WorldWideScience

Sample records for preparedness health care

  1. Business continuity and pandemic preparedness: US health care versus non-health care agencies.

    Science.gov (United States)

    Rebmann, Terri; Wang, Jing; Swick, Zachary; Reddick, David; delRosario, John Leon

    2013-04-01

    Only limited data are available on US business continuity activities related to biologic events. A questionnaire was administered to human resource professionals during May-July 2011 to assess business continuity related to biologic events, incentives businesses are providing to maximize worker surge capacity, and seasonal influenza vaccination policy. Linear regressions were used to describe factors associated with higher business continuity and pandemic preparedness scores. The χ(2) and Fisher exact tests compared health care versus non-health care businesses on preparedness indicators. Possible business continuity and pandemic preparedness scores ranged from 0.5 to 27 and 0 to 15, with average resulting scores among participants at 13.2 and 7.3, respectively. Determinants of business continuity and pandemic preparedness were (1) business size (larger businesses were more prepared), (2) type of business (health care more prepared), (3) having human resource professional as company disaster planning committee member, and (4) risk perception of a pandemic in the next year. Most businesses (63.3%, n = 298) encourage staff influenza vaccination; 2.1% (n = 10) mandate it. Only 10% of businesses (11.0%, n = 52) provide employee incentives, and fewer than half (41.0%, n = 193) stockpile personal protective equipment. Despite the recent H1N1 pandemic, many US businesses lack adequate pandemic plans. It is critical that businesses of all sizes and types become better prepared for a biologic event. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Ebola: Emergency preparedness and perceived response of Malaysian health care providers.

    Science.gov (United States)

    Rajiah, Kingston; Maharajan, Mari Kannan; Binti Samsudin, Sarah Zakiah; Tan, Choo Lin; Tan Yen Pei, Adeline; Wong San Ying, Audrey

    2016-12-01

    We studied the emergency preparedness and perceived response for Ebola virus disease among various health care providers in Malaysia using a self-report questionnaire. Most of the health care providers felt that they were able to respond to Ebola virus disease and were aware of the level of preparedness needed during emergency. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Assessing School Emergency Care Preparedness.

    Science.gov (United States)

    Hale, Charles; Varnes, Jill

    A study assessed the emergency health care preparedness of a north central Florida public school district in light of seven criteria: (1) school policies regarding delivery of emergency health care; (2) identification of school personnel responsible for rendering emergency care; (3) training levels of emergency health care providers (first aid and…

  4. Nurses' preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care

    Directory of Open Access Journals (Sweden)

    Sundborg Eva M

    2012-01-01

    Full Text Available Abstract Background Intimate partner violence (IPV has a deep impact on women's health. Nurses working in primary health care need to be prepared to identify victims and offer appropriate interventions, since IPV is often seen in primary health care. The aim of the study was to assess nurses' preparedness to identify and provide nursing care to women exposed to IPV who attend primary health care. Method Data was collected using a questionnaire to nurses at the primary health care centres. The response rate was 69.3%. Logistic regression analysis was used to test relationships among variables. Results Shortcomings were found regarding preparedness among nurses. They lacked organisational support e.g. guidelines, collaboration with others and knowledge regarding the extensiveness of IPV. Only half of them always asked women about violence and mostly when a woman was physically injured. They felt difficulties to know how to ask and if they identified violence they mostly offered the women a doctor's appointment. Feeling prepared was connected to obtaining knowledge by themselves and also to identifying women exposed to IPV. Conclusion The majority of the nurses were found to be quiet unprepared to provide nursing care to women exposed to IPV. Consequences might be treatment of symptoms but unidentified abuse and more and unnecessary suffering for these women. Improvements are needed on both at the level of the organisation and individual.

  5. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

    Directory of Open Access Journals (Sweden)

    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  6. Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016.

    Science.gov (United States)

    Shope, Timothy R; Walker, Benjamin H; Aird, Laura D; Southward, Linda; McCown, John S; Martin, Judith M

    2017-06-01

    Children in child care centers represent an important population to consider in attempts to mitigate the spread of an influenza pandemic. This national survey, conducted in 2008 and 2016, assessed directors' reports of their child care centers' pandemic influenza preparation before and after the 2009 H1N1 novel influenza pandemic. This was a telephone-based survey of child care center directors randomly selected from a national database of licensed US child care centers who were queried about their preparedness for pandemic influenza. We grouped conceptually related items in 6 domains into indexes: general infection control, communication, seasonal influenza control, use of health consultants, quality of child care, and perceived barriers. These indexes, along with other center and director characteristics, were used to predict pandemic influenza preparedness. Among 1500 and 518 child care center directors surveyed in 2008 and 2016, respectively, preparation for pandemic influenza was low and did not improve. Only 7% of directors had taken concrete actions to prepare their centers. Having served as a center director during the 2009 influenza pandemic did not influence preparedness. After adjusting for covariates, child care health consultation and years of director's experience were positively associated with pandemic influenza preparation, whereas experiencing perceived barriers such as lack of knowing what to do in the event of pandemic influenza, was negatively associated with pandemic influenza preparedness. Pandemic influenza preparedness of child care center's directors needs to improve. Child care health consultants are likely to be important collaborators in addressing this problem. Copyright © 2017 by the American Academy of Pediatrics.

  7. Policy statement--emergency information forms and emergency preparedness for children with special health care needs.

    Science.gov (United States)

    2010-04-01

    Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.

  8. Disaster preparedness for technology and electricity-dependent children and youth with special health care needs.

    Science.gov (United States)

    Sakashita, Kazumi; Matthews, Wallace J; Yamamoto, Loren G

    2013-06-01

    Children and youth with special health care needs (CYSHCN) are complex and often dependent on electrical devices (technoelectric dependent) for life support/maintenance. Because they are reliant on electricity and electricity failure is common, the purpose of this study was to survey their preparedness for electricity failure. Parents and caregivers of technoelectric CYSHCN were asked to complete a preparedness questionnaire. We collected a convenience sample of 50 patients. These 50 patients utilized a total of 166 electrical devices. A home ventilator, oxygen concentrator, and a feeding pump were identified as the most important device for the children in 35 of the 50 patients, yet only 19 of the 35 patients could confirm that this device had a battery backup. Also, 22 of the 50 patients had a prolonged power failure preparedness plan. Technoelectric-dependent CYSHCN are poorly prepared for electrical power failure.

  9. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

    Directory of Open Access Journals (Sweden)

    Monica Zolezzi

    2017-02-01

    Full Text Available Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorst achieved similar knowledge scores, less than half (n = 38, 47% were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32% were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3. Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as major by nursing students. Future integration of interprofessional educational (IPE activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  10. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management.

    Science.gov (United States)

    Zolezzi, Monica; Abdallah, Oraib; Aden, Suad; Major, Stella; White, Diana; El-Awaisi, Alla

    2017-02-21

    Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing health care students' (HCSs) knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorts achieved similar knowledge scores, less than half ( n = 38, 47%) were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32%) were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3). Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as a major by nursing students. Future integration of interprofessional educational (IPE) activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  11. State health policy for terrorism preparedness.

    Science.gov (United States)

    Ziskin, Leah Z; Harris, Drew A

    2007-09-01

    State health policy for terrorism preparedness began before the terrorist attacks on September 11, 2001, but was accelerated after that day. In a crisis atmosphere after September 11, the states found their policies changing rapidly, greatly influenced by federal policies and federal dollars. In the 5 years since September 11, these state health policies have been refined. This refinement has included a restatement of the goals and objectives of state programs, the modernization of emergency powers statutes, the education and training of the public health workforce, and a preparation of the health care system to better care for victims of disasters, including acts of terrorism.

  12. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

    Directory of Open Access Journals (Sweden)

    Augustina Angelina Annan

    2017-06-01

    Full Text Available Abstract Background The recent Ebola Virus Disease (EVD epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hospital based cross sectional study involving 101 HCWs from two facilities in Kumasi, Ghana to assess the level of preparedness of HCWs to respond to any possible EVD. Methods We administered a face-to-face questionnaire using an adapted WHO (2015 and CDC (2014 Checklist for Ebola Preparedness and assessed overall knowledge gaps, and preparedness of the Ghanaian HCWs in selected health facilities of the Ashanti Region of Ghana from October to December 2015. Results A total 92 (91.09% HCWs indicated they were not adequately trained to handle an EVD suspected case. Only 25.74% (n = 26 considered their facilities sufficiently equipped to handle and manage EVD patients. When asked which disinfectant to use after attending to and caring for a suspected patient with EVD, only 8.91% (n = 9 could correctly identify the right disinfectant (χ2 = 28.52, p = 0.001. Conclusion Our study demonstrates poor knowledge and ill preparedness and unwillingness of many HCWs to attend to EVD. Beyond knowledge acquisition, there is the need for more training from time to time to fully prepare HCWs to handle any possible EVD case.

  13. A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care

    Directory of Open Access Journals (Sweden)

    Roberto G. Lucchini

    2017-01-01

    Full Text Available Abstract Background The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. Methods Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i exposure assessment; ii exposed populations; iii health surveillance; iv follow-up and research outputs; v observed physical and mental health effects; vi treatment and benefits; and vii outreach activities. Results Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1 Know who was there; 2 Have public health input to the disaster response; 3 Collect health and needs data rapidly; 4 Take care of the affected; 5 Emergency preparedness; 6 Data driven, needs assessment, advocacy. Conclusions Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of

  14. A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care.

    Science.gov (United States)

    Lucchini, Roberto G; Hashim, Dana; Acquilla, Sushma; Basanets, Angela; Bertazzi, Pier Alberto; Bushmanov, Andrey; Crane, Michael; Harrison, Denise J; Holden, William; Landrigan, Philip J; Luft, Benjamin J; Mocarelli, Paolo; Mazitova, Nailya; Melius, James; Moline, Jacqueline M; Mori, Koji; Prezant, David; Reibman, Joan; Reissman, Dori B; Stazharau, Alexander; Takahashi, Ken; Udasin, Iris G; Todd, Andrew C

    2017-01-07

    The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats.

  15. Assessment of ebola virus disease, health care infrastructure, and preparedness - four counties,Southeastern Liberia, august 2014.

    Science.gov (United States)

    Forrester, Joseph D; Pillai, Satish K; Beer, Karlyn D; Neatherlin, John; Massaquoi, Moses; Nyenswah, Tolbert G; Montgomery, Joel M; De Cock, Kevin

    2014-10-10

    Ebola virus disease (Ebola) is a multisystem disease caused by a virus of the genus Ebolavirus. In late March 2014, Ebola cases were described in Liberia, with epicenters in Lofa County and later in Montserrado County. While information about case burden and health care infrastructure was available for the two epicenters, little information was available about remote counties in southeastern Liberia. Over 9 days, August 6-14, 2014, Ebola case burden, health care infrastructure, and emergency preparedness were assessed in collaboration with the Liberian Ministry of Health and Social Welfare in four counties in southeastern Liberia: Grand Gedeh, Grand Kru, River Gee, and Maryland. Data were collected by health care facility visits to three of the four county referral hospitals and by unstructured interviews with county and district health officials, hospital administrators, physicians, nurses, physician assistants, and health educators in all four counties. Local burial practices were discussed with county officials, but no direct observation of burial practices was conducted. Basic information about Ebola surveillance and epidemiology, case investigation, contact tracing, case management, and infection control was provided to local officials.

  16. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2011-08-29

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.  Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 8/30/2011.

  17. Public health and terrorism preparedness: cross-border issues.

    Science.gov (United States)

    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

    2005-01-01

    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

  18. Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review.

    Science.gov (United States)

    Gowing, Jeremy R; Walker, Kim N; Elmer, Shandell L; Cummings, Elizabeth A

    2017-06-01

    Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps. Discussion The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation. The literature identified that all types of disaster preparedness activities lead to improvements in knowledge, skills, or attitude preparedness for disasters. Most studies focused on external disasters and the preparedness of medical, nursing, public health, or paramedic professionals. There needs to be a greater focus on the whole health care team, including allied health

  19. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.

  20. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  1. Community Health Centers: The Untapped Resource for Public Health and Medical Preparedness

    OpenAIRE

    Wood, Kanen M.

    2008-01-01

    This article appeared in Homeland Security Affairs (January 2009), v.5 no.1 HSPD-21 was recently released to the public calling for a transformation in the national approach to public health and medical preparedness in the United States. The latest deliberations, as prioritized by this strategy, are to bolster the nation's ability to manage a public health crisis by stimulating improvements in the areas of biosurveillance, countermeasure distribution, mass casualty care, and community resi...

  2. Ebola Preparedness Planning and Collaboration by Two Health Systems in Wisconsin, September to December 2014.

    Science.gov (United States)

    Leonhardt, Kathryn Kraft; Keuler, Megan; Safdar, Nasia; Hunter, Paul

    2016-08-01

    We describe the collaborative approach used by 2 health systems in Wisconsin to plan and prepare for the threat of Ebola virus disease. This was a descriptive study of the preparedness planning, infection prevention, and collaboration with public health agencies undertaken by 2 health systems in Wisconsin between September and December 2014. The preparedness approach used by the 2 health systems relied successfully on their robust infrastructure for planning and infection prevention. In the setting of rapidly evolving guidance and unprecedented fear regarding Ebola, the 2 health systems enhanced their response through collaboration and coordination with each other and government public health agencies. Key lessons learned included the importance of a rigorous planning process, robust infection prevention practices, and coalitions between public and private health sectors. The potential threat of Ebola virus disease stimulated emergency preparedness in which acute care facilities played a leading role in the public health response. Leveraging the existing expertise of health systems is essential when faced with emerging infectious diseases. (Disaster Med Public Health Preparedness. 2016;10:691-697).

  3. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Science.gov (United States)

    Bintabara, Deogratius; Mpondo, Bonaventura C T

    2018-01-01

    Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary

  4. Emergency preparedness for those who care for infants in developed country contexts

    Directory of Open Access Journals (Sweden)

    Gribble Karleen D

    2011-11-01

    Full Text Available Abstract Emergency management organisations recognise the vulnerability of infants in emergencies, even in developed countries. However, thus far, those who care for infants have not been provided with detailed information on what emergency preparedness entails. Emergency management authorities should provide those who care for infants with accurate and detailed information on the supplies necessary to care for them in an emergency, distinguishing between the needs of breastfed infants and the needs of formula fed infants. Those who care for formula fed infants should be provided with detailed information on the supplies necessary for an emergency preparedness kit and with information on how to prepare formula feeds in an emergency. An emergency preparedness kit for exclusively breastfed infants should include 100 nappies and 200 nappy wipes. The contents of an emergency preparedness for formula fed infants will vary depending upon whether ready-to-use liquid infant formula or powdered infant formula is used. If ready-to-use liquid infant formula is used, an emergency kit should include: 56 serves of ready-to-use liquid infant formula, 84 L water, storage container, metal knife, small bowl, 56 feeding bottles and teats/cups, 56 zip-lock plastic bags, 220 paper towels, detergent, 120 antiseptic wipes, 100 nappies and 200 nappy wipes. If powdered infant formula is used, an emergency preparedness kit should include: two 900 g tins powdered infant formula, 170 L drinking water, storage container, large cooking pot with lid, kettle, gas stove, box of matches/lighter, 14 kg liquid petroleum gas, measuring container, metal knife, metal tongs, feeding cup, 300 large sheets paper towel, detergent, 100 nappies and 200 nappy wipes. Great care with regards hygiene should be taken in the preparation of formula feeds. Child protection organisations should ensure that foster carers responsible for infants have the resources necessary to formula feed in the

  5. Progress in Public Health Emergency Preparedness-United States, 2001-2016.

    Science.gov (United States)

    Murthy, Bhavini Patel; Molinari, Noelle-Angelique M; LeBlanc, Tanya T; Vagi, Sara J; Avchen, Rachel N

    2017-09-01

    To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.

  6. Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: a correlational, cross-sectional study.

    Science.gov (United States)

    Henriksson, Anette; Årestedt, Kristofer

    2013-07-01

    Family caregivers in palliative care often report feeling insufficiently prepared to handle the caregiver role. Preparedness has been confirmed as a variable that may actually protect family caregiver well-being. Preparedness refers to how ready family caregivers perceive they are for the tasks and demands in the caregiving role. The aim of this study was to explore factors associated with preparedness and to further investigate whether preparedness is associated with caregiver outcomes. This was a correlational study using a cross-sectional design. The study took place in three specialist palliative care units and one haematology unit. A total of 125 family caregivers of patients with life-threatening illness participated. Preparedness was significantly associated with higher levels of hope and reward and with a lower level of anxiety. In contrast, preparedness was not associated with depression or health. Being female and cohabiting with the patient were significantly associated with a higher level of preparedness. The relationship to the patient was significantly associated with preparedness, while social support, place of care, time since diagnosis and age of the patients showed no association. Feelings of preparedness seem to be important for how family caregivers experience the unique situation when caring for a patient who is severely ill and close to death. Our findings support the inclusion of preparedness in support models for family caregivers in palliative care. Psycho-educational interventions could preferably be designed aiming to increase family caregiver's preparedness to care, including practical care, communication and emotional support.

  7. The South Dakota Model: Health Care Professions Student Disaster Preparedness and Deployment Training.

    Science.gov (United States)

    Owens, Matt P; Buffington, Cheri; Frost, Michael P; Waldner, Randall J

    2017-12-01

    The Association of American Medical Colleges recommended an increase in medical education for public health emergencies, bioterrorism, and weapons of mass destruction in 2003. The University of South Dakota Sanford School of Medicine (USD SSOM) implemented a 1-day training event to provide disaster preparedness training and deployment organization for health professions students called Disaster Training Day (DTD). Hospital staff and emergency medical services personnel provided the lecture portion of DTD using Core Disaster Life Support (CDLS; National Disaster Life Support Foundation) as the framework. Pre-test and post-test analyses were presented to the students. Small group activities covered leadership, anaphylaxis, mass fatality, points of dispensing deployment training, psychological first aid, triage, and personal protective equipment. Students were given the option to sign up for statewide deployment through the South Dakota Statewide Emergency Registry of Volunteers (SERV SD). DTD data and student satisfaction surveys from 2009 to 2016 were reviewed. Since 2004, DTD has provided disaster preparedness training to 2246 students across 13 health professions. Significant improvement was shown on CDLS post-test performance with a t-score of -14.24 and a resulting P value of training, small group sessions, and perceived self-competency relating to disaster response. SERV SD registration increased in 2015, and 77.5% of the participants registered in 2016. DTD at the USD SSOM provides for an effective 1-day disaster training course for health professions students. Resources from around the state were coordinated to provide training, liability coverage, and deployment organization for hundreds of students representing multiple health professions. (Disaster Med Public Health Preparedness. 2017;11:735-740).

  8. Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza.

    Science.gov (United States)

    Kayman, Harvey; Ablorh-Odjidja, Angela

    2006-01-01

    Public health professionals are responsible for ensuring the health of the nation, which requires that planners for public health emergencies recognize that not including protection for underserved or marginalized communities poses a risk to the entire population. To assure the protection of these populations in the event of a pandemic outbreak, preparedness planning will benefit from the application of several principles of social justice in assuring the protection of all individuals. This article will review the history between public health and social justice, provide a brief review of pandemic preparedness planning efforts, discuss the importance of and make recommendations for the incorporation of principles of social justice in the development of pandemic preparedness plans, and highlight some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation's health.

  9. Residents' Attitude, Knowledge, and Perceived Preparedness Toward Caring for Patients from Diverse Sociocultural Backgrounds.

    Science.gov (United States)

    Marshall, Jessie Kimbrough; Cooper, Lisa A; Green, Alexander R; Bertram, Amanda; Wright, Letitia; Matusko, Niki; McCullough, Wayne; Sisson, Stephen D

    2017-01-01

    Purpose: Training residents to deliver care to increasingly diverse patients in the United States is an important strategy to help alleviate racial and ethnic disparities in health outcomes. Cross-cultural care training of residents continues to present challenges. This study sought to explore the associations among residents' cross-cultural attitudes, preparedness, and knowledge about disparities to better elucidate possible training needs. Methods: This cross-sectional study used web-based questionnaires from 2013 to 2014. Eighty-four internal medicine residency programs with 954 residents across the United States participated. The main outcome was perceived preparedness to care for sociocultural diverse patients. Key Results: Regression analysis showed attitude toward cross-cultural care (beta coefficient [β]=0.57, 95% confidence interval [CI]: 0.49-0.64, p attitude toward cross-cultural care and their level of exposure to patients from diverse sociocultural backgrounds. Future studies should examine the role of residents' cross-cultural care-related attitudes on their ability to care for diverse patients.

  10. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Directory of Open Access Journals (Sweden)

    Deogratius Bintabara

    Full Text Available Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania.This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50% of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level.Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension.The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership

  11. Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

    Science.gov (United States)

    Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

    2010-04-01

    To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency

  12. Design of the national health security preparedness index.

    Science.gov (United States)

    Uzun Jacobson, Evin; Inglesby, Tom; Khan, Ali S; Rajotte, James C; Burhans, Robert L; Slemp, Catherine C; Links, Jonathan M

    2014-01-01

    The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts.

  13. Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

    Science.gov (United States)

    Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

    2007-01-01

    The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

  14. Examining the importance of incorporating emergency preparedness and disaster training core competencies into allied health curricula.

    Science.gov (United States)

    Curtis, Tammy

    2015-01-01

    Preparation for responding to emergency events that does not warrant outside help beyond the local community resources or responding to disaster events that is beyond the capabilities of the local community both require first responders and healthcare professionals to have interdisciplinary skills needed to function as a team for saving lives. To date, there is no core emergency preparedness and disaster planning competencies that have been standardized at all levels across the various allied health curricula disciplines. To identify if emergency preparedness and disaster training content are currently being taught in allied health program courses, to identify possible gaps within allied health curricula, and to explore the perceptions of allied health college educators for implementing emergency preparedness and disaster training core competencies into their existing curricula, if not already included. A quantitative Internet-based survey was conducted in 2013. Convenient sample. Fifty-one allied health college educators completed the survey. Descriptive statistics indicated that the majority of allied health college instructors do not currently teach emergency preparedness and disaster training core competency content within their current allied health discipline; however, their perceived level of importance for inclusion of the competencies was high. The results of this study supported the need for developing and establishing a basic national set of standardized core emergency preparedness and disaster planning competencies at all levels across various allied health curricula disciplines to ensure victims receive the best patient care and have the best possible chance of survival.

  15. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  16. Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

    Science.gov (United States)

    Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

    2007-08-01

    Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

  17. The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness.

    Science.gov (United States)

    Dionne-Odom, J Nicholas; Demark-Wahnefried, Wendy; Taylor, Richard A; Rocque, Gabrielle B; Azuero, Andres; Acemgil, Aras; Martin, Michelle Y; Astin, Meka; Ejem, Deborah; Kvale, Elizabeth; Heaton, Karen; Pisu, Maria; Partridge, Edward E; Bakitas, Marie A

    2017-08-01

    Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. Cross-sectional survey within eight community-based southeastern U.S. cancer centers was conducted. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy. Caregivers (n = 294) averaged 66 years, were mostly female (72.8%), white (91.2%), Protestant (76.2%), retired (54.4%), and patients' spouse/partner (60.2%). Approximately, half were rural-dwellers (46.9%) with incomes 1 year (68%). Nearly a quarter (23%) reported high depression and 34% reported borderline or high anxiety. Low engagement in all self-care practices was associated with worse caregiver anxiety, depression, and mental HRQoL (all p values Caregivers with lower health responsibility, spiritual growth, interpersonal relation, and stress management scores had lower preparedness and decision-making self-efficacy. A significant proportion of caregivers simultaneously report low engagement in all forms of self-care practices, high depression and anxiety, and low HRQoL mental health scores. Caregiver well-being, preparedness, and decision-making self-efficacy might be optimized through interventions targeted at enhancing health responsibility, stress management, interpersonal relationships, and spiritual growth self-care practices.

  18. Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia.

    Science.gov (United States)

    Yi, Siyan; Ngin, Chanrith; Pal, Khuondyla; Khol, Vohith; Tuot, Sovannary; Sau, Sokunmealiny; Chhoun, Pheak; Mburu, Gitau; Choub, Sok Chamreun; Chhim, Kolab; Ly, Penhsun

    2017-07-17

    Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia. In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15-17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a high- or low level of preparedness for transition. Bivariate and multivariate analyses were conducted. Of 223 adolescents, 55.2% were male, and their mean age was 15.8 years. Overall, 53.3% had a high level of preparedness for transition. As part of the transition protocol, 2.7% had completed a transfer form, 24.7% had a transition case manager, 29.6% had been counselled about the transition, and 19.7% had visited an adult ART clinic. In multivariate analysis, a higher level of preparedness for transition was independently associated with older age (AOR 2.44, 95% CI 1.34-4.46; p = 0.004), family having received social support for their health (AOR 5.32, 95% CI 1.97-14.36; p = 0.001), knowing the kind of treatment they received (ART) (AOR 12.67, 95% CI 2.91-15.19; p = 0.001), trust in friends or family for HIV treatment (AOR 7.82, 95% CI 1.13-8.89; p = 0.008), receiving counseling on transition (AOR 3.17, 95% CI 1.15-8.76; p = 0.03), having a 'Case Manager' identified to support them during the preparation process for transition (AOR 3.89, 95% CI 1.08-13.96; p = 0.04), and satisfaction with preparation process for transition in general (AOR 0.35, 95% CI 0.03-0.87; p = 0.01). A range of individual, social and health system and services factors may determine successful

  19. Measuring healthcare preparedness: an all-hazards approach

    Directory of Open Access Journals (Sweden)

    Marcozzi David E

    2012-10-01

    Full Text Available Abstract In a paper appearing in this issue, Adini, et al. describe a struggle familiar to many emergency planners—the challenge of planning for all scenarios. The authors contend that all-hazards, or capabilities-based planning, in which a set of core capabilities applicable to numerous types of events is developed, is a more efficient way to achieve general health care system emergency preparedness than scenario-based planning. Essentially, the core of what is necessary to plan for and respond to one kind of disaster (e.g. a biologic event is also necessary for planning and responding to other types of disasters, allowing for improvements in planning and maximizing efficiencies. While Adini, et al. have advanced the science of health care emergency preparedness through their consideration of 490 measures to assess preparedness, a shorter set of validated preparedness measures would support the dual goals of accountability and improved outcomes and could provide the basis for determining which actions in the name of preparedness really matter.

  20. Public health preparedness in Alberta: a systems-level study

    Directory of Open Access Journals (Sweden)

    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  1. Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

    Science.gov (United States)

    Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

    2007-01-01

    Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

  2. Public Health Preparedness Funding: Key Programs and Trends From 2001 to 2017.

    Science.gov (United States)

    Watson, Crystal R; Watson, Matthew; Sell, Tara Kirk

    2017-09-01

    To evaluate trends in funding over the past 16 years for key federal public health preparedness and response programs at the US Department of Health and Human Services, to improve understanding of federal funding history in this area, and to provide context for future resource allocation decisions for public health preparedness. In this 2017 analysis, we examined the funding history of key federal programs critical to public health preparedness by reviewing program budget data collected for our annual examination of federal funding for biodefense and health security programs since fiscal year (FY) 2001. State and local preparedness at the Centers for Disease Control and Prevention initially received $940 million in FY2002 and resulted in significant preparedness gains, but funding levels have since decreased by 31%. Similarly, the Hospital Preparedness Program within the Office of the Assistant Secretary for Preparedness and Response was funded at a high of $515 million in FY2003, but funding was reduced by 50%. Investments in medical countermeasure development and stockpiling remained relatively stable. The United States has made significant progress in preparing for disasters and advancing public health infrastructure. To enable continued advancement, federal funding commitments must be sustained.

  3. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    communication barriers experienced by public health and health care personnel. Forty-eight studies provided evidence on how to create and sustain preparedness systems. Results included how to build social capital across organizations and citizens and how to develop sustainable and useful planning efforts that maintain flexibility and rely on available medical data. Twenty-six studies provided evidence on the usefulness of measurement efforts, such as community and organizational needs assessments, and new methods to learn from the response to critical incidents. In the United States, the field of public health emergency preparedness system research has been supported by the US Centers for Disease Control and Prevention since the release of the 2008 Institute of Medicine letter report. The first definition of public health emergency preparedness appeared in 2007, and before 2008 there was a lack of research and empirical evidence across all 4 research areas identified by the Institute of Medicine. This field can be considered relatively new compared with other research areas in public health; for example, tobacco control research can rely on more than 70 years of knowledge production. However, this review demonstrates that, during the past 7 years, public health emergency preparedness system research has evolved from generic inquiry to the analysis of specific interventions with more empirical studies. Public Health Implications: The results of this review provide an evidence base for public health practitioners responsible for enhancing key components of preparedness and response such as communication, training, and planning efforts.

  4. The World Trade Center Attack Disaster preparedness: health care is ready, but is the bureaucracy?

    Science.gov (United States)

    Mattox, Kenneth

    2001-01-01

    When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness. PMID:11737919

  5. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    OpenAIRE

    Gulzar H. Shah; Bobbie Newell; Ruth E. Whitworth

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved em...

  6. Personal characteristics associated with resident physicians' self perceptions of preparedness to deliver cross-cultural care.

