more likely to report family commitments as a barrier than men. Respondents suggested healthier options in vending machines and the hospital cafeteria, healthy recipes, and time and/or facilities for exercise at work as options to help overcome these barriers.Conclusion: Work schedules and family commitments are frequently reported by providers as barriers to healthy lifestyle. Efforts to reduce such barriers may lead to improved health habits among providers.Keywords: diet, exercise, counseling, prevention, gender, barriers, health

  6. Assessment of personality type and medical specialty choice among medical students from Karachi; using Myers-Briggs Type Indicator (MBTI) tool.

    Science.gov (United States)

    Jafrani, Sana; Zehra, Nosheen; Zehra, Muneeza; Abuzar Ali, Syed Muhmmad; Abubakar Mohsin, Saiyed Abdullah; Azhar, Rasheed

    2017-04-01

    To assess personality type of medical students and associate it with their choice of medical specialty. This cross-sectional study was conducted in February 2014 at one public and one private medical university of Karachi, and comprised medical students. A self- administered questionnaire based on Myers-Briggs type indicator was used to collect data which was analysed using SPSS 20. Of the 400 participants, there were 200(50%) each from public and private universities. Of all, 201(50.3%) students were found to be extroverted and 199(49.8%) were introverted personality types. Clinical fields were the main preference of students after their medical degree as selected by 317(79.2%) students; of the, Extroverted-Sensing-Feeling-Perceptive was the most common type identified in39(7.2%) students. Extroverted-Sensing-Feeling-Perceptive 11(2.8%), Extroverted-Sensing-Thinking-Judging 12(3%), Extroverted-Sensing-Feeling-Judging 5(1.3%), Introverted-Sensing-Feeling-Judging 6(1.5%), Introverted-Sensing-Thinking-Perceptive 7(1.8%) had preference for surgery, medicine, gynaecology, paediatrics and cardiology, respectively. Personality had significant impact on specialty and career choice.

  7. Semantic Web, Reusable Learning Objects, Personal Learning Networks in Health: Key Pieces for Digital Health Literacy.

    Science.gov (United States)

    Konstantinidis, Stathis Th; Wharrad, Heather; Windle, Richard; Bamidis, Panagiotis D

    2017-01-01

    The knowledge existing in the World Wide Web is exponentially expanding, while continuous advancements in health sciences contribute to the creation of new knowledge. There are a lot of efforts trying to identify how the social connectivity can endorse patients' empowerment, while other studies look at the identification and the quality of online materials. However, emphasis has not been put on the big picture of connecting the existing resources with the patients "new habits" of learning through their own Personal Learning Networks. In this paper we propose a framework for empowering patients' digital health literacy adjusted to patients' currents needs by utilizing the contemporary way of learning through Personal Learning Networks, existing high quality learning resources and semantics technologies for interconnecting knowledge pieces. The framework based on the concept of knowledge maps for health as defined in this paper. Health Digital Literacy needs definitely further enhancement and the use of the proposed concept might lead to useful tools which enable use of understandable health trusted resources tailored to each person needs.

  8. Personal health systems and value creation mechanisms in occupational health care.

    Science.gov (United States)

    Auvinen, Ari-Matti

    2007-01-01

    Personal Health Systems are believed to have great business potential among citizens, but they might reach also an important market in occupational health care. However, in reaching the occupational health care market, it is important to understand the value creation and value configuration mechanisms of this particular market. This paper also claims that in such a business-to-business market service integrators are needed to compose for the various customers specific offerings combing a tailored variety of products and services to suit their specific needs.

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

    Science.gov (United States)

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

    2015-07-01

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

  10. Alternatives to project-specific consent for access to personal information for health research: Insights from a public dialogue

    Directory of Open Access Journals (Sweden)

    Abelson Julia

    2008-11-01

    Full Text Available Abstract Background The role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues. Methods We conducted seven day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly. Results Broad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research. Conclusion Because no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record

  11. Alternatives to project-specific consent for access to personal information for health research: insights from a public dialogue.

    Science.gov (United States)

    Willison, Donald J; Swinton, Marilyn; Schwartz, Lisa; Abelson, Julia; Charles, Cathy; Northrup, David; Cheng, Ji; Thabane, Lehana

    2008-11-19

    The role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues. We conducted seven day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly. Broad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research. Because no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for

  12. Examining the Role of Anxiety and Apathy in Health Consumers' Intentions to Use Patient Health Portals for Personal Health Information Management

    Science.gov (United States)

    Torres, Carlos A.

    2011-01-01

    This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…

  13. Disadvantaged persons' participation in health promotion projects: some structural dimensions.

    Science.gov (United States)

    Boyce, W F

    2001-05-01

    A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.

  14. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  15. What should primary health care practitioners know about factors influencing young people’s food choices?

    OpenAIRE

    Louise Holmberg; John Coveney; Julie Henderson; Samantha Meyer

    2010-01-01

    BackgroundTo identify factors that determine the nature and extent ofyoung consumers trust in food; sources of information whichinfluence young consumer food choices; and how trustimpacts on young people’s food choices.MethodIn-depth qualitative research interviews were conducted withyoung women and men, who are the primary food purchasersin their household (n=8)ResultsFood choices of young adults were generally determined bycost and convenience. The overall perception was thatAustralian food...

  16. The impact of front-of-pack marketing attributes versus nutrition and health information on parents' food choices.

    Science.gov (United States)

    Georgina Russell, Catherine; Burke, Paul F; Waller, David S; Wei, Edward

    2017-09-01

    Front-of-pack attributes have the potential to affect parents' food choices on behalf of their children and form one avenue through which strategies to address the obesogenic environment can be developed. Previous work has focused on the isolated effects of nutrition and health information (e.g. labeling systems, health claims), and how parents trade off this information against co-occurring marketing features (e.g. product imagery, cartoons) is unclear. A Discrete Choice Experiment was utilized to understand how front-of-pack nutrition, health and marketing attributes, as well as pricing, influenced parents' choices of cereal for their child. Packages varied with respect to the two elements of the Australian Health Star Rating system (stars and nutrient facts panel), along with written claims, product visuals, additional visuals, and price. A total of 520 parents (53% male) with a child aged between five and eleven years were recruited via an online panel company and completed the survey. Product visuals, followed by star ratings, were found to be the most significant attributes in driving choice, while written claims and other visuals were the least significant. Use of the Health Star Rating (HSR) system and other features were related to the child's fussiness level and parents' concerns about their child's weight with parents of fussy children, in particular, being less influenced by the HSR star information and price. The findings suggest that front-of-pack health labeling systems can affect choice when parents trade this information off against marketing attributes, yet some marketing attributes can be more influential, and not all parents utilize this information in the same way. Copyright © 2017. Published by Elsevier Ltd.

  17. A multi-level approach to travel mode choice - How person characteristics and situation specific aspects determine car use in a student sample

    OpenAIRE

    Kløckner, Christian; Friedrichsmeier, Thomas

    2011-01-01

    The presented study analyses travel mode choice in a student sample on four frequent trips: To the university, to work, to the favourite leisure activity, and to the favourite shop. The decision to use the car in contrast to alternative travel modes is modelled for each individual trip using a two-level structural equation model with trip specific attributes on Level 1 and person specific attributes on Level 2. Data was gathered in an online travel survey on a student sample of the Ruhr-Unive...

  18. 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.

  19. 75 FR 25887 - Order of Suspension of Trading; In the Matter of Alyn Corp., American HealthChoice, Inc...

    Science.gov (United States)

    2010-05-10

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Order of Suspension of Trading; In the Matter of Alyn Corp., American HealthChoice, Inc., American Holding Investments, Inc., American Midland Corp... Amwest Environmental Group, Inc. May 6, 2010. It appears to the Securities and Exchange Commission that...

  20. Associations between the Five-Factor Model of Personality and Health Behaviors among College Students

    Science.gov (United States)

    Raynor, Douglas A.; Levine, Heidi

    2009-01-01

    Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…

  1. Personality differences predict health-risk behaviors in young adulthood: evidence from a longitudinal study.

    Science.gov (United States)

    Caspi, A; Begg, D; Dickson, N; Harrington, H; Langley, J; Moffitt, T E; Silva, P A

    1997-11-01

    In a longitudinal study of a birth cohort, the authors identified youth involved in each of 4 different health-risk behaviors at age 21: alcohol dependence, violent crime, unsafe sex, and dangerous driving habits. At age 18, the Multidimensional Personality Questionnaire (MPQ) was used to assess 10 distinct personality traits. At age 3, observational measures were used to classify children into distinct temperament groups. Results showed that a similar constellation of adolescent personality traits, with developmental origins in childhood, is linked to different health-risk behaviors at 21. Associations between the same personality traits and different health-risk behaviors were not an artifact of the same people engaging in different health-risk behaviors; rather, these associations implicated the same personality type in different but related behaviors. In planning campaigns, health professionals may need to design programs that appeal to the unique psychological makeup of persons most at risk for health-risk behaviors.

  2. Health information: reconciling personal privacy with the public good of human health.

    Science.gov (United States)

    Gostin, L O

    2001-01-01

    The success of the health care system depends on the accuracy, correctness and trustworthiness of the information, and the privacy rights of individuals to control the disclosure of personal information. A national policy on health informational privacy should be guided by ethical principles that respect individual autonomy while recognizing the important collective interests in the use of health information. At present there are no adequate laws or constitutional principles to help guide a rational privacy policy. The laws are scattered and fragmented across the states. Constitutional law is highly general, without important specific safeguards. Finally, a case study is provided showing the important trade-offs that exist between public health and privacy. For a model public health law, see www.critpath.org/msphpa/privacy.

  3. The Impact of Health Literacy on a Patient's Decision to Adopt a Personal Health Record

    Science.gov (United States)

    Noblin, Alice M.; Wan, Thomas T. H.; Fottler, Myron

    2012-01-01

    Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients’ relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize the full potential of PHRs. PMID:23209454

  4. Factors Affecting Usage of a Personal Health Record (PHR) to Manage Health

    Science.gov (United States)

    Taha, Jessica; Czaja, Sara J.; Sharit, Joseph; Morrow, Daniel G.