    Science.gov (United States)

    Lopez, Lenny; Vranceanu, Ana-Maria; Cohen, Amy P; Betancourt, Joseph; Weissman, Joel S

    2008-12-01

    Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities. To determine whether, controlling for training received in medical school or during residency, resident physician socio-cultural characteristics influence self-perceived preparedness and skill in delivering cross-cultural care. National survey of resident physicians. A probability sample of residents in seven specialties in their final year of training at US academic health centers. Nine resident characteristics were analyzed. Differences in preparedness and skill were assessed using the chi(2) statistic and multivariate logistic regression. Fifty-eight percent (2047/3500) of residents responded. The most important factor associated with improved perceived skill level in performing selected tasks or services believed to be useful in treating culturally diverse patients was having received cross-cultural skills training during residency (OR range 1.71-4.22). Compared with white residents, African American physicians felt more prepared to deal with patients with distrust in the US healthcare system (OR 1.63) and with racial or ethnic minorities (OR 1.61), Latinos reported feeling more prepared to deal with new immigrants (OR 1.88) and Asians reported feeling more prepared to deal with patients with health beliefs at odds with Western medicine (1.43). Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care. This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in

  7. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  8. Epidemiology of ebolavirus disease (EVD and occupational EVD in health care workers in Sub-Saharan Africa: Need for strengthened public health preparedness

    Directory of Open Access Journals (Sweden)

    Nlandu Roger Ngatu

    2017-09-01

    Full Text Available Ebolavirus disease (EVD is a severe contagious disease in humans, and health care workers (HCW are at risk of infection when caring for EVD patients. This paper highlights the epidemiologic profile of EVD and its impact on the health care workforce in Africa. A documentary study was conducted which consisted of a review of available literature regarding the epidemiology of EVD, occupational EVD (OEVD, and work safety issues in Sub-Saharan Africa; the literature findings are enriched by field experiences from the authors. EVD outbreaks have already caused 30,500 cases in humans of whom 12,933 died (as of September 9, 2015, and the number of infected HCW has dramatically increased. All eight HCW infected during the 2014 outbreak in Democratic Republic of the Congo died, whereas during the recent West African EVD epidemic more than 890 HCW were infected, with a case fatality rate of 57%. Occupational exposure to blood and other body fluids due to inadequate use of personal protective equipment and needle stick or sharp injuries are among factors that contribute to the occurrence of OEVD. Prevention of OEVD should be one of the top priorities in EVD outbreak preparedness and management, and research should be conducted to elucidate occupational and other factors that expose HCW to EVD. In addition to regularly training HCW to be adequately prepared to care for patients with EVD, it is critical to strengthen the general health care system and improve occupational safety in medical settings of countries at risk.

  9. Cultural competence and perceptions of community health workers' effectiveness for reducing health care disparities.

    Science.gov (United States)

    Mobula, Linda M; Okoye, Mekam T; Boulware, L Ebony; Carson, Kathryn A; Marsteller, Jill A; Cooper, Lisa A

    2015-01-01

    Community health worker (CHW) interventions improve health outcomes of patients from underserved communities, but health professionals' perceptions of their effectiveness may impede integration of CHWs into health care delivery systems. Whether health professionals' attitudes and skills, such as those related to cultural competence, influence perceptions of CHWs, is unknown. A questionnaire was administered to providers and clinical staff from 6 primary care practices in Maryland from April to December 2011. We quantified the associations of self-reported cultural competence and preparedness with attitudes toward the effectiveness of CHWs using logistic regression adjusting for respondent age, race, gender, provider/staff status, and years at the practice. We contacted 200 providers and staff, and 119 (60%) participated. Those reporting more cultural motivation had higher odds of perceiving CHWs as helpful for reducing health care disparities (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 3.48-28.80). Those reporting more frequent culturally competent behaviors also had higher odds of believing CHWs would help reduce health disparities (OR = 3.58, 95% CI = 1.61-7.92). Attitudes toward power and assimilation were not associated with perceptions of CHWs. Cultural preparedness was associated with perceived utility of CHWs in reducing health care disparities (OR = 2.33, 95% CI = 1.21-4.51). Providers and staff with greater cultural competence and preparedness have more positive expectations of CHW interventions to reduce healthcare disparities. Cultural competency training may complement the use of CHWs and support their effective integration into primary care clinics that are seeking to reduce disparities. © The Author(s) 2014.

  10. Terrorism preparedness: Web-based resource management and the TOPOFF 3 exercise.

    Science.gov (United States)

    Jacobs, Lenworth M; Burns, Karyl J

    2006-03-01

    The bombings of London on July 7, 2005 highlight the need for continued vigilance and readiness to respond to terrorist attacks. Trauma centers need to be at the core of preparedness activities. The State of Connecticut has taken a lead in preparedness and was selected as a site for the US Department of Homeland Security's Top Officials Three Exercise (TOPOFF 3), the largest and most extensive antiterrorism drill ever conducted. All 32 acute care hospitals in Connecticut took part in the drill. The simulated attacks were designed to test all aspects of emergency preparedness including the ability of hospitals to treat large numbers of victims and effectively monitor and implement mechanisms for surge capacity. In Connecticut, TOPOFF 3 tested the Bioterrorism Preparedness Web Application that was designed to be the primary communication and resource management tool during a terrorist event or public health emergency. This paper describes: 1) the impetus for the State of Connecticut Department of Public Health's Bioterrorism Preparedness Web Application; 2) the strategies used to ensure its readiness and appropriate utilization during a public health emergency; and 3) its use for communication and resource management by the Department of Public Health and the acute care hospitals during TOPOFF 3. The Bioterrorism Preparedness Web Application was successfully implemented and used during TOPOFF 3 to assess surge capacity and other resources. Careful development and implementation of the Web application, or any communication system, as well as training and regular practice are required to ensure effective use during a public health emergency.

  11. Art of disaster preparedness in European union: a survey on the health systems.

    Science.gov (United States)

    Djalali, Ahmadreza; Della Corte, Francesco; Foletti, Marco; Ragazzoni, Luca; Ripoll Gallardo, Alba; Lupescu, Olivera; Arculeo, Chris; von Arnim, Götz; Friedl, Tom; Ashkenazi, Michael; Fischer, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

    2014-12-17

    Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal. Disaster medicine; Disaster preparedness

  12. Epidemiology of ebolavirus disease (EVD) and occupational EVD in health care workers in Sub-Saharan Africa: Need for strengthened public health preparedness.

    Science.gov (United States)

    Ngatu, Nlandu Roger; Kayembe, Ntumba Jean-Marie; Phillips, Elayne Kornblatt; Okech-Ojony, Joa; Patou-Musumari, Masika; Gaspard-Kibukusa, Mukunda; Madone-Mandina, Ndona; Godefroid-Mayala, Mabasi; Mutaawe, Lubogo; Manzengo, Casimir; Roger-Wumba, Dimosi; Nojima, Sayumi

    2017-10-01

    Ebolavirus disease (EVD) is a severe contagious disease in humans, and health care workers (HCW) are at risk of infection when caring for EVD patients. This paper highlights the epidemiologic profile of EVD and its impact on the health care workforce in Africa. A documentary study was conducted which consisted of a review of available literature regarding the epidemiology of EVD, occupational EVD (OEVD), and work safety issues in Sub-Saharan Africa; the literature findings are enriched by field experiences from the authors. EVD outbreaks have already caused 30,500 cases in humans of whom 12,933 died (as of September 9, 2015), and the number of infected HCW has dramatically increased. All eight HCW infected during the 2014 outbreak in Democratic Republic of the Congo died, whereas during the recent West African EVD epidemic more than 890 HCW were infected, with a case fatality rate of 57%. Occupational exposure to blood and other body fluids due to inadequate use of personal protective equipment and needle stick or sharp injuries are among factors that contribute to the occurrence of OEVD. Prevention of OEVD should be one of the top priorities in EVD outbreak preparedness and management, and research should be conducted to elucidate occupational and other factors that expose HCW to EVD. In addition to regularly training HCW to be adequately prepared to care for patients with EVD, it is critical to strengthen the general health care system and improve occupational safety in medical settings of countries at risk. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  13. Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

    Science.gov (United States)

    Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

    2016-04-01

    Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience. © 2016 AABB.

  14. Challenge of hospital emergency preparedness: analysis and recommendations.

    Science.gov (United States)

    Barbera, Joseph A; Yeatts, Dale J; Macintyre, Anthony G

    2009-06-01

    In the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research.

  15. The effects of terrorism on adult mental health: a public health preparedness approach

    Directory of Open Access Journals (Sweden)

    Sameera S. Karnik

    2014-01-01

    Full Text Available Terrorism is a disruptive man-made disaster event challenging human health and wellbeing. It is a hostile activity which brings about much casualty, even death. It not only causes physical casualties but also brings about psychological morbidity and can lead to long term mental disorders. The effects of terrorist attacks on people’s psychological health covers a wide range such as acute stress symptoms to long term disorders like Post-traumatic Stress Disorder (PTSD. The psychological disorder due to traumatic distress is treated with psychotherapies such as psychosocial intervention, psychological debriefing, psychological first aid care, psychological counseling services, and psychoeducation. Government is supporting state and local public health departments to develop efficient public health preparedness planning programs in case of emergency situations. There are some newer approaches working towards enhancing health security and managing responses to a psychological impact of a disaster event like a terrorist attack.

  16. Assessing a decade of public health preparedness: progress on the precipice?

    Science.gov (United States)

    Gursky, Elin A; Bice, Gregory

    2012-03-01

    September 11 and the subsequent anthrax attacks marked the beginning of significant investment by the federal government to develop a national public health emergency response capability. Recognizing the importance of the public health sector's contribution to the burgeoning homeland security enterprise, this investment was intended to convey a "dual benefit" by strengthening the overall public health infrastructure while building preparedness capabilities. In many instances, federal funds were used successfully for preparedness activities. For example, electronic health information networks, a Strategic National Stockpile, and increased interagency cooperation have all contributed to creating a more robust and prepared enterprise. Additionally, the knowledge of rarely seen or forgotten pathogens has been regenerated through newly established public health learning consortia, which, too, have strengthened relationships between the practice and academic communities. Balancing traditional public health roles with new preparedness responsibilities heightened public health's visibility, but it also presented significant complexities, including expanded lines of reporting and unremitting inflows of new guidance documents. Currently, a rapidly diminishing public health infrastructure at the state and local levels as a result of federal budget cuts and a poor economy serve as significant barriers to sustaining these nascent federal public health preparedness efforts. Sustaining these improvements will require enhanced coordination, collaboration, and planning across the homeland security enterprise; an infusion of innovation and leadership; and sustained transformative investment for governmental public health.

  17. Terrorism and emergency preparedness in state and territorial public health departments--United States, 2004.

    Science.gov (United States)

    2005-05-13

    After the events of September 11, 2001, federal funding for state public health preparedness programs increased from $67 million in fiscal year (FY) 2001 to approximately $1 billion in FY 2002. These funds were intended to support preparedness for and response to terrorism, infectious disease outbreaks, and other public health threats and emergencies. The Council of State and Territorial Epidemiologists (CSTE) assessed the impact of funding on epidemiologic capacity, including terrorism preparedness and response, in state health departments in November 2001 and again in May 2004, after distribution of an additional $1 billion in FY 2003. This report describes the results of those assessments, which indicated that increased funding for terrorism preparedness and emergency response has rapidly increased the number of epidemiologists and increased capacity for preparedness at the state level. However, despite the increase in epidemiologists, state public health officials estimate that 192 additional epidemiologists, an increase of 45.3%, are needed nationwide to fully staff terrorism preparedness programs.

  18. Resident cross-cultural training, satisfaction, and preparedness.

    Science.gov (United States)

    Frintner, Mary Pat; Mendoza, Fernando S; Dreyer, Benard P; Cull, William L; Laraque, Danielle

    2013-01-01

    To describe the diversity of pediatric residents and examine relationships of cross-cultural training experiences with training satisfaction, perceived preparedness for providing culturally effective care, and attitudes surrounding care for underserved populations. A cross-sectional survey was conducted of a national random sample of graduating pediatric residents and an additional sample of minority residents. Using weighted analysis, we used multivariate regression to test for differences in satisfaction, preparedness, and attitudes between residents with more and less cross-cultural experiences during residency, controlling for residents' characteristics and experiences before training. The survey response rate was 57%. Eleven percent were Hispanic, 61% white, 21% Asian, 9% African American, 9% other racial/ethnic groups; 34% grew up in a bi- or multilingual family. Ninety-three percent of residents were satisfied with their residency training, 81% with the instruction they received on health and health care disparities, and 54% on global health issues. Ninety-six percent of residents felt they were prepared to care for patients from diverse backgrounds, but fewer felt prepared to care for families with beliefs at odds with Western medicine (49%) and families who receive alternative or complementary care (37%). Residents with more cross-cultural experiences during residency reported being better prepared than those with less experience to care for families with limited English proficiency (adjusted odds ratio [aOR] 2.11; 95% confidence interval [CI] 1.40-3.17), new immigrants (aOR 1.91; 95% CI 1.32-2.75), and with religious beliefs that might affect clinical care (aOR 1.62; 95% CI 1.13-2.32). Pediatric residents begin their training with diverse cross-cultural backgrounds and experiences. Residency experiences in cross-cultural care contribute to feelings of preparedness to care for diverse US children. Copyright © 2013 Academic Pediatric Association. Published

  19. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    Science.gov (United States)

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  20. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication.

    Science.gov (United States)

    Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele

    2010-06-01

    Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

  1. APPROACH TO ASSESSING THE PREPAREDNESS OF HOSPITALS TO POWER OUTAGES

    Directory of Open Access Journals (Sweden)

    Lenka BREHOVSKÁ

    2017-06-01

    Full Text Available Within the secondary impacts of electricity blackouts, it is necessary to pay attention to facilities providing medical care for the population, namely the hospitals. Hospitals represent a key position in the provision of health care also in times of crisis. These facilities must provide constant care; it is therefore essential that the preparedness of such facilities is kept at a high level. The basic aim of this article is to analyse the preparedness of hospitals to power outages (power failures, blackouts within a pilot study. On that basis, a SWOT analysis is used to determine strengths and weaknesses of the system of preparedness of hospitals to power outages and solutions for better security of hospitals are defined. The sample investigated consists of four hospitals founded by the Regional Authority (hospitals Nos. 1-4 and one hospital founded by the Ministry of Health of the Czech Republic (hospital No. 5. The results of the study shows that most weaknesses of the preparedness of hospitals are represented by inadequately addressed reserves of fuel for the main backup power supply, poor knowledge of employees who are insufficiently retrained, and old backup power supplies (even 35 years in some cases.

  2. The changing health priorities of earthquake response and implications for preparedness: a scoping review.

    Science.gov (United States)

    Cartwright, C; Hall, M; Lee, A C K

    2017-09-01

    Earthquakes have substantial impacts on mortality in low- and middle-income countries (LMIC). The academic evidence base to support Disaster Risk Reduction activities in LMIC settings is, however, limited. We sought to address this gap by identifying the health and healthcare impacts of earthquakes in LMICs and to identify the implications of these findings for future earthquake preparedness. Scoping review. A scoping review was undertaken with systematic searches of indexed databases to identify relevant literature. Key study details, findings, recommendations or lessons learnt were extracted and analysed across individual earthquake events. Findings were categorised by time frame relative to earthquakes and linked to the disaster preparedness cycle, enabling a profile of health and healthcare impacts and implications for future preparedness to be established. Health services need to prepare for changing health priorities with a shift from initial treatment of earthquake-related injuries to more general health needs occurring within the first few weeks. Preparedness is required to address mental health and rehabilitation needs in the medium to longer term. Inequalities of the impact of earthquakes on health were noted in particular for women, children, the elderly, disabled and rural communities. The need to maintain access to essential services such as reproductive health and preventative health services were identified. Key preparedness actions include identification of appropriate leaders, planning and training of staff. Testing of plans was advocated within the literature with evidence that this is possible in LMIC settings. Whilst there are a range of health and healthcare impacts of earthquakes, common themes emerged in different settings and from different earthquake events. Preparedness of healthcare systems is essential and possible, in order to mitigate the adverse health impacts of earthquakes in LMIC settings. Preparedness is needed at the community

  3. "Skip the infection, get the injection": a case study in emergency preparedness education.

    Science.gov (United States)

    Adams, Lavonne M; Canclini, Sharon B; Frable, Pamela Jean

    2015-01-01

    The frequency of natural and manmade disasters along with increasing potential for public health emergencies emphasizes the need for emergency preparedness education. Because nurses are the largest group of health professionals to meet the needs of those affected by disasters and public health emergencies, schools of nursing need to prepare graduates who are knowledgeable about disaster and public health emergency management. The use of core competencies may be a means to ensure consistent application of best practices in disaster health care. The next step in competency development involves validation through evidence. Through documentation and dissemination of their experiences with emergency preparedness education, schools of nursing can provide supportive evidence to aid in competency development. The purpose of this paper is present a case study of an ongoing and evolving public health nursing education project consistent with disaster health care and emergency preparedness competencies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Preparedness in Long-Term Care: A Novel Approach to Address Gaps in Evacuation Tracking.

    Science.gov (United States)

    Prot, Emilie Y; Clements, Bruce

    2017-02-01

    With an aging population, the number of elderly individuals residing in long-term care (LTC) facilities will continue to grow and pose unique challenges to disaster preparedness and response. With this rapidly growing vulnerable population, it becomes imperative to identify enhanced and novel preparedness strategies and measures. LTC residents not only have complicated medical needs, including the timing of dispensing multiple medications, but frequently have cognitive and mobility deficits as well. In nearly every major disaster, elderly populations have suffered disproportionate morbidity and mortality. This is often due to elderly evacuees getting overlooked in the chaos of an initial response. Instituting measures to rapidly recognize this population in a crowd during an evacuation will reduce their risk. This commentary reviews the LTC facility evacuation challenges of the 2013 explosion of the West Fertilizer Company plant in West, Texas, and offers a novel solution of mandating the wearing of pink vests by all nursing home residents in case of an evacuation. The pink vests quickly alert disaster rescue and response workers of LTC residents with special needs. (Disaster Med Public Health Preparedness. 2017;11:28-30).

  5. Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

    LENUS (Irish Health Repository)

    O'Connor, L

    2015-01-01

    Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

  6. Ensuring the Health, Safety and Preparedness of U.S. Medical Students Participating in Global Health Electives Overseas.

    Science.gov (United States)

    Imperato, Pascal James; Bruno, Denise M; Monica Sweeney, M

    2016-04-01

    Global health electives based in resource-poor countries have become extremely popular with medical students from resource rich ones. As the number of such programs and participants increase, so too do the absolute health and safety risks. It is clear from a number of published reports that many institutions provide little or no meaningful preparedness for students and do little to ensure their health and safety. These deficiencies together can affect students, their foreign hosts, and sponsoring institutions. The School of Public Health at the State University of New York, Downstate Medical Center, and its predecessor, the Department of Preventive Medicine and Community Health, have sponsored a 6-8 week global health elective for fourth year medical students since 1980. The purposes of this elective are to provide students with an opportunity to observe the health care and public health systems in resource-poor countries, provide medical service, and have a cross-cultural experience. Over the course of the past 35 years, 386 students have participated in this global health elective in more than 41 resource-poor countries. Recent annual applications for this elective have been as high as 44 out of a class of 200 students. Over the past 10 years, annual acceptance rates have varied, ranging from a low of 32 % in 2007-2008 to a high of 74 % in 2010-2011 and 2013-2014. Careful screening, including a written application, review of academic records and personal interviews, has resulted in the selection of highly mature, adaptable, and dedicated students who have performed well at overseas sites. Appropriately preparing students for an overseas global health experience in resource-poor countries requires the investment of much professional and staff time and effort. At the SUNY Downstate School of Public Health, these resources have underpinned our Global Health in Developing Countries elective for many years. As a result, the elective is characterized by meticulous

  7. Emergency preparedness in obstetrics.

    Science.gov (United States)

    Haeri, Sina; Marcozzi, David

    2015-04-01

    During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

  8. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

    OpenAIRE

    Augustina Angelina Annan; Denis Dekugmen Yar; Michael Owusu; Eno Akua Biney; Paa Kobina Forson; Portia Boakye Okyere; Akosua Adumea Gyimah; Ellis Owusu-Dabo

    2017-01-01

    Abstract Background The recent Ebola Virus Disease (EVD) epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to) any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS) regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hos...

  9. Lesbian, Gay, Bisexual, and Transgender Patient Care: Medical Students' Preparedness and Comfort.

    Science.gov (United States)

    White, William; Brenman, Stephanie; Paradis, Elise; Goldsmith, Elizabeth S; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Tran, Eric; Wells, Maggie; Chamberlain, Lisa J; Fetterman, David M; Garcia, Gabriel

    2015-01-01

    Phenomenon: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant barriers in accessing appropriate and comprehensive medical care. Medical students' level of preparedness and comfort caring for LGBT patients is unknown. An online questionnaire (2009-2010) was distributed to students (n = 9,522) at 176 allopathic and osteopathic medical schools in Canada and the United States, followed by focus groups (2010) with students (n = 35) at five medical schools. The objective of this study was to characterize LGBT-related medical curricula, to determine medical students' assessments of their institutions' LGBT-related curricular content, and to evaluate their comfort and preparedness in caring for LGBT patients. Of 9,522 survey respondents, 4,262 from 170 schools were included in the final analysis. Most medical students (2,866/4,262; 67.3%) evaluated their LGBT-related curriculum as "fair" or worse. Students most often felt prepared addressing human immunodeficiency virus (HIV; 3,254/4,147; 78.5%) and non-HIV sexually transmitted infections (2,851/4,136; 68.9%). They felt least prepared discussing sex reassignment surgery (1,061/4,070; 26.1%) and gender transitioning (1,141/4,068; 28.0%). Medical education helped 62.6% (2,669/4,262) of students feel "more prepared" and 46.3% (1,972/4,262) of students feel "more comfortable" to care for LGBT patients. Four focus group sessions with 29 students were transcribed and analyzed. Qualitative analysis suggested students have significant concerns in addressing certain aspects of LGBT health, specifically with transgender patients. Insights: Medical students thought LGBT-specific curricula could be improved, consistent with the findings from a survey of deans of medical education. They felt comfortable, but not fully prepared, to care for LGBT patients. Increasing curricular coverage of LGBT-related topics is indicated with emphasis on exposing students to LGBT patients in clinical settings.

  10. The impact of cross-cultural interactions on medical students' preparedness to care for diverse patients.

    Science.gov (United States)

    Niu, Nina N; Syed, Zeba A; Krupat, Edward; Crutcher, Betty N; Pelletier, Stephen R; Shields, Helen M

    2012-11-01

    Medical students who graduate from schools with diverse student populations are more likely to rate themselves as prepared to care for diverse patients compared with students who graduate from more homogenous schools. This study aimed to identify the types of cross-cultural interactions associated with students' self-rated preparedness. In 2010, the authors developed and administered a Web-based survey that queried Harvard Medical School students about their voluntary interethnic interactions (studying, socializing), participation in diversity-related extracurricular activities, and self-rated preparedness to care for diverse patients. The authors separated students' responses regarding interethnic interactions and participation in diversity-related extracurricular activities into high and low participation, then determined the association between these responses and those to questions about students' self-rated preparedness to care for diverse patients. They used ANOVA and Z tests of proportion to analyze their data. Of 724 eligible students, 460 completed the survey (64%). Seventy-five percent (324/433) believed they were prepared to care for patients from backgrounds different from their own. Students who spent >75% of their study time with students from different backgrounds or who participated in a greater number of diversity-related extracurricular activities were more likely to rate themselves as prepared to care for diverse patients overall and to perform seven other skills. Voluntary cross-cultural interactions, both studying and socializing, are associated with higher self-rated preparedness to care for patients from diverse backgrounds. Medical schools should continue to support multicultural pursuits to prepare students to become physicians sensitive to the needs of diverse patients.

  11. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    Science.gov (United States)

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

  12. Emergency and disaster preparedness for chronically ill patients: a review of recommendations

    Directory of Open Access Journals (Sweden)

    Tomio J

    2014-12-01

    Full Text Available Jun Tomio,1 Hajime Sato2 1Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 2Department of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Japan Abstract: Recent disasters, especially those in developed countries, have highlighted the importance of disaster preparedness measures for chronic diseases. A number of surviving patients experienced the exacerbation of a chronic illness, such as hypertension, diabetes, cancer, and chronic respiratory diseases, due to disaster-related stress, interruption of care, or both; for some patients, these exacerbations resulted in death. Here, we review reports from recent disasters in developed countries and summarize the recommendations for disaster preparedness of chronically ill patients. A considerable number of recommendations based on the lessons learned from recent disasters have been developed, and they provide practical and essential steps to prevent treatment interruption during and after a disaster. To improve preparedness efforts, we suggest that health care providers should be aware of the following three suggestions: 1 recommendations should be evidence-based; 2 recommendations should contain consistent messages; and 3 recommendations should be feasible. Keywords: disaster, chronic illness, preparedness

  13. How Health Department Contextual Factors Affect Public Health Preparedness (PHP) and Perceptions of the 15 PHP Capabilities.

    Science.gov (United States)

    Horney, Jennifer A; Carbone, Eric G; Lynch, Molly; Wang, Z Joan; Jones, Terrance; Rose, Dale A

    2017-09-01

    To assess how health department contextual factors influence perceptions of the 15 Public Health Preparedness Capabilities, developed by the Centers for Disease Control and Prevention (CDC) to provide guidance on organizing preparedness activities. We conducted an online survey and focus group between September 2015 and May 2016 with directors of preparedness programs in state, metropolitan, and territorial jurisdictions funded by CDC's Public Health Emergency Preparedness (PHEP) cooperative agreement. The survey collected demographic information and data on contextual factors including leadership, partnerships, organizational structure, resources and structural capacity, and data and evaluation. Seventy-seven percent (48 of 62) of PHEP directors completed the survey and 8 participated in the focus group. Respondents were experienced directors (mean = 10.6 years), and 58% led 7 or more emergency responses. Leadership, partnerships, and access to fiscal and human resources were associated with perception and use of the capabilities. Despite some deficiencies, PHEP awardees believe the capabilities provide useful guidance and a flexible framework for organizing their work. Contextual factors affect perceptions of the capabilities and possibly the effectiveness of their use. Public Health Implications. The capabilities can be used to address challenges in preparedness, including identifying evidence-based practices, developing performance measures, and improving responses.

  14. Online public health preparedness training programs: an evaluation of user experience with the technological environment.

    Science.gov (United States)

    Nambisan, Priya

    2010-01-01

    preparedness training targeted at diverse audiences including the general public, health care and public health professionals, and emergency responders. Strategies for improving participants' pragmatic, hedonic, sociability and usability experiences are outlined. There are ample opportunities to improve the pragmatic, hedonic, sociability and usability experiences of the target audience. This is critical to improve the participants' learning and retention as well as the completion rates for the courses offered. Online emergency preparedness programs are likely to play a crucial role in preparing emergency responders at all levels in the future and their success has critical implications for public health informatics.

  15. Evidence-based point-of-care tests and device designs for disaster preparedness.

    Science.gov (United States)

    Brock, T Keith; Mecozzi, Daniel M; Sumner, Stephanie; Kost, Gerald J

    2010-01-01

    To define pathogen tests and device specifications needed for emerging point-of-care (POC) technologies used in disasters. Surveys included multiple-choice and ranking questions. Multiple-choice questions were analyzed with the chi2 test for goodness-of-fit and the binomial distribution test. Rankings were scored and compared using analysis of variance and Tukey's multiple comparison test. Disaster care experts on the editorial boards of the American Journal of Disaster Medicine and the Disaster Medicine and Public Health Preparedness, and the readers of the POC Journal. Vibrio cholera and Staphylococcus aureus were top-ranked pathogens for testing in disaster settings. Respondents felt that disaster response teams should be equipped with pandemic infectious disease tests for novel 2009 H1N1 and avian H5N1 influenza (disaster care, p disaster settings, respondents preferred self-contained test cassettes (disaster care, p disaster care, p disaster care scenarios, in which Vibrio cholera, methicillin-sensitive and methicillin-resistant Staphylococcus aureus, and Escherichia coli ranked the highest. POC testing should incorporate setting-specific design criteria such as safe disposable cassettes and direct blood sampling at the site of care.

  16. Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats

    Directory of Open Access Journals (Sweden)

    Dausey David J

    2007-05-01

    Full Text Available Abstract Background Since 2001, state and local health departments in the United States (US have accelerated efforts to prepare for high-impact public health emergencies. One component of these activities has been the development and conduct of exercise programs to assess capabilities, train staff and build relationships. This paper summarizes lessons learned from tabletop exercises about public health emergency preparedness and about the process of developing, conducting, and evaluating them. Methods We developed, conducted, and evaluated 31 tabletop exercises in partnership with state and local health departments throughout the US from 2003 to 2006. Participant self evaluations, after action reports, and tabletop exercise evaluation forms were used to identify aspects of the exercises themselves, as well as public health emergency responses that participants found more or less challenging, and to highlight lessons learned about tabletop exercise design. Results Designing the exercises involved substantial collaboration with representatives from participating health departments to assure that the scenarios were credible, focused attention on local preparedness needs and priorities, and were logistically feasible to implement. During execution of the exercises, nearly all health departments struggled with a common set of challenges relating to disease surveillance, epidemiologic investigations, communications, command and control, and health care surge capacity. In contrast, performance strengths were more varied across participating sites, reflecting specific attributes of individual health departments or communities, experience with actual public health emergencies, or the emphasis of prior preparedness efforts. Conclusion The design, conduct, and evaluation of the tabletop exercises described in this report benefited from collaborative planning that involved stakeholders from participating health departments and exercise developers and

  17. assessment of the birth and emergency preparedness level of ...

    African Journals Online (AJOL)

    honey

    2014-03-31

    Mar 31, 2014 ... the birth and emergency preparedness level of 250 pregnant women attending Antenatal Care (ANC) in a Primary. Health Care (PHC) ... obtained from the hypothesis method and based on the following assumption: 95% confidence level, prevalence .... order to reduce morbidity and mortality in pregnancy.

  18. Public health preparedness of health providers: meeting the needs of diverse, rural communities.

    Science.gov (United States)

    Hsu, Chiehwen Ed; Mas, Francisco Soto; Jacobson, Holly E; Harris, Ann Marie; Hunt, Victoria I; Nkhoma, Ella T

    2006-11-01

    Meeting the needs of public health emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to public health emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of public health emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies.

  19. Staff preparedness for providing palliative and end-of-life care in long-term care homes: Instrument development and validation.

    Science.gov (United States)

    Chan, Helen Yl; Chun, Gloria Km; Man, C W; Leung, Edward Mf

    2018-05-01

    Although much attention has been on integrating the palliative care approach into services of long-term care homes for older people living with frailty and progressive diseases, little is known about the staff preparedness for these new initiatives. The present study aimed to develop and test the psychometric properties of an instrument for measuring care home staff preparedness in providing palliative and end-of-life care. A 16-item instrument, covering perceived knowledge, skill and psychological readiness, was developed. A total of 247 staff members of different ranks from four care homes participated in the study. Exploratory factor analysis using the principal component analysis extraction method with varimax rotation was carried out for initial validation. Known group comparison was carried out to examine its discriminant validity. Reliability of the instrument was assessed based on test-retest reliability of a subsample of 20 participants and the Cronbach's alpha of the items. Exploratory factor analysis showed that the instrument yielded a three-factor solution, which cumulatively accounted for 68.5% of the total variance. Three subscales, namely, willingness, capability and resilience, showed high internal consistency and test-retest reliability. It also showed good discriminant validity between staff members of professional and non-professional groups. This is a brief, valid and reliable scale for measuring care home staff preparedness for providing palliative and end-of-life care. It can be used to identify their concerns and training needs in providing palliative and end-of-life care, and as an outcome measure to evaluate the effects of interventional studies for capacity building in this regard. Geriatr Gerontol Int 2018; 18: 745-749. © 2018 Japan Geriatrics Society.

  20. Differential effects of professional leaders on health care teams in chronic disease management groups.

    Science.gov (United States)

    Wholey, Douglas R; Disch, Joanne; White, Katie M; Powell, Adam; Rector, Thomas S; Sahay, Anju; Heidenreich, Paul A

    2014-01-01

    Leadership by health care professionals is likely to vary because of differences in the social contexts within which they are situated, socialization processes and societal expectations, education and training, and the way their professions define and operationalize key concepts such as teamwork, collaboration, and partnership. This research examines the effect of the nurse and physician leaders on interdependence and encounter preparedness in chronic disease management practice groups. The aim of this study was to examine the effect of complementary leadership by nurses and physicians involved in jointly producing a health care service on care team functioning. The design is a retrospective observational study based on survey data. The unit of analysis is heart failure care groups in U.S. Veterans Health Administration medical centers. Survey and administrative data were collected in 2009 from 68 Veterans Health Administration medical centers. Key variables include nurse and physician leadership, interdependence, psychological safety, coordination, and encounter preparedness. Reliability and validity of survey measures were assessed with exploratory factor analysis and Cronbach alphas. Multivariate analyses tested hypotheses. Professional leadership by nurses and physicians is related to encounter preparedness by different paths. Nurse leadership is associated with greater team interdependence, and interdependence is positively associated with respect. Physician leadership is positively associated with greater psychological safety, respect, and shared goals but is not associated with interdependence. Respect is associated with involvement in learning activities, and shared goals are associated with coordination. Coordination and involvement in learning activities are positively associated with encounter preparedness. By focusing on increasing interdependence and a constructive climate, nurse and physician leaders have the opportunity to increase care coordination

  1. Health care logistics: who has the ball during disaster?

    Science.gov (United States)

    Vanvactor, Jerry D

    2011-05-10

    In contemporary organizations, a wide gamut of options is available for sustaining and supporting health care operations. When disaster strikes, despite having tenable plans for routine replenishment and operations, many organizations find themselves ill-prepared, ill-equipped, and without effective mechanisms in place to sustain operations during the immediate aftermath of a crisis. Health care operations can be abruptly halted due to the non-availability of supply. The purpose of this work is to add to a necessary, growing body of works related specifically to health care logistics preparedness and disaster mitigation. Logistics management is a specialized genre of expertise within the health care industry and is largely contributive to the success or failure of health care organizations. Logistics management requires extensive collaboration among multiple stakeholders-internal and external to an organization. Effective processes and procedures can be largely contributive to the success or failure of organizational operations. This article contributes to the closure of an obvious gap in professional and academic literature related to disaster health care logistics management and provides timely insight into a potential problem for leaders industry-wide. One critical aspect of disaster planning is regard for competent logistics management and the effective provision of necessary items when they are needed most. In many communities, there seems to be little evidence available regarding health care logistics involvement in disaster planning; at times, evidence of planning efforts perceptibly end at intra-organizational doors within facilities. Strategic planners are being continually reminded that health care organizations serve a principal role in emergency preparedness planning and must be prepared to fulfill the associated possibilities without notification. The concern is that not enough attention is being paid to repeated lessons being observed in disasters and

  2. Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

    Directory of Open Access Journals (Sweden)

    Putthasri Weerasak

    2010-06-01

    Full Text Available Abstract Background Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. Methods The study relied on the Systemic Rapid Assessment (SYSRA toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. Results The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission

  3. Using exercises to improve public health preparedness in Asia, the Middle East and Africa.

    Science.gov (United States)

    Dausey, David J; Moore, Melinda

    2014-07-27

    Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization's preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency preparedness and response in

  4. Birth preparedness and complication readiness - a qualitative study among community members in rural Tanzania.

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B; Kayombo, Edmund; Mbekenga, Columba; Axemo, Pia; Darj, Elisabeth

    2015-01-01

    Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers.

  5. The significance of interfamilial relationships on birth preparedness and complication readiness in Pakistan.

    Science.gov (United States)

    Ghani, Usman; Crowther, Susan; Kamal, Yasir; Wahab, Muhammad

    2018-03-29

    In the interests of improving maternal health care and survival, the issue of birth preparedness and complication readiness has been much debated and has remained a priority for the international health community. The provision of birth preparedness and complications readiness is determined by a range of different factors. The main aim of this study is to identify and measure the influence of husbands and other family relationships on birth preparedness and complications readiness in the Khyber Pakhtunkhwa province of Pakistan. This study is a cross-sectional exploratory study. Data was collected through a survey questionnaire. Logistic regression and descriptive analysis was used. Analysis indicated that the mother-in-law's role, men's and women's level of education and interfamilial relationships are still the most significant factors influencing birth preparedness and complications readiness. Of the respondents, 86% were receiving antenatal care and 76.5% were planning for the birth to take place in state-run hospitals or private obstetric and gynae clinics. The tendency to take up antenatal care in Khyber Pakhtunkhwa can mainly be credited to a mutual understanding between husband and wife and a good relationship between the woman and her mother-in-law. Highlighting the significance of these relationships has implications for ensuring birth preparedness and complications readiness. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Birth preparedness and complication readiness – a qualitative study among community members in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Furaha August

    2015-06-01

    Full Text Available Background: Birth preparedness and complication readiness (BP/CR strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. Design: A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. Results: The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. Conclusions: This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via

  7. Birth preparedness and complication readiness – a qualitative study among community members in rural Tanzania

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B.; Kayombo, Edmund; Mbekenga, Columba; Axemo, Pia; Darj, Elisabeth

    2015-01-01

    Background Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. Design A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. Results The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. Conclusions This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers

  8. Birth preparedness and complication readiness in pregnant women attending urban tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Vasundhara Kamineni

    2017-01-01

    Full Text Available Background: Birth preparedness and complication readiness (BP/CR is a strategy to promote the timely use of skilled maternal and neonatal care and is based on the theory that preparing for childbirth and being ready for complications reduce delay in obtaining care. Study Objective: The objective of this study was to evaluate the incidence and predictors of birth preparedness, knowledge on danger signs, and emergency readiness among pregnant women attending outpatient clinic of a tertiary care hospital. Patients and Methods: Six hundred pregnant women attending the outpatient department of a tertiary care hospital for the first time in an urban setting were interviewed using a tool adapted from the “Monitoring BP/CR-tools and indicators for maternal and new born health” of the “JHPIEGO.” The outcomes of the study were birth preparedness, knowledge of severe illness, and emergency readiness. Results: Six hundred pregnant women were in the study. Mean age of respondents was 25.2 (±4 years. The mean gestation at enrolment was 18.7 ± 8 weeks. Among the women who participated in the survey, 20% were illiterate, 70% were homemakers and nearly 70% had a monthly family income >Rs. 15,197 (n = 405. Three hundred and sixteen mothers (52% were primigravida. As defined in the study, 71.5% were birth prepared. However, 59 women (9.8% did not identify a place of delivery, 102 (17% had not started saving money, and 99 mothers (16.5% were not aware of purchasing materials needed for delivery. The predictors of birth preparedness are multiparity (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.4–3.1, registration in the antenatal clinic in the first trimester (OR: 3.7, 95% CI: 2.2–6.1, educational status of women (OR: 1.9, 95% CI: 1.2–3.0, and pregnancy supervison by a doctor (OR: 5, 95% CI: 2.8–6.6. One hundred and sixty-four women (27% made no arrangements in the event of an emergency, 376 women (63% were not aware of their blood group

  9. End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity

    Science.gov (United States)

    Tait, Glendon R.; Hodges, Brian D.

    2009-01-01

    Objective: The authors examined psychiatric residents' attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. Methods: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey…

  10. Impact of extreme weather events and climate change for health and social care systems.

    Science.gov (United States)

    Curtis, Sarah; Fair, Alistair; Wistow, Jonathan; Val, Dimitri V; Oven, Katie

    2017-12-05

    This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.

  11. National Ambulatory Medical Care Survey: terrorism preparedness among office-based physicians, United States, 2003-2004.

    Science.gov (United States)

    Niska, Richard W; Burt, Catharine W

    2007-07-24

    This investigation describes terrorism preparedness among U.S. office-based physicians and their staffs in identification and diagnosis of terrorism-related conditions, training methods and sources, and assistance with diagnosis and reporting. The National Ambulatory Medical Care Survey (NAMCS) is an annual national probability survey of approximately 3,000 U.S. nonfederal, office-based physicians. Terrorism preparedness items were added in 2003 and 2004. About 40 percent of physicians or their staffs received training for anthrax or smallpox, but less than one-third received training for any of the other exposures. About 42.2 percent of physicians, 13.5 percent of nurses, and 9.4 percent of physician assistants and nurse practitioners received training in at least one exposure. Approximately 56.2 percent of physicians indicated that they would contact state or local public health officials for diagnostic assistance more frequently than federal agencies and other sources. About 67.1 percent of physicians indicated that they would report a suspected terrorism-related condition to the state or local health department, 50.9 percent to the Centers for Disease Control and Prevention (CDC), 27.5 percent to the local hospital, and 1.8 percent to a local elected official's office. Approximately 78.8 percent of physicians had contact information for the local health department readily available. About 53.7 percent had reviewed the diseases reportable to health departments since September 2001, 11.3 percent had reviewed them before that month, and 35 percent had never reviewed them.

  12. The global dimensions of public health preparedness and implications for US action.

    Science.gov (United States)

    Moore, Melinda

    2012-06-01

    The globalization of public health is both real and relevant throughout the United States and to Americans traveling or residing abroad. US public policy responses are evolving, but a crisper and more comprehensive global perspective is needed. I suggest four timely US actions to address today's competing realities of globalization and economic austerity: raise awareness among clinicians and local health departments; capture and share exemplary disaster management practices across countries; ensure that US global health investments are effective, efficient, and sustainable; and think globally while acting locally to enhance US health security. The reauthorization of the Pandemic and All-Hazards Preparedness Act of 2006 provides an opportunity to more clearly address the global dimensions of domestic preparedness.

  13. Building resiliency: a cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness.

    Science.gov (United States)

    Gowan, Monica E; Kirk, Ray C; Sloan, Jeff A

    2014-06-09

    Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown. We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships. We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness. How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and

  14. In Preparation or Response: Examining Health Care Coalitions Amid a Changing Economic and Political Landscape.

    Science.gov (United States)

    Dornauer, Mark E

    2015-12-01

    The Office of the Assistant Secretary for Preparedness and Response within the US Department of Health and Human Services leads the nation in preparing for, responding to, and recovering from the adverse health effects of public health emergencies, in part through formal collaborations between hospitals, health systems, community health centers, public health departments, and community organizations via health care coalitions (HCCs). HCCs endeavor to meet the medical surge demands inherent to disasters and to improve health outcomes before, during, and after public health emergencies. Nevertheless, significant changes in health economics and policy can impact the operations, capabilities, and scope of HCCs. Specifically, hospital consolidation and the Affordable Care Act (ACA) are altering the national health care landscape, as well as the emergency preparedness sector, and are challenging HCCs to adapt to large-scale, industry-wide transformations. This article examines HCCs in the context of the developments of hospital consolidation and the ACA in order to facilitate future discourse regarding the strategy and policy of HCCs amid a changing economic and political landscape.

  15. Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

    Science.gov (United States)

    Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

    During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD). In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness. In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital. Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed. Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious

  16. The US CDC Centers for public health preparedness : building a nationwide exemplar network

    Energy Technology Data Exchange (ETDEWEB)

    Harris, D.A.; Paulson, G.; Perry, E. [New Jersey Univ. of Medicine and Dentistry, New Brunswick, NJ (United States). School of Public Health

    2005-07-01

    The network of Centers for Public Health Preparedness (CPHP) was created by the United States Centers for Disease Control and Prevention in response to the perception that public health professionals were inadequately prepared to respond to terrorism incidents, natural disasters and similar major events. The events of September 11, 2001 and the subsequent anthrax attacks confirmed the wisdom of a concerted approach to emergency preparedness. This paper provides an outline of the network's recent activities as well as a review of the rationale, history and progress of the network to date. In the most recent grant cycle, each center was required to allocate 20 per cent of its resources to network-wide activities, including contribution of CPHP-developed materials to a central resource center maintained by the Association of Schools of Public Health. The materials are publicly available and are to be used in the development of training programs; the establishment of 19 or more exemplar groups that focus on specific preparedness-related knowledge domains such as mental health, educational evaluation methods and field epidemiology, who are also expected to develop tool kits of validated and fully described training materials for use by any CPHP person or group. The outcome of the CPHP network activities is the development of a more comprehensive and robust core of preparedness training materials that aim to facilitate rapid and effective training, while at the same time eliminating redundancy and duplication of effort. It was concluded that the expenditure of 20 per cent of center funds on network development activities is forcing the academically based CPHPs to adopt a new collaborative paradigm in order to ensure effective nationwide preparedness. 3 refs.

  17. Measures of emergency preparedness contributing to nursing home resilience.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2017-12-13

    Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

  18. Birth preparedness, complication readiness and fathers' participation in maternity care in a northern Nigerian community.

    Science.gov (United States)

    Iliyasu, Zubairu; Abubakar, Isa S; Galadanci, Hadiza S; Aliyu, Muktar H

    2010-03-01

    The role of men in maternity care in Africa is understudied, despite their economic dominance and decision making power. In a patriarchal society like northern Nigeria, pregnancy and childbirth are often regarded as exclusively women's affairs. Using data from interviewer administered questionnaires and in-depth interviews; we assessed birth preparedness, complication readiness and male participation in maternity care in Ungogo, a northern Nigerian community. Majority of pregnancies were unplanned (96%). Only 32.1% of men ever accompanied their spouses for maternity care. There was very little preparation for skilled assistance during delivery (6.2%), savings for emergencies (19.5%) or transportation during labour (24.2%). Young paternal age (adjusted odds ratio [AOR] = 1.5, 95% confidence interval [CI] = 1.2-2.6), formal education (AOR = 1.9, 95% CI=1.1-3.4) and non-Hausa Fulani ethnicity (AOR=2.3, 95% CI = 1.4-3.3) were independent predictors of male participation in maternity care. There is a need to increase involvement of men in their partner's maternity care through peer-led, culturally-sensitive community education and appropriate health system reforms.

  19. A review of critical care nursing and disease outbreak preparedness.

    Science.gov (United States)

    Makamure, Miranda; Makamure, Muriel; Mendiola, Williane; Renteria, Daisy; Repp, Melissa; Willden, Azshwee

    2013-01-01

    The impact of disease outbreaks continues to increase globally. As frontline staff, critical care nurses (CCNs) are more likely to be confronted with the need to care for affected patients. With different pathological diseases emerging, CCNs play an integral role in disease outbreaks. The advanced skill set of CCNs is pivotal in the management and care of patients during an outbreak. Lack of planning and preparation before disease outbreaks leads to detrimental patient outcomes. Panic, chaos, and fear for personal safety cause stress and anxiety for unprepared nurses. However, this problem can be resolved. Comprehensive planning, training, and education can better prepare intensive care unit nurses for disease outbreaks. This article reviews some of the current literature on intensive care unit nurse preparedness for disease outbreaks in the United States. This article also offers strategies that may be used to better prepare CCNs for disease outbreaks.

  20. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    OpenAIRE

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Background: Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries.Objective: This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak.Design: A rigorous literature review was conducted using eight electronic databases a...

  1. Legal Considerations for Health Care Practitioners After Superstorm Sandy.

    Science.gov (United States)

    Hershey, Tina Batra; Van Nostrand, Elizabeth; Sood, Rishi K; Potter, Margaret

    2016-06-01

    During disaster response and recovery, legal issues often arise related to the provision of health care services to affected residents. Superstorm Sandy led to the evacuation of many hospitals and other health care facilities and compromised the ability of health care practitioners to provide necessary primary care. This article highlights the challenges and legal concerns faced by health care practitioners in the aftermath of Sandy, which included limitations in scope of practice, difficulties with credentialing, lack of portability of practitioner licenses, and concerns regarding volunteer immunity and liability. Governmental and nongovernmental entities employed various strategies to address these concerns; however, legal barriers remained that posed challenges throughout the Superstorm Sandy response and recovery period. We suggest future approaches to address these legal considerations, including policies and legislation, additional waivers of law, and planning and coordination among multiple levels of governmental and nongovernmental organizations. (Disaster Med Public Health Preparedness. 2016;10:518-524).

  2. Have Maryland local health departments effectively put in place the information technology relevant to emergency preparedness?

    Science.gov (United States)

    Nguh, Jonas

    2013-01-01

    Ever since the terrorist attacks of 9/11, the federal government has increased funding for emergency preparedness. However, the literature continues to document several areas of weaknesses in public health emergency management by local health departments (LHD). This lack of preparedness affects the entire public. The purpose of this study was to determine whether or not Maryland LHDs have effectively put in place the information technology (IT) that is relevant for emergency preparedness. Base Firm-wide IT Infrastructure Services and the Feeny/Willcocks Framework for Core IS Capabilities are the two conceptual frameworks used in this study. This qualitative study used the survey method and the data were analyzed through content analysis. The results revealed that utilization, practice, and performance of IT by Maryland LHDs are not efficient or effective. Recommendations included the development of "best practices," increased funding for IT infrastructure and the establishment of strategic management framework for IT initiatives. Implications for positive social change include the development of recommendations to enhance emergency preparedness practice, and advancement of knowledge so as to facilitate the functions, and duties of health departments in emergency preparedness operations.

  3. Pandemic preparedness - Risk management and infection control for all respiratory infection outbreaks.

    Science.gov (United States)

    Nori, Annapurna; Williams, Mary-Anne

    2009-11-01

    There has been substantial effort and activity in regards to pandemic planning, preparedness and response, mainly in the realm of public health. However, general practitioners and other primary care providers are important players in the health response to a pandemic. To discuss the importance of general practice preparedness for managing respiratory infection outbreaks and to provide a model for the general practice response. Pandemic planning and preparedness in general practice is ultimately a crucial risk management exercise, the cornerstone of which is sound infection control. As planning will be significantly aided by, and should extend to, other respiratory outbreaks, we propose a framework for managing outbreaks of respiratory infections with a focus on planned, practised and habitual infection control measures, and a stepwise response according to the extent and severity of the outbreak.

  4. Enhancing Global Health Security: US Africa Command's Disaster Preparedness Program.

    Science.gov (United States)

    Morton Hamer, Melinda J; Reed, Paul L; Greulich, Jane D; Beadling, Charles W

    2018-03-07

    US Africa Command's Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizations to promote stability and security on the African continent by engaging with African Partner Nations' (PN) civil and military authorities to improve disaster management capabilities. From 2008 to 2015, DPP conducted disaster preparedness and response programming with 17 PNs. DPP held a series of engagements with each, including workshops, strategic planning, developing preparedness and response plans, tabletop exercises, and prioritizing disaster management capability gaps identified through the engagements. DPP partners collected data for each PN to further capacity building efforts. Thus far, 9 countries have completed military pandemic plans, 10 have developed national pandemic influenza plans, 9 have developed military support to civil authorities plans, and 11 have developed disaster management strategic work plans. There have been 20 national exercises conducted since 2009. DPP was cited as key in implementation of Ebola response plans in PNs, facilitated development of disaster management agencies in DPP PNs, and trained nearly 800 individuals. DPP enhanced PNs' ability to prepare and respond to crises, fostering relationships between international agencies, and improving civil-military coordination through both national and regional capacity building. (Disaster Med Public Health Preparedness. 2018;page 1 of 11).

  5. Social Capital Enhanced Disaster Preparedness and Health Consultations after the 2011 Great East Japan Earthquake and Nuclear Power Station Accident.

    Science.gov (United States)

    Hasegawa, Makoto; Murakami, Michio; Takebayashi, Yoshitake; Suzuki, Satoshi; Ohto, Hitoshi

    2018-03-14

    After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in the percentage of those who prepared for disasters and who utilized health checkups in Fukushima Prefecture, and identified the factors governing disaster preparedness and utilization of health checkups. We used the public opinion survey from 2011 to 2015 ( n = 677-779 each year) on prefectural policies that is conducted every year by the Fukushima Prefecture government Public Consultation Unit. We found that the percentage of those who prepare for disasters decreased, while that for health checkups did not significantly change. With regard to disaster preparedness, experiences of disaster enhance disaster preparedness, while bonds with other local people help to maintain preparedness. For health checkups, familiarity with the welfare service was the most important factor governing such consultations. The findings suggest that social capital should be promoted in order to improve disaster preparedness. The findings also suggest that residents' accessibility to medical and welfare services is also important in promoting the utilization of health checkups.

  6. A home health agency's pandemic preparedness and experience with the 2009 H1N1 pandemic.

    Science.gov (United States)

    Rebmann, Terri; Citarella, Barbara; Subramaniam, Divya S; Subramaniam, Dipti P

    2011-11-01

    Adequate pandemic preparedness is imperative for home health agencies. A 23-item pandemic preparedness survey was administered to home health agencies in the spring of 2010. The Kruskal-Wallis (KW) test was used to evaluate the relationships between agency size and preparedness indicators. Significant findings were further analyzed by the Mann-Whitney (MW) U post hoc test. The response rate was 25% (526/2,119). Approximately one-third of respondents (30.4%; n = 131) reported experiencing trouble obtaining supplies during the 2009 H1N1 pandemic. Small agencies were significantly more likely (Krusal-Wallis [KW] = 9.2; P agency pandemic preparedness, including surge capacity and participation in disaster drills, that need to be addressed. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  8. Ebola, Zika and the International Health Regulations ? implications for Port Health Preparedness

    OpenAIRE

    Glynn, R. W.; Boland, M.

    2016-01-01

    Background The outbreak of Ebola Virus Disease in West Africa in 2014-2015 was unprecedented in terms of its scale and consequence.? This, together with the emergence of Zika virus as a Public Health Emergency of International Concern in 2016, has again highlighted the potential for disease to spread across international borders and provided an impetus for countries to review their Port Health preparedness. This report reviews the legislative framework and actions taken under this framework i...

  9. Protecting health from climate change: Preparedness of medical interns

    Directory of Open Access Journals (Sweden)

    Majra Jai

    2009-01-01

    Full Text Available Context : Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff. Aims : To study the preparedness of medical interns to meet the challenge of protecting health from climate change. Settings and Design: Medical colleges in a coastal town. Cross-sectional study. Materials and Methods: A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded. Statistical Analysis Used: Proportions, percentage, Chi-test. Results : About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%, eight (6%, and 17 (13%, respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge. Conclusions : Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.

  10. A national survey on health department capacity for community engagement in emergency preparedness.

    Science.gov (United States)

    Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

    2015-01-01

    Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

  11. Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2016-08-01

    Introduction Disasters often overwhelm a community's capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response. Problem Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes' comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG's report on nursing home preparedness to identify current gaps. A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/"bounced back" as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress. Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency

  12. e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China.

    Science.gov (United States)

    Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; Macintyre, C Raina

    2013-03-13

    To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). PRIMARY AND SECONDARY MEASURES: For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers' exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient

  13. Terrorism preparedness in state health departments--United States, 2001-2003.

    Science.gov (United States)

    2003-10-31

    The anthrax attacks in fall 2001 highlighted the role of infectious disease (ID) epidemiologists in terrorism preparedness and response. Beginning in 2002, state health departments (SHDs) received approximately 1 billion dollars in new federal funding to prepare for and respond to terrorism, infectious disease outbreaks, and other public health threats and emergencies. This funding is being used in part to improve epidemiologic and surveillance capabilities. To determine how states have used a portion of their new funding to increase ID epidemiology capacity, the Iowa Department of Public Health's Center for Acute Disease Epidemiology and the Iowa State University Department of Microbiology conducted two surveys of U.S. state epidemiologists during September 2000-August 2001 and October 2002-June 2003. This report summarizes the results of these surveys, which determined that although the number of SHD epidemiology workers assigned to ID and terrorism preparedness increased by 132%, concerns remained regarding the ability of SHDs to hire qualified personnel. These findings underscore the need to develop additional and more diverse training venues for current and future ID epidemiologists.

  14. Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

    Science.gov (United States)

    Carter, Nancy C.; And Others

    This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

  15. Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2015-01-01

    PHENOMENON: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for … ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). INSIGHTS: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for

  16. Community Mental Health Preparedness in Disasters: A Qualitative Content Analysis in an Iranian Context

    Directory of Open Access Journals (Sweden)

    Juliet Roudini

    2017-07-01

    Conclusion: Mental health preparedness is a multifactorial phenomenon that requires a clear understanding and definition of perceived threats, public trust on social structure and formal and informal supportive organization. This preparedness involves proportional, mental, social, familial, religious beliefs, and cultural sensitivity along with the ability to handle mentally disastrous situation, which can be measured after concept analysis and tool development process.

  17. Situating Preparedness Education within Public Pedagogy

    Science.gov (United States)

    Kitagawa, Kaori

    2017-01-01

    Both "disaster preparedness" and "public pedagogy" have been broadly defined and diversely utilised. Preparedness has been dealt with in disciplines such as civil engineering, the sociology of disasters, public health and psychology, rather than education. Recently, inquiries into the learning and teaching of preparedness have…

  18. Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh.

    Science.gov (United States)

    Moinuddin, Md; Christou, Aliki; Hoque, Dewan Md Emdadul; Tahsina, Tazeen; Salam, Shumona Sharmin; Billah, Sk Masum; Kuppens, Lianne; Matin, Md Ziaul; Arifeen, Shams El

    2017-01-01

    Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh. To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices. A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis. Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6). Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low

  19. Birth preparedness and complication readiness (BPCR among pregnant women in hard-to-reach areas in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Moinuddin

    Full Text Available Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.Less than a quarter (24.5% of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7, district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9, receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8, and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9. Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1, use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1, practice clean cord care (OR = 1.3, CI: 1.0-1.5, receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2 or their newborn (OR = 2.6, CI: 2.1-3.3, and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6.Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality

  20. Social justice in pandemic preparedness.

    Science.gov (United States)

    DeBruin, Debra; Liaschenko, Joan; Marshall, Mary Faith

    2012-04-01

    Pandemic influenza planning in the United States violates the demands of social justice in 2 fundamental respects: it embraces the neutrality of procedural justice at the expense of more substantive concern with health disparities, thus perpetuating a predictable and preventable social injustice, and it fails to move beyond lament to practical planning for alleviating barriers to accessing care. A pragmatic social justice approach, addressing both health disparities and access barriers, should inform pandemic preparedness. Achieving social justice goals in pandemic response is challenging, but strategies are available to overcome the obstacles. The public engagement process of one state's pandemic ethics project influenced the development of these strategies.

  1. A taxonomy of state public health preparedness units: an empirical examination of organizational structure.

    Science.gov (United States)

    Menachemi, Nir; Yeager, Valerie A; Duncan, W Jack; Katholi, Charles R; Ginter, Peter M

    2012-01-01

    State public health preparedness units (SPHPUs) were developed in response to federal funding to improve response to disasters: a responsibility that had not traditionally been within the purview of public health. The SPHPUs were created within the existing public health organizational structure, and their placement may have implications for how the unit functions, how communication takes place, and ultimately how well the key responsibilities are performed. This study empirically identifies a taxonomy of similarly structured SPHPUs and examines whether this structure is associated with state geographic, demographic, and threat-vulnerability characteristics. Data representing each SPHPU were extracted from publically available sources, including organizational charts and emergency preparedness plans for 2009. A cross-sectional segmentation analysis was conducted of variables representing structural attributes. Fifty state public health departments. Variables representing "span of control" and "hierarchal levels" were extracted from organizational charts. Structural "complexity" and "centralization" were extracted from state emergency preparedness documents and other secondary sources. On average, 6.6 people report to the same manager as the SPHPU director; 2.1 levels separate the SPHPU director from the state health officer; and a mean of 13.5 agencies collaborate with SPHPU during a disaster. Despite considerable variability in how SPHPUs had been structured, results of the cluster and principal component analysis identified 7 similarly structured groups. Neither the taxonomic groups nor the individual variables representing structure were found to be associated with state characteristics, including threat vulnerabilities. Our finding supports the hypothesis that SPHPUs are seemingly inadvertently (eg, not strategically) organized. This taxonomy provides the basis for which future research can examine how SPHPU structure relates to performance measures and

  2. Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013.

    Science.gov (United States)

    Kurkjian, Katie M; Winz, Michelle; Yang, Jun; Corvese, Kate; Colón, Ana; Levine, Seth J; Mullen, Jessica; Ruth, Donna; Anson-Dwamena, Rexford; Bayleyegn, Tesfaye; Chang, David S

    2016-04-01

    For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia. Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions. Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions. The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth's Community Health Improvement Plan.