    2018-01-01

    As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients’ ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40–59 years) and 51 older adults (60–85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one’s task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PMID:24364414

  5. Personal Informatics in the Wild: Hacking Habits for Health & Happiness

    DEFF Research Database (Denmark)

    Li, Ian; Froehlich, Jon; Larsen, Jakob Eg

    2013-01-01

    Personal informatics is a class of systems that help people collect personal information to improve selfknowledge. Improving self-knowledge can foster selfinsight and promote positive behaviors, such as healthy living and energy conservation. The development of personal informatics applications p...

  6. Does modifying the household food budget predict changes in the healthfulness of purchasing choices among low- and high-income women?

    Science.gov (United States)

    Inglis, Victoria; Ball, Kylie; Crawford, David

    2009-04-01

    Food cost has a strong influence on food purchases and given that persons of low income often have more limited budgets, healthier foods may be overlooked in favour of more energy-dense lower-cost options. The aim of this study was to investigate whether modifications to the available household food budget led to changes in the healthfulness of food purchasing choices among women of low and high income. A quasi-experimental design was used which included a sample of 74 women (37 low-income women and 37 high-income women) who were selected on the basis of their household income and sent an itemised shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and those foods they would remove if they were restricted by 25% of their budget. When asked what foods they would add with a larger household food budget, low-income women chose more foods from the 'healthier' categories whereas high-income women chose more foods from the less 'healthier' categories. However, making the budgets of low- and high-income women more 'equivalent' did not eradicate income differences in overall healthfulness of food purchasing choices. This study highlights the importance of cost when making food purchasing choices among low- and high-income groups. Public health strategies aimed at reducing income inequalities in diet might focus on promoting healthy diets that are low cost.

  7. Factors influencing choice of skilled birth attendance at ANC: evidence from the Kenya demographic health survey.

    Science.gov (United States)

    Nyongesa, Caroline; Xu, Xiaoyue; Hall, John J; Macharia, William M; Yego, Faith; Hall, Brigid

    2018-04-10

    In Kenya, skilled attendance at delivery is well below the international target of 90% and the maternal mortality ratio is high at 362 (CI 254-471) per 100,000 live births despite various interventions. The preventative role of skilled attendance at delivery makes it a benchmark indicator for safe motherhood. Maternal health data from the Service Provision Assessment Survey, a subset of the 2010 Kenya Demographic Health Survey was analyzed. Logistic regression models were employed using likelihood ratio test to explore association between choice of skilled attendance and predictor variables. Overall, 94.8% of women are likely to seek skilled attendance at delivery. Cost, education level, number of antenatal visits and sex of provider were strongly associated with client's intention to deliver with a skilled birth attendant at delivery. Women who reported having enough money set aside for delivery were 4.34 (p < 0.002, 95% CI: 1.73; 10.87) times more likely to seek skilled attendance. Those with primary education and above were 6.6 times more likely to seek skilled attendance than those with no formal education (p < 0.001, 95% CI: 3.66; 11.95). Women with four or more antenatal visits were 5.95 (p < 0.018, 95% CI: 1.35; 26.18) times more likely to seek skilled attendance. Compared to men, female providers impacted more on the client's plan (OR = 2.02 (p < 0.014, 95% CI: 1.35; 3.53). Interventions aimed at improving skilled attendance at delivery should include promotion of formal education of women and financial preparation for delivery. Whenever circumstances permit, women should be allowed to choose gender of preferred professional attendant at delivery.

  8. Health on Impulse : When Low Self-Control Promotes Healthy Food Choices

    NARCIS (Netherlands)

    Salmon, S.J.; Fennis, B.M.; Ridder, D.T.D.; Adriaanse, M.A.; de Vet, E.

    Objective: Food choices are often made mindlessly, when individuals are not able or willing to exert self-control. Under low self-control, individuals have difficulties to resist palatable but unhealthy food products. In contrast to previous research aiming to foster healthy choices by promoting

  9. Health on impulse: when low self-control promotes healthy food choices

    NARCIS (Netherlands)

    Salmon, S.J.; Fennis, B.M.; Ridder, de D.T.D.; Adriaanse, M.A.; Vet, de E.

    2014-01-01

    OBJECTIVE: Food choices are often made mindlessly, when individuals are not able or willing to exert self-control. Under low self-control, individuals have difficulties to resist palatable but unhealthy food products. In contrast to previous research aiming to foster healthy choices by promoting

  10. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    Science.gov (United States)

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  11. Differences in Dietary Preferences, Personality and Mental Health in Australian Adults with and without Food Addiction.

    Science.gov (United States)

    Burrows, Tracy; Hides, Leanne; Brown, Robyn; Dayas, Christopher V; Kay-Lambkin, Frances

    2017-03-15

    Increased obesity rates, an evolving food supply and the overconsumption of energy dense foods has led to an increase in research exploring addictive eating behaviours. This study aimed to investigate food addiction in a sample of Australian adults using the revised Yale Food Addiction Survey (YFAS) 2.0 tool and how it is associated with dietary intake, personality traits and mental health issues. Australian adults were invited to complete an online survey that collected information including: demographics, dietary intake, depression, anxiety, stress and personality dimensions including impulsivity, sensation seeking, hopelessness and anxiety sensitivity. A total of 1344 individuals were recruited with the samples comprising 75.7% female, mean age 39.8 ± 13.1 years (range 18-91 years) and body mass index BMI 27.7 ± 9.5. Food addiction was identified in 22.2% of participants using the YFAS 2.0 tool, which classified the severity of food addiction as "mild" in 0.7% of cases, "moderate" in 2.6% and "severe" in 18.9% of cases. Predictors of severe food addiction were female gender (odds ratio (OR) 3.65 95% CI 1.86-7.11) and higher levels of soft drink OR 1.36 (1.07-1.72), confectionary consumption and anxiety sensitivity 1.16 (1.07-1.26). Overall people with "severe" (OR 13.2, 5.8-29.8) or extremely severe depressive symptoms (OR 15.6, range 7.1-34.3) had the highest odds of having severe food addiction. The only variable that reduced the odds of having severe food addiction was vegetable intake. The current study highlights that addictive food behaviours are associated with a complex pattern of poor dietary choices and a clustering with mental health issues, particularly depression.

  12. Differences in Dietary Preferences, Personality and Mental Health in Australian Adults with and without Food Addiction

    Directory of Open Access Journals (Sweden)

    Tracy Burrows

    2017-03-01

    Full Text Available Increased obesity rates, an evolving food supply and the overconsumption of energy dense foods has led to an increase in research exploring addictive eating behaviours. This study aimed to investigate food addiction in a sample of Australian adults using the revised Yale Food Addiction Survey (YFAS 2.0 tool and how it is associated with dietary intake, personality traits and mental health issues. Australian adults were invited to complete an online survey that collected information including: demographics, dietary intake, depression, anxiety, stress and personality dimensions including impulsivity, sensation seeking, hopelessness and anxiety sensitivity. A total of 1344 individuals were recruited with the samples comprising 75.7% female, mean age 39.8 ± 13.1 years (range 18–91 years and body mass index BMI 27.7 ± 9.5. Food addiction was identified in 22.2% of participants using the YFAS 2.0 tool, which classified the severity of food addiction as “mild” in 0.7% of cases, “moderate” in 2.6% and “severe” in 18.9% of cases. Predictors of severe food addiction were female gender (odds ratio (OR 3.65 95% CI 1.86–7.11 and higher levels of soft drink OR 1.36 (1.07–1.72, confectionary consumption and anxiety sensitivity 1.16 (1.07–1.26. Overall people with “severe” (OR 13.2, 5.8–29.8 or extremely severe depressive symptoms (OR 15.6, range 7.1–34.3 had the highest odds of having severe food addiction. The only variable that reduced the odds of having severe food addiction was vegetable intake. The current study highlights that addictive food behaviours are associated with a complex pattern of poor dietary choices and a clustering with mental health issues, particularly depression.

  13. Investigating the impact of a health game on implicit attitudes towards food and food choice behaviour of young adults.

    Science.gov (United States)

    Alblas, Eva; Folkvord, Frans; Anschütz, Doeschka J; van 't Riet, Jonathan; Granic, Isabela; Ketelaar, Paul; Buijzen, Moniek

    2018-05-25

    Improving diets by stimulating fruit and vegetable consumption might be beneficial, in particular when they substitute energy-dense products. The aim of present study was to investigate whether a health game can be used to positively affect healthy implicit attitudes (IAs) towards food and subsequent food choice behaviour of young adults. A 2 (Time: baseline vs. post-test) x 2 (Condition: health game vs. control game) x 2 (Baseline IAs: healthy IAs vs. less healthy IAs) mixed-subjects design was used with 125 participants (age: M = 20.17, SD = 1.88). IAs towards food were assessed at baseline and post-test using an Implicit Association Test (IAT). Additionally, food choice behaviour was assessed after game play. At baseline, the majority of participants had healthy IAs (i.e., favouring fruit over chocolate snacks). At post-test, significantly less healthy IAs were observed in the control condition, while this reduction was not significant in the health game condition. Regarding food choice behaviour, participants with healthy baseline IAs were more likely to select fruit in the health game condition than participants with healthy baseline IAs in the control game condition. However, participants with less healthy baseline IAs were less likely to select fruit in the health game condition than in the control condition. We found tentative support that health games can be used to influence IAs towards food and positively affect food choice behaviour. However, this influence was only observed for those with healthy baseline IAs. The current version of the health game would primarily benefit those already healthy and could negatively affect those that need the intervention most, so modifications are recommendable. Copyright © 2018. Published by Elsevier Ltd.