  3. Participatory public health systems research: value of community involvement in a study series in mental health emergency preparedness.

    Science.gov (United States)

    McCabe, O Lee; Marum, Felicity; Semon, Natalie; Mosley, Adrian; Gwon, Howard; Perry, Charlene; Moore, Suzanne Straub; Links, Jonathan M

    2012-01-01

    Concerns have arisen over recent years about the absence of empirically derived evidence on which to base policy and practice in the public health system, in general, and to meet the challenge of public health emergency preparedness, in particular. Related issues include the challenge of disaster-caused, behavioral health surge, and the frequent exclusion of populations from studies that the research is meant to aid. To characterize the contributions of nonacademic collaborators to a series of projects validating a set of interventions to enhance capacity and competency of public mental health preparedness planning and response. Urban, suburban, and rural communities of the state of Maryland and rural communities of the state of Iowa. Study partners and participants (both of this project and the studies examined) were representatives of academic health centers (AHCs), local health departments (LHDs), and faith-based organizations (FBOs) and their communities. A multiple-project, case study analysis was conducted, that is, four research projects implemented by the authors from 2005 through 2011 to determine the types and impact of contributions made by nonacademic collaborators to those projects. The analysis involved reviewing research records, conceptualizing contributions (and providing examples) for government, faith, and (nonacademic) institutional collaborators. Ten areas were identified where partners made valuable contributions to the study series; these "value-areas" were as follows: 1) leadership and management of the projects; 2) formulation and refinement of research topics, aims, etc; 3) recruitment and retention of participants; 4) design and enhancement of interventions; 5) delivery of interventions; 6) collection, analysis, and interpretation of data; 7) dissemination of findings; 8) ensuring sustainability of faith/government preparedness planning relationships; 9) optimizing scalability and portability of the model; and 10) facilitating

  4. 76 FR 58466 - Request for Comments on World Health Organization Pandemic Influenza Preparedness Framework

    Science.gov (United States)

    2011-09-21

    ... response, including implementation of the World Health Organization Pandemic Influenza Preparedness... INFORMATION: Written comments are sought in light of the approval of the World Health Organization (WHO... DEPARTMENT OF COMMERCE International Trade Administration Request for Comments on World Health...

  5. Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district.

    Science.gov (United States)

    Thwala, Siphiwe Bridget Pearl; Blaauw, Duane; Ssengooba, Freddie

    2018-01-01

    Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (pfacilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions.

  6. Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

    Science.gov (United States)

    Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari

    2016-01-01

    We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

  7. Legal preparedness: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

    Science.gov (United States)

    Courtney, Brooke; Hodge, James G; Toner, Eric S; Roxland, Beth E; Penn, Matthew S; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan; Christian, Michael D; Powell, Tia

    2014-10-01

    hospitals and practitioners who act in good faith from liability. Finally, to address anticipated staffing shortages during severe and prolonged disasters and pandemics, governments should develop approaches to formally expand the availability of qualified health-care workers, such as through using official foreign medical teams. As a fundamental element of health-care and public health emergency planning and preparedness, the law underlies critical aspects of disaster and pandemic responses. Effective responses require comprehensive advance planning efforts that include assessments of complex legal issues and authorities. Recent disasters have shown that although law is a critical response tool, it can also be used to hold health-care stakeholders who fail to appropriately plan for or respond to disasters and pandemics accountable for resulting patient or staff harm. Claims of liability from harms allegedly suffered during disasters and pandemics cannot be avoided altogether. However, appropriate planning and legal protections can help facilitate sound, consistent decision-making and support response participation among health-care entities and practitioners.

  8. Public Health Crisis Preparedness and Response in Korea

    Science.gov (United States)

    Lee, Hye-Young; Oh, Mi-Na; Park, Yong-Shik; Chu, Chaeshin; Son, Tae-Jong

    2013-01-01

    Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases. PMID:24298444

  9. Mental Health Care for LGBT Older Adults in Long-Term Care Settings: Competency, Training, and Barriers for Mental Health Providers.

    Science.gov (United States)

    Smith, Ronald W; Altman, Jennifer K; Meeks, Suzanne; Hinrichs, Kate Lm

    2018-06-07

    To assess mental health providers' experience with LGBT older adults in long-term care (LTC) settings and perceived barriers to quality care. Providers (N = 57) completed an online survey on demographics and practice characteristics. They were also asked about: number of LGBT residents they've worked with, relevance of LGBT issues to their practice, preparedness, willingness to learn, hours of formal/informal training, and barriers to providing care to LGBT patients. Respondents were 63% psychologists, 16% social workers, 14% psychiatrists, and 5% nurses, most of whom practiced in LTC consulting roles. Most providers felt working with LGBT issues was relevant to their practice and felt well-prepared and willing to learn, though they were unaware of evidence based practices (EBTs), especially for LTC settings. They had little coursework on LGBT issues, and identified lack of training, stigma, and residents concealing their identity as the greatest barriers to quality care. Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care. LGBT-specific training and EBTs are needed. Facilities need to address stigma with residents and providers.

  10. The road to developing an advanced degree program in public health preparedness.

    Science.gov (United States)

    Cherry, Robert A; Davis, Tom

    2007-08-01

    The master of homeland security (MHS) degree in public health preparedness at the Pennsylvania State University College of Medicine is the first degree program of its kind offered by any U.S. medical school. The field of public health preparedness has been increasingly viewed as a new, emerging professional discipline, which academic medicine is well positioned to complement. The process by which the MHS program has evolved from conception to realization is a case study in the mission-based alignment of core values and leadership between the government and academic medicine. Recognizing the need for multidisciplinary involvement, the program architects reconsidered the traditional approach to the development and implementation of new graduate degree programs. Instead, a more flexible, loosely connected network of strategic partners and alliances was adopted. These partnerships were developed and cultivated by vested individuals who excelled in specific core competencies and came together to create value. This allowed for both the expertise and flexibility needed to adapt quickly to the evolving homeland security environment in the United States. To that end, this article describes the 10-step multidisciplinary program-development process that spanned three years and culminated in the establishment of this new graduate degree program. The MHS program as it now stands focuses on public health preparedness, including epidemiological evaluation, disaster communication and psychology, agricultural biosecurity, and critical infrastructure protection. The program is geared toward the practicing professional already working in the field, and its graduates are positioned to be among the top leaders, educators, and researchers in homeland security.

  11. Psychological Correlates of Civilian Preparedness for Conflicts.

    Science.gov (United States)

    Bodas, Moran; Siman-Tov, Maya; Kreitler, Shulamith; Peleg, Kobi

    2017-08-01

    Preparedness for emergencies and disasters is imperative for public resilience. Previous studies have revealed low levels of civilian preparedness for conflicts. Classic behavioral models prove inapt in describing preparedness patterns in victimized populations chronically exposed to this threat. In an effort to expand this perspective, we hypothesized that other psychological constructs are correlated with preparedness. A cross-sectional, Internet-based study was performed in Israel in early 2016. A sociodemographically diverse sample included 385 participants, Jews and Arabs. The tools included a preparedness index, sense of preparedness questionnaire, Trait Anxiety Inventory, Life Orientation Test, Behavioral Inhibition & Activation System scales, and ego defenses. The results suggested that optimistic and rational individuals reported significantly higher levels of preparedness, whereas those who scored highly on the trait anxiety scale and those with a tendency to use denial coping mechanisms reported significantly lower levels of preparedness. The findings suggest that additional constructs, other than classic threat perception components, might play a key role in governing preparedness behavior. In particular, psychological manipulation of dispositional optimism or optimistic thinking might be effective in motivating preparedness behavior. Future research should explore such innovative ways to promoting preparedness. (Disaster Med Public Health Preparedness. 2017;11:451-459).

  12. Mass-Fatality Incident Preparedness Among Faith-Based Organizations.

    Science.gov (United States)

    Zhi, Qi; Merrill, Jacqueline A; Gershon, Robyn R

    2017-12-01

    organizations (73%) and less likely with local death care sector organizations (27%) or Departments of Health (DOHs; 32%). The study suggests improvements are needed in terms of staff training in general, and specifically, drills with planning partners are needed. Greater cooperation and inclusion of FBOs in national planning and training will likely benefit overall MFI preparedness in the US. Zhi Q , Merrill JA , Gershon RR . Mass-fatality incident preparedness among faith-based organizations. Prehosp Disaster Med. 2017;32(6):596-603.

  13. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis.

    Science.gov (United States)

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. The importance of PHLP has grown during the past decade and focuses mainly on infection-disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States' utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

  14. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    Directory of Open Access Journals (Sweden)

    Odeya Cohen

    2015-10-01

    Full Text Available Background: Public health legal preparedness (PHLP for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC and developed countries. Objective: This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design: A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results: The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions: The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

  15. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    Science.gov (United States)

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Background Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. Objective This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended. PMID:26449204

  16. Assessment of Ebola virus disease preparedness in the WHO South-East Asia Region.

    Science.gov (United States)

    Vong, Sirenda; Samuel, Reuben; Gould, Philip; El Sakka, Hammam; Rana, Bardan J; Pinyowiwat, Vason; Bezbaruah, Supriya; Ofrin, Roderico

    2016-12-01

    To conduct assessments of Ebola virus disease preparedness in countries of the World Health Organization (WHO) South-East Asia Region. Nine of 11 countries in the region agreed to be assessed. During February to November 2015 a joint team from WHO and ministries of health conducted 4-5 day missions to Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. We collected information through guided discussions with senior technical leaders and visits to hospitals, laboratories and airports. We assessed each country's Ebola virus disease preparedness on 41 tasks under nine key components adapted from the WHO Ebola preparedness checklist of January 2015. Political commitment to Ebola preparedness was high in all countries. Planning was most advanced for components that had been previously planned or tested for influenza pandemics: multilevel and multisectoral coordination; multidisciplinary rapid response teams; public communication and social mobilization; drills in international airports; and training on personal protective equipment. Major vulnerabilities included inadequate risk assessment and risk communication; gaps in data management and analysis for event surveillance; and limited capacity in molecular diagnostic techniques. Many countries had limited planning for a surge of Ebola cases. Other tasks needing improvement included: advice to inbound travellers; adequate isolation rooms; appropriate infection control practices; triage systems in hospitals; laboratory diagnostic capacity; contact tracing; and danger pay to staff to ensure continuity of care. Joint assessment and feedback about the functionality of Ebola virus preparedness systems help countries strengthen their core capacities to meet the International Health Regulations.

  17. Birth preparedness and complication readiness among pregnant women in Tehulederie district, Northeast Ethiopia: a community-based cross-sectional study.

    Science.gov (United States)

    Endeshaw, Demlie Belete; Gezie, Lema Derseh; Yeshita, Hedija Yenus

    2018-01-01

    Motherhood is a time of anticipation of joy for a woman, her family, and her community. In spite of this fact, it is not as enjoyable as it should be because of numerous reasons. Insufficiency or lack of birth preparedness and complication readiness is the most common reason. The aim of this study was to assess the practice of birth preparedness and complication readiness and associated factors among pregnant women in Tehuledere district, northeast Ethiopia. A community-based cross-sectional study was conducted in Tehuledere district, northeast Ethiopia. Participants were selected using the multistage sampling technique, and data were analyzed both descriptively and analytically using the binary logistic regression. Out of the total 507 samples, 500 (response rate 98.6%) pregnant women participated in the study. Less than half (44.6%) and (43.4%) of the respondents had knowledge and practice on birth preparedness and complication readiness, respectively. In the multivariate analysis, knowledge of birth preparedness and complication readiness (AOR = 1.648, 95%CI: 1.073, 2.531), knowledge of danger signs during pregnancy (AOR = 2.802, 95% CI: 1.637, 4.793), gestational age (AOR = 3.379, 95% CI: 2.114, 5.401), and antenatal care follow up starting time (AOR = 2.841, 95% CI: 1.330, 6.068) were significantly associated with the practice of birth preparedness and complication readiness, but pregnant women in rural areas (AOR = 0.442, 95% CI:0.244, 0.803) were less associated with birth preparedness and complication readiness compared to women in urban settlements. This study identified that poor knowledge, inadequate birth preparedness, and complication readiness were prevalent among mothers in the study area. Government officials, partners, and health care providers working in the areas of maternal and child health should operate together to maximize birth preparedness and complication readiness practices.

  18. Perceptions of Preparedness for Interprofessional Practice: A Survey of Health Professional Students at Three Universities

    Directory of Open Access Journals (Sweden)

    Alexa M. Sevin

    2015-01-01

    Full Text Available Objective: The purpose of this study was to evaluate health professions students’ understanding of their own and others’ roles on interprofessional (IP teams, assess students’ perceptions of their preparedness to practice in an IP team, and determine differences by type of learning institution and participation in interprofessional education (IPE. Methods: Medical, nursing, and pharmacy students at three Ohio universities with unique IP learning models were surveyed. Descriptive statistics, analysis of variance (ANOVA, chi-square, and two sample t- tests were used to compare measures of knowledge, IPE participation, and preparedness. Results: Of the 981 invited students, 273 completed the survey (27.8% response. Overall, 70.7% of participants felt prepared to work on an IP team. Those who reported participation in IPE were more likely to feel prepared to practice on an IP team compared to those who did not (76.8% [149/194] vs. 55.3% [42/76], p=0.0005. Participation in IPE did not significantly affect knowledge scores (participators 79.6% vs. non-participators 81.0%, p=0.1731. Those who had higher profession-specific knowledge scores were more likely to feel prepared to work with that specific profession. Conclusions: Participation in IPE activities in the representative institutions was high, as was knowledge of professional roles. Both participation in IPE and increased knowledge of roles were associated with increased student-assessed preparedness. Advancement of skills and behaviors including knowledge of roles and other competencies may all be important. Pharmacy in particular should prioritize IPE as a means to elucidate our role on the patient care team.   Type: Original Research

  19. Counseling Transgender College Students: Perceptions of College Mental Health Clinicians' Preparedness

    Science.gov (United States)

    Couture, Valerie

    2017-01-01

    The purpose of this study was to assess the perceived preparedness levels of college mental health clinicians to counsel transgender college students. Multicultural counseling competency is required of professional counselors and transgender individuals are considered to be part of the multicultural population. A survey was completed by college…

  20. Improving water, sanitation and hygiene in health-care facilities, Liberia.

    Science.gov (United States)

    Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

    2017-07-01

    The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

  1. Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

    Science.gov (United States)

    Siegfried, Alexa L; Carbone, Eric G; Meit, Michael B; Kennedy, Mallory J; Yusuf, Hussain; Kahn, Emily B

    2017-10-01

    This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information

  2. Weaving latino cultural concepts into Preparedness Core Competency training.

    Science.gov (United States)

    Riley-Jacome, Mary; Parker, Blanca Angelica Gonzalez; Waltz, Edward C

    2014-01-01

    The New York • New Jersey Preparedness and Emergency Response Learning Center (NY•NJ PERLC) is one of 14 Centers funded by the Centers for Disease Control and Prevention designed to address the preparedness and response training and education needs of the public health workforce. One of the important niches, or focus areas for the Center, is training to improve the capacity of public health workers to respond with competence to the needs of vulnerable populations. During every phase of a disaster, racial and ethnic minorities, including Latinos, suffer worse outcomes than the general population. Communities with diverse cultural origins and limited English speakers often present more complex issues during public health emergencies. Training that incorporates cultural concepts into the Preparedness Core Competencies may improve the ability of public health workers to engage the Latino community in preparedness activities and ultimately improve outcomes during disasters. This article describes initiatives undertaken by the NY•NJ PERLC to improve the capacity of the public health workforce to respond competently to the needs of Latino populations. In 2012, the Center collaborated with national, state, and local partners to develop a nationwide broadcast founded on the Preparedness Core Competencies, Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness. The widely viewed broadcast (497 sites in 47 states and 13 nations) highlighted the commonalities and differences within Latino culture that can impact emergency preparedness and response and outlined practical strategies to enhance participation. The success of the broadcast spurred a number of partner requests for training and technical assistance. Lessons learned from these experiences, including our "undercover" work at local Points of Dispensing, are incorporated into subsequent interactive trainings to improve the competency of public health workers. Participants recommended

  3. Self-Perceived End-of-Life Care Competencies of Health-Care Providers at a Large Academic Medical Center.

    Science.gov (United States)

    Montagnini, Marcos; Smith, Heather M; Price, Deborah M; Ghosh, Bidisha; Strodtman, Linda

    2018-01-01

    In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. To assess health-care professionals' self-perceived competencies regarding the provision of EOL care in hospitalized patients. Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.

  4. Cross-sectional Survey of Long-Term Care Facilities in the Rockaway Peninsula: Preparedness and Response During Hurricane Sandy.

    Science.gov (United States)

    Jiang, Lynn; Tedeschi, Christopher; Subaiya, Saleena

    2018-04-01

    Few studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm. A cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached. Of 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs. Many LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194-200).

  5. Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

    Science.gov (United States)

    Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

    2018-04-01

    Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

  6. The Meta-Leadership Summit for Preparedness Initiative: An Innovative Model to Advance Public Health Preparedness and Response

    Science.gov (United States)

    Sobelson, Robyn K.; Young, Andrea C.; Marcus, Leonard J.; Dorn, Barry C.; Neslund, Verla S.; McNulty, Eric J.

    2017-01-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as “good” or “outstanding,” and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts. PMID:24251597

  7. The meta-leadership summit for preparedness initiative: an innovative model to advance public health preparedness and response.

    Science.gov (United States)

    Sobelson, Robyn K; Young, Andrea C; Marcus, Leonard J; Dorn, Barry C; Neslund, Verla S; McNulty, Eric J

    2013-12-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as "good" or "outstanding," and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts.

  8. Preparedness for eHealth: Health Sciences Students’ Knowledge, Skills, and Confidence

    Directory of Open Access Journals (Sweden)

    Mary Lam

    2016-07-01

    Full Text Available There is increasing recognition of the role eHealth will play in the effective and efficient delivery of healthcare. This research challenges the assumption that students enter university as digital natives, able to confidently and competently adapt their use of information and communication technology (ICT to new contexts. This study explored health sciences students’ preparedness for working, and leading change, in eHealth-enabled environments. Using a cross-sectional study design, 420 undergraduate and postgraduate students participated in an online survey investigating their understanding of and attitude towards eHealth, frequency of online activities and software usage, confidence learning and using ICTs, and perceived learning needs. Although students reported that they regularly engaged with a wide range of online activities and software and were confident learning new ICT skills especially where they have sufficient time or support, their understanding of eHealth was uncertain or limited. Poor understanding of and difficulty translating skills learned in personal contexts to the professional context may impair graduates ability to con-fidently engage in the eHealth-enabled workplace. These results suggest educators need to scaffold the learning experience to ensure students build on their ICT knowledge to transfer this to their future workplaces.

  9. Ebola virus disease: radiology preparedness.

    Science.gov (United States)

    Bluemke, David A; Meltzer, Carolyn C

    2015-02-01

    At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

  10. Rural Community Disaster Preparedness and Risk Perception in Trujillo, Peru.

    Science.gov (United States)

    Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott

    2017-08-01

    Introduction Disasters will continue to occur throughout the world and it is the responsibility of the government, health care systems, and communities to adequately prepare for potential catastrophic scenarios. Unfortunately, low-and-middle-income countries (LMICs) are especially vulnerable following a disaster. By understanding disaster preparedness and risk perception, interventions can be developed to improve community preparedness and avoid unnecessary mortality and morbidity following a natural disaster. Problem The purpose of this study was to assess disaster preparedness and risk perception in communities surrounding Trujillo, Peru. After designing a novel disaster preparedness and risk perception survey based on guidelines from the International Federation of Red Cross and Red Crescent Societies (IFRC; Geneva, Switzerland), investigators performed a cross-sectional survey of potentially vulnerable communities surrounding Trujillo, Peru. Data were entered and analyzed utilizing the Research Electronic Data Capture (REDCap; Harvard Catalyst; Boston, Massachusetts USA) database. A total of 230 study participants were surveyed, composed of 37% males, 63% females, with ages ranging from 18-85 years old. Those surveyed who had previously experienced a disaster (41%) had a higher perception of future disaster occurrence and potential disaster impact on their community. Overall, the study participants consistently perceived that earthquakes and infection had the highest potential impact of all disasters. Twenty-six percent of participants had an emergency supply of food, 24% had an emergency water plan, 24% had a first aid kit at home, and only 20% of the study participants had an established family evacuation plan. Natural and man-made disasters will remain a threat to the safety and health of communities in all parts of the world, especially within vulnerable communities in LMICs; however, little research has been done to identify disaster perception

  11. Unlocking community capabilities for improving maternal and newborn health: participatory action research to improve birth preparedness, health facility access, and newborn care in rural Uganda

    Directory of Open Access Journals (Sweden)

    Elizabeth Ekirapa-Kiracho

    2016-11-01

    Full Text Available Abstract Background Community capacities and resources must be harnessed to complement supply side initiatives addressing high maternal and neonatal mortality rates in Uganda. This paper reflects on gains, challenges and lessons learnt from working with communities to improve maternal and newborn health in rural Uganda. Methods A participatory action research project was supported from 2012 to 2015 in three eastern districts. This project involved working with households, saving groups, sub county and district leaders, transporters and village health teams in diagnosing causes of maternal and neonatal mortality and morbidity, developing action plans to address these issues, taking action and learning from action in a cyclical manner. This paper draws from project experience and documentation, as well as thematic analysis of 20 interviews with community and district stakeholders and 12 focus group discussions with women who had recently delivered and men whose wives had recently delivered. Results Women and men reported increased awareness about birth preparedness, improved newborn care practices and more male involvement in maternal and newborn health. However, additional direct communication strategies were required to reach more men beyond the minority who attended community dialogues and home visits. Saving groups and other saving modalities were strengthened, with money saved used to meet transport costs, purchase other items needed for birth and other routine household needs. However saving groups required significant support to improve income generation, management and trust among members. Linkages between savings groups and transport providers improved women’s access to health facilities at reduced cost. Although village health teams were a key resource for providing information, their efforts were constrained by low levels of education, inadequate financial compensation and transportation challenges. Ensuring that the village health

  12. Communicating public health preparedness information to pregnant and postpartum women: an assessment of Centers for Disease Control and Prevention web pages.

    Science.gov (United States)

    McDonough, Brianna; Felter, Elizabeth; Downes, Amia; Trauth, Jeanette

    2015-04-01

    Pregnant and postpartum women have special needs during public health emergencies but often have inadequate levels of disaster preparedness. Thus, improving maternal emergency preparedness is a public health priority. More research is needed to identify the strengths and weaknesses of various approaches to how preparedness information is communicated to these women. A sample of web pages from the Centers for Disease Control and Prevention intended to address the preparedness needs of pregnant and postpartum populations was examined for suitability for this audience. Five of the 7 web pages examined were considered adequate. One web page was considered not suitable and one the raters split between not suitable and adequate. None of the resources examined were considered superior. If these resources are considered some of the best available to pregnant and postpartum women, more work is needed to improve the suitability of educational resources, especially for audiences with low literacy and low incomes.

  13. Preparedness for natural disasters among older US adults: a nationwide survey.

    Science.gov (United States)

    Al-Rousan, Tala M; Rubenstein, Linda M; Wallace, Robert B

    2015-10-01

    We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents. We sampled adults aged 50 years or older (n = 1304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness. Participant (n = 1304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, public health, and emergency management sectors of society.

  14. [Preparedness for natural disasters among older US adults: a nationwide survery].

    Science.gov (United States)

    Al-rousan, Tala M; Rubenstein, Linda M; Wallace, Robert B

    2014-12-01

    We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents. We sampled adults aged 50 years or older (n = 1 304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness. Participant (n = 1 304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness. Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, public health, and emergency management sectors of society.

  15. Radiation Emergency Preparedness Tools: Psychological First Aid

    Centers for Disease Control (CDC) Podcasts

    2010-12-30

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes Psychological First Aid and a newly developed multimedia training program, entitled "Psychological First Aid in Radiation Disasters.".  Created: 12/30/2010 by National Center for Environmental Health (NCEH) Radiation Studies Branch and Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 1/13/2011.

  16. Factors that affect parent perceptions of provider-family partnership for children with special health care needs.

    Science.gov (United States)

    Knapp, Caprice A; Madden, Vanessa L; Marcu, Mircea I

    2010-09-01

    Partnering between families and their children's providers is a cornerstone of family-centered care. This study aimed to identify factors associated with family-provider partnership and determine the association between partnership and other outcome measures for children with special health care needs (CSHCN). Descriptive, bivariate, and multivariate analyses were conducted using data from the 2005-2006 National Survey of Children with Special Health Care Needs. Multivariate models showed that CSHCN who are White non-Hispanic, younger than 12, reside in households with incomes above 400% of the federal poverty level, and have a usual source of care were associated with family-provider partnership. Multivariate models showed that family-provider partnership was significantly associated with adequate insurance, early and continual screening, organized health care services, and transition preparedness. Family-provider partnership was associated with 20% fewer emergency department visits and 9% fewer school days missed. This study suggests that policies aimed at promoting family-provider partnership could increase health outcomes for CSHCN.

  17. Ebola virus disease surveillance and response preparedness in northern Ghana

    Directory of Open Access Journals (Sweden)

    Martin N. Adokiya

    2016-05-01

    Full Text Available Background: The recent Ebola virus disease (EVD outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases. Objective: The objective of this study was to assess the EVD surveillance and response system in northern Ghana. Design: This was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Surveillance and Response reports (August 2014 to March 2015 were collated from each district. Results: In 2014 and 2015, a total of 10 suspected Ebola cases were clinically diagnosed from four districts. Out of the suspected cases, eight died and the cause of death was unexplained. All the 10 suspected cases were reported, none was confirmed. The informants had knowledge on EVD surveillance and data reporting. However, there were gaps such as delayed reporting, low quality protective equipment (e.g. gloves, aprons, inadequate staff, and lack of laboratory capacity. The majority (38/47 of the respondents were not satisfied with EVD surveillance system and response preparedness due to lack of infrared thermometers, ineffective screening, and lack of isolation centres. Conclusion: EVD surveillance and response preparedness is insufficient and the epidemic is a wake-up call for early detection and response preparedness. Ebola surveillance remains

  18. Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies.

    Science.gov (United States)

    Donovan, Catherine V; Markiewicz, Milissa; Horney, Jennifer A

    2014-05-28

    In 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina. A survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring. Of 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009. Following a system-wide review of preparedness in North Carolina, the state's regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

  19. State-level emergency preparedness and response capabilities.

    Science.gov (United States)

    Watkins, Sharon M; Perrotta, Dennis M; Stanbury, Martha; Heumann, Michael; Anderson, Henry; Simms, Erin; Huang, Monica

    2011-03-01

    Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an "all-hazards" approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed. A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique. Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities. Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and

  20. [Impact of a disaster preparedness training program on health staff].

    Science.gov (United States)

    Parra Cotanda, Cristina; Rebordosa Martínez, Mónica; Trenchs Sainz de la Maza, Victoria; Luaces Cubells, Carles

    2016-09-01

    The aim of this study is to evaluate the effectiveness of a disaster preparedness training program in a Paediatric Emergency Department (PED). A quasi-experimental study was conducted using an anonymous questionnaire that was distributed to health care providers of a PED in a tertiary paediatric hospital. The questions concerned the disaster plan (DP), including theoretical and practical aspects. Questionnaires were distributed and completed in January 2014 (period 1) and November 2014 (period 2). The disaster training program includes theoretical and practical sessions. A total of 110 questionnaires were collected in period 1, and 80 in period 2. Almost three-quarters (71.3%) of PED staff attended the theoretical sessions, and 43.8% attended the practical sessions. The application of this training program significantly improved knowledge about the DP, but no improvement was observed in the practical questions. PED staff felt more prepared to face a disaster after the training program (15.5% vs. 41.8%, Ptraining program improved some knowledge about the disaster plan, but it has not improved responses in practical situations, which may be due to the low attendance at practical sessions and the time between the training program and the questionnaires. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. 78 FR 79081 - Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid...

    Science.gov (United States)

    2013-12-27

    ... Conditions for Coverage CHAP Community Health Accreditation Program CMHC Community Mental Health Center COI... Pathology Services (Sec. 485.727) N. Emergency Preparedness Regulations for Community Mental Health Centers... Preparedness for Community Mental Health Centers (CMHCs)--Training and Testing (Sec. 485.920(d)) R. Conditions...

  2. Radiation Emergency Preparedness Tools: Virtual Community Reception Center

    Centers for Disease Control (CDC) Podcasts

    2011-02-28

    This podcast is an overview of resources from the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes a web-based training tool known as a Virtual Community Reception Center (vCRC).  Created: 2/28/2011 by National Center for Environmental Health (NCEH) Radiation Studies Branch and Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 2/28/2011.

  3. Health crises due to infectious and communicable diseases : European preparedness and response tools in an international context.

    Science.gov (United States)

    Mahy, Patrick; Collard, Jean-Marc; Gala, Jean-Luc; Herman, Philippe; Groof, Dirk De; Quoilin, Sophie; Sneyers, Myriam

    2017-06-01

    The combination of changes in eating habits, ways of living, globalisation, extensive travelling and the migration of millions of people around the world may be contributing to increased health risks. Certainly, health crises today are proving highly complex. More and more people are travelling and may carry with them unexpected virus vectors such as mosquitoes. Preparedness is challenging and there is a need for action plans to safeguard the growing at-risk population. Health crises can potentially affect a large proportion of the population and may lead to a significant increase in mortality or to an abnormally high death rate. This should be integrated into the general concept of national and international surveillance in order to provide a prepared response in the event of crisis. This paper provides an inventory of the relevant laws, guidelines and tools in Europe (and to a lesser degree, beyond), and proposes answers to the health crisis problems associated with infectious and communicable diseases. In crisis management, communication is an important factor to consider. This paper can serve as a tool for people involved in crisis preparedness.

  4. Health system preparedness for integration of mental health services in rural Liberia.

    Science.gov (United States)

    Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L

    2017-07-27

    There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical

  5. Situational awareness in public health preparedness settings

    Science.gov (United States)

    Mirhaji, Parsa; Michea, Yanko F.; Zhang, Jiajie; Casscells, Samuel W.

    2005-05-01

    September 11 2001 attacks and following Anthrax mailings introduced emergent need for developing technologies that can distinguish between man made and natural incidents in the public health level. With this objective in mind, government agencies started a funding effort to foster the design, development and implementation of such systems on a wide scale. But the outcomes have not met the expectations set by the resources invested. Multiple elements explain this phenomenon: As it has been frequent with technology, introduction of new surveillance systems to the workflow equation has occurred without taking into consideration the need for understanding and inclusion of deeper personal, psychosocial, organizational and methodological concepts. The environment, in which these systems are operating, is complex, highly dynamic, uncertain, risky, and subject to intense time pressures. Such 'difficult' environments are very challenging to the human as a decision maker. In this paper we will challenge these systems from the perspective of human factors design. We will propose employment of systematic situational awareness research for design and implementation of the next generation public health preparedness infrastructures. We believe that systems designed based on results of such analytical definition of the domain enable public health practitioners to effectively collect the most important cues from the environment, process, interpret and understand the information in the context of organizational objectives and immediate tasks at hand, and use that understanding to forecast the short term and long term impact of the events in the safety and well being of the community.

  6. Overview of preparedness and response for Middle East respiratory syndrome coronavirus (MERS-CoV) in Oman.

    Science.gov (United States)

    Al-Abaidani, I S; Al-Maani, A S; Al-Kindi, H S; Al-Jardani, A K; Abdel-Hady, D M; Zayed, B E; Al-Harthy, K S; Al-Shaqsi, K H; Al-Abri, S S

    2014-12-01

    Several countries in the Middle East and around 22 countries worldwide have reported cases of human infection with the Middle East respiratory syndrome coronavirus (MERS-CoV). The exceptionally high fatality rate resulting from MERS-CoV infection in conjunction with the paucity of knowledge about this emerging virus has led to major public and international concern. Within the framework of the national acute respiratory illness surveillance, the Ministry of Health in the Sultanate of Oman has announced two confirmed cases of MERS-CoV to date. The aim of this report is to describe the epidemiological aspects of these two cases and to highlight the importance of public health preparedness and response. The absence of secondary cases among contacts of the reported cases can be seen as evidence of the effectiveness of infection prevention and control precautions as an important pillar of the national preparedness and response plan applied in the health care institutions in Oman. Copyright © 2014. Published by Elsevier Ltd.

  7. Overview of preparedness and response for Middle East respiratory syndrome coronavirus (MERS-CoV in Oman

    Directory of Open Access Journals (Sweden)

    I.S. Al-Abaidani

    2014-12-01

    Full Text Available Several countries in the Middle East and around 22 countries worldwide have reported cases of human infection with the Middle East respiratory syndrome coronavirus (MERS-CoV. The exceptionally high fatality rate resulting from MERS-CoV infection in conjunction with the paucity of knowledge about this emerging virus has led to major public and international concern. Within the framework of the national acute respiratory illness surveillance, the Ministry of Health in the Sultanate of Oman has announced two confirmed cases of MERS-CoV to date. The aim of this report is to describe the epidemiological aspects of these two cases and to highlight the importance of public health preparedness and response. The absence of secondary cases among contacts of the reported cases can be seen as evidence of the effectiveness of infection prevention and control precautions as an important pillar of the national preparedness and response plan applied in the health care institutions in Oman.

  8. Back-to-School Preparedness

    Centers for Disease Control (CDC) Podcasts

    2014-07-28

    CDC provides direction, support, and coordination to help the public be prepared. This podcast discusses how parents and students can be prepared at school.  Created: 7/28/2014 by Office of Public Health Preparedness and Response (PHPR).   Date Released: 7/31/2014.

  9. Medical preparedness for radiation emergency in Japan

    International Nuclear Information System (INIS)

    Akashi, Makoto

    1997-01-01

    Medical preparedness for radiation emergency in Japan is primary for off-site public protection. Many things remains to be discussed about on-site emergency medical problems. On the other hand, each nuclear facility should have a countermeasure plan of radiation emergency including medical measures for the emergency. Disaster countermeasure act and a guideline from NSC entitled 'Off-site emergency planning and preparedness for nuclear power plants' establish the system for countermeasures in radiation emergencies. The guideline also establishes medical plans in radiation emergencies, including care system for the severely contaminated or injured. NIRS is designated by the guideline as the definite care hospital for radiation injuries and is prepared to dispatch medical specialists and to receive the injured. NIRS conducts clinical follow-up studies of the injured, researches of diagnosis and treatments for radiation injuries, and education and training for medical personnel. NIRS has the plans to serve as the reference center for emergency in Japan and also in Asia, if necessary. NIRS would like to serve as a member of WHO Collaborating Center for Radiation Emergency Medical Preparedness and Assistance (REMPAN). Now NIRS is making preparation for providing 24-hours direct or consultative assistance with medical problems associated with radiation accidents in local, national, and hopefully international incidents. (author)

  10. Assessing the congruence of transition preparedness as reported by parents and their adolescents with special health care needs.

    Science.gov (United States)

    Knapp, Caprice; Huang, I-Chan; Hinojosa, Melanie; Baker, Kimberly; Sloyer, Phyllis

    2013-02-01

    Several studies have investigated how prepared adolescents are to transition to adult health care and barriers to transition for adolescents with special health care needs. The majority of these studies, however, have only assessed these experiences from the parents' point of view. Our study aims to assess the congruence of adolescents and parents reported transition planning and the factors associated with planning. A secondary data analysis was conducted using telephone survey data. Data were collected from parents and adolescents with special health care needs who received health care through Florida's Title V public insurance program. The final sample included 376 matched pairs of adolescent-parent surveys. To assess health care transition planning, respondents were asked if discussions had occurred with the adolescents' doctor, nurse, or with each other. Parents reported higher levels of planning than adolescents. Results show the lowest level of agreement between the parent and adolescent reports (κ < 0.2) and the highest level of agreement when parents and adolescents were asked if they discussed transition with each other (κ = 0.19). Regression results suggest that older adolescents are more prepared (vs. younger) and that adolescents whose parents have lower educational attainment are less prepared for transition. Results from this study suggest that there may be miscommunication around discussions related to transition, although further research is warranted. It is important to ensure that adolescents, not just parents, have a thorough understanding of transition since they will ultimately be responsible for their own health care once they reach adulthood.

  11. Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

    Science.gov (United States)

    Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

    2015-06-01

    Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  12. Alternate Care Sites for the Management of Medical Surge in Disasters

    Science.gov (United States)

    2013-12-01

    care facilities are in place  Plan for community based surge hospital bed surge capacity is in place  A 50-bed nursing subunit—per 50,000...attempt to assess the preparedness of the hospital system, HHS/ASPR commissioned The Center for Biosecurity of UPMC to examine various responses to...catastrophic health efforts. The 11 report The Next Challenge in Healthcare Preparedness: Catastrophic Health Events (Center for Biosecurity of UPMC

  13. 78 FR 7784 - Office of the Secretary; Office of the Assistant Secretary for Preparedness and Response...

    Science.gov (United States)

    2013-02-04

    ... Center (ECCC) (ANC5) from under the Office of Preparedness and Emergency Operations (ANC) to operating... Preparedness and Emergency Operations (ANC), delete the following component ``Division of Emergency Care...

  14. Australian intern pharmacists’ perceived preparedness for practice, and their expectations and experiences of the internship year and future career intentions

    Directory of Open Access Journals (Sweden)

    Mak VSL

    2013-11-01

    Full Text Available Vivienne SL Mak,1,2 Geoff March,2 Alice Clark,2 Andrew L Gilbert21Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 2Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: A key objective of Australia's health care reform is a skilled, flexible, and well-trained workforce. To meet these requirements, the training of health professionals, including pharmacists, needs to be focused on patient care processes, and students must develop competencies in the delivery of patient care. Pharmacy graduates need to be well prepared for new and alternative career pathways through their education and training, to be a part of the future workforce. This study explores Australian intern pharmacists' perceived preparedness for practice, the match between their expectations and experience to meet the requirements of health professionals in Australia's health care reforms, and their future career intentions.Methods: Two questionnaires were sent by post to all 136 intern pharmacists in South Australia; one was sent early in their internship and the second follow-up questionnaire was sent near the completion of their internship.Results: Pharmacy graduates felt prepared for patient care, medicines information, and primary health care roles. A mismatch between expectations and actual experiences was found. By the end of the internship, 45% agree/strongly agree that they wanted to do something else other than being a practicing pharmacist.Conclusion: The current internship model no longer meets the needs and expectations of knowledgeable and skilled pharmacy graduates. An alternative internship model, which considers the expectations of graduates, is required.Keywords: intern pharmacist, preparedness, expectations, experiences, internship, future career

  15. Governance on home care in Europe.

    NARCIS (Netherlands)

    Genet, N.; Boerma, W.; Hutchinson, A.; Garms-Homolova, V.; Naiditch, M.; Lamura, G.; Chlabicz, S.; Ersek, K.; Laszlo, G.; Fagerstrom, C.; Bolibar, B.

    2010-01-01

    Introduction: Demand for health and social care services in the community will grow as a result of the ageing of populations across Europe. At present, however, very little is known about the preparedness of national home care systems for changing demand, which is not just quantitative but also

  16. Radiological and nuclear emergency preparedness and response. How well are we prepared?

    International Nuclear Information System (INIS)

    Geick, Gunther H.G.; Herrmann, Andre R.; Koch, Doris; Meisenberg, Oliver; Rauber, Dominique; Stuerm, Rolf P.; Weiss, Wolfgang; Miska, Horst; Schoenhacker, Stefan

    2011-01-01

    The contributions to this topic are dealing, in a broad overview, with important aspects of Nuclear Emergency Preparedness and Response, like the influence of the new ICRP recommendations number 103 and number 109 on emergency preparedness and on planning for response, possible problems in installing and operating emergency care centres, experience from exercises as well as the training of response personnel in Austria and Germany. Finally, measures in emergency preparedness with regard to a dirty bomb attack are reported by means of an INEX-4-exercise in Switzerland. (orig.)

  17. Women's autonomy and husbands' involvement in maternal health care in Nepal.

    Science.gov (United States)

    Thapa, Deependra Kaji; Niehof, Anke

    2013-09-01

    Both increasing women's autonomy and increasing husbands' involvement in maternal health care are promising strategies to enhance maternal health care utilization. However, these two may be at odds with each other insofar as autonomous women may not seek their husband's involvement, and involved husbands may limit women's autonomy. This study assessed the relationship between women's autonomy and husbands' involvement in maternal health care. Field work for this study was carried out during September-November 2011 in the Kailali district of Nepal. In-depth interviews and focus group discussions were used to investigate the extent of husbands' involvement in maternal health care. A survey was carried out among 341 randomly selected women who delivered a live baby within one year prior to the survey. The results show that husbands were involved in giving advice, supporting to reduce the household work burden, and making financial and transportation arrangements for the delivery. After adjustment for other covariates, economic autonomy was associated with lower likelihood of discussion with husband during pregnancy, while domestic decision-making autonomy was associated with both lower likelihood of discussion with husband during pregnancy and the husband's presence at antenatal care (ANC) visits. Movement autonomy was associated with lower likelihood of the husband's presence at ANC visits. Intra-spousal communication was associated with higher likelihood of discussing health with the husband during pregnancy, birth preparedness, and the husbands' presence at the health facility delivery. The magnitude and direction of association varied per autonomy dimension. These findings suggest that programs to improve the women's autonomy and at the same time increase the husband's involvement should be carefully planned. Despite the traditional cultural beliefs that go against the involvement of husbands, Nepalese husbands are increasingly entering into the area of maternal

  18. Inequities in resources and preparedness for surgical complications ...

    African Journals Online (AJOL)

    Health-worker training and health-system strengthening are considered important ... To determine preparedness for, and health-system constraints to, safe caesarean section in southern Gauteng hospitals. Methods. This was a ... delivery constraints included an unequal staff distribution between central hospitals and lower ...

  19. Exploring the Demands on Nurses Working in Health Care Facilities During a Large-Scale Natural Disaster

    Directory of Open Access Journals (Sweden)

    Gillian C. Scrymgeour

    2016-06-01

    Full Text Available Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organizations represents an important adjunct to nurse education, policy development, and research considerations. Although this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analyzed using an ecological and interactive systems framework. Ten of the 12 retained studies included evacuation, revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organizational, functional, and competency issues in regard to the complexity of decision making and overall preparedness. The integrative review also identified that the unique roles, competencies, and demands on nurses working in hospitals and residential health care facilities during a natural disaster appear invisible within the highly visible event.

  20. Are universities preparing nurses to meet the challenges posed by the Australian mental health care system?

    Science.gov (United States)

    Wynaden, D; Orb, A; McGowan, S; Downie, J

    2000-09-01

    The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students' perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students' perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre-testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.

  1. Prepared to react? Assessing the functional capacity of the primary health care system in rural Orissa, India to respond to the devastating flood of September 2008

    Directory of Open Access Journals (Sweden)

    Michael Marx

    2012-03-01

    Full Text Available Background: Early detection of an impending flood and the availability of countermeasures to deal with it can significantly reduce its health impacts. In developing countries like India, public primary health care facilities are frontline organizations that deal with disasters particularly in rural settings. For developing robust counter reacting systems evaluating preparedness capacities within existing systems becomes necessary. Objective: The objective of the study is to assess the functional capacity of the primary health care system in Jagatsinghpur district of rural Orissa in India to respond to the devastating flood of September 2008. Methods: An onsite survey was conducted in all 29 primary and secondary facilities in five rural blocks (administrative units of Jagatsinghpur district in Orissa state. A pre-tested structured questionnaire was administered face to face in the facilities. The data was entered, processed and analyzed using STATA® 10. Results: Data from our primary survey clearly shows that the healthcare facilities are ill prepared to handle the flood despite being faced by them annually. Basic utilities like electricity backup and essential medical supplies are lacking during floods. Lack of human resources along with missing standard operating procedures; pre-identified communication and incident command systems; effective leadership; and weak financial structures are the main hindering factors in mounting an adequate response to the floods. Conclusion: The 2008 flood challenged the primary curative and preventive health care services in Jagatsinghpur. Simple steps like developing facility specific preparedness plans which detail out standard operating procedures during floods and identify clear lines of command will go a long way in strengthening the response to future floods. Performance critiques provided by the grass roots workers, like this one, should be used for institutional learning and effective preparedness

  2. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

    This podcast discusses the special concerns many older adults face during a disaster. It is primarily targeted to public health and aging services professionals.  Created: 1/26/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).   Date Released: 1/26/2009.

  3. Impact of a Simulation-Based Communication Workshop on Resident Preparedness for End-of-Life Communication in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Abraham Markin

    2015-01-01

    Full Text Available Introduction. Although residents frequently lead end-of-life (EOL discussions in the intensive care unit (ICU, training in EOL care during residency has been required only recently, and few educational interventions target EOL communication in the ICU. This study evaluated a simulation-based intervention designed to improve resident EOL communication skills with families in the ICU. Methods. Thirty-four second-year internal medicine residents at a large urban teaching hospital participated in small group sessions with faculty trained in the “VitalTalk” method. A Likert-type scale questionnaire measured self-assessed preparedness before, immediately following, and approximately 9 months after intervention. Data were analyzed using Wilcoxon rank-sum analysis. Results. Self-assessed preparedness significantly improved for all categories surveyed (preintervention mean; postintervention mean; p value, including discussing bad news (3.3; 4.2; p<0.01, conducting a family conference (3.1; 4.1; p<0.01, discussing treatment options (3.2; 3.9; p<0.01, discussing discontinuing ICU treatments (2.9; 3.5; p<0.01, and expressing empathy (3.9; 4.5; p<0.01. Improvement persisted at follow-up for all items except “expressing empathy.” Residents rated the educational quality highly. Conclusion. This study provides evidence that brief simulation-based interventions can produce lasting improvements in residents’ confidence to discuss EOL care with family members of patients in the ICU.

  4. Resident Dyads Providing Transition Care to Adolescents and Young Adults With Chronic Illnesses and Neurodevelopmental Disabilities.

    Science.gov (United States)

    Chung, Richard J; Jasien, Joan; Maslow, Gary R

    2017-04-01

    Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration. Residents from pediatrics, medicine-pediatrics, and internal medicine training programs participated in a transitions clinic for patients with chronic health conditions aged 16 to 26 years. Residents attended 1 to 4 half-day clinic sessions during 1-month ambulatory rotations. Pediatrics/adult medicine resident dyads collaboratively performed psychosocial and medical transition consultations that addressed health care navigation, self-care, and education and vocation topics. Two to 3 attending physicians supervised each clinic session (4 hours) while concurrently seeing patients. Residents completed a preclinic survey about baseline attitudes and experiences, and a postclinic survey about their transitions clinic experiences, changes in attitudes, and transition care preparedness. A total of 46 residents (100% of those eligible) participated in the clinic and completed the preclinic survey, and 25 (54%) completed the postclinic survey. A majority of respondents to the postclinic survey reported positive experiences. Residents in both pediatrics and internal medicine programs reported improved preparedness for providing transition care to patients with chronic health conditions and communicating effectively with colleagues in other disciplines. A dyadic model of collaborative transition care training was positively received and yielded improvements in immediate self-assessed transition care preparedness.

  5. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  6. Prisons' preparedness for pandemic flu and the ethical issues.

    Science.gov (United States)

    van't Hoff, G; Fedosejeva, R; Mihailescu, L

    2009-06-01

    In Europe at any given time there are about 1,8 million people imprisoned in penal institutions. About 1 million personnel are working in prisons. With prisons, from the start there are fundamental problems in many parts of Europe. Poor housing conditions in prisons and a high proportion of prisoners who already suffer from severe health problems mean the chance of an outbreak in prison during a pandemic must be quite high. We expect it can be up to 90%. In this article we explain what the characteristics are of the prison population from a health point of view. A high rate of detainees suffers from mental health disorders and/or addiction. A high prevalence of communicable and infectious diseases is the rule, not an exception. According to the European Prison Rules and many other international rules, statements and documents prison health care should be an integral part of the public health system of any country. However, it has to be accepted that the prison population is the least popular in society and in politics. In reality in many countries in Europe the situation in prison cannot meet the level strived for by the European Prison Rules. We compare preparedness on pandemic flu in The Netherlands, Latvia and Romania. We explore the problems and ethical issues that may arise if a pandemic breaks out. There are three ethical dilemmas that require consideration: equivalence of care and prisoners' right to health care; prisoners' interests verses society's interests; countries in need and calls for bilateral help.

  7. Committee Opinion No. 726: Hospital Disaster Preparedness for Obstetricians and Facilities Providing Maternity Care.

    Science.gov (United States)

    2017-12-01

    Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery. Recent evidence suggests that floods and human-influenced environmental disasters increase the risks of spontaneous miscarriages, preterm births, and low-birth-weight infants among pregnant women. The potential surge in maternal and neonatal patient volume due to mass-casualty events, transfer of high-acuity patients, or redirection of patients because of geographic barriers presents unique challenges for obstetric care facilities. These circumstances require that facilities plan for additional increases in necessary resources and staffing. Although emergencies may be unexpected, hospitals and obstetric delivery units can prepare to implement plans that will best serve maternal and pediatric care needs when disasters occur. Clear designation of levels of maternal and neonatal care facilities, along with establishment of a regional network incorporating hospitals that provide maternity services and those that do not, will enable rapid transport of obstetric patients to the appropriate facilities, ensuring the right care at the right time. Using common terminology for triage and transfer and advanced knowledge of regionalization and levels of care will facilitate disaster preparedness.

  8. Mass-casualty events at schools: a national preparedness survey.

    Science.gov (United States)

    Graham, James; Shirm, Steve; Liggin, Rebecca; Aitken, Mary E; Dick, Rhonda

    2006-01-01

    Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.

  9. Impact of the 2011 Revolution on Hospital Disaster Preparedness in Yemen.

    Science.gov (United States)

    Aladhrai, Saleem Ahmed; Djalali, Ahmadreza; Della Corte, Francesco; Alsabri, Mohammed; El-Bakri, Nahid Karrar; Ingrassia, Pier Luigi

    2015-08-01

    Hospitals are expected to serve the medical needs of casualties in the face of a disaster or other crisis, including man-made conflicts. The aim of this study was to evaluate the impact of the 2011 Yemeni revolution on hospital disaster preparedness in the capital city of Sana'a. The study was conducted in September 2011 and 2013. For evaluation purposes, the hospital emergency response checklist published by the World Health Organization (WHO) was used. Additional information was also obtained to determine what steps were being taken by hospital authorities to improve hospital preparedness. The study selected 11 hospitals. At the time of the first evaluation, 7 hospitals were rated "unacceptable" for level of preparedness and 4 were rated "insufficient," receiving a WHO checklist rating of 10 to 98. At the second evaluation, 5 hospitals were rated "unacceptable," 3 "insufficient," and 1 "effective," receiving a rating of 9 to 134. Unfortunately, this study shows that between 2011 and 2013, no significant progress was made in hospital disaster preparedness in Sana'a. In a disaster-prone country like Yemen, the current situation calls for drastic improvement. Health system authorities must take responsibility for issuing strategic plans as well as standards, guidelines, and procedures to improve hospital disaster preparedness.

  10. Involving Youth in Community Emergency Preparedness: Impacts of a Multistate Initiative

    Directory of Open Access Journals (Sweden)

    Pamela Powell

    2009-12-01

    Full Text Available The National Preparedness Guidelines (2007 state, “as uniformed responders account for less than 1% of the total U.S. population, it is clear that citizens must be better prepared, trained, and practiced on how best to take care of themselves and assist others in those first crucial hours during and after a catastrophic incident.” This is increasingly more evident due to recent disasters such as hurricane Katrina. The Alert, Evacuate and Shelter (AES program identified and trained youth/adult teams to use geospatial technology to map shelter locations and evacuation routes. Training began with team building activities to strengthen and build youth/adult preparedness partnerships. Program evaluations revealed a major shift in thinking about the positive potential level of involvement of youth in emergencies. Survey results immediately following trainings revealed statistically significant increases in participant knowledge gain regarding emergency preparedness. Follow-up evaluations indicate the success of this project in meeting community preparedness goals.

  11. Business and public health collaboration for emergency preparedness in Georgia: a case study

    Directory of Open Access Journals (Sweden)

    Berkelman Ruth L

    2006-11-01

    Full Text Available Abstract Background Governments may be overwhelmed by a large-scale public health emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, public health officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other public health and business leaders interested in developing similar partnerships. Methods The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration. Results The partnership is based on shared objectives to protect public health and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither public health agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges. Conclusion As a result of this partnership, essential relationships have been established, substantial private resources and

  12. Business and public health collaboration for emergency preparedness in Georgia: a case study

    Science.gov (United States)

    Buehler, James W; Whitney, Ellen A; Berkelman, Ruth L

    2006-01-01

    Background Governments may be overwhelmed by a large-scale public health emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, public health officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other public health and business leaders interested in developing similar partnerships. Methods The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration. Results The partnership is based on shared objectives to protect public health and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither public health agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges. Conclusion As a result of this partnership, essential relationships have been established, substantial private resources and capabilities have been engaged in

  13. Assessment of Closed Point-of-Dispensing (POD) Preparedness in St. Louis County, Missouri, 2012-2016.

    Science.gov (United States)

    Rebmann, Terri; Anthony, John; Loux, Travis M; Mulroy, Julia; Sitzes, Rikki

    Little is known about closed point-of-dispensing (POD) site preparedness-especially how these entities progress in their preparedness efforts over time. The purpose of this study was to assess the preparedness of a closed POD network. Between 2012 and 2016, 30% to 50% of POD entities in the St. Louis County region were assessed each year, for a total of 138 site evaluations from 62 entities. The assessment tool included 41 components of closed POD preparedness, each scored either 0 = not met or 1 = met. POD preparedness scores could range from 0 to 41. Chi-square tests were conducted to compare the percentage of entities that had each preparedness indicator. A multilevel linear model with a random intercept for each agency was used to model longitudinal changes in closed POD preparedness. POD preparedness scores were higher in 2016 than in 2012 (31.5 vs. 26.5, t = 14.3, p trend in preparedness, and, on average, entities met only 65.4% of the preparedness indicators. Only a third of entities reported hosting a POD exercise at least once every 2 years (32.3%, n = 20). From the multilevel regression, determinants of better POD preparedness include having been assessed more often, employing a business continuity expert, and not being a long-term care agency. Closed POD entities should continue to work toward better preparedness, to better ensure successful deployment. Findings from this study indicate that more frequent assessments likely enhance preparedness at closed POD entities.

  14. Classroom-based and distance learning education and training courses in end-of-life care for health and social care staff: a systematic review.

    Science.gov (United States)

    Pulsford, David; Jackson, Georgina; O'Brien, Terri; Yates, Sue; Duxbury, Joy

    2013-03-01

    Staff from a range of health and social care professions report deficits in their knowledge and skills when providing end-of-life and palliative care, and education and training has been advocated at a range of levels. To review the literature related to classroom-based and distance learning education and training initiatives for health and social care staff in end-of-life and palliative care, in terms of their target audience, extent, modes of delivery, content and teaching and learning strategies, and to identify the most effective educational strategies for enhancing care. A systematic review of the literature evaluating classroom-based and distance learning education and training courses for health and social care staff in end-of-life and palliative care. Online databases CINAHL, MEDLINE, EMBASE and PSYCHINFO between January 2000 and July 2010. Studies were selected that discussed specific education and training initiatives and included pre-and post-test evaluation of participants' learning. 30 studies met eligibility criteria. The majority reported successful outcomes, though there were some exceptions. Level of prior experience and availability of practice reinforcement influenced learning. Participative and interactive learning strategies were predominantly used along with discussion of case scenarios. Multi-professional learning was infrequently reported and service user and carer input to curriculum development and delivery was reported in only one study. Classroom-based education and training is useful for enhancing professionals' skills and perceived preparedness for delivering end-of-life care but should be reinforced by actual practice experience.

  15. Knowledge translation in health care: a concept analysis.

    Science.gov (United States)

    Khoddam, Homeira; Mehrdad, Neda; Peyrovi, Hamid; Kitson, Alison L; Schultz, Timothy J; Athlin, Asa Muntlin

    2014-01-01

    Although knowledge translation is one of the most widely used concepts in health and medical literature, there is a sense of ambiguity and confusion over its definition. The aim of this paper is to clarify the characteristics of KT. This will assist the theoretical development of it and shape its implementation into the health care system Methods: Walker and Avant's framework was used to analyze the concept and the related literature published between 2000 and 2010 was reviewed. A total of 112 papers were analyzed. Review of the literature showed that "KT is a process" and "implementing refined knowledge into a participatory context through a set of challenging activities" are the characteristics of KT. Moreover, to occur successfully, KT needs some necessary antecedents like an integrated source of knowledge, a receptive context, and preparedness. The main consequence of successful process is a change in four fields of healthcare, i.e. quality of patient care, professional practice, health system, and community. In addition, this study revealed some empirical referents which are helpful to evaluate the process. By aiming to portray a clear picture of KT, we highlighted its attributes, antecedents, consequences and empirical referents. Identifying the characteristics of this concept may resolve the existing ambiguities in its definition and boundaries thereby facilitate distinction from similar concepts. In addition, these findings can be used as a knowledge infrastructure for developing the KT-related models, theories, or tools.

  16. Knowledge Management Framework for Emerging Infectious Diseases Preparedness and Response: Design and Development of Public Health Document Ontology.

    Science.gov (United States)

    Zhang, Zhizun; Gonzalez, Mila C; Morse, Stephen S; Venkatasubramanian, Venkat

    2017-10-11

    There are increasing concerns about our preparedness and timely coordinated response across the globe to cope with emerging infectious diseases (EIDs). This poses practical challenges that require exploiting novel knowledge management approaches effectively. This work aims to develop an ontology-driven knowledge management framework that addresses the existing challenges in sharing and reusing public health knowledge. We propose a systems engineering-inspired ontology-driven knowledge management approach. It decomposes public health knowledge into concepts and relations and organizes the elements of knowledge based on the teleological functions. Both knowledge and semantic rules are stored in an ontology and retrieved to answer queries regarding EID preparedness and response. A hybrid concept extraction was implemented in this work. The quality of the ontology was evaluated using the formal evaluation method Ontology Quality Evaluation Framework. Our approach is a potentially effective methodology for managing public health knowledge. Accuracy and comprehensiveness of the ontology can be improved as more knowledge is stored. In the future, a survey will be conducted to collect queries from public health practitioners. The reasoning capacity of the ontology will be evaluated using the queries and hypothetical outbreaks. We suggest the importance of developing a knowledge sharing standard like the Gene Ontology for the public health domain. ©Zhizun Zhang, Mila C Gonzalez, Stephen S Morse, Venkat Venkatasubramanian. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 11.10.2017.