  14. Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

    Science.gov (United States)

    Kneale, Laura; Choi, Yong; Demiris, George

    2016-01-01

    Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

  15. An agent-based simulation model of patient choice of health care providers in accountable care organizations.

    Science.gov (United States)

    Alibrahim, Abdullah; Wu, Shinyi

    2018-03-01

    Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

  16. Mental health problems among internally displaced persons in Darfur.

    Science.gov (United States)

    Hamid, Abdalla A R M; Musa, Saif A

    2010-08-01

    War victims are regarded as one of the highest risk groups for mental disturbances. This study investigated the effects of the Darfur conflict on mental health of 430 internally displaced persons (IDPs) from three camps located around Fasher and Nyala towns. A stratified random sampling technique was used to select participants. Male participants represented 50.6% of the sample while female participants represented 49.4%. The Posttraumatic Stress Disorder Checklist and the General Health Questionnaire (GHQ-28) were used in addition to a questionnaire measuring demographic variables and living conditions. It was hypothesized that high prevalence of posttraumatic stress disorder (PTSD) symptoms and of nonpsychotic psychiatric symptoms will be evident. Results showed a high dissatisfaction rate (72%) with living conditions among IDPs. There was also high prevalence of PTSD (54%) and general distress (70%) among IDPs. Female participants showed more somatic symptoms than their male counterparts. Married participants were more distressed, anxious, and showed more social dysfunction, while single ones reported more avoidance symptoms. Significant differences related to date of displacement were found in PTSD and hyperarousal. The group of IDPs displaced in 2003 scored higher on these scales than those displaced in 2004 and 2005. There was also significant difference related to date of displacement in distress, somatic symptoms, depression, anxiety, and social dysfunction. IDPs displaced in 2003 scored higher on these scales. Results are discussed in light of the study hypotheses and previous findings. It is concluded that three factors might affect the dissatisfaction of IDPs with living conditions inside camps. These are: lack of employment, unsuitability of food items, and lack of security around camps. It was recommended that psychological support services should be among the prime relief services provided by aid agencies.

  17. Person-centered osteopathic practice: patients’ personality (body, mind, and soul and health (ill-being and well-being

    Directory of Open Access Journals (Sweden)

    Elin Fahlgren

    2015-10-01

    Full Text Available Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul. Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being. We suggest Cloninger’s personality model, comprising temperament (i.e., body and character (i.e., mind and soul, as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1 the relationships between personality and health among osteopathic patients, (2 differences in personality between patients and a control group, and (3 differences in health within patients depending on the presenting problem and gender.Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem. We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender.Results. The patients’ personality explained the variance of all of the well-being (R2 between .19 and .54 and four of the ill-being (R2 between .05 and .43 measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions

  18. Sociotechnical Challenges of Developing an Interoperable Personal Health Record

    Science.gov (United States)

    Gaskin, G.L.; Longhurst, C.A.; Slayton, R.; Das, A.K.

    2011-01-01

    Objectives To analyze sociotechnical issues involved in the process of developing an interoperable commercial Personal Health Record (PHR) in a hospital setting, and to create guidelines for future PHR implementations. Methods This qualitative study utilized observational research and semi-structured interviews with 8 members of the hospital team, as gathered over a 28 week period of developing and adapting a vendor-based PHR at Lucile Packard Children’s Hospital at Stanford University. A grounded theory approach was utilized to code and analyze over 100 pages of typewritten field notes and interview transcripts. This grounded analysis allowed themes to surface during the data collection process which were subsequently explored in greater detail in the observations and interviews. Results Four major themes emerged: (1) Multidisciplinary teamwork helped team members identify crucial features of the PHR; (2) Divergent goals for the PHR existed even within the hospital team; (3) Differing organizational conceptions of the end-user between the hospital and software company differentially shaped expectations for the final product; (4) Difficulties with coordination and accountability between the hospital and software company caused major delays and expenses and strained the relationship between hospital and software vendor. Conclusions Though commercial interoperable PHRs have great potential to improve healthcare, the process of designing and developing such systems is an inherently sociotechnical process with many complex issues and barriers. This paper offers recommendations based on the lessons learned to guide future development of such PHRs. PMID:22003373

  19. Modeling the mental health effects of victimization among homeless persons

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  20. Modeling the mental health effects of victimization among homeless persons.

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  1. Personal health records as portal to the electronic medical record.

    Science.gov (United States)

    Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

    2014-03-01

    This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients.

  2. Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.

    Science.gov (United States)

    van Leeuwen, Christel M; Post, Marcel W; Westers, Paul; van der Woude, Lucas H; de Groot, Sonja; Sluis, Tebbe; Slootman, Hans; Lindeman, Eline

    2012-01-01

    To clarify relationships between activities, participation, mental health, and life satisfaction in persons with spinal cord injury (SCI) and specify how personal factors (self-efficacy, neuroticism, appraisals) interact with these components. We hypothesized that (1) activities are related directly to participation, participation is related directly to mental health and life satisfaction, and mental health and life satisfaction are 2 interrelated outcome variables; and (2) appraisals are mediators between participation and mental health and life satisfaction, and self-efficacy and neuroticism are related directly to mental health and life satisfaction and indirectly through appraisals. Follow-up measurement of a multicenter prospective cohort study 5 years after discharge from inpatient rehabilitation. Eight Dutch rehabilitation centers with specialized SCI units. Persons (N=143) aged 18 to 65 years at the onset of SCI. Not applicable. Mental health was measured by using the Mental Health subscale of the 36-Item Short Form Health Survey and life satisfaction with the sum score of "current life satisfaction" and "current life satisfaction compared with life satisfaction before SCI." Structural equation modeling showed that activities and neuroticism were related to participation and explained 49% of the variance in participation. Self-efficacy, neuroticism, and 2 appraisals were related to mental health and explained 35% of the variance in mental health. Participation, 3 appraisals, and mental health were related to life satisfaction and together explained 50% of the total variance in life satisfaction. Mental health and life satisfaction can be seen as 2 separate but interrelated outcome variables. Self-efficacy and neuroticism are related directly to mental health and indirectly to life satisfaction through the mediating role of appraisals. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Willingness to share personal health record data for care improvement and public health: a survey of experienced personal health record users

    Directory of Open Access Journals (Sweden)

    Weitzman Elissa R

    2012-05-01

    Full Text Available Abstract Background Data stored in personally controlled health records (PCHRs may hold value for clinicians and public health entities, if patients and their families will share them. We sought to characterize consumer willingness and unwillingness (reticence to share PCHR data across health topics, and with different stakeholders, to advance understanding of this issue. Methods Cross-sectional 2009 Web survey of repeat PCHR users who were patients over 18 years old or parents of patients, to assess willingness to share their PCHR data with an-out-of-hospital provider to support care, and the state/local public health authority to support monitoring; the odds of reticence to share PCHR information about ten exemplary health topics were estimated using a repeated measures approach. Results Of 261 respondents (56% response rate, more reported they would share all information with the state/local public health authority (63.3% than with an out-of-hospital provider (54.1% (OR 1.5, 95% CI 1.1, 1.9; p = .005; few would not share any information with these parties (respectively, 7.9% and 5.2%. For public health sharing, reticence was higher for most topics compared to contagious illness (ORs 4.9 to 1.4, all p-values  Conclusions Pediatric patients and their families are often willing to share electronic health information to support health improvement, but remain cautious. Robust trust models for PCHR sharing are needed.

  4. The Mass Comm Type: Student Personality Traits, Motivations, and the Choice between News and Strategic Communication Majors

    Science.gov (United States)

    Crawford, Elizabeth Crisp; Fudge, Julie; Hubbard, Glenn T.; Filak, Vincent F.

    2013-01-01

    A study of news media and strategic communication majors (n = 273) revealed differences in regard to personality indices and impetuses for selecting to pursue degrees. Showing overall agreement in the importance of openness, agreeableness, and conscientiousness, strategic communication students were significantly higher in their ratings of…

  5. Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

    Science.gov (United States)

    Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

    2017-11-06

    Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

  6. Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study.

    Science.gov (United States)

    Lieneck, Cristian; Nowicki, Michael

    2015-01-01

    A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. Inherent personality characteristics of leaders often play a major role in personal as well as organizational success to include those in health care finance positions of responsibility. A replication study was conducted to determine the Myers-Briggs personality-type differences between practicing health care finance professionals in 2014, as compared with a previous 2003 study. Results indicate a significant shift between both independent samples of health care finance professionals over the 10-year period from original high levels of introversion to that of extraversion, as well as higher sensing personality preferences, as compared with the original sample's high level of intuition preferences. Further investigation into the evolving role of the health care finance manager is suggested, while continued alignment of inherent, personal characteristics is suggested to meet ongoing changes in the industry.

  7. Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years.

    Science.gov (United States)

    Gallo, Agatha M; Wilkie, Diana J; Yao, Yingwei; Molokie, Robert E; Stahl, Christiane; Hershberger, Patricia E; Zhao, Zhongsheng; Suarez, Marie L; Johnson, Bonnye; Angulo, Rigoberto; Carrasco, Jesus; Angulo, Veronica; Thompson, Alexis A

    2016-04-01

    Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n = 138) or SCT (n = 96) (age 18-35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p = .004) but not intention (p = .18) or behavior (p = .69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p = .04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.

  8. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    NARCIS (Netherlands)

    Wendel, S.; Dellaert, B.G.C.; Ronteltap, A.; Trijp, van J.C.M.

    2013-01-01

    Background: Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine

  9. Consumers' intention to use health recommendation systems to receive personalized nutrition advice

    NARCIS (Netherlands)

    S. Wendel (Sonja); B.G.C. Dellaert (Benedict); A. Ronteltap (Amber); H.C.M. van Trijp (Hans)

    2013-01-01

    textabstractBackground: Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We

  10. Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.

  11. Medical students and personal smartphones in the clinical environment: the impact on confidentiality of personal health information and professionalism.