  17. A scrutiny of tools used for assessment of hospital disaster preparedness in Iran.

    Science.gov (United States)

    Heidaranlu, Esmail; Ebadi, Abbas; Ardalan, Ali; Khankeh, Hamidreza

    2015-01-01

    In emergencies and disasters, hospitals are among the first and most vital organizations involved. To determine preparedness of a hospital to deal with crisis, health system requires tools compatible with the type of crisis. The present study aimed to evaluate the accuracy of tools used for assessment of hospitals preparedness for major emergencies and disasters in Iran. In this review study, all studies conducted on hospital preparedness to deal with disasters in Iran in the interim 2000-2015 were examined. The World Health Organization (WHO) criteria were used to assess focus of studies for entry in this study. Of the 36 articles obtained, 28 articles that met inclusion criteria were analyzed. In accordance with the WHO standards, focus of tools used was examined in three areas (structural, nonstructural, and functional). In nonstructural area, the most focus of preparation tools was on medical gases, and the least focus on office and storeroom furnishings and equipment. In the functional area, the most focus was on operational plan, and the least on business continuity. Half of the tools in domestic studies considered structural safety as indicator of hospital preparedness. The present study showed that tools used contain a few indicators approved by the WHO, especially in the functional area. Moreover, a lack of a standard indigenous tool was evident, especially in the functional area. Thus, to assess hospital disaster preparedness, the national health system requires new tools compatible with scientific tool design principles, to enable a more accurate prediction of hospital preparedness in disasters before they occur.

  18. TEKNA - preparedness seminary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    The seminary contains several presentations on various aspects of preparedness in the offshore petroleum sector. The authority organization, Norwegian regulations, industrial management, planning and principles are discussed. Risk assessment and preparedness analysis is emphasized. Some technological aspects are also discussed.

  19. Committee Opinion No. 726 Summary: Hospital Disaster Preparedness for Obstetricians and Facilities Providing Maternity Care.

    Science.gov (United States)

    2017-12-01

    Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery. Recent evidence suggests that floods and human-influenced environmental disasters increase the risks of spontaneous miscarriages, preterm births, and low-birth-weight infants among pregnant women. The potential surge in maternal and neonatal patient volume due to mass-casualty events, transfer of high-acuity patients, or redirection of patients because of geographic barriers presents unique challenges for obstetric care facilities. These circumstances require that facilities plan for additional increases in necessary resources and staffing. Although emergencies may be unexpected, hospitals and obstetric delivery units can prepare to implement plans that will best serve maternal and pediatric care needs when disasters occur. Clear designation of levels of maternal and neonatal care facilities, along with establishment of a regional network incorporating hospitals that provide maternity services and those that do not, will enable rapid transport of obstetric patients to the appropriate facilities, ensuring the right care at the right time. Using common terminology for triage and transfer and advanced knowledge of regionalization and levels of care will facilitate disaster preparedness.

  20. Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part II. Educational and Training Initiatives.

    Science.gov (United States)

    Burkle, Frederick M; Kushner, Adam L; Giannou, Christos; Paterson, Mary A; Wren, Sherry M; Burnham, Gilbert

    2018-05-07

    ABSTRACTNo discipline has been impacted more by war and armed conflict than health care has. Health systems and health care providers are often the first victims, suffering increasingly heinous acts that cripple the essential health delivery and public health infrastructure necessary for the protection of civilian and military victims of the state at war. This commentary argues that current instructional opportunities to prepare health care providers fall short in both content and preparation, especially in those operational skill sets necessary to manage multiple challenges, threats, and violations under international humanitarian law and to perform triage management in a resource-poor medical setting. Utilizing a historical framework, the commentary addresses the transformation of the education and training of humanitarian health professionals from the Cold War to today followed by recommendations for the future. (Disaster Med Public Health Preparedness. 2018;page 1 of 14).

  1. Nuclear threats and emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Mustonen, R.; Aaltonen, H.; Laaksonen, J.; Lahtinen, J.; Rantavaara, A.; Reponen, H.; Rytoemaa, T.; Suomela, M.; Toivonen, H.; Varjoranta, T.

    1995-10-01

    The political and economic upheavals which have taken place in Eastern Europe have had an impact on radiation and nuclear safety throughout Europe. Emergency preparedness systems for unexpected nuclear events have been developed further in all European countries, and prosperous western nations have invested in improving the safety of East European nuclear power plants. The economic crisis facing countries of the former Soviet Union has also promoted illicit trade in nuclear materials; this has made it necessary for various border guards and police authorities to intensify their collaboration and to tighten border controls. On 3-4 October 1995, Finnish Centre for Radiation and Nuclear Safety (STUK) arranged a seminar on nuclear threats and emergency preparedness in Finland. In addition to STUK experts, a wide range of rescue and civil defence authorities, environmental health specialists and other persons engaged in emergency preparedness attended the seminar. The publication contains a compilation of reports presented at the seminar. The reports cover a broad spectrum of nuclear threats analyzed at STUK, the impacts of radioactive fallout on human beings and on the environment, and preparedness systems by which the harmful effects of radiation or nuclear accidents can, if necessary, be minimized. (33 figs., 5 tabs.)

  2. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant : A Systematic Review

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; van Elteren, Marianne; van Roosmalen, Jos; Stekelenburg, Jelle; Portela, Anayda

    2015-01-01

    Background Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on

  3. Experience-based knowledge in nuclear and radiological emergency preparedness - involvement of national stake holders. Report from the EURANOS project; Erfaringsbasert kunnskap i norsk atomberedskap - medvirkning fra beroerte parter. Rapport fra EURANOS-prosjektet

    Energy Technology Data Exchange (ETDEWEB)

    Bay-Larsen, I.; Oughton, D.; Liland, A.; Eikelmann, I.M.; Hansen, H.S.

    2009-05-15

    The report identifies and summarises the most important experiences related to long term rehabilitation of contaminated areas after the Chernobyl accident, as phrased by representatives from the agricultural sector (including reindeer herding), primary health care, academia, NGOs, local and regional authorities, as well as national authorities with responsibilities for emergency preparedness within their sector. It also includes recommendations for future collaboration to ensure competence and stake holder involvement in Norwegian nuclear and radiological emergency preparedness. (Author)

  4. 75 FR 42448 - Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency...

    Science.gov (United States)

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response; Notice of..., 1972, that the Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and...

  5. Integrating hospitals into community emergency preparedness planning.

    Science.gov (United States)

    Braun, Barbara I; Wineman, Nicole V; Finn, Nicole L; Barbera, Joseph A; Schmaltz, Stephen P; Loeb, Jerod M

    2006-06-06

    Strong community linkages are essential to a health care organization's overall preparedness for emergencies. To assess community emergency preparedness linkages among hospitals, public health officials, and first responders and to investigate the influence of community hazards, previous preparation for an event requiring national security oversight, and experience responding to actual disasters. With expert advice from an advisory panel, a mailed questionnaire was used to assess linkage issues related to training and drills, equipment, surveillance, laboratory testing, surge capacity, incident management, and communication. A simple random sample of 1750 U.S. medical-surgical hospitals. Of 678 hospital representatives that agreed to participate, 575 (33%) completed the questionnaire in early 2004. Respondents were hospital personnel responsible for environmental safety, emergency management, infection control, administration, emergency services, and security. Prevalence and breadth of participation in community-wide planning; examination of 17 basic elements in a weighted analysis. In a weighted analysis, most hospitals (88.2% [95% CI, 84.1% to 92.3%]) engaged in community-wide drills and exercises, and most (82.2% [CI, 77.8% to 86.5%]) conducted a collaborative threat and vulnerability analysis with community responders. Of all respondents, 57.3% (CI, 52.1% to 62.5%) reported that their community plans addressed the hospital's need for additional supplies and equipment, and 73.0% (CI, 68.1% to 77.9%) reported that decontamination capacity needs were addressed. Fewer reported a direct link to the Health Alert Network (54.4% [CI, 49.3% to 59.5%]) and around-the-clock access to a live voice from a public health department (40.0% [CI, 35.0% to 45.0%]). Performance on many of 17 basic elements was better in large and urban hospitals and was associated with a high number of perceived hazards, previous national security event preparation, and experience in actual

  6. Experience of migrant care and needs for cultural competence training among public health workers in Korea.

    Science.gov (United States)

    Chae, Duckhee; Lee, Jina; Asami, Keiko; Kim, Hyunlye

    2018-05-01

    This study explored the experiences of public health workers (PHWs) providing health care for migrants living in Korea and clarified needs for cultural competence training. Twenty-six PHWs from five public health centers in Gwangju city, South Korea, participated in this exploratory qualitative study. Five semi-structured focus group interviews of PHWs were conducted from September to December 2016. A directed content analysis approach was conducted using four categories: perceived characteristics of migrants, interaction between PHWs and migrants, interaction between PHWs and organizations/systems, and cultural competence training needs. PHWs perceived that migrants lacked autonomy in health decisions and awareness of health behaviors. PHWs experienced difficulties in communicating and in establishing trusting relationships. They found clients hard to reach and easy to miss, a lack of continuity in health care programs, and inadequate human and material resources. They preferred passive teaching methods to activity-based simulation. PHWs believed essential training should be provided through e-learning to all PHWs, including management. PHWs reported experiencing multiple challenges from a lack of preparedness for culturally competent care and their clients' vulnerability. Development of cultural competence training is suggested through e-learning that reflects the PHWs' experiences and provides systematic support. © 2018 Wiley Periodicals, Inc.

  7. Educational competencies and technologies for disaster preparedness in undergraduate nursing education: an integrative review.

    Science.gov (United States)

    Jose, Mini M; Dufrene, Claudine

    2014-04-01

    This integrative review of literature was conducted to determine (1) what are the suitable disaster preparedness competencies for undergraduate nursing curriculum? and (2) what are the suitable methods of instruction to deliver disaster preparedness content? A literature search was conducted on three major electronic databases: Ovid MEDLINE, PubMed and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the keywords; Disaster Preparedness, Disaster and nursing education; disaster response and nursing education. Limiters used were published within the last 10 years and in nursing field. Out of the 190 articles retrieved, eight were research articles that met the inclusion criteria. These articles were carefully reviewed and the results are summarized in two sections to answer the research questions. There was no uniformity of intended competencies among the studies, though all studies used resources from reputed national and international organizations. All the studies reviewed adhered to a systematic approach in delivering content and used eclectic methods including multiple technologies to enhance the educational outcomes. Most of the studies had incorporated simulation in different ways involving low to high fidelity simulators, virtual simulation and live actors. Content and length of the programs were greatly varied but stayed focused on the general principles of disaster management and appropriate for the level of the students within the programs. More rigorous research is needed in this area since all published articles had deficiencies in the methodologies, especially in data collection and analysis. Disaster preparedness education was found to be a suitable activity for interprofessional education. © 2013.

  8. Mapping individuals' earthquake preparedness in China

    Science.gov (United States)

    Wu, Guochun; Han, Ziqiang; Xu, Weijin; Gong, Yue

    2018-05-01

    Disaster preparedness is critical for reducing potential impact. This paper contributes to current knowledge of disaster preparedness using representative national sample data from China, which faces high earthquake risks in many areas of the country. The adoption of earthquake preparedness activities by the general public, including five indicators of material preparedness and five indicators of awareness preparedness, were surveyed and 3245 respondents from all 31 provinces of Mainland China participated in the survey. Linear regression models and logit regression models were used to analyze the effects of potential influencing factors. Overall, the preparedness levels are not satisfied, with a material preparation score of 3.02 (1-5), and awareness preparation score of 2.79 (1-5), nationally. Meanwhile, residents from western China, which has higher earthquake risk, have higher degrees of preparedness. The concern for disaster risk reduction (DRR) and the concern for building safety and participation in public affairs are consistent positive predictors of both material and awareness preparedness. The demographic and socioeconomic variables' effects, such as gender, age, education, income, urban/rural division, and building size, vary according to different preparedness activities. Finally, the paper concludes with a discussion of the theoretical contribution and potential implementation.

  9. Evaluation of the Implementation of Preparedness Education at mount Bromo and Merapi Valley Communities, Year 2012

    Directory of Open Access Journals (Sweden)

    Mugeni Sugiharto

    2016-01-01

    Full Text Available Background: Basic education through counseling mitigation program is on Statute No 24 Year 2007, Health Minister Decree No 145 year 2007, Decree of Mining an Energy Minister. Preparedness education is efforts to increase knowledge and awareness to face of the volcano disaster, in order to survive and stay healthy. The purpose of this study was to evaluated the implementation of educational preparedness in disaster-prone communities on the slopes of Mount Bromo and Mount Merapi Methods: Croessectional methode, Big sample is 100 people from Bromo area in the Ngadirejo village to 25 people, in the Wonokerso village 25 people, whereas in the Merapi area in the Mangunharjo village 25 people andthe Jaranan village of 25 people. Samples are purvosif determined that only the community on the slopes of Bromo and Merapi eruption affected. Secondary data was obtained from the institution carrying out preparedness education. Results: Preparedness Education through counseling had a basic level of central and local regulation is the reference work BPPD officer. Agencies involved counseling is District Health Offi ce and Health Centre, PMI, LSM,BPBD. Impact preparedness counseling is when the eruption of the volcano was about to evacuate people, including most of the people Bromo, in order to survive, in addition to the public while maintaining the health of the PHBs, to stay healthy. Conclusion: Preparedness education is based on the regulation of the central and local level to help people to volcanic eruptions. The focus of its activities is the procedure for evacuation, rescue and PHBS are implemented on an ongoing basis. Recommendation: Important implement sustainable counseling, so that people have a lasting awareness preparedness for facing volcanic eruptions.

  10. Preparedness 101: Zombie Pandemic

    Science.gov (United States)

    ... Partner Tools and Resources Communication Resources Blog Infographics Social Media Graphics Videos CDC Workshop for Risk-based Funding Campaigns Safe and Well Selfie Preparedness Month Preparedness Month ...

  11. Workplace Preparedness for Terrorism

    National Research Council Canada - National Science Library

    Ursano, Robert J

    2006-01-01

    Comprehensive workplace preparedness for terrorism must address and integrate the psychological and behavioral aspects of terrorism preparedness and response in order to address issues of human continuity...

  12. Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination.

    Science.gov (United States)

    Swift, Melanie D; Aliyu, Muktar H; Byrne, Daniel W; Qian, Keqin; McGown, Paula; Kinman, Patricia O; Hanson, Katherine Louise; Culpepper, Demoyne; Cooley, Tamara J; Yarbrough, Mary I

    2017-09-01

    To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the "Flulapalooza method" as a best practice model to enhance efficiency.

  13. Preparedness for clinical practice - Perceptions of graduates and their work supervisors

    International Nuclear Information System (INIS)

    Mackay, S.J.; Anderson, A.C.; Hogg, P.

    2008-01-01

    Purpose: The standards of performance of healthcare professionals are now well defined and used to determine health professional curricula. Empirical research evidence exists in medicine and nursing which explores how well these curricula prepare their students for clinical practice but not in the radiography profession. This research aims to determine how well prepared newly qualified radiographers were for clinical practice and to identify strengths and weaknesses in their preparedness to inform curriculum development. Methods: A postal questionnaire and semi-structured interview were used to obtain data from newly qualified diagnostic radiographers and their work-based supervisors. The questionnaire assessed graduate preparedness against a number of items drawn from published documents which define UK radiographic practice. Statistical analysis, using ANOVA and Wilcoxon, examined differences between the groups' perception of preparedness. A sample of graduates and their work supervisors were interviewed to explore preparedness. Results: There were significant differences (p ≤ 0.05) between; the preparedness scores of the graduates and supervisors, with supervisors rating the graduates higher than the graduates themselves; subscales of teamwork (p ≤ 0.05), personal attributes (p ≤ 0.05) and digital skills (p ≤ 0.01). No significant differences were found between graduates employed in their training hospital and those employed elsewhere. Interview data revealed perceived areas of graduate strength, weaknesses and areas for curriculum development. Suggestions for improvement to the methodology were identified for exploring preparedness in other health professional programmes. Conclusion: The graduates were well prepared for their role as a diagnostic radiographer. Some curriculum development is needed in specific areas and advice on methodological improvement is offered

  14. Improving Latino disaster preparedness using social networks.

    Science.gov (United States)

    Eisenman, David P; Glik, Deborah; Gonzalez, Lupe; Maranon, Richard; Zhou, Qiong; Tseng, Chi-Hong; Asch, Steven M

    2009-12-01

    Culturally targeted, informal social networking approaches to improving disaster preparedness have not been empirically tested. In partnership with community health promoters and the Los Angeles County Department of Public Health, this study tested a disaster preparedness program for Latino households. This study had a community-based, randomized, longitudinal cohort design with two groups and was conducted during February-October 2007. Assessments were made at baseline and 3 months. Analyses were carried out January-October 2008. Community-based study of 231 Latinos living in Los Angeles County. Participants were randomly assigned to attending platicas (small-group discussions led by a health promoter/promotora de salud) or receiving "media" (a culturally tailored mailer). A total of 187 (81.0%) completed the 3-month follow-up. A self-reported disaster preparedness checklist was used. Among participants who did not have emergency water pre-intervention, 93.3% of those in the platica arm had it at follow-up, compared to 66.7% in the media arm (p=0.003). Among participants who did not have food pre-intervention, 91.7% in the platica arm reported it at follow-up, compared to 60.6% in the media arm (p=0.013). Finally, among participants who did not have a family communication plan pre-intervention, 70.4% in the platica arm reported one at follow-up, compared to 42.3% in the media arm (p=0.002). Although both arms improved in stockpiling water and food and creating a communication plan, the platica arm showed greater improvement than the media group.

  15. [El niño phenomenon and natural disasters: public health interventions for disaster preparedness and response].

    Science.gov (United States)

    Hijar, Gisely; Bonilla, Catherine; Munayco, Cesar V; Gutierrez, Ericson L; Ramos, Willy

    2016-06-01

    This article reviews public health interventions for preparedness and response to natural disasters within the context of El Niño phenomenon using systematic reviews and a review of revisions with emphasis on vector-borne diseases, water-borne diseases, malnutrition, heat stress, drought, flood-associated diseases, mental health problems, vulnerability of the physical health-system infrastructure, as well as long-term policies aimed at protecting the populations of these cases. Environmental interventions were identified, including vector control, chemoprophylaxis, immunization, and intradomiciliary water treatment. While these finds are based primarily on systematic reviews, it is necessary to evaluate the benefit of these interventions within the population, according to the context of each region.

  16. Emergency nurses' perceptions of emergency department preparedness for an ebola outbreak: A qualitative descriptive study.

    Science.gov (United States)

    Pincha Baduge, Mihirika Sds; Moss, Cheryle; Morphet, Julia

    2017-05-01

    Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak. A qualitative descriptive design was used to collect and analyse data in one metropolitan emergency department in Victoria, Australia. Four focus groups were conducted with 13 emergency nurses. Data were thematically analysed. Major themes emerged from the data: organisational, personal and future preparedness. Participants' believed that both the organisation and themselves had achieved desirable and appropriate preparedness for ebola in their emergency setting. Participants trusted their organisation to prepare and protect them for ebola. Appropriate policies, procedures, and equipment infrastructure were reportedly in place. Nurses' decisions to care for a patient with ebola were informed by professional commitment, and personal responsibilities. Participants were concerned about transmitting ebola to their families, and suggested that more regular training in personal protective equipment would increase confidence and skill in self-protection. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  17. Preparedness Now! An Emergency Survival Guide

    CERN Document Server

    Edwards, Aton

    2009-01-01

    In uncertain times, a solid preparedness plan is essential for every individual and family. PREPAREDNESS NOW! navigates the new realities of twenty-first century living: extreme weather, economic instability, terror attacks, and more. Packed with checklists, resources, and step-by-step instructions, PREPAREDNESS NOW! details everything needed for office, car, and home preparedness. This newly expanded and revised edition includes an extended chapter on food and water storage and urban gardening, techniques in personal defense, and the latest and best preparedness products on the market. This b

  18. Mapping individuals' earthquake preparedness in China

    Directory of Open Access Journals (Sweden)

    G. Wu

    2018-05-01

    Full Text Available Disaster preparedness is critical for reducing potential impact. This paper contributes to current knowledge of disaster preparedness using representative national sample data from China, which faces high earthquake risks in many areas of the country. The adoption of earthquake preparedness activities by the general public, including five indicators of material preparedness and five indicators of awareness preparedness, were surveyed and 3245 respondents from all 31 provinces of Mainland China participated in the survey. Linear regression models and logit regression models were used to analyze the effects of potential influencing factors. Overall, the preparedness levels are not satisfied, with a material preparation score of 3.02 (1–5, and awareness preparation score of 2.79 (1–5, nationally. Meanwhile, residents from western China, which has higher earthquake risk, have higher degrees of preparedness. The concern for disaster risk reduction (DRR and the concern for building safety and participation in public affairs are consistent positive predictors of both material and awareness preparedness. The demographic and socioeconomic variables' effects, such as gender, age, education, income, urban/rural division, and building size, vary according to different preparedness activities. Finally, the paper concludes with a discussion of the theoretical contribution and potential implementation.

  19. Impact of the Great East Japan Earthquake and tsunami on health, medical care and public health systems in Iwate Prefecture, Japan, 2011.

    Science.gov (United States)

    Nohara, Masaru

    2011-10-01

    The Great East Japan Earthquake was one of the largest earthquakes ever recorded in global history. The damage was spread over a wide area, with the worst-hit areas being Iwate, Miyagi and Fukushima prefectures. In this paper we report on the damage and the impact of the damage to describe the health consequences among disaster victims in Iwate Prefecture. In Iwate Prefecture the tsunami claimed 4659 lives, with 1633 people missing. In addition to electricity, water and gas being cut off following the disaster, communication functions were paralysed and there was a lack of gasoline. Medical and public health teams from Iwate Prefecture and around the country, including many different specialists, engaged in a variety of public health activities mainly at evacuation centres, including medical and mental health care and activities to prevent infectious diseases. Given the many fatalities, there were relatively few patients who required medical treatment for major injuries. However, there were significant medical needs in the subacute and chronic phases of care in evacuation centres, with great demand for medical treatment and public health assistance, measures to counteract infection and mental health care. By referring to past experiences of national and international large-scale disasters, it was possible to respond effectively to the health-related challenges. However, there are still challenges concerning how to share information and coordinate overall activities among multiple public health response teams. Further examination will be required to ensure better preparedness in response to future disasters.

  20. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  1. Evaluation of Functional Preparedness and Non Structural Safety of Different Health Units of Kermanshah University of Medical Sciences in Coping With Natural Disasters

    Directory of Open Access Journals (Sweden)

    Abdollah Dargahi

    2017-07-01

    Conclusion: In general, the results showed that the average performance percentage and non-structural vulnerability of health units and various other departments are moderate at the headquarters of health centers. According to the study results, disasters like earthquake, dust, flood, and landslide frequently required preparedness in the whole region.

  2. Current status on educational program for radiation emergency medical preparedness in Korea

    International Nuclear Information System (INIS)

    Kim, E. S.; Kong, H. J.; Noh, J. H.; Kim, C. S.

    2002-01-01

    There are several educational programs in worldwide for the user of radiation, radioisotopes, and nuclear power plant. REAC/TS is one of the most famous centers for radiation emergency personnel. REMPAN, one of the World Health Organization is also to promote the medical preparedness for radiation accident and provide advice and assistance in the case of radiation accident and radiological emergency. There are a variety of educational programs of radiation emergency, but not many programs of medical preparedness in Korea. Therefore, it is introduced here Korean current environment and future direction of educational programs for the radiation emergency medical preparedness

  3. Roles and contributions of pharmacists in regulatory affairs at the Centers for Disease Control and Prevention for public health emergency preparedness and response.

    Science.gov (United States)

    Bhavsar, Tina R; Kim, Hye-Joo; Yu, Yon

    To provide a general description of the roles and contributions of three pharmacists from the Regulatory Affairs program (RA) at the Centers for Disease Control and Prevention (CDC) who are involved in emergency preparedness and response activities, including the 2009 pandemic influenza A (H1N1) public health emergency. Atlanta, GA. RA consists of a staff of nine members, three of whom are pharmacists. The mission of RA is to support CDC's preparedness and emergency response activities and to ensure regulatory compliance for critical medical countermeasures against potential threats from natural, chemical, biological, radiological, or nuclear events. RA was well involved in the response to the H1N1 outbreak through numerous activities, such as submitting multiple Emergency Use Authorization (EUA) requests to the Food and Drug Administration, including those for medical countermeasures to be deployed from the Strategic National Stockpile, and developing the CDC EUA website (www.cdc.gov/h1n1flu/eua). RA will continue to support current and future preparedness and emergency response activities by ensuring that the appropriate regulatory mechanisms are in place for the deployment of critical medical countermeasures from the Strategic National Stockpile against threats to public health.

  4. Investment, managerial capacity, and bias in public health preparedness.

    Science.gov (United States)

    Langabeer, James R; DelliFraine, Jami L; Tyson, Sandra; Emert, Jamie M; Herbold, John

    2009-01-01

    Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP). The aim of the authors is to use a management framework to evaluate capacity, and to explore the "immediacy bias" impact on investment stability. This study employs a longitudinal study design, incorporating survey research of the entire population of 68 health departments in the state of Texas. The authors assessed the investment-capacity relationship through several statistical methods. The authors created a structural measure of managerial capacity through principal components analysis, factorizing 10 independent variables and augment this with a perceived readiness level reported from PHP managers. The authors then employ analysis of variance, correlation analyses, and other descriptive statistics. There has been a 539 percent coefficient of variation in funding at the local level between the years 2004 and 2008, and a 63 percent reduction in total resources since the peak of funding, using paired sample data. Results suggest that investment is positively associated with readiness and managerial capacity in local health departments. The authors also find that investment was related to greater community collaboration, higher adoption of Incident Command System (ICS) structure, and more frequent operational drills and exercises. Greater investment is associated with higher levels of capacity and readiness. The authors conclude from this that investment should be stabilized and continued, and not be influenced by historical cognitive biases.

  5. Corporate preparedness for pandemic influenza: a survey of pharmaceutical and biotechnology companies in Montgomery County, Maryland.

    Science.gov (United States)

    Watkins, Rissah J; Barnett, Daniel J; Links, Jonathan M

    2008-09-01

    We conducted a survey of corporate preparedness for pandemic influenza among biotechnology and pharmaceutical companies in Montgomery County, Maryland, to determine the level of preparedness for this industry and geographic region. The survey, based on the HHS Business Pandemic Influenza Planning Checklist, established whether a company had a preparedness plan specific to pandemic influenza, the contents of its plan, or its reasons for a lack of a plan. A total of 50 companies participated in the survey. Of these, 40 did not have any type of preparedness plan, 3 were drafting plans, 6 had general preparedness plans that could be applied to an influenza pandemic, and only 1 company had a preparedness plan specifically designed to address pandemic influenza. Biotechnology and pharmaceutical companies in this geographic region are currently not well prepared for pandemic influenza. Public health officials should offer more help, possibly in the form of a model small business preparedness plan, and collaboration between companies should be encouraged to foster sharing of preparedness plans.

  6. Transportation Emergency Preparedness Program (TEPP)

    International Nuclear Information System (INIS)

    1991-04-01

    The Transportation Emergency Preparedness Program (TEPP) will develop and enhance integrated emergency preparedness capabilities in two major areas. First, the program is responsible for planning and ensuring proper DOE response to transportation incidents involving DOE shipments. Second, the program is responsible for ensuring DOE can carry out its responsibilities under regulations, the National Contingency Plan (NCP) and the Federal Radiological Emergency Response Plan (FRERP) to provide technical advice and assistance as needed for any transportation incident involving radioactive or mixed hazard materials. This plan proposes a strategy for developing a comprehensive Transportation Emergency Preparedness Program, including a well organized central management and coordination structure, that serves as a process to identify, verify, and establish a consolidated effort across the Department in this very important area. This plan assumes Emergency Management to be the full range of emergency activities necessary for mitigation, preparedness, response and recovery while Emergency Preparedness activities are primarily those necessary in preparation for Incident Response Emergency Preparedness, which is the focus of this strategy plan, requires a well organized central coordination structure to be effective. 7 refs

  7. Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

    Science.gov (United States)

    Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

    2009-01-01

    In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

  8. Nigerian dentists and oral health-care of pregnant women: Knowledge, attitude and belief

    Directory of Open Access Journals (Sweden)

    Agnes O Umoh

    2013-01-01

    Full Text Available Background: Pregnant women seek preventive, interventional and rehabilitative oral health-care for their oral health and protection of their fetus and babies after delivery. The objective of the study was to determine the Nigerian Dentist′s knowledge, attitude and belief pertaining to the oral health-care of pregnant women. Materials and Methods: This cross-sectional of Nigerian dentist was conducted between June and December, 2011 using Huebner et al., modified dentist′s attitude to the pregnant women questionnaire Results: The overall response rate of 92.5% (149/160. Receipt of continuing medical education (CME was reported among the participants on periodontal disease of pregnant patients (22.1%, oral hygiene of pregnant patients (20.1%, early childhood caries (35.6% and general dental problem (51.0%. The majority (92.6% agreed that Dentists have the skill to counsel pregnant patients, But only 73.8% of them provided oral hygiene instruction frequently to pregnant patients and even fewer (6.0% were involved in educational advice on oral health for young women. Many of the participants agreed that counseling pregnant patients about periodontal disease and its effect on the developing baby is of utmost importance. Participants also dominantly agreed that dental treatment should be part of prenatal care and 97.3% of them opined that physician recommendation will increase the likelihood of pregnant seeking dental care. More than half (56.4% of the participants reported that Dentists should be concerned about being sued if something goes wrong with the pregnancy. The recommended ways to improve oral health-care of pregnant women among the participants were through CME (92.6%, provision of educational materials on oral health-care of pregnant women (93.3% and information on ways to counsel pregnant women (98.0%. Conclusion: Data from this study revealed high preparedness, positive attitude and favorable disposition in dental care provision for

  9. Birth Preparedness and Complication Readiness of Pregnant ...

    African Journals Online (AJOL)

    Birth Preparedness and Complication Readiness of Pregnant Women Attending the Three Levels of Health Facilities in Ife Central Local Government, Nigeria. ... Only 24 (6.0%) had adequate knowledge of obstetric danger signs without prompting. Three hundred and forty (84.8%) and 312 (78.3%) women respectively had ...

  10. Effectiveness of the Home Based Life Saving Skills training by community health workers on knowledge of danger signs, birth preparedness, complication readiness and facility delivery, among women in Rural Tanzania.