    Science.gov (United States)

    Tran, Kim; Morra, Dante; Lo, Vivian; Quan, Sherman D; Abrams, Howard; Wu, Robert C

    2014-05-22

    Smartphones are becoming ubiquitous in health care settings. The increased adoption of mobile technology such as smartphones may be attributed to their use as a point-of-care information source and to perceived improvements in clinical communication and efficiency. However, little is known about medical students' use of personal smartphones for clinical work. The intent of the study was to examine final-year medical students' experience with and attitudes toward using personal mobile technology in the clinical environment, with respect to the perceived impact on patient confidentiality and provider professionalism. Cross-sectional surveys were completed by final-year medical students at the University of Toronto. Respondents were asked about the type of personal mobile phone they use, security features on their personal phone, experiences using their personal phone during clinical rotations, and attitudes about using their personal phone for clinical work purposes. The overall response rate was 45.4% (99/218). Smartphone ownership was prevalent (98%, 97/99) with the majority (86%, 85/99) of participants using their personal phones for patient-related communication during clinical rotations. A total of 26% (26/99) of participants reported not having any type of security feature on their personal phone, 94% (90/96) of participants agreed that using their personal phone for clinical work makes them more efficient, and 86% (82/95) agreed that their personal phone allows them to provide better patient care. Although 68% (65/95) of participants believe that the use of personal phones for patient-related communication with colleagues poses a risk to the privacy and confidentiality of patient health information, 22% (21/96) of participants still use their personal phone to text or email identifiable patient data to colleagues. Our findings suggest that the use of personal smartphones for clinical work by medical students is prevalent. There is a need to more fully address

  12. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

    Science.gov (United States)

    Trinkoff, A.M.; Storr, C.L.; Wilson, M.L.; Gurses, A.P.

    2015-01-01

    Summary Background To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model. Objectives To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. Methods A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Results Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Conclusions Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their

  13. Lifetime trauma, personality traits, and health: A pathway to midlife health status.

    Science.gov (United States)

    Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R; Barckley, Maureen; Klest, Bridget; Dubanoski, Joan P; Hillier, Teresa A

    2016-07-01

    This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health. Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school. Self-reported adult personality assessments, lifetime histories of trauma experience, and objectively assessed physiological dysregulation were obtained between ages 45-55. Women tended to report more high-betrayal trauma than men, whereas men reported more low-betrayal trauma than women. Women who were judged by their teachers to be less agreeable and less conscientious in childhood reported more lifetime trauma, suggesting instrumental trait processes. For both genders, neuroticism and openness/intellect/imagination in adulthood, but not in childhood, were associated with lifetime trauma, suggesting reactive trait processes. For both genders, trauma experience was correlated with dysregulation and with Body Mass Index (BMI). The indirect paths from childhood conscientiousness to adult dysregulation and BMI through total teen and adult trauma were significant for women, but not for men (indirect effect for women's dysregulation = -.025, p = .040, 95% confidence interval [CI] = -.048, -.001; indirect effect for women's BMI = -.037, p = .009, 95% CI = -.067, -.008). Teen and adult trauma experience appears to be a hitherto unidentified mechanism in women underlying the association between conscientiousness and health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Knowledge of primary health care and career choice at primary health care settings among final year medical students - challenges to human resources for health in Vietnam.

    Science.gov (United States)

    Giang, Kim Bao; Minh, Hoang Van; Hien, Nguyen Van; Ngoc, Nguyen Minh; Hinh, Nguyen Duc

    2015-01-01

    There is a shortage of medical doctors in primary health care (PHC) settings in Vietnam. Evidence about the knowledge medical students have about PHC and their career decision-making is important for making policy in human resources for health. The objective of this study was to analyse knowledge and attitudes about PHC among medical students in their final year and their choice to work in PHC after graduation. A cross-sectional study was conducted among 400 final year general medical students from Hanoi Medical University. Self-administered interviews were conducted. Key variables were knowledge, awareness of the importance of PHC and PHC career choices. Descriptive and analytic statistics were performed. Students had essential knowledge of the concept and elements of PHC and were well aware of its importance. However, only one-third to one half of them valued PHC with regard to their professional development or management opportunities. Less than 1% of students would work at commune or district health facilities after graduation. This study evidences challenges related to increasing the number of medical doctors working in PHC settings. Immediate and effective interventions are needed to make PHC settings more attractive and to encourage medical graduates to start and continue a career in PHC.

  15. Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

    Science.gov (United States)

    Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

    2015-01-01

    Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the

  16. Participating in a Food-Assisted Maternal and Child Nutrition and Health Program in Rural Guatemala Alters Household Dietary Choices.

    Science.gov (United States)

    Jensen, Melissa L; Frongillo, Edward A; Leroy, Jef L; Blake, Christine E

    2016-08-01

    Food assistance programs may alter food choices, but factors determining households' decisions regarding food acquisition, preparation, and consumption in the context of food aid are not well understood. This study aimed to understand how the Programa Comunitario Materno Infantil de Diversificación Alimentaria (Mother-Child Community Food Diversification Program; PROCOMIDA), a food-assisted maternal and child health and nutrition program in rural Alta Verapaz, Guatemala, altered household food choices. We conducted semistructured interviews and focus groups with 63 households in 3 participating (n = 32 households) and 3 control (n = 31) villages. A last-day food recall (without estimating quantities) and food-frequency questionnaire that used food cards assessed dietary choices. Qualitative analysis used thematic a priori and emergent coding; food group consumption frequencies were analyzed by using 2-level, logistic, mixed modeling, and chi-square testing while accounting for community clustering. Compared with control households, PROCOMIDA changed household food choices through a combination of providing food resources (with monthly food rations) and new knowledge and skills related to health and food (in the program's behavior change communication component) while reinforcing existing knowledge and beliefs. PROCOMIDA families consumed rice, red beans, and oil more frequently than did control families (differences of 2.20 (P foods were in the rations. PROCOMIDA families also ate chicken, local plants, and some vegetables more frequently. The importance of these foods was emphasized in the behavioral change communication component; these foods may have been more accessible because provision of food rations freed resources. Our findings suggest that if a program provides food free of cost to rural indigenous families in the context of a maternal and child nutrition and health program, it may be important to include a well-designed behavioral change communication

  17. Basic Health, Women’s Health, and Mental Health Among Internally Displaced Persons in Nyala Province, South Darfur, Sudan

    Science.gov (United States)

    Kim, Glen; Torbay, Rabih; Lawry, Lynn

    2007-01-01

    Objectives. We assessed basic health, women’s health, and mental health among Sudanese internally displaced persons in South Darfur. Methods. In January 2005, we surveyed 6 registered internally displaced persons camps in Nyala District. Using systematic random sampling, we surveyed 1293 households, interviewing 1 adult female per household (N=1274); respondents’ households totaled 8643 members. We inquired about respondents’ mental health, opinions on women’s rights, and the health status of household members. Results. A majority of respondents had access to rations, shelter, and water. Sixty-eight percent (861 of 1266) used no birth control, and 53% (614 of 1147) reported at least 1 unattended birth. Thirty percent (374 of 1238) shared spousal decisions on timing and spacing of children, and 49% (503 of 1027) reported the right to refuse sex. Eighty-four percent (1043 of 1240) were circumcised. The prevalence of major depression was 31% (390 of 1253). Women also expressed limited rights regarding marriage, movement, and access to health care. Eighty-eight percent (991 of 1121) supported equal educational opportunities for women. Conclusions. Humanitarian aid has relieved a significant burden of this displaced population’s basic needs. However, mental and women’s health needs remain largely unmet. The findings indicate a limitation of sexual and reproductive rights that may negatively affect health. PMID:17138925

  18. Basic health, women's health, and mental health among internally displaced persons in Nyala Province, South Darfur, Sudan.

    Science.gov (United States)

    Kim, Glen; Torbay, Rabih; Lawry, Lynn

    2007-02-01

    We assessed basic health, women's health, and mental health among Sudanese internally displaced persons in South Darfur. In January 2005, we surveyed 6 registered internally displaced persons camps in Nyala District. Using systematic random sampling, we surveyed 1293 households, interviewing 1 adult female per household (N=1274); respondents' households totaled 8643 members. We inquired about respondents' mental health, opinions on women's rights, and the health status of household members. A majority of respondents had access to rations, shelter, and water. Sixty-eight percent (861 of 1266) used no birth control, and 53% (614 of 1147) reported at least 1 unattended birth. Thirty percent (374 of 1238) shared spousal decisions on timing and spacing of children, and 49% (503 of 1027) reported the right to refuse sex. Eighty-four percent (1043 of 1240) were circumcised. The prevalence of major depression was 31% (390 of 1253). Women also expressed limited rights regarding marriage, movement, and access to health care. Eighty-eight percent (991 of 1121) supported equal educational opportunities for women. Humanitarian aid has relieved a significant burden of this displaced population's basic needs. However, mental and women's health needs remain largely unmet. The findings indicate a limitation of sexual and reproductive rights that may negatively affect health.

  19. Changes in physical health among participants in a multidisciplinary health programme for long-term unemployed persons

    NARCIS (Netherlands)

    C.A. Schutgens (Christine); M. Schuring (Merel); T. Voorham (Toon); A. Burdorf (Alex)

    2009-01-01

    textabstractBackground. The relationship between poor health and unemployment is well established. Health promotion among unemployed persons may improve their health. The aims of this study were to investigate characteristics of non-participants and drop-outs in a multidisciplinary health promotion

  20. A global travelers' electronic health record template standard for personal health records.

    Science.gov (United States)

    Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

    2012-01-01

    Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.

  1. Digital health increasing the impact with personalized design

    OpenAIRE

    Empelen, P. van; Otten, W.; Molema, H.; Keijsers, J.; Mooij, R.

    2016-01-01

    Digital health is considered the ‘holy grail’ of effective and sustainable health(care). It uses the latest technology, apps and data to support and improve health. Digital health tools can benefit both patients and healthy individuals, with support and advice. But healthcare professionals, policymakers and scientist can also benefit from the (big) data and insights collected by digital health applications. A well-known example of digital health is eHealth, which provides information- and com...

  2. Ageing and mental health resources for older persons in the African ...

    African Journals Online (AJOL)

    To better understand the organisation of care for older persons, data are being collected to reduce the imbalance between 'disease information\\' and 'resource information\\' – information that addresses older persons\\' needs in terms of mental health care. This review presents some results from the continent. Mental health ...

  3. The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

    Science.gov (United States)

    McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

    2018-06-01

    Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

  4. 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

  5. Potential side effects of unhealthy lifestyle choices and health risks on basal and reactive heart rate variability in college drinkers.

    Science.gov (United States)

    Udo, Tomoko; Mun, Eun-Young; Buckman, Jennifer F; Vaschillo, Evgeny G; Vaschillo, Bronya; Bates, Marsha E

    2013-09-01

    Emerging adults often begin making independent lifestyle choices during college, yet the association of these choices with fundamental indicators of health and adaptability is unclear. The present study examined the relationship between health risks and neurocardiac function in college drinkers. Heart rate variability (HRV) was assessed at baseline and in reaction to a paced breathing challenge in 212 college drinkers (53.8% women). Basal HRV served as a general indicator of health. Reactive HRV (during paced breathing) was used as a marker of an individual's adaptability to challenge. The relationship of HRV to alcohol use, cigarette use, exercise, sleep, and body mass index (BMI) was assessed. Greater alcohol use and less exercise were associated with lower basal HRV. BMI was unrelated to basal HRV but was negatively associated with reactive HRV during the breathing challenge. High levels of alcohol use and lack of exercise are negative correlates of cardiovascular and general health, even in apparently healthy college drinkers. The negative relationship between BMI and reactive HRV suggests that overweight individuals have reduced ability to psychophysiologically adapt to challenges; understanding the temporal course of this relationship is needed. This study highlights the importance of examining HRV at baseline and in response to a challenge to capture the active neurocardiac processes that contribute to health and adaptive responding. The suppressive effects of health risks on HRV are modifiable; thus, HRV may be useful in evaluating the health benefits of lifestyle change and in promoting change behaviors in college drinkers.

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

    Directory of Open Access Journals (Sweden)

    Denis Mike

    2011-07-01

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

  7. The detrimental impact of maladaptive personality on public mental health: a challenge for psychiatric practice

    Directory of Open Access Journals (Sweden)

    Michael Pascal Hengartner

    2015-06-01

    Full Text Available Experts in personality psychology and personality disorders have long emphasised the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment and disability pensioning; second, relate to the prevalence, incidence and co-occurrence of common mental disorders; third, impair functioning, symptom remission and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders, but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice.

  8. It's "Supposed" to Be Personal: Personal and Educational Factors Associated with Sexual Health Attitudes, Knowledge, Comfort and Skill in Health Profession Students

    Science.gov (United States)

    West, Lindsey M.; Stepleman, Lara M.; Wilson, Christina K.; Campbell, Jeff; Villarosa, Margo; Bodie, Brittany; Decker, Matthew

    2012-01-01

    The health professional and the patient are cultural beings with beliefs and attitudes that are shaped by family traditions, social development, and exposure to novel experiences. As such, it is especially important for health profession students to gain awareness about the personal and educational factors that likely inform their practice and…

  9. Health-seeking behavior and medical facility choice in Samsun, Turkey.

    Science.gov (United States)

    Dündar, Cihad

    2017-09-01

    Examining the factors that play a role in determining patient preferences for different healthcare institutions. This descriptive study was conducted in five family health centers (FHC) and in six hospitals in Samsun Province in Turkey. The data were collected from 1700 volunteer patients by using a structured questionnaire, while they were waiting for consultation. The average number of out-patient visits was 9.5±6.4 per person in 2012. Individuals aged less than 18 and more than 65 years old had higher preferences for FHCs, while those aged 19-64 years preferred primarily private hospitals. The order of preferences for FHC, public and private hospitals did not vary with the educational level. An increase in educational level was associated with a decrease in the preference for FHCs and in increase in the preference for private hospitals. The first three reasons given for preferring a hospital were 'the presence of a specialist', 'availability of good equipment and technology', and 'trust on the diagnosis and treatment', while 'proximity', 'receiving adequate information', and 'being treated well' were the reasons given by participants who preferred a FHC. Providing medical equipment and staff support for improving diagnostic capacity of FHCs can accommodate patient expectations and shift the demand from hospitals to FHCs. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Cultural concepts of the person and mental health in Africa.

    Science.gov (United States)

    Kpanake, Lonzozou

    2018-04-01

    People in different cultures have different concepts of the person that underlie self-understanding and self-representation. These concepts influence many aspects of individuals' life experience, including illness and expectations toward recovery. Psychotherapies aim to promote adaptive change in experience and behavior. This goal is embedded in a social and cultural context that promotes or sanctions a particular notion of personhood. If every system of psychotherapy depends on implicit models of personhood, which varies cross-culturally, then the goals and methods of therapeutic change must consider the cultural concept of the person. This paper reviews cultural concepts of the person in relation to communal values, practices, and systems of thought observed across many African cultural contexts. It presents a practical framework that can inform therapists working with African clients. Many African cultures promote a relational-oriented personhood, in which an individual manifests his or her personhood through connections to three distinct forms of agency: (a) spiritual agency, including God, ancestors, and spirits that influence the person; (b) social agency, including the family, the clan, and the community, with extension to humanity; and (c) self-agency, which is responsible for the person's inner experience. This distinctive form of personhood underlies concepts of the "normal" person, understandings of mental illness, help-seeking behavior, and clients' needs and expectations. Implications of this cultural concept of the person for psychotherapy with African clients are discussed.

  11. School Experiences Influence Personal Health and Interpersonal Relationships of Adolescents: The Canadian Case

    Science.gov (United States)

    Ma, Xin

    2007-01-01

    Canadian data from the 1998 Cross-National Survey on Health Behaviors in School-Aged Children were analyzed to examine the effects of school experiences on personal health (physical health, mental health, self-esteem, helplessness, and body image) and interpersonal relationships (number of close friends and making friends) among adolescents.…

  12. Focus on People: Rethinking the Power and Potential of Personal Health Records - Q and A

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.

  13. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 2

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.

  14. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 1

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.

  15. Improving the quality of discrete-choice experiments in health: how can we assess validity and reliability?

    Science.gov (United States)

    Janssen, Ellen M; Marshall, Deborah A; Hauber, A Brett; Bridges, John F P

    2017-12-01

    The recent endorsement of discrete-choice experiments (DCEs) and other stated-preference methods by regulatory and health technology assessment (HTA) agencies has placed a greater focus on demonstrating the validity and reliability of preference results. Areas covered: We present a practical overview of tests of validity and reliability that have been applied in the health DCE literature and explore other study qualities of DCEs. From the published literature, we identify a variety of methods to assess the validity and reliability of DCEs. We conceptualize these methods to create a conceptual model with four domains: measurement validity, measurement reliability, choice validity, and choice reliability. Each domain consists of three categories that can be assessed using one to four procedures (for a total of 24 tests). We present how these tests have been applied in the literature and direct readers to applications of these tests in the health DCE literature. Based on a stakeholder engagement exercise, we consider the importance of study characteristics beyond traditional concepts of validity and reliability. Expert commentary: We discuss study design considerations to assess the validity and reliability of a DCE, consider limitations to the current application of tests, and discuss future work to consider the quality of DCEs in healthcare.

  16. A systematic review, and meta-analyses, of the impact of health-related claims on dietary choices.

    Science.gov (United States)

    Kaur, Asha; Scarborough, Peter; Rayner, Mike

    2017-07-11

    Health-related claims are statements regarding the nutritional content of a food (nutrition claims) and/or indicate that a relationship exists between a food and a health outcome (health claims). Their impact on food purchasing or consumption decisions is unclear. This systematic review measured the effect of health-related claims, on pre-packaged foods in retail settings, on adult purchasing decisions (real and perceived). In September 2016, we searched MEDLINE, EMBASE, PsychINFO, CAB abstracts, Business Source Complete, and Web of Science/Science Citation Index & Social Science Citation Index for articles in English published in peer-review journals. Studies were included if they were controlled experiments where the experimental group(s) included a health-related claim and the control group involved an identical product without a health-related claim. Included studies measured (at an individual or population level); actual or intended choice, purchases, and/or consumption. The primary outcome was product choices and purchases, the secondary outcome was food consumption and preference. Results were standardised through calculating odds ratios and 95% confidence intervals (CI) for the likelihood of choosing a product when a health-related claim was present. Results were combined in a random-effects meta-analysis. Thirty-one papers were identified, 17 of which were included for meta-analyses. Most studies were conducted in Europe (n = 17) and the USA (n = 7). Identified studies were choice experiments that measured the likelihood of a product being chosen when a claim was present compared to when a claim was not present, (n = 16), 15 studies were experiments that measured either; intent-rating scale outcomes (n = 8), consumption (n = 6), a combination of the two (n = 1), or purchase data (n = 1). Overall, 20 studies found that claims increase purchasing and/or consumption, eight studies had mixed results, and two studies found consumption

  17. Real-time personal exposure and health condition monitoring system

    Energy Technology Data Exchange (ETDEWEB)

    Saitou, Isamu; Kanda, Hiroaki; Asai, Akio; Takeishi, Naoki; Ota, Yoshito [Hitachi Aloka Medical, Ltd., Measuring Systems Engineering Dept., Tokyo (Japan); Hanawa, Nobuhiro; Ueda, Hisao; Kusunoki, Tsuyoshi; Ishitsuka, Etsuo; Kawamura, Hiroshi [Japan Atomic Energy Agency, Oarai Research and Development Center, Oarai, Ibaraki (Japan)

    2012-03-15

    JAEA (Japan Atomic Energy Agency) and HAM (Hitachi Aloka Medical, Ltd) have proposed novel monitoring system for workers of nuclear facility. In these facilities, exposure management for workers is mainly used access control and personal exposure recordings. This system is currently only for reports management but is not confirmative for surveillance when work in progress. Therefore, JAEA and HAM integrate access control and personal exposure recordings and two real-time monitoring systems which are position sensing and vital sign monitor. Furthermore change personal exposure management to real-time management, this system integration prevents workers from risk of accidents, and makes possible take appropriate action quickly. This novel system is going to start for tentative operation, using position sensing and real-time personal dosimeter with database in Apr. 2012. (author)

  18. Digital health increasing the impact with personalized design

    NARCIS (Netherlands)

    Empelen, P. van; Otten, W.; Molema, H.; Keijsers, J.; Mooij, R.