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B; Mpembeni, Rose; Axemo, Pia; Darj, Elisabeth

    2016-06-02

    In spite of government efforts, maternal mortality in Tanzania is currently at more than 400 per 100,000 live births. Community-based interventions that encourage safe motherhood and improved health-seeking behaviour through acquiring knowledge on the danger signs and improving birth preparedness, and, ultimately, reduce maternal mortality, have been initiated in different parts of low-income countries. Our aim was to evaluate if the Home Based Life Saving Skills education by community health workers would improve knowledge of danger signs, birth preparedness and complication readiness and facility-based deliveries in a rural community in Tanzania. A quasi-experimental study design was used to evaluate the effectiveness of Home Based Life Saving Skills education to pregnant women and their families through a community intervention. An intervention district received training with routine care. A comparison district continued to receive routine antenatal care. A structured household questionnaire was used in order to gather information from women who had delivered a child within the last two years before the intervention. This questionnaire was used in both the intervention and comparison districts before and after the intervention. The net intervention effect was estimated using the difference between the differences in the intervention and control districts at baseline and endline. A total of 1,584 and 1,486 women were interviewed at pre-intervention and post intervention, respectively. We observed significant improvement of knowledge of three or more danger signs during pregnancy (15.2 % vs. 48.1 %) with a net intervention effect of 29.0 % (95 % CI: 12.8-36.2; p effect on the knowledge of three or more danger signs during childbirth (15.3 % vs. 43.1 %) with a net intervention effect of 18.3 % (95 % CI: 11.4-25.2; p effect of 9.4 % (95 % CI: 6.4-15.7; p effect of 10.3 % (95 % CI: 10.3-20.3; p effect of 25.3 % (95 % CI: 16.9-33.2; p

  11. Transportation radiological emergency preparedness: STAR 95 Exercise final report

    International Nuclear Information System (INIS)

    1998-01-01

    Emergency response for a transportation accident involving radiological materials, while not inherently difficult, presents a challenge for several reasons. These accidents, although they can occur anywhere, are rare. Also, although the health consequences are usually slight, accidents involving radioactive materials generally cause a great deal of concern, both for the emergency responders and the general public. How can communities be prepared for an event that requires some technical knowledge, but is so rare that it will never occur in most areas, without expending an effort disproportionate to the actual risk? How can one appropriately deal with an event that may cause excessive public concern? These questions are at the heart of the preparedness issues this program addressed. The overall goal of the Transportation Emergency Preparedness Program was to establish the framework for a coordinated response by all levels of government to a transportation accident involving radioactive material. The Program involved both preparedness activities and the development, conduct and evaluation of a field exercise in Saratoga County, New York. This Report concentrates on the functional activities, lessons learned, recommendations, and action plans for improving preparedness and response to a transportation accident involving radioactive materials

  12. Transition to Work: Effects of Preparedness and Goal Construction on Employment and Depressive Symptoms

    Science.gov (United States)

    Koivisto, Petri; Vuori, Jukka; Vinokur, Amiram D.

    2010-01-01

    This study examines the mediating role of employment preparedness in improving employment, mental health, and construction of work-life goals among young vocational school graduates who participated in the School-to-Work effectiveness trial. The trial included a 1-week intervention program that focused on enhancing employment preparedness. In this…

  13. 75 FR 35035 - Office of the Assistant Secretary for Preparedness and Response; Statement of Organization...

    Science.gov (United States)

    2010-06-21

    ... organizational change is to retitle the OPHEP as the Office of the Assistant Secretary for Preparedness and... health and medical preparedness, including Emergency Support Function 8 (ESF 8). Furthermore, the ASPR... Center (SOC), Centers for Disease Control and Prevention (CDC) Headquarters staff, the Director's...

  14. Staff perception on biomedical or health care waste management: a qualitative study in a rural tertiary care hospital in India.

    Directory of Open Access Journals (Sweden)

    Sudhir Chandra Joshi

    Full Text Available Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management.A qualitative study was conducted using 10 focus group discussions (FGDs, with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i role of Health Care Waste Management (HCWM in prevention of health care associated infections, (ii awareness of and views about HCWM-related guidelines/legislation, (iii current HCWM practices, (iv perception and preparedness related to improvements of the current practices, and (v proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi and analysed using content analysis.Two themes were identified: Theme (A, 'Challenges in integration of HCWM in organizational practice,' with the categories (I Awareness and views about HCWM, (II Organizational practices regarding HCWM, and (III Challenges in Implementation of HCWM; and Theme (B, 'Interventions to improve HCWM,' with three categories, (I Educational and motivational interventions, (II Organizational culture change, and (III Policy-related interventions.A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings.

  15. Family emergency preparedness plans in severe tornadoes.

    Science.gov (United States)

    Cong, Zhen; Liang, Daan; Luo, Jianjun

    2014-01-01

    Tornadoes, with warnings usually issued just minutes before their touchdowns, pose great threats to properties and people's physical and mental health. Few studies have empirically investigated the association of family emergency preparedness planning and observed protective behaviors in the context of tornadoes. The purpose of this study was to examine predictors for the action of taking shelter at the time of tornadoes. Specifically, this study investigated whether having a family emergency preparedness plan was associated with higher likelihood of taking shelter upon receiving tornado warnings. This study also examined the effects of socioeconomic status and functional limitations on taking such actions. A telephone survey based on random sampling was conducted in 2012 with residents in Tuscaloosa AL and Joplin MO. Each city experienced considerable damages, injuries, and casualties after severe tornadoes (EF-4 and EF-5) in 2011. The working sample included 892 respondents. Analysis was conducted in early 2013. Logistic regression identified emergency preparedness planning as the only shared factor that increased the likelihood of taking shelter in both cities and the only significant factor in Joplin. In Tuscaloosa, being female and white also increased the likelihood of taking shelter. Disability was not found to have an effect. This study provided empirical evidence on the importance of having a family emergency preparedness plan in mitigating the risk of tornadoes. The findings could be applied to other rapid-onset disasters. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  16. Community's Emergency Preparedness for Flood Hazards in Dire-dawa Town, Ethiopia: A Qualitative Study.

    Science.gov (United States)

    Ejeta, Luche Tadesse

    2018-02-21

    houses to temporarily protect the flooding; establishment of communication channels between communities to alarm each other in the event of flood disaster; and reforestation of the already deforested mountainous areas surrounding the town. However, concerns were raised by study participants about strengths of the constructed flood protection dams. Furthermore, the non-structural emergency preparedness measures identified by this study were not comprehensive; for example, residents were not trained in first aid, first aid kits were not provided, there was no linkage being established between communities and health facilities so as to provide emergency medical care to victims in the event of flood disaster. The findings of this study concur with some of the previous quantitative studies' results in that the past direct and indirect disaster experiences invoke preparedness intention and actual preparedness for flood hazards at individuals, communities and organizations levels. The only one quantitative and behavioral based study conducted thus far in Dire Dawa town reported the strong association of past flood disaster experience with household emergency preparedness. Among the residents there was a tendency to rely on the dams to be constructed with "good quality" and "higher strength" than making preparedness efforts on their own at their households. Structural measures such as building of dams, dikes, levees, and channel improvements could be means of mitigation measures; however, solely relying on these measures could have far reaching consequences. To mitigate flood hazards, dams were built and in addition, in Kebele-05 where an NGO was operating, some non-structural emergency preparedness measures were undertaken. In the course of construction of flood protection dams, ensuring communities ' involvement is needed ; and at the same time undertaking comprehensive non-structural emergency preparedness measures in all Kebeles is highly recommended. Emergency, Preparedness

  17. Evaluation of a model training program for respiratory-protection preparedness at local health departments.

    Science.gov (United States)

    Alfano-Sobsey, Edie; Kennedy, Bobby; Beck, Frank; Combs, Brian; Kady, Wendy; Ramsey, Steven; Stockweather, Allison; Service, Will

    2006-04-01

    Respiratory-protection programs have had limited application in local health departments and have mostly focused on protecting employees against exposure to tuberculosis (TB). The need to provide the public health workforce with effective respiratory protection has, however, been underscored by recent concerns about emerging infectious diseases, bioterrorism attacks, drug-resistant microbes, and environmental exposures to microbial allergens (as in recent hurricane flood waters). Furthermore, OSHA has revoked the TB standard traditionally followed by local health departments, replacing it with a more stringent regulation. The additional OSHA requirements may place increased burdens on health departments with limited resources and time. For these reasons, the North Carolina Office of Public Health Preparedness and Response and industrial hygienists of the Public Health Regional Surveillance Teams have developed a training program to facilitate implementation of respiratory protection programs at local health departments. To date, more than 1,400 North Carolina health department employees have been properly fit-tested for respirator use and have received training in all aspects of respiratory protection. This article gives an overview of the development and evaluation of the program. The training approach presented here can serve as a model that other health departments and organizations can use in implementing similar respiratory-protection programs.

  18. Local health and social care responses to implementing the national cold weather plan.

    Science.gov (United States)

    Heffernan, C; Jones, L; Ritchie, B; Erens, B; Chalabi, Zaid; Mays, N

    2017-09-18

    The Cold Weather Plan (CWP) for England was launched by the Department of Health in 2011 to prevent avoidable harm to health by cold weather by enabling individuals to prepare and respond appropriately. This study sought the views of local decision makers involved in the implementation of the CWP in the winter of 2012/13 to establish the effects of the CWP on local planning. It was part of a multi-component independent evaluation of the CWP. Ten LA areas were purposively sampled which varied in level of deprivation and urbanism. Fifty-two semi-structured interviews were held with health and social care managers involved in local planning between November 2012 and May 2013. Thematic analysis revealed that the CWP was considered a useful framework to formalize working arrangements between agencies though local leadership varied across localities. There were difficulties in engaging general practitioners, differences in defining vulnerable individuals and a lack of performance monitoring mechanisms. The CWP was welcomed by local health and social care managers, and improved proactive winter preparedness. Areas for improvement include better integration with general practice, and targeting resources at socially isolated individuals in cold homes with specific interventions aimed at reducing social isolation and building community resilience. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  19. Dangerous quantities of radioactive material (D-values). Emergency preparedness and response. Publication date: August 2006

    International Nuclear Information System (INIS)

    2006-08-01

    Radioactive material is widely used in industry, medicine, education and agriculture. In addition, it occurs naturally. The health risk posed by these materials vary widely depending on many factors, the most important of which are the amount of the material involved and its physical and chemical form. Therefore, there is a need to identify the quantity and type of radioactive material for which emergency preparedness and other arrangements (e.g. security) are warrant due to the health risk they pose. The aim of this publication is to provide practical guidance for Member States on that quantity of radioactive material that may be considered dangerous. A dangerous quantity is that, which if uncontrolled, could be involved in a reasonable scenario resulting in the death of an exposed individual or a permanent injury, which decreases that person's quality of life. This publication is published as part of the IAEA Emergency Preparedness and Response Series. It supports several publications including: the IAEA Safety Requirements 'Preparedness and Response for a Nuclear or Radiological Emergency', IAEA Safety Standards Series No. GS-R-2. IAEA, Vienna (2002); IAEA Safety Guide 'Categorization of Radioactive Sources', IAEA Safety Standards Series No RS-G-1.9, IAEA, Vienna (2005) and IAEA Safety Guide 'Arrangements for Preparedness for a Nuclear or Radiological Emergency' IAEA Safety Standards Series No. GS-G-2.1, IAEA, Vienna (2006). The procedures and data in this publication have been prepared with due attention to accuracy. However, as part of the review process, they undergo ongoing quality assurance checks. Comments are welcome and, following a period that will allow for a more extensive review, the IAEA may revise this publication as part of the process of continuous improvement. The publication uses a number of exposure scenarios, risk models and dosimetric data, which could be used during the response to nuclear or radiological emergency or other purposes

  20. Impact of the Great East Japan Earthquake and tsunami on health, medical care and public health systems in Iwate Prefecture, Japan, 2011

    Directory of Open Access Journals (Sweden)

    Masaru Nohara

    2011-12-01

    Full Text Available Problem: The Great East Japan Earthquake was one of the largest earthquakes ever recorded in global history. The damage was spread over a wide area, with the worst-hit areas being Iwate, Miyagi and Fukushima prefectures. In this paper we report on the damage and the impact of the damage to describe the health consequences among disaster victims in Iwate Prefecture.Context: In Iwate Prefecture the tsunami claimed 4659 lives, with 1633 people missing. In addition to electricity, water and gas being cut off following the disaster, communication functions were paralysed and there was a lack of gasoline.Action: Medical and public health teams from Iwate Prefecture and around the country, including many different specialists, engaged in a variety of public health activities mainly at evacuation centres, including medical and mental health care and activities to prevent infectious diseases.Outcome: Given the many fatalities, there were relatively few patients who required medical treatment for major injuries. However, there were significant medical needs in the subacute and chronic phases of care in evacuation centres, with great demand for medical treatment and public health assistance, measures to counteract infection and mental health care.Discussion: By referring to past experiences of national and international large-scale disasters, it was possible to respond effectively to the health-related challenges. However, there are still challenges concerning how to share information and coordinate overall activities among multiple public health response teams. Further examination will be required to ensure better preparedness in response to future disasters.

  1. Emergency Preparedness Safety Climate and Other Factors Associated With Mental Health Outcomes Among World Trade Center Disaster Evacuees.

    Science.gov (United States)

    Sherman, Martin F; Gershon, Robyn R; Riley, Halley E M; Zhi, Qi; Magda, Lori A; Peyrot, Mark

    2017-06-01

    We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation. We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder. After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower "emergency preparedness safety climate" scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress. Improving the "emergency preparedness safety climate" of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326-336).

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

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

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

  3. Mixed messages: residents' experiences learning cross-cultural care.

    Science.gov (United States)

    Park, Elyse R; Betancourt, Joseph R; Kim, Minah K; Maina, Angela W; Blumenthal, David; Weissman, Joel S

    2005-09-01

    An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations. Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences. Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources. Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.

  4. Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Charlotte Hanlon

    Full Text Available Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda participating in the PRogramme for Improving Mental health carE (PRIME. The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential

  5. Risk, Politics, and Money: The Need for a Value-Based Model for Financing Public Health Preparedness and Response

    Science.gov (United States)

    2014-12-01

    evaluating the costs associated with natural and man-made disasters and events. In this era of fiscal conservatism , one of the biggest challenges in...associated with natural and man-made disasters and events. In this era of fiscal conservatism , one of the biggest challenges in designing and funding...In this era of fiscal conservatism , one of the biggest challenges in designing and funding public health preparedness is deciding exactly how much

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

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

  7. Design and management of public health outreach using interoperable mobile multimedia: an analysis of a national winter weather preparedness campaign

    Directory of Open Access Journals (Sweden)

    Cesar Bandera

    2016-05-01

    Full Text Available Abstract Background The Office of Public Health Preparedness and Response (OPHPR in the Centers for Disease Control and Prevention conducts outreach for public preparedness for natural and manmade incidents. In 2011, OPHPR conducted a nationwide mobile public health (m-Health campaign that pushed brief videos on preparing for severe winter weather onto cell phones, with the objective of evaluating the interoperability of multimedia m-Health outreach with diverse cell phones (including handsets without Internet capability, carriers, and user preferences. Methods Existing OPHPR outreach material on winter weather preparedness was converted into mobile-ready multimedia using mobile marketing best practices to improve audiovisual quality and relevance. Middleware complying with opt-in requirements was developed to push nine bi-weekly multimedia broadcasts onto subscribers’ cell phones, and OPHPR promoted the campaign on its web site and to subscribers on its govdelivery.com notification platform. Multimedia, text, and voice messaging activity to/from the middleware was logged and analyzed. Results Adapting existing media into mobile video was straightforward using open source and commercial software, including web pages, PDF documents, and public service announcements. The middleware successfully delivered all outreach videos to all participants (a total of 504 videos regardless of the participant’s device. 54 % of videos were viewed on cell phones, 32 % on computers, and 14 % were retrieved by search engine web crawlers. 21 % of participating cell phones did not have Internet access, yet still received and displayed all videos. The time from media push to media viewing on cell phones was half that of push to viewing on computers. Conclusions Video delivered through multimedia messaging can be as interoperable as text messages, while providing much richer information. This may be the only multimedia mechanism available to outreach campaigns

  8. Design and management of public health outreach using interoperable mobile multimedia: an analysis of a national winter weather preparedness campaign.

    Science.gov (United States)

    Bandera, Cesar

    2016-05-25

    The Office of Public Health Preparedness and Response (OPHPR) in the Centers for Disease Control and Prevention conducts outreach for public preparedness for natural and manmade incidents. In 2011, OPHPR conducted a nationwide mobile public health (m-Health) campaign that pushed brief videos on preparing for severe winter weather onto cell phones, with the objective of evaluating the interoperability of multimedia m-Health outreach with diverse cell phones (including handsets without Internet capability), carriers, and user preferences. Existing OPHPR outreach material on winter weather preparedness was converted into mobile-ready multimedia using mobile marketing best practices to improve audiovisual quality and relevance. Middleware complying with opt-in requirements was developed to push nine bi-weekly multimedia broadcasts onto subscribers' cell phones, and OPHPR promoted the campaign on its web site and to subscribers on its govdelivery.com notification platform. Multimedia, text, and voice messaging activity to/from the middleware was logged and analyzed. Adapting existing media into mobile video was straightforward using open source and commercial software, including web pages, PDF documents, and public service announcements. The middleware successfully delivered all outreach videos to all participants (a total of 504 videos) regardless of the participant's device. 54 % of videos were viewed on cell phones, 32 % on computers, and 14 % were retrieved by search engine web crawlers. 21 % of participating cell phones did not have Internet access, yet still received and displayed all videos. The time from media push to media viewing on cell phones was half that of push to viewing on computers. Video delivered through multimedia messaging can be as interoperable as text messages, while providing much richer information. This may be the only multimedia mechanism available to outreach campaigns targeting vulnerable populations impacted by the digital divide

  9. Emergency planning and preparedness for nuclear facilities

    International Nuclear Information System (INIS)

    1986-01-01

    In order to review the advances made over the past seven years in the area of emergency planning and preparedness supporting nuclear facilities and consider developments which are on the horizon, the IAEA at the invitation of the Government of Italy, organized this International Symposium in co-operation with the Italian Commission for Nuclear and Alternative Energy Sources, Directorate of Nuclear Safety and Health Protection (ENEA-DISP). There were over 250 designated participants and some 70 observers from 37 Member States and four international organizations in attendance at the Symposium. The Symposium presentations were divided into sessions devoted to the following topics: emergency planning (20 papers), accident assessment (30 papers), protective measures and recovery operations (10 papers) and emergency preparedness (16 papers). A separate abstract was prepared for each of these papers

  10. What is Going to Move the Needle on Citizen Preparedness? Can America Create a Culture of Preparedness?

    Science.gov (United States)

    2008-03-01

    their findings applied to citizen preparedness. Messaging, sociology, psychology, marketing principles , and public health expertise in behavior...use of marketing principles and techniques to influence a target audience to voluntarily accept, reject, modify, or abandon a behavior for the...benefit of individuals, groups, or society as a whole. (Philip Kotler , Ned Roberto, Nancy Lee, 2002) Social marketing is “…A process for influencing human

  11. Pandemic Influenza: An Analysis of State Preparedness and Response Plans

    National Research Council Canada - National Science Library

    Lister, Sarah A; Stockdale, Holly

    2007-01-01

    .... Since 2002, Congress has provided funding to all U.S. states, territories, and the District of Columbia, to enhance federal, state and local preparedness for public health threats in general, and an influenza ( flu...

  12. Challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes: a qualitative analysis.

    Science.gov (United States)

    Al-Shaqsi, Sultan; Gauld, Robin; Lovell, Sarah; McBride, David; Al-Kashmiri, Ammar; Al-Harthy, Abdullah

    2013-03-15

    Disasters are a growing global phenomenon. New Zealand has suffered several major disasters in recent times. The state of healthcare disaster preparedness in New Zealand prior to the Canterbury earthquakes is not well documented. To investigate the challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes. Semi-structured interviews with emergency planners in all the District Health Boards (DHBs) in New Zealand in the period between January and March 2010. The interview protocol revolved around the domains of emergency planning adopted by the World Health Organization. Seventeen interviews were conducted. The main themes included disinterest of clinical personnel in emergency planning, the need for communication backup, the integration of private services in disaster preparedness, the value of volunteers, the requirement for regular disaster training, and the need to enhance surge capability of the New Zealand healthcare system to respond to disasters. Prior to the Canterbury earthquakes, healthcare disaster preparedness faced multiple challenges. Despite these challenges, New Zealand's healthcare response was adequate. Future preparedness has to consider the lessons learnt from the 2011 earthquakes to improve healthcare disaster planning in New Zealand.

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

    Science.gov (United States)

    Horne, L Chad

    2017-01-01

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

  14. Hospital Preparedness to Respond to Biological and Chemical Terrorist Attack

    International Nuclear Information System (INIS)

    Florin, P.

    2007-01-01

    There is a growing concern about the terrorist use of chemical or biological agents against civilian population. A large proportion of hospitals are probably poorly prepared to handle victims of chemical or biological terrorism. At national level, starting with 2008 hospitals will be under the administration and control of local authorities. That is good opportunities for local authorities and public health office to tailor the activity of the hospitals to the real needs in the area of responsibility, and to allocate the suitable budget for them. Commonly hospitals are not fully prepared to respond to massive casualty disaster of any kind, either i their capacity to care for large numbers of victims or in their ability to provide care in coordination with a regional or national incident command structure. Preparedness activities to respond properly to chemical or biological attack including the adequate logistic, the principle of training and drill for the hospital emergency units and medical personal, communication and integration of the hospital team in local and regional civil response team are developed by the author.(author)

  15. Canadian residents' perceptions of cross-cultural care training in graduate medical school.

    Science.gov (United States)

    Singh, Barinder; Banwell, Emma; Groll, Dianne

    2017-12-01

    The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine.

  16. Canadian residents’ perceptions of cross-cultural care training in graduate medical school

    Science.gov (United States)

    Singh, Barinder; Banwell, Emma; Groll, Dianne

    2017-01-01

    Background The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. Methods The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Results Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. Conclusion While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine. PMID:29354194

  17. Emergency planning and response preparedness in Slovenia

    International Nuclear Information System (INIS)

    Martincic, R.; Frlin-Lubi, A.; Usenicnik, B.

    2000-01-01

    Disasters do occur and so do nuclear or radiological accidents. Experience has shown that advance emergency response preparedness is essential in order to mitigate the consequences of an accident. In Slovenia, the Civil Protection Organization is the responsible authority for emergency preparedness and response to any kind of disasters. The Krko Nuclear Power Plant is the only nuclear power plant in Slovenia. To date the plant has operated safely and no serious incidents have been recorded. Slovenia nevertheless, maintains a high level of emergency preparedness, which is reflected in the area of prevention and safety and in the area of emergency response preparedness. The emergency management system for nuclear emergencies is incorporated into an overall preparedness and response system. The paper presents an overview of nuclear or radiological emergency response preparedness in Slovenia and its harmonization with the international guidelines. (author)

  18. IAEA New recommendations in the area of emergency preparedness

    International Nuclear Information System (INIS)

    Maresova, B.; Koc, J.; Burianova, J.

    2014-01-01

    The poster is based on the latest recommendations of the IAEA safety standards relating to a response to an occurrence of radiation emergency situations. One analyzes how to implement the reference levels of the general criteria in the current practice providing an emergency preparedness in the Czech Republic. However, as the general criteria are represented by dose values, it is proposed to introduce the predetermined operational intervention levels (OILs). The operational intervention levels expressed in directly measurable dosimetric parameters along with the values of emergency action levels (EALs) represent a new direction in the area of emergency preparedness which streamlines a choice of suitable protective actions in the event of radiological accident. The poster also presents the draft how to apply the general system for an assessment of radiological health risks based on the block schemes connecting directly measured dosimetric values with the corresponding radiation health risks. (authors)

  19. Emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Koivukoski, J.

    1993-01-01

    Although the menace of nuclear war still persists, the focus in national emergency preparedness in Finland is presently on emergencies involving nuclear installations. The nuclear power plants, nuclear submarines and other installations in the former USSR are a major reason for this. In this article the main features and organization of emergency preparedness in Finland are described. (orig.)

  20. Preparedness events in 2008

    International Nuclear Information System (INIS)

    2009-01-01

    NRPA have as Secretariat for the Crisis Committee and the nuclear preparedness organization in 2008 published several reports of incidents of radioactivity and radioactive pollution to the nuclear preparedness organization, media and the public. In addition to these events, there have been some incidents with radiation and small radioactive sources in Norway during this year. (AG)

  1. Birth preparedness, complication readiness and other determinants of place of delivery among mothers in Goba District, Bale Zone, South East Ethiopia.

    Science.gov (United States)

    Belda, Semere Sileshi; Gebremariam, Mulugeta Betre

    2016-04-06

    Ethiopia is one of the countries with the highest maternal mortality ratio 676/100,000 LB and the lowest skilled delivery at birth (10%) in 2011. Skilled delivery care and provision of emergency obstetric care prevents many of these deaths. Despite implementation of birth preparedness and complication readiness packages to antenatal care users since 2007 in the study area, yet an overwhelming proportion of births take place at home. The effect of birth preparedness and complication readiness on place of delivery is not well known and studied in this context. A community based case control study preceded by initial census was conducted on a total of 358 sampled respondents (119 cases and 239 controls) who were selected using stratified two stage sampling technique. A pre-tested and standardized questionnaire with a face-to-face interview was used to collect the data, and then data was cleaned, coded and entered in to SPSS version-21 for analysis. Binary logistic regression models were run to identify predictors of place of delivery and Odds ratio with 95% CI was used to assess presence of associations at a 0.05 level of significance. The mean (± Standard Deviation) age of respondents was; 27.41(±5.8) and 28.84(±5.7) years for the cases and the controls respectively. Two third (67.1%) of the childbirths took place in the respondents house while only (32.9%) gave birth in health facilities. Great proportion (79.7%) of the cases and two third (34.0%) of the controls were well-prepared for birth and complication. Maternal education, religion, distance from health facility, knowledge of availability of ambulance transport and history of obstetric complication were significantly associated with place of delivery (P-value delivery (AOR =2.55, 95% CI: 1.12, 5.84). The study identified better institutional delivery service utilization by mothers who were well-prepared for birth and complication. Strategies that increase the preparedness of mothers for birth and

  2. Service availability and readiness for diabetes care at health ...

    African Journals Online (AJOL)

    Background: Non-communicable diseases (NCDs) are the leading causes of death globally. Available data demonstrate that nearly 80% deaths of NCDs occur in low- and middle-income countries. Of these deaths, an estimated 1.5 million, or 4% were due to diabetes. In Ethiopia, data on the preparedness of health facilities ...

  3. Polio infrastructure strengthened disease outbreak preparedness and response in the WHO African Region.

    Science.gov (United States)

    Kouadio, Koffi; Okeibunor, Joseph; Nsubuga, Peter; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks. We reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response. Polio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries' preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect

  4. Health impacts of climate change and health and social inequalities in the UK.

    Science.gov (United States)

    Paavola, Jouni

    2017-12-05

    This article examines how social and health inequalities shape the health impacts of climate change in the UK, and what the implications are for climate change adaptation and health care provision. The evidence generated by the other articles of the special issue were interpreted using social justice reasoning in light of additional literature, to draw out the key implications of health and social inequalities for health outcomes of climate change. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes. Age, pre-existing medical conditions and social deprivation are found to be the key (but not only) factors that make people vulnerable and to experience more adverse health outcomes related to climate change impacts. In the future, climate change, aging population and decreasing public spending on health and social care may aggravate inequality of health outcomes related to climate change. Health education and public preparedness measures that take into account differential exposure, sensitivity and adaptive capacity of different groups help address health and social inequalities to do with climate change. Adaptation strategies based on individual preparedness, action and behaviour change may aggravate health and social inequalities due to their selective uptake, unless they are coupled with broad public information campaigns and financial support for undertaking adaptive measures.

  5. Pharmaceutical care in Kuwait: hospital pharmacists' perspectives.

    Science.gov (United States)

    Katoue, Maram G; Awad, Abdelmoneim I; Schwinghammer, Terry L; Kombian, Samuel B

    2014-12-01

    Pharmaceutical care practice has been championed as the primary mission of the pharmacy profession, but its implementation has been suboptimal in many developing countries including Kuwait. Pharmacists must have sufficient knowledge, skills, and positive attitudes to practise pharmaceutical care, and barriers in the pharmacy practice model must be overcome before pharmaceutical care can be broadly implemented in a given healthcare system. To investigate hospital pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care, and the barriers to its implementation in Kuwait. Six general hospitals, eight specialized hospitals and seven specialized health centers in Kuwait. A descriptive, cross-sectional survey was distributed to all pharmacists working in the governmental hospitals in Kuwait (385 pharmacists). Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (standard deviations) were calculated and compared using statistical package for social sciences, version 20. Statistical significance was accepted at a p value of Kuwait. Completed surveys were received from 250 (64.9%) of the 385 pharmacists. Pharmacists expressed overall positive attitudes towards pharmaceutical care. They felt well prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Pharmacists with more practice experience expressed significantly more positive attitudes towards pharmaceutical care (p = 0.001) and they felt better prepared to provide pharmaceutical care competencies (p Kuwait advocate implementation of pharmaceutical care while also appreciating the organizational, technical and professional barriers to its widespread adoption. Collaborative efforts between health authorities and educational institutions, and the integration of innovative approaches in

  6. Preparedness for emerging infectious diseases: pathways from anticipation to action.

    Science.gov (United States)

    Brookes, V J; Hernández-Jover, M; Black, P F; Ward, M P

    2015-07-01

    Emerging and re-emerging infectious disease (EID) events can have devastating human, animal and environmental health impacts. The emergence of EIDs has been associated with interconnected economic, social and environmental changes. Understanding these changes is crucial for EID preparedness and subsequent prevention and control of EID events. The aim of this review is to describe tools currently available for identification, prioritization and investigation of EIDs impacting human and animal health, and how these might be integrated into a systematic approach for directing EID preparedness. Environmental scanning, foresight programmes, horizon scanning and surveillance are used to collect and assess information for rapidly responding to EIDs and to anticipate drivers of emergence for mitigating future EID impacts. Prioritization of EIDs - using transparent and repeatable methods - based on disease impacts and the importance of those impacts to decision-makers can then be used for more efficient resource allocation for prevention and control. Risk assessment and simulation modelling methods assess the likelihood of EIDs occurring, define impact and identify mitigation strategies. Each of these tools has a role to play individually; however, we propose integration of these tools into a framework that enhances the development of tactical and strategic plans for emerging risk preparedness.