    2016-01-01

    Digital health is considered the ‘holy grail’ of effective and sustainable health(care). It uses the latest technology, apps and data to support and improve health. Digital health tools can benefit both patients and healthy individuals, with support and advice. But healthcare professionals,

  19. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 1

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  20. Focus on People: Rethinking the Power and Potential of Personal Health Records - Q and A

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  1. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 2

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  2. Utilization of emergency medical transports and hospital admissions among persons with behavioral health conditions.

    Science.gov (United States)

    Cuddeback, Gary; Patterson, P Daniel; Moore, Charity Galena; Brice, Jane H

    2010-04-01

    Emergency medical services transport and emergency department misuse among persons with behavioral health conditions is a concern. Administrative data were used to examine medical transports and hospital admissions among persons with behavioral health conditions. Data on 70,126 medical transports to emergency departments in three southeastern counties were analyzed. Compared with general medical transports, fewer behavioral health transports resulted in a hospital admission. Among behavioral health transports, persons with schizophrenia were 2.62 times more likely than those with substance use disorders to be admitted, and persons with mood disorders were 4.36 times more likely than those with substance use disorders to be admitted. Also, among behavioral health transports, rural transports were less likely than more urban transports to result in a hospital admission. More training of emergency medical services personnel and more behavioral health crisis resources, especially targeting rural areas and substance use disorders, are needed.

  3. Adolescents demonstrate improvement in obesity risk behaviors after completion of choice, control & change, a curriculum addressing personal agency and autonomous motivation.

    Science.gov (United States)

    Contento, Isobel R; Koch, Pamela A; Lee, Heewon; Calabrese-Barton, Angela

    2010-12-01

    The rapid increase of obesity and diabetes risk beginning in youth, particularly those from disadvantaged communities, calls for prevention efforts. To examine the impact of a curriculum intervention, Choice, Control & Change, on the adoption of the energy balance-related behaviors of decreasing sweetened drinks, packaged snacks, fast food, and leisure screen time, and increasing water, fruits and vegetables, and physical activity, and on potential psychosocial mediators of the behaviors. Ten middle schools were randomly assigned within matched pairs to either intervention or comparison/delayed control conditions during the 2006-2007 school year. Students were from low-income New York City neighborhoods; 562 were in the intervention condition, and 574 in the comparison condition. Students received the 24 Choice, Control & Change lessons that used science inquiry investigations to enhance motivation for action, and social cognitive and self-determination theories to increase personal agency and autonomous motivation to take action. Self-report instruments to measure energy balance-related behaviors targeted by the curriculum and potential psychosocial mediators of the behaviors. Analysis of covariance with group (intervention/control) as a fixed factor and pretest as covariate. Students in intervention schools compared to the delayed intervention controls reported consumption of considerably fewer sweetened drinks and packaged snacks, smaller sizes of fast food, increased intentional walking for exercise, and decreased leisure screen time, but showed no increases in their intakes of water, fruits, and vegetables. They showed substantial increases in positive outcome expectations about the behaviors, self-efficacy, goal intentions, competence, and autonomy. The Choice, Control & Change curriculum was effective in improving many of the specifically targeted behaviors related to reducing obesity risk, indicating that combining inquiry-based science education and

  4. Does personality affect health-related quality of life? A systematic review

    Science.gov (United States)

    Huang, I-Chan; Lee, Joy L.; Ketheeswaran, Pavinarmatha; Jones, Conor M.; Revicki, Dennis A.; Wu, Albert W.

    2017-01-01

    Background Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear. Methods This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study. Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%. Conclusions Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation. PMID:28355244

  5. [Discharge planning in which a discharge planning nurse was involved in the choice of nutrition management for an elderly person with dementia].

    Science.gov (United States)

    Tanaka, Yuko; Ohori, Yoko; Seshimo, Akiyoshi

    2013-12-01

    A discharge planning nurse at an acute care hospital conducted discharge planning for an elderly person with dementia who is in his/her 90s and his/her family. The nurse was involved in the choice of nutrition management method and was able to support the family's decision-making. The family had high expectations for oral ingestion, and there was disparity between those expectations and the actual state of the disease, in which aspiration occurred frequently. The nurse respected the family's wishes, but also helped the family to correctly understand the state of the disease and to make satisfactory choices about future daily life. In order to guarantee safety, the discharge planning nurse held a conference with people related to homecare, such as the home-visiting physician, the home-visiting nurse, and the care manager. As a result of the conference, that family was able to feel satisfied with and choose gastrostomy as the nutrition method. The current situation was better understood because information was shared with the community, and the confidence in the community was strengthened by giving consideration to the family's burden. It was reconfirmed that the cooperation of local staff members is useful in discharge planning.

  6. A Big Five approach to self-regulation: personality traits and health trajectories in the Hawaii longitudinal study of personality and health.

    Science.gov (United States)

    Hampson, Sarah E; Edmonds, Grant W; Barckley, Maureen; Goldberg, Lewis R; Dubanoski, Joan P; Hillier, Teresa A

    2016-01-01

    Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits. The Big Five approach to personality was used here to investigate the associations between childhood traits, trait-related regulatory processes and changes in health across middle age. Participants (N = 1176) were members of the Hawaii longitudinal study of personality and health. Teacher assessments of the participants' traits when they were in elementary school were related to trajectories of self-rated health measured on 6 occasions over 14 years in middle age. Five trajectories of self-rated health were identified by latent class growth analysis: Stable Excellent, Stable Very Good, Good, Decreasing and Poor. Childhood Conscientiousness was the only childhood trait to predict membership in the Decreasing class vs. the combined healthy classes (Stable Excellent, Stable Very Good and Good), even after controlling for adult Conscientiousness and the other adult Big Five traits. The Decreasing class had poorer objectively assessed clinical health measured on one occasion in middle age, was less well-educated, and had a history of more lifespan health-damaging behaviors compared to the combined healthy classes. These findings suggest that higher levels of childhood Conscientiousness (i.e. greater self-discipline and goal-directedness) may prevent subsequent health decline decades later through self-regulatory processes involving the acquisition of lifelong healthful behavior patterns and higher educational attainment.

  7. An Examination of the Self-directed Online Leadership Learning Choices of Public Health Professionals: The Maternal and Child Health Public Health Leadership Institute Experience.

    Science.gov (United States)

    Fernandez, Claudia S P; Noble, Cheryl C; Jensen, Elizabeth T

    To assess the self-selected asynchronous leadership module-based learning choices of public health professionals participating in the Maternal and Child Health Public Health Leadership Institute (MCH PHLI). Online module completion and evaluation data were used to determine the topics most utilized by the Fellows; whether the topics and mode of training were acceptable, relevant, and practical; and whether participant characteristics explained any usage patterns. A total of 109 enrolled Fellows in the MCH PHLI program. Module frequency of selection by Fellows; Fellows' rating scores in regard to relevance, practicality, and acceptability of module topics. All program titles were highly rated. The 5 most frequently selected module topics were employee engagement (87.2%), talent acquisition strategies (84.4%), employee motivation (79.8%), emotional intelligence (78.9%), and workforce development strategies (68.8%). The least accessed topics focused on cultural competence (15.6%), social marketing (25.7%), effective communication and advocacy (25.7%), family partnerships (25.9%), and creating learning organizations (31.2%). All module topics provided were rated as relevant, practical, and acceptable to these public health leaders. Self-directed computer-based learning was rated strongly by the MCH public health leaders in this study. Such an approach can be used to customize training to individual needs and interests. These findings suggest that inclusion of skills that enable public health leaders to effectively work with and through others was of core interest in the MCH PHLI. The finding of higher usage of topics related to workforce management can provide guidance for those developing leadership development programs for maternal and child health professionals. In addition, leadership needs and interests should be assessed regularly to ensure that competency-based leadership development guidelines are adapting to the evolving and complex challenges faced by leaders

  8. Choice of organic foods is related to perceived consequences for human health and to environmentally friendly behaviour.

    Science.gov (United States)

    Magnusson, Maria K; Arvola, Anne; Hursti, Ulla Kaisa Koivisto; Aberg, Lars; Sjödén, Per-Olow

    2003-04-01

    We designed a questionnaire concerned with attitudes and behaviour towards organic foods, environmentally friendly behaviour (EFB), and perceived consequences of organic food choice in terms of human health, the environment and animal welfare. It was mailed in 1998 to a random nation-wide sample of 2000 Swedish citizens, ages 18-65 years, and 1154 (58%) responded. Self-reported purchase of organic foods was most strongly related to perceived benefit for human health. Performance of EFBs such as refraining from car driving was also a good predictor of purchase frequency. The results indicate that egoistic motives are better predictors of the purchase of organic foods than are altruistic motives.

  9. Factors that influence beverage choices at meal times. An application of the food choice kaleidoscope framework.

    Science.gov (United States)

    Mueller Loose, S; Jaeger, S R

    2012-12-01

    Beverages are consumed at almost every meal occasion, but knowledge about the factors that influence beverage choice is less than for food choice. The aim of this research was to characterize and quantify factors that influence beverage choices at meal times. Insights into what beverages are chosen by whom, when and where can be helpful for manufacturers, dieticians/health care providers, and health policy makers. A descriptive framework - the food choice kaleidoscope (Jaeger et al., 2011) - was applied to self-reported 24h food recall data from a sample of New Zealand consumers. Participants (n=164) described 8356 meal occasions in terms of foods and beverages consumed, and the contextual characteristics of the occasion. Beverage choice was explored with random-parameter logit regressions to reveal influences linked to food items eaten, context factors and person factors. Thereby this study contributed to the food choice kaleidoscope research approach by expressing the degree of context dependency in the form of odds ratios and according significance levels. The exploration of co-occurrence of beverages with food items suggests that beverage-meal item combinations can be meal specific. Furthermore, this study integrates psychographic variables into the 'person' mirror of the food choice kaleidoscope. A measure of habit in beverage choice was obtained from the inter-participant correlation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Smartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion.

    Science.gov (United States)

    Martin, Corby K; Gilmore, L Anne; Apolzan, John W; Myers, Candice A; Thomas, Diana M; Redman, Leanne M

    2016-03-16

    Synonymous with increased use of mobile phones has been the development of mobile health (mHealth) technology for improving health, including weight management. Behavior change theory (eg, the theory of planned behavior) can be effectively encapsulated into mobile phone-based health improvement programs, which is fostered by the ability of mobile phones and related devices to collect and transmit objective data in near real time and for health care or research professionals and clients to communicate easily. To describe SmartLoss, a semiautomated mHealth platform for weight loss. We developed and validated a dynamic energy balance model that determines the amount of weight an individual will lose over time if they are adherent to an energy intake prescription. This model was incorporated into computer code that enables adherence to a prescribed caloric prescription determined from the change in body weight of the individual. Data from the individual are then used to guide personalized recommendations regarding weight loss and behavior change via a semiautomated mHealth platform called SmartLoss, which consists of 2 elements: (1) a clinician dashboard and (2) a mobile phone app. SmartLoss includes and interfaces with a network-connected bathroom scale and a Bluetooth-connected accelerometer, which enables automated collection of client information (eg, body weight change and physical activity patterns), as well as the systematic delivery of preplanned health materials and automated feedback that is based on client data and is designed to foster prolonged adherence with body weight, diet, and exercise goals. The clinician dashboard allows for efficient remote monitoring of all clients simultaneously, which may further increase adherence, personalization of treatment, treatment fidelity, and efficacy. Evidence of the efficacy of the SmartLoss approach has been reported previously. The present report provides a thorough description of the SmartLoss Virtual Weight

  11. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

    Science.gov (United States)

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  12. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  13. Trajectories of physical and mental health among persons with morbid obesity and persons with COPD: a longitudinal comparative study

    Directory of Open Access Journals (Sweden)

    Bonsaksen T

    2016-04-01

    Full Text Available Tore Bonsaksen,1 May Solveig Fagermoen,2 Anners Lerdal2,3 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 2Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, 3Department for Patient Safety and Development, Lovisenberg Diakonale Hospital, Oslo, NorwayBackground: Morbid obesity and chronic obstructive pulmonary disease (COPD are prevalent diseases associated with impaired health-related quality of life (HRQoL. Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field.Methods: A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis.Results: Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains.Conclusion: A more favorable trajectory

  14. Smoking, alcohol, and dietary choices: evidence from the Portuguese National Health Survey

    Directory of Open Access Journals (Sweden)

    Santos Ana

    2007-07-01

    Full Text Available Abstract Background Unhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits. The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population. Methods The study sample included all participants in the third Portuguese National Health Survey who were older than 19 years (20,302 women and 17,923 men. Participants were selected from households in the five regions of Portugal (NUTS II classification, using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, lifestyle and health, smoking, and intakes of selected food and beverages. Age-adjusted and education-adjusted binomial and multinomial logistic regression models were fitted separately for males and females, to estimate the magnitude of the association between smoking and the consumption of various food and beverage groups. Results When heavy smokers were compared with non-smokers, the odds ratio (OR favouring soup consumption was 0.60 (95% Confidence Interval [95%CI]: 0.54–0.68 in males and 0.46 (95% CI: 0.33–0.65 in females. Similar ORs were observed for vegetables (males: OR = 0.56, 95%CI: 0.49–0.64; females: OR = 0.47, 95%CI: 0.32–0.69 and fruit (males: OR = 0.36, 95%CI: 0.31–0.41; females: OR = 0.29, 95%CI: 0.19–0.44. Overall, these food items were consumed at significantly lower levels as cigarette consumption increased. Heavy male smokers, compared to non-smokers, presented lower odds favouring milk consumption (OR = 0.89; 95%CI: 0.67–0.89. When heavy smokers were compared with non-smokers, the ORs favouring wine drinking, among heavy drinkers, were 1.47 (95%CI: 1.27–1.70 in men and 3.97 (95%CI: 2.07–7.61 in women. Similar ORs were observed for beer (males: OR = 3.30; 95%CI: 2.87–3.78; females: OR = 23

  15. 75 FR 51083 - Office of Clinical and Preventive Services Maternal and Child Health Program: Project Choices...

    Science.gov (United States)

    2010-08-18

    ... a media-recruited cohort of women. High risk women were defined as 18-44 years of age, fertile... drinks per occasion in the past month. Each woman was provided with a 4-session motivation counseling... the CHOICES materials for AI/AN populations describing approaches that address social and cultural...

  16. Momentous Choices: Testing nonstandard decision models in health and housing markets

    NARCIS (Netherlands)

    M. Filko (Martin)

    2013-01-01

    markdownabstract__Abstract__ During more than half a century, several strands of research contributed to the development of decision theory. The standard normative model for choice under uncertainty – expected utility – was given a foundation by von Neumann and Morgenstern (1944) and Savage

  17. Understanding views on everyday use of personal health information: Insights from community dwelling older adults.

    Science.gov (United States)

    Hartzler, A L; Osterhage, K; Demiris, G; Phelan, E A; Thielke, S M; Turner, A M

    2018-09-01

    Older adults apply various strategies to pursue healthy aging, but we know little about their views and use of personal health information to accomplish those ends. As a first step in formulating the role of personal health information management (PHIM) in healthy aging, we explored the perspectives of older adults on health and health information used in their everyday lives through four focus groups with 25 community-dwelling adults aged 60 and over. We found that the concept of wellness-the holistic and multidimensional nature of health and wellbeing-plays prominently in how older adults think about health and health information. Participants expressed wellness from a position of personal strength, rather than health-related deficits, by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement. Although these themes involve personal health information, existing PHIM systems that focus on disease management are generally not designed to support wellness activities. Substantial opportunity exists to fill this wellness support gap with innovative health information technology designed for older adults. Findings carry implications for the design of PHIM tools that support healthy aging and methods for engaging older adults as co-producers of this critical support.

  18. Los registros de salud personal: el caso de la Carpeta Personal de Salud de Cataluña Personal health records: the case of the Personal Health Folder of Catalonia (Spain

    Directory of Open Access Journals (Sweden)

    Francesc Saigí

    2012-12-01

    Full Text Available Este trabajo explora las posibilidades de la Carpeta Personal de Salud e identifica la brecha entre el potencial de esta herramienta y las aplicaciones que ofrece a través de Internet. Se presenta la Carpeta Personal de Salud, un proyecto vinculado a la Historia Clínica Compartida de Cataluña, que ofrece un punto de acceso a la información sobre la propia salud que es seguro, personalizado y soportado por las tecnologías de la información y la comunicación. La experiencia, realizada íntegramente por la Consejería de Salud de la Generalitat de Cataluña, escogió una metodología mediante encuesta anónima. Los resultados han sido de gran relevancia para obtener información sobre la idoneidad de los datos publicados y las expectativas de una herramienta dirigida a la población en general.The aims of this study were to explore the possibilities of the Personal Health Folder and to identify the gap between the potential applications of this tool and what it offers through the Internet. The Personal Health Folder is presented, a project linked to the Shared Medical Record of Catalonia (Spain, which provides citizens with an access point to information about their health insurance, customized and supported by information and communication technologies. The project was carried out by the Ministry of Health of the Government of Catalonia (Generalitat de Catalunya and data were gathered through an anonymous survey. The results were critical to obtain information on the suitability of the published data and on the expectations of a tool aimed at the general population.

  19. Unmet health care needs for persons with environmental sensitivity

    OpenAIRE

    Gibson, Pamela Reed; Kovach, Shannon; Lupfer, Alexis

    2015-01-01

    Pamela Reed Gibson, Shannon Kovach, Alexis LupferDepartment of Psychology, James Madison University, Harrisonburg, VA, USAAbstract: Studies of unmet health care needs have shown that women, people with poor health, and people with lower socioeconomic status are more likely to report having unmet health care needs. In this study, we examined the types of and reasons for unmet health care needs in 465 people with environmental sensitivities. A second area of inquiry involved negative reactions ...

  20. Clinical, classroom, or personal education: attitudes about health literacy.

    Science.gov (United States)

    Logan, Robert A

    2007-04-01

    This study explores how diverse attitudes about health literacy are assessed by medical librarians and other health care professionals. An online survey of thirty-six items was conducted using Q methodology in two phases in spring 2005 and winter 2006. Respondents (n = 51) were nonrandomly self-selected from a convenience sample of members of the Medical Library Association and a group of environmental health consultants to the National Library of Medicine. Three factors were identified. Factor 1 is optimistic and supportive of health literacy's transformative sociocultural and professional potential, if clinical settings become a launching point for health literacy activities. Factor 2 is less optimistic about health literacy's potential to improve clinical or patient outcomes and prefers to focus health literacy initiatives on classroom education settings. Factor 3 supports improving the nation's health literacy but tends to support health literacy initiatives when people privately interact with health information materials. Each factor's attitudes about the appropriate educational venue to initiate health literacy activities are different and somewhat mutually exclusive. This suggests that health literacy is seen through different perceptual frameworks that represent a possible source of professional disagreement.

  1. Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing

    Science.gov (United States)

    Balasubramaniam, S.; Kavitha, V.

    2015-01-01

    Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud. PMID:25767826

  2. Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing

    Directory of Open Access Journals (Sweden)

    S. Balasubramaniam

    2015-01-01

    Full Text Available Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.

  3. Geometric data perturbation-based personal health record transactions in cloud computing.

    Science.gov (United States)

    Balasubramaniam, S; Kavitha, V

    2015-01-01

    Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.

  4. Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets.

    Science.gov (United States)

    Yogo, Motohiro

    2016-06-01

    In a life-cycle model, a retiree faces stochastic health depreciation and chooses consumption, health expenditure, and the allocation of wealth between bonds, stocks, and housing. The model explains key facts about asset allocation and health expenditure across health status and age. The portfolio share in stocks is low overall and is positively related to health, especially for younger retirees. The portfolio share in housing is negatively related to health for younger retirees and falls significantly in age. Finally, out-of-pocket health expenditure as a share of income is negatively related to health and rises in age.