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

    Science.gov (United States)

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

    2011-08-01

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

  8. Earthquake Preparedness Among Japanese Hemodialysis Patients in Prefectures Heavily Damaged by the 2011 Great East Japan Earthquake.

    Science.gov (United States)

    Sugisawa, Hidehiro; Shimizu, Yumiko; Kumagai, Tamaki; Sugisaki, Hiroaki; Ohira, Seiji; Shinoda, Toshio

    2017-08-01

    The purpose of this study was to explore the factors related to earthquake preparedness in Japanese hemodialysis patients. We focused on three aspects of the related factors: health condition factors, social factors, and the experience of disasters. A mail survey of all the members of the Japan Association of Kidney Disease Patients in three Japanese prefectures (N = 4085) was conducted in March, 2013. We obtained 1841 valid responses for analysis. The health factors covered were: activities of daily living (ADL), mental distress, primary renal diseases, and the duration of dialysis. The social factors were: socioeconomic status, family structure, informational social support, and the provision of information regarding earthquake preparedness from dialysis facilities. The results show that the average percentage of participants that had met each criterion of earthquake preparedness in 2013 was 53%. Hemodialysis patients without disabled ADL, without mental distress, and requiring longer periods of dialysis, were likely to meet more of the earthquake preparedness criteria. Hemodialysis patients who had received informational social support from family or friends, had lived with spouse and children in comparison to living alone, and had obtained information regarding earthquake preparedness from dialysis facilities, were also likely to meet more of the earthquake preparedness criteria. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  9. Bridging the Gap in Hospital Preparedness

    National Research Council Canada - National Science Library

    Adwell, James P

    2007-01-01

    .... This paper reviews personnel attitudes towards preparedness at Johns Hopkins Hospital, types of training used in disaster preparedness and their effectiveness, the use of individual and family...

  10. Family caregivers of older adults on home enteral nutrition have multiple unmet task-related training needs and low overall preparedness for caregiving.

    Science.gov (United States)

    Silver, Heidi J; Wellman, Nancy S; Galindo-Ciocon, Daisy; Johnson, Paulette

    2004-01-01

    We used stress process theory to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. In this article, we describe the specific tasks family caregivers performed and their unique training needs in the context of caregiver preparedness, competence, effectiveness, and health care use. Hospital billing lists from two university-affiliated institutions in Miami, FL, were used to identify older adults who had enteral tubes placed over a 6-month period. Consent was obtained from those older adults discharged for the first time on home enteral nutrition and their family caregivers at the first scheduled outpatient visit. In-home interviews were conducted with a diverse sample of 30 family caregivers (14 white, 8 Hispanic, 7 African-American, 1 Asian) during their first 3 months (mean=1.83+/-0.69 months) of home enteral nutrition caregiving. Descriptive statistics were used to summarize data for all variables; chi(2) analysis was conducted to analyze differences in categorical variables. One-way analysis of variance was used to analyze mean differences among caregivers grouped by ethnicity for total number of hours and tasks performed. Post hoc comparisons were conducted using the Tukey HSD test. The Spearman rho correlations were calculated to assess bivariate associations between quantitative variables. Caregivers reported providing from 6 to 168 hours of care weekly (mean=61.87+/-49.67 hours), in which they performed an average of 19.73+/-8.09 caregiving tasks daily. Training needs identified were greatest for technical and nutrition-related tasks. Preparedness for caregiving scores were low (mean=1.72, maximum=4.0) and positively correlated with caregiver competence (P<.001) and self-rated caregiver effectiveness (P=.004). Preparedness negatively correlated with health care use (P=.03). Caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving

  11. Nuclear threats and emergency preparedness in Finland; Ydinuhkat ja varautuminen

    Energy Technology Data Exchange (ETDEWEB)

    Mustonen, R; Aaltonen, H; Laaksonen, J; Lahtinen, J; Rantavaara, A; Reponen, H; Rytoemaa, T; Suomela, M; Toivonen, H; Varjoranta, T

    1995-10-01

    The political and economic upheavals which have taken place in Eastern Europe have had an impact on radiation and nuclear safety throughout Europe. Emergency preparedness systems for unexpected nuclear events have been developed further in all European countries, and prosperous western nations have invested in improving the safety of East European nuclear power plants. The economic crisis facing countries of the former Soviet Union has also promoted illicit trade in nuclear materials; this has made it necessary for various border guards and police authorities to intensify their collaboration and to tighten border controls. On 3-4 October 1995, Finnish Centre for Radiation and Nuclear Safety (STUK) arranged a seminar on nuclear threats and emergency preparedness in Finland. In addition to STUK experts, a wide range of rescue and civil defence authorities, environmental health specialists and other persons engaged in emergency preparedness attended the seminar. The publication contains a compilation of reports presented at the seminar. The reports cover a broad spectrum of nuclear threats analyzed at STUK, the impacts of radioactive fallout on human beings and on the environment, and preparedness systems by which the harmful effects of radiation or nuclear accidents can, if necessary, be minimized. (33 figs., 5 tabs.).

  12. The Relationship between Knowledge and Attitude of Managers with Preparedness of Healthcare Centers in Rey Health Network against Earthquake Risk - 2013

    Directory of Open Access Journals (Sweden)

    Mohammad Asadzadeh

    2014-06-01

    Conclusions: Considering that managers’ knowledge was rather low, preparedness among centers was low as well. According to low knowledge and unsuitable preparedness, more theoretical and practical trainings and maneuvers were necessary to be held for managers about earthquake preparedness.

  13. Disaster Preparedness Knowledge, Beliefs, Risk-Perceptions, and Mitigating Factors of Disaster Preparedness Behaviors of Undergraduate Students at a Large Midwest University

    Science.gov (United States)

    Goddard, Stacy

    2017-01-01

    Disaster preparedness is a national public health concern. The risk of individuals and communities affected by a natural disaster has increased, and unfortunately this trend is expected to continue. College students could play a primary role in responding to and recovering from a major disaster if they have sufficiently prepared for a disaster. A…

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

    Science.gov (United States)

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

    2015-12-16

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

  15. Nuclear emergency preparedness in Canada

    International Nuclear Information System (INIS)

    1993-03-01

    The preparedness of utilities and government agencies at various levels for dealing with nuclear emergencies occurring at nuclear reactors in Canada is reviewed and assessed. The review is centered on power reactors, but selected research reactors are included also. Emergency planning in the U.S.A., Germany and France, and international recommendations on emergency planning are reviewed to provide background and a basis for comparison. The findings are that Canadians are generally well protected by existing nuclear emergency plans at the electric utility and provincial levels but there are improvements that can be made, mainly at the federal level and in federal-provincial coordination. Ten issues of importance are identified: commitment to nuclear emergency planning by the federal government; division of federal and provincial roles and responsibilities; auditing of nuclear emergency preparedness of all levels of government and of electric utilities; the availability of technical guidance appropriate to Canada; protective action levels for public health and safety; communication with the public; planning and response for the later phases of a nuclear emergency; off-site exercises and training; coordination of international assistance; and emergency planning for research reactors. (L.L.) 79 refs., 2 tabs

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

    Science.gov (United States)

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

    2017-01-01

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

  17. How to assess and prepare health systems in low- and middle-income countries for integration of services-a systematic review.

    Science.gov (United States)

    Topp, Stephanie M; Abimbola, Seye; Joshi, Rohina; Negin, Joel

    2018-03-01

    Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle-income countries (LMICs). We adopted a modified systematic review with aspects of realist review, including quantitative and qualitative studies that incorporated assessment of health system preparedness for and capacity to implement integrated services. We searched Medline via Ovid, Web of Science and the Cochrane library using terms adapted from Dudley and Garner's systematic review on integration in LMICs. From an initial list of 10 550 articles, 206 were selected for full-text review by two reviewers who independently reviewed articles and inductively extracted and synthesized themes related to health system preparedness. We identified five 'context' related categories and four health system 'capability' themes. The contextual enabling and constraining factors for frontline service integration were: (1) the organizational framework of frontline services, (2) health care worker preparedness, (3) community and client preparedness, (4) upstream logistics and (5) policy and governance issues. The intersecting health system capabilities identified were the need for: (1) sufficiently functional frontline health services, (2) sufficiently trained and motivated health care workers, (3) availability of technical tools and equipment suitable to facilitate integrated frontline services and (4) appropriately devolved authority and decision-making processes to enable frontline managers and staff to adapt integration to local circumstances. Moving beyond claims that integration is defined differently by different programs and thus unsuitable for comparison, this review demonstrates that synthesis is possible. It presents a common set of contextual factors and health system capabilities

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

    Directory of Open Access Journals (Sweden)

    Camila Eugenia Roseira

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

  19. Health care operations management

    NARCIS (Netherlands)

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

    2012-01-01

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

  20. Radiological and nuclear emergency preparedness and response. How well are we prepared?; Radiologischer und nuklearer Notfallschutz. Wie gut sind wir vorbereitet?

    Energy Technology Data Exchange (ETDEWEB)

    Geick, Gunther H.G. [Dataport, Altenholz (Germany); Herrmann, Andre R. [HERRMANN Consultant, Basel (Switzerland); Koch, Doris [Ministerium fuer Justiz, Gleichstellung und Integration, Kiel (Germany); Meisenberg, Oliver [Helmholtz Zentrum Muenchen Deutsches Forschungszentrum fuer Gesundheit und Umwelt GmbH, Neuherberg (Germany); Rauber, Dominique [Bundesamt fuer Bevoelkerungsschutz (BABS), Zuerich (CH). Eidgenoessisches Dept. fuer Verteidigung, Bevoelkerungsschutz und Sport (VBS); Stuerm, Rolf P. [SafPro AG, Basel (Switzerland); Weiss, Wolfgang [Bundesamt fuer Strahlenschutz, Salzgitter (Germany); Miska, Horst; Schoenhacker, Stefan

    2011-07-01

    The contributions to this topic are dealing, in a broad overview, with important aspects of Nuclear Emergency Preparedness and Response, like the influence of the new ICRP recommendations number 103 and number 109 on emergency preparedness and on planning for response, possible problems in installing and operating emergency care centres, experience from exercises as well as the training of response personnel in Austria and Germany. Finally, measures in emergency preparedness with regard to a dirty bomb attack are reported by means of an INEX-4-exercise in Switzerland. (orig.)

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

    Science.gov (United States)

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

    2018-02-01

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

  2. Updated preparedness and response framework for influenza pandemics.

    Science.gov (United States)

    Holloway, Rachel; Rasmussen, Sonja A; Zaza, Stephanie; Cox, Nancy J; Jernigan, Daniel B

    2014-09-26

    The complexities of planning for and responding to the emergence of novel influenza viruses emphasize the need for systematic frameworks to describe the progression of the event; weigh the risk of emergence and potential public health impact; evaluate transmissibility, antiviral resistance, and severity; and make decisions about interventions. On the basis of experience from recent influenza responses, CDC has updated its framework to describe influenza pandemic progression using six intervals (two prepandemic and four pandemic intervals) and eight domains. This updated framework can be used for influenza pandemic planning and serves as recommendations for risk assessment, decision-making, and action in the United States. The updated framework replaces the U.S. federal government stages from the 2006 implementation plan for the National Strategy for Pandemic Influenza (US Homeland Security Council. National strategy for pandemic influenza: implementation plan. Washington, DC: US Homeland Security Council; 2006. Available at http://www.flu.gov/planning-preparedness/federal/pandemic-influenza-implementation.pdf). The six intervals of the updated framework are as follows: 1) investigation of cases of novel influenza, 2) recognition of increased potential for ongoing transmission, 3) initiation of a pandemic wave, 4) acceleration of a pandemic wave, 5) deceleration of a pandemic wave, and 6) preparation for future pandemic waves. The following eight domains are used to organize response efforts within each interval: incident management, surveillance and epidemiology, laboratory, community mitigation, medical care and countermeasures, vaccine, risk communications, and state/local coordination. Compared with the previous U.S. government stages, this updated framework provides greater detail and clarity regarding the potential timing of key decisions and actions aimed at slowing the spread and mitigating the impact of an emerging pandemic. Use of this updated framework is

  3. Oral Health Care Delivery Within the Accountable Care Organization.

    Science.gov (United States)

    Blue, Christine; Riggs, Sheila

    2016-06-01

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

  4. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

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

  5. Mathematical assessment of Canada's pandemic influenza preparedness plan.

    Science.gov (United States)

    Gumel, Abba B; Nuño, Miriam; Chowell, Gerardo

    2008-03-01

    The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for prepared-ness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan. A mathematical model of the transmission dynamics of influenza was used to keep track of the population according to risk of infection (low or high) and infection status (susceptible, exposed or infectious). The model was parametrized using available Canadian demographic data. The model was then used to evaluate the key components outlined in the Canadian plan. The results indicated that the number of cases, mortalities and hospitalizations estimated in the Canadian plan may have been underestimated; the use of antivirals, administered therapeutically, prophylactically or both, is the most effective single intervention followed by the use of a vaccine and basic public health measures; and the combined use of pharmaceutical interventions (antivirals and vaccine) can dramatically minimize the burden of the pending influenza pandemic in Canada. Based on increasing concerns of Oseltamivir resistance (wide-scale implementation), coupled with the expected unavailability of a suitable vaccine during the early stages of a pandemic, the present study evaluated the potential impact of non-pharmaceutical interventions (NPIs) which were not emphasized in the current Canadian plan. To this end, the findings suggest that the use of NPIs can drastically reduce the burden of a pandemic in Canada. A deterministic model was designed and used to assess Canada's pandemic preparedness plan. The study showed that the estimates of pandemic influenza burden given in the Canada pandemic preparedness plan may be an underestimate, and that Canada

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

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

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

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

    Science.gov (United States)

    2011-01-01

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

  8. Emergency preparedness at Ignalina NPP

    International Nuclear Information System (INIS)

    Kairys, A.

    1998-01-01

    Brief review of Ignalina NPP safety upgrading and personnel preparedness to act in cases of accidents is presented. Though great activities are performed in enhancing the plant operation safety, the Ignalina NPP management pays a lot of attention to preparedness for emergency elimination and take measures to stop emergency spreading. A new Ignalina NPP emergency preparedness plan was drawn up and became operational. It is the main document to carry out organizational, technical, medical, evacuation and other activities to protect plant personnel, population, the plant and the environment from accident consequences. Great assistance was rendered by Swedish experts in drawing this new emergency preparedness plan. The plan consists of 3 parts: general part, operative part and appendixes. The plan is applied to the Ignalina NPP personnel, Special and Fire Brigade and also to other contractor organizations personnel carrying out works at Ignalina NPP. There are set the following emergency classes: incident, emergency situation, alert, local emergency, general emergency. Separate intervention level corresponds to each emergency class. Overview of personnel training to act in case of an emergency is also presented

  9. [Health care networks].

    Science.gov (United States)

    Mendes, Eugênio Vilaça

    2010-08-01

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

  10. Emergency preparedness

    International Nuclear Information System (INIS)

    Yanev, P.I.; Hom, S.; Kircher, C.A.; Bailey, N.D.

    1985-01-01

    These lecture notes include the following subject areas: (1) earthquake mitigation planning - general approach and in-house program; (2) seismic protection of equipment and non-structural systems; and (3) disaster preparedness and self help program

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

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

  12. On-site emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Vilkamo, O.

    1998-01-01

    General scheme of emergency preparedness in Finland is presented including legal framework, emergency organization and detailed description of plans and procedures. Emergency plan in Finland cover the following matters: classification of emergency situations and description of events and accidents, description of emergency organization, description of the arrangements for alerting and data transfer, management of an emergency situation and radiation protection, worker safety and radiation protection, on- and off-site radiation measurements during a preparedness situation, provision of information, rooms, equipment and facilities, post emergency debriefing and measures, a description of the maintenance of preparedness

  13. Continuous Vigilance - Evaluating Preparedness for a Biological Event

    Directory of Open Access Journals (Sweden)

    Bruria eAdini

    2014-04-01

    Full Text Available Objective: Effective response to biological events necessitates ongoing evaluation of preparedness. This study was a bilateral German-Israeli collaboration aimed at developing an evaluation tool for assessing preparedness of medical facilities for biological events.Methods: Measurable parameters were identified through a literature review for inclusion in the evaluation tool and disseminated to 228 content experts in 2 modified Delphi cycles. Focus groups were conducted to identify psychosocial needs of the medical teams. Table top and functional exercises were implemented to review applicability of the tool. Results: 117 experts from Germany and Israel participated in the modified Delphi. Out of 188 parameters that were identified, 183 achieved a consensus of >75% of the content experts. Following comments recommended in the Delphi cycles, and feedback from focus groups and hospital exercises, the final tool consisted of 172 parameters. Median level of importance of each parameter was calculated based on ranking recommended in the Delphi process. Computerized web-based software was developed to calculate scores of preparedness for biological events.Conclusions: Ongoing evaluation means, such as the tool developed in the study, can facilitate the need for a valid and reliable mechanism that may be widely adopted and implemented as quality assurance measures. The tool is based on measurable parameters and indicators that can effectively present strengths and weaknesses in managing a response to a public health threat, and accordingly, steps can be implemented to improve readiness. Adoption of such a tool is an important component of assuring public health and effective emergency management.Contact person regarding the evaluation tool: adinib@bgu.ac.ilLink to the computerized tool: http://www.be-prep.com/us

  14. Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

    Science.gov (United States)

    Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

    2017-11-17

    The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.

  15. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Yanev, P.I.; Hom, S.; Kircher, C.A.; Bailey, N.D.

    1985-01-01

    These lecture notes include the following subject areas: (1) earthquake mitigation planning - general approach and in-house program; (2) seismic protection of equipment and non-structural systems; and (3) disaster preparedness and self help program. (ACR)

  16. A new preparedness policy for EMS logistics.

    Science.gov (United States)

    Lee, Seokcheon

    2017-03-01

    Response time in emergency medical services (EMS) is defined as the interval for an ambulance to arrive the scene after receipt of a 911 call. When several ambulances are available upon the receipt of a new call, a decision of selecting an ambulance has to be made in an effort to reduce response time. Dispatching the closest unit available is commonly used in practice; however, recently the Preparedness policy was designed that is in a simplistic form yet being capable of securing a long-term efficiency. This research aims to improve the Preparedness policy, resolving several critical issues inherent in the current form of the policy. The new Preparedness policy incorporates a new metric of preparedness based on the notion of centrality and involves a tuning parameter, weight on preparedness, which has to be appropriately chosen according to operational scenario. Computational experiment shows that the new policy significantly improves the former policy robustly in various scenarios.

  17. Social Network Types and Acute Stroke Preparedness Behavior

    Directory of Open Access Journals (Sweden)

    Bernadette Boden-Albala

    2011-08-01

    Full Text Available Objectives: Presence of informal social networks has been associated with favorable health and behaviors, but whether different types of social networks impact on different health outcomes remains largely unknown. We examined the associations of different social network types (marital dyad, household, friendship, and informal community networks with acute stroke preparedness behavior. We hypothesized that marital dyad best matched the required tasks and is the most effective network type for this behavior. Methods: We collected in-person interview and medical record data for 1,077 adults diagnosed with stroke and transient ischemic attack. We used logistic regression analyses to examine the association of each social network with arrival at the emergency department (ED within 3 h of stroke symptoms. Results: Adjusting for age, race-ethnicity, education, gender, transportation type to ED and vascular diagnosis, being married or living with a partner was significantly associated with early arrival at the ED (odds ratio = 2.0, 95% confidence interval: 1.2–3.1, but no significant univariate or multivariate associations were observed for household, friendship, and community networks. Conclusions: The marital/partnership dyad is the most influential type of social network for stroke preparedness behavior.

  18. Rebuilding Emergency Care After Hurricane Sandy.

    Science.gov (United States)

    Lee, David C; Smith, Silas W; McStay, Christopher M; Portelli, Ian; Goldfrank, Lewis R; Husk, Gregg; Shah, Nirav R

    2014-04-09

    A freestanding, 911-receiving emergency department was implemented at Bellevue Hospital Center during the recovery efforts after Hurricane Sandy to compensate for the increased volume experienced at nearby hospitals. Because inpatient services at several hospitals remained closed for months, emergency volume increased significantly. Thus, in collaboration with the New York State Department of Health and other partners, the Health and Hospitals Corporation and Bellevue Hospital Center opened a freestanding emergency department without on-site inpatient care. The successful operation of this facility hinged on key partnerships with emergency medical services and nearby hospitals. Also essential was the establishment of an emergency critical care ward and a system to monitor emergency department utilization at affected hospitals. The results of this experience, we believe, can provide a model for future efforts to rebuild emergency care capacity after a natural disaster such as Hurricane Sandy. (Disaster Med Public Health Preparedness. 2014;0:1-4).

  19. Is previous disaster experience a good predictor for disaster preparedness in extreme poverty households in remote Muslim minority based community in China?

    Science.gov (United States)

    Chan, Emily Y Y; Kim, Jean H; Lin, Cherry; Cheung, Eliza Y L; Lee, Polly P Y

    2014-06-01

    Disaster preparedness is an important preventive strategy for protecting health and mitigating adverse health effects of unforeseen disasters. A multi-site based ethnic minority project (2009-2015) is set up to examine health and disaster preparedness related issues in remote, rural, disaster prone communities in China. The primary objective of this reported study is to examine if previous disaster experience significantly increases household disaster preparedness levels in remote villages in China. A cross-sectional, household survey was conducted in January 2011 in Gansu Province, in a predominately Hui minority-based village. Factors related to disaster preparedness were explored using quantitative methods. Two focus groups were also conducted to provide additional contextual explanations to the quantitative findings of this study. The village household response rate was 62.4 % (n = 133). Although previous disaster exposure was significantly associated with perception of living in a high disaster risk area (OR = 6.16), only 10.7 % households possessed a disaster emergency kit. Of note, for households with members who had non-communicable diseases, 9.6 % had prepared extra medications to sustain clinical management of their chronic conditions. This is the first study that examined disaster preparedness in an ethnic minority population in remote communities in rural China. Our results indicate the need of disaster mitigation education to promote preparedness in remote, resource-poor communities.

  20. Fear of Terrorism in New York After the September 11 Terrorist Attacks: Implications for Emergency Mental Health and Preparedness

    Science.gov (United States)

    Boscarino, Joseph A.; Figley, Charles R.; Adams, Richard E.

    2009-01-01

    To examine the public’s response to future terrorist attacks, we surveyed 1,001 New Yorkers in the community one year after the September 11 attacks. Overall, New Yorkers were very concerned about future terrorist attacks and also concerned about attacks involving biological or nuclear weapons. In addition, while most New Yorkers reported that if a biological or nuclear attack occurred they would evaluate available information before evacuating, a significant number reported they would immediately evacuate, regardless of police or public health communications to the contrary. The level of public concern was significantly higher on all measures among New York City and Long Island residents (downstate) compared to the rest of the state. A model predicting higher fear of terrorism indicated that downstate residents, women, those 45 to 64 years old, African Americans and Hispanics, those with less education/income, and those more likely to flee, were more fearful of future attacks. In addition, making disaster preparations and carefully evaluating emergency information also predicted a higher level of fear as well. A second model predicting who would flee suggested that those more likely to evaluate available information were less likely to immediately evacuate, while those with a higher fear of future attacks were more likely to flee the area. Given these findings and the possibility of future attacks, mental health professionals need to be more involved in preparedness efforts, especially related to the psychological impact of attacks involving weapons of mass destruction. PMID:14730761

  1. Perceived coping & concern predict terrorism preparedness in Australia.

    Science.gov (United States)

    Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Jones, Alison L; Barr, Margo; Raphael, Beverley

    2012-12-27

    In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. Adults in New South Wales (NSW) completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI) in 2010 (N=2038). Responses were weighted against the NSW population. Multiple logistic regression analyses were conducted to evaluate the relationship between personal coping/concern factors and terrorism-related preparedness and avoidance behaviours, and to control for potential confounders such as socio-demographic and threat perception factors. Increased vigilance for suspicious behaviours was the most commonly reported behavioural response to perceived terrorism threat. Multivariate analyses showed that the factor combination of high perceived coping and higher concern was the most consistent predictor of terrorism preparedness behaviours and evacuation intentions, including increased vigilance (Adjusted Odd Ratios (AOR)=2.07, p=0.001) learning evacuation plans (AOR=1.61, p=0.05), establishing emergency contact plans (AOR=2.73, pterrorism preparedness behaviours are strongly associated with perceived high coping but that this relationship is also mediated by personal concerns relating to this threat. Cognitive variables such as coping self-efficacy are increasingly targeted as part of natural hazard preparedness and are a viable intervention target for terrorism preparedness initiatives. Raising individual coping perceptions may promote greater general and incident-specific preparedness and could form an integral element of community resilience strategies

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

    Science.gov (United States)

    Frank, S R

    2000-04-01

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

  3. Regulation of the State Office of Nuclear Safety No. 318/2002 of 13 June 2002 specifying details to ensure emergency preparedness of nuclear facilities and workplaces handling ionizing radiation sources, and requirements for the contents of internal emergency plans and emergency rules

    International Nuclear Information System (INIS)

    2002-01-01

    The Regulation addresses the following issues: definition of a radiological event and interventions to be accomplished if a radiological event takes place; emergency preparedness; establishing a radiological event; assessment of a radiological event; warnings, notifications and alarms during a radiological event; intervention - management, procedures, instructions; radiological situation monitoring programme; provisions to restrict human exposure; health care provisions; documentation; informing the State Office of Nuclear Safety; personnel instructions and training; emergency preparedness inspection; internal emergency plan; emergency rules; and related issues. This Regulation supersedes Regulation No. 219/1997. (P.A.)

  4. Consumer Directed Health Care

    OpenAIRE

    John Goodman

    2006-01-01

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

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

    Science.gov (United States)

    Mitchell, Penny

    2009-02-01

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

  6. Medical students' preparedness for professional activities in early clerkships.

    Science.gov (United States)

    Bosch, Josefin; Maaz, Asja; Hitzblech, Tanja; Holzhausen, Ylva; Peters, Harm

    2017-08-22

    Sufficient preparedness is important for transitions to workplace participation and learning in clinical settings. This study aims to analyse medical students' preparedness for early clerkships using a three-dimensional, socio-cognitive, theory-based model of preparedness anchored in specific professional activities and their supervision level. Medical students from a competency-based undergraduate curriculum were surveyed about preparedness for 21 professional activities and level of perceived supervision during their early clerkships via an online questionnaire. Preparedness was operationalized by the three dimensions of confidence to carry out clerkship activities, being prepared through university teaching and coping with failure by seeking support. Factors influencing preparedness and perceived stress as outcomes were analysed through step-wise regression. Professional activities carried out by the students (n = 147; 19.0%) and their supervision levels varied. While most students reported high confidence to perform the tasks, the activity-specific analysis revealed important gaps in preparation through university teaching. Students regularly searched for support in case of difficulty. One quarter of the variance of each preparedness dimension was explained by self-efficacy, supervision quality, amount of prior clerkship experience and nature of professional activities. Preparedness contributed to predicting perceived stress. The applied three-dimensional concept of preparedness and the task-specific approach provided a detailed and meaningful view on medical students' workplace participation and experiences in early clerkships.

  7. Operations management in health care.

    Science.gov (United States)

    Henderson, M D

    1995-01-01

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

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

    Science.gov (United States)

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

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

  9. Resilient health care

    DEFF Research Database (Denmark)

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

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

  10. Perceived coping & concern predict terrorism preparedness in Australia

    Directory of Open Access Journals (Sweden)

    Stevens Garry

    2012-12-01

    Full Text Available Abstract Background In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. Methods Adults in New South Wales (NSW completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI in 2010 (N=2038. Responses were weighted against the NSW population. Multiple logistic regression analyses were conducted to evaluate the relationship between personal coping/concern factors and terrorism-related preparedness and avoidance behaviours, and to control for potential confounders such as socio-demographic and threat perception factors. Results Increased vigilance for suspicious behaviours was the most commonly reported behavioural response to perceived terrorism threat. Multivariate analyses showed that the factor combination of high perceived coping and higher concern was the most consistent predictor of terrorism preparedness behaviours and evacuation intentions, including increased vigilance (Adjusted Odd Ratios (AOR=2.07, p=0.001 learning evacuation plans (AOR=1.61, p=0.05, establishing emergency contact plans (AOR=2.73, p Conclusion The findings of this study suggest that terrorism preparedness behaviours are strongly associated with perceived high coping but that this relationship is also mediated by personal concerns relating to this threat. Cognitive variables such as coping self-efficacy are increasingly targeted as part of natural hazard preparedness and are a viable intervention target for terrorism preparedness initiatives. Raising individual coping perceptions may promote greater general and

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

    Science.gov (United States)

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

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

  12. Pharmacists’ preparedness to contribute to achieving the objectives of Australia’s National Primary Health Care Strategy: attitudes, beliefs and awareness

    DEFF Research Database (Denmark)

    Mak, Vivienne S.L.; Clark, Alice; Poulsen, Joo Hanne

    2012-01-01

    included hospital pharmacists and another, consultant pharmacists. Key findings: Four themes emerged: (1) poor awareness of health care reform agenda; (2) strong adherence to the supply model; (