  5. Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets*

    Science.gov (United States)

    Yogo, Motohiro

    2016-01-01

    In a life-cycle model, a retiree faces stochastic health depreciation and chooses consumption, health expenditure, and the allocation of wealth between bonds, stocks, and housing. The model explains key facts about asset allocation and health expenditure across health status and age. The portfolio share in stocks is low overall and is positively related to health, especially for younger retirees. The portfolio share in housing is negatively related to health for younger retirees and falls significantly in age. Finally, out-of-pocket health expenditure as a share of income is negatively related to health and rises in age. PMID:27766005

  6. Health surveillance of persons engaged in radiation work

    International Nuclear Information System (INIS)

    1993-01-01

    The aims of the health surveillance of the workers engaged in radiation work prescribed in the section 33 of the Finnish Radiation Act (592/91) are: (1) to ensure that the workers are suitable for the radiation work, (2) to monitor the health of the workers during the radiation work, and (3) to define the implications to the health if the radiation exposure exceeding the prescribed maximum value or other abnormal exposure is suspected or observed. The health requirements related to radiation work, aspects to be considered in the health surveillance, and procedures relating to observed or suspected overexposure are defined in this guide

  7. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    Science.gov (United States)

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  8. Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005.

    Science.gov (United States)

    Elliott, John O; Lu, Bo; Moore, J Layne; McAuley, James W; Long, Lucretia

    2008-08-01

    Based on the 2005 California Health Interview Survey, persons with a history of epilepsy report lower educational attainment, lower annual income, and poorer health status, similar to other state-based epidemiological surveys. Previous studies have found persons with epilepsy exercise less and smoke more than the nonepilepsy population. The medical literature has also shown that antiepileptic drugs may cause nutritional deficiencies. Persons with a history of epilepsy in the 2005 CHIS report they walk more for transportation, drink more soda, and eat less salad than the nonepilepsy population. Exercise and dietary behaviors at recommended levels have been found to reduce mortality from many comorbid conditions such as cardiovascular disease, stroke, depression, anxiety, and osteoporosis for which persons with epilepsy are at increased risk. Health professionals in the epilepsy field should step up their efforts to engage patients in health promotion, especially in the areas of exercise, diet, and smoking cessation.

  9. Promoting Healthful Exercise for Visually Impaired Persons with Diabetes.

    Science.gov (United States)

    Weitzman, D. M.

    1993-01-01

    This article discusses the importance of exercise for many people with visual impairments and diabetes. It lists precautions for the person with visual impairments and diabetes and specifies who should not exercise, explains "diabetes-specific" benefits of exercise, suggests a format for a safe workout, and includes an example of a successful…

  10. Hazardous alcohol users during pregnancy: psychiatric health and personality traits.

    Science.gov (United States)

    Magnusson, Asa; Göransson, Mona; Heilig, Markus

    2007-07-10

    We examined alcohol use disorders, psychiatric symptoms and personality traits in women reporting alcohol use during pregnancy. In a pilot cohort (n=139), subjects were screened for alcohol use disorders, and assessed for psychopathology, personality traits, and alcohol use during the first trimester. Those reporting consumption exceeding a conservative threshold for harmful use were offered a diagnostic psychiatric interview. The main findings of the pilot study were replicated using a large sample of women in the third trimester (n=715), who were screened for alcohol use disorders, had their consumption during pregnancy assessed, and were assessed for personality traits. In the pilot cohort, only a minority of women who consumed significant amounts of alcohol during pregnancy fulfilled alcohol dependence criteria, or had scores on the Alcohol Use Disorder Identification Test typically associated with such a diagnosis. Psychiatric morbidity was also unremarkable as assessed by self-reported symptom intensity. The distinguishing feature was high novelty seeking. The results were robustly confirmed in the replication study. Most women with significant alcohol consumption during pregnancy do not seem to be alcohol dependent. Instead, use during pregnancy may reflect impulsive personality traits, and be correlated with additional risk behaviors.

  11. Meeting the health information needs of prostate cancer patients using personal health records.

    Science.gov (United States)

    Pai, H H; Lau, F; Barnett, J; Jones, S

    2013-12-01

    There is interest in the use of health information technology in the form of personal health record (phr) systems to support patient needs for health information, care, and decision-making, particularly for patients with distressing, chronic diseases such as prostate cancer (pca). We sought feedback from pca patients who used a phr. For 6 months, 22 pca patients in various phases of care at the BC Cancer Agency (bcca) were given access to a secure Web-based phr called provider, which they could use to view their medical records and use a set of support tools. Feedback was obtained using an end-of-study survey on usability, satisfaction, and concerns with provider. Site activity was recorded to assess usage patterns. Of the 17 patients who completed the study, 29% encountered some minor difficulties using provider. No security breaches were known to have occurred. The two most commonly accessed medical records were laboratory test results and transcribed doctor's notes. Of survey respondents, 94% were satisfied with the access to their medical records, 65% said that provider helped to answer their questions, 77% felt that their privacy and confidentiality were preserved, 65% felt that using provider helped them to communicate better with their physicians, 83% found new and useful information that they would not have received by talking to their health care providers, and 88% said that they would continue to use provider. Our results support the notion that phrs can provide cancer patients with timely access to their medical records and health information, and can assist in communication with health care providers, in knowledge generation, and in patient empowerment.

  12. Balancing Demand and Supply for Veterans' Health Care: A Summary of Three RAND Assessments Conducted Under the Veterans Choice Act.

    Science.gov (United States)

    Farmer, Carrie M; Hosek, Susan D; Adamson, David M

    2016-06-20

    In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act") in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector.

  13. Supermarket and Grocery Store–Based Interventions to Promote Healthful Food Choices and Eating Practices: A Systematic Review

    Science.gov (United States)

    Meinen, Amy M.; Nitzke, Susan A.; Martinez-Donate, Ana P.

    2013-01-01

    Introduction Increasingly high rates of obesity have heightened interest among researchers and practitioners in identifying evidence-based interventions to increase access to healthful foods and beverages. Because most food purchasing decisions are made in food stores, such settings are optimal for interventions aimed at influencing these decisions. The objective of this review was to synthesize the evidence on supermarket and grocery store interventions to promote healthful food choices. Methods We searched PubMed through July 2012 to identify original research articles evaluating supermarket and grocery store interventions that promoted healthful food choices. We categorized each intervention by type of intervention strategy and extracted and summarized data on each intervention. We developed a scoring system for evaluating each intervention and assigned points for study design, effectiveness, reach, and availability of evidence. We averaged points for each intervention category and compared the strength of the evidence for each category. Results We identified 58 articles and characterized 33 interventions. We found 7 strategies used alone or in combination. The most frequently used strategy was the combination of point-of-purchase and promotion and advertising (15 interventions); evidence for this category was scored as sufficient. On average, of 3 points possible, the intervention categories scored 2.6 for study design, 1.1 for effectiveness, 0.3 for reach, and 2 for availability of evidence. Three categories showed sufficient evidence; 4 showed insufficient evidence; none showed strong evidence. Conclusion More rigorous testing of interventions aimed at improving food and beverage choices in food stores, including their effect on diet and health outcomes, is needed. PMID:23578398

  14. Assessing the Effect of a Personal Health Management System Within Retirement Communities: A Preliminary Investigation.

    Science.gov (United States)

    Slivinske, Lee R.; Kosberg, Jordan I.

    1984-01-01

    Describes a holistic health care program (Personal Health Management System) initiated within several retirement communities. Initial findings suggested that program participants experienced significant increases in their health and well-being while nonequivalent control group subjects did not. Conceptual and methodological issues are discussed.…

  15. Assessing Conscientious Personality in Primary Care: An Opportunity for Prevention and Health Promotion

    Science.gov (United States)

    Israel, Salomon; Moffitt, Terrie E.

    2014-01-01

    The articles in this special section bolster the already strong evidence base that personality differences in the trait of conscientiousness predict health. What is now needed is a research agenda for translating documented risk associations between low conscientiousness and poor health into policies and interventions that improve health outcomes…

  16. 78 FR 78362 - National Institute for Occupational Safety and Health Personal; Notice of public meeting in...

    Science.gov (United States)

    2013-12-26

    ... Institute for Occupational Safety and Health Personal; Notice of public meeting in Endicott, New York AGENCY: The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control.... SUMMARY: The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease...

  17. 78 FR 12065 - National Institute for Occupational Safety and Health Personal Protective Technology for...

    Science.gov (United States)

    2013-02-21

    ... Institute for Occupational Safety and Health Personal Protective Technology for Pesticide Handlers: Stakeholder Meeting AGENCY: The National Institute for Occupational Safety and Health (NIOSH) of the Centers...: Notice of public meeting. SUMMARY: The National Institute for Occupational Safety and Health (NIOSH) of...

  18. Incorporating Personal Health Records into the Disease Management of Rural Heart Failure Patients

    Science.gov (United States)

    Baron, Karen Parsley

    2012-01-01

    Personal Health Records (PHRs) allow patients to access and in some cases manage their own health records. Their potential benefits include access to health information, enhanced asynchronous communication between patients and clinicians, and convenience of online appointment scheduling and prescription refills. Potential barriers to PHR use…

  19. Medical Students and Personal Smartphones in the Clinical Environment: The Impact on Confidentiality of Personal Health Information and Professionalism

    OpenAIRE

    Tran, Kim; Morra, Dante; Lo, Vivian; Quan, Sherman D; Abrams, Howard; Wu, Robert C

    2014-01-01

    Background Smartphones are becoming ubiquitous in health care settings. The increased adoption of mobile technology such as smartphones may be attributed to their use as a point-of-care information source and to perceived improvements in clinical communication and efficiency. However, little is known about medical students’ use of personal smartphones for clinical work. Objective The intent of the study was to examine final-year medical students’ experience with and attitudes toward using per...

  20. Promotion of Well-Being in Person-Centered Mental Health Care

    OpenAIRE

    Cloninger, C. Robert; Zohar, Ada H.; Cloninger, Kevin M.

    2010-01-01

    An understanding of the mechanisms of personality development provides a systematic way to promote health as an integrated state of physical, mental, social, and spiritual well-being. Individual differences in personality are causal antecedents of the full range of psychopathology. The maturation with integration of personality appears to be an important mechanism by which diverse modalities of treatment promote wellness and reduce illness. First, the authors review the relationship between p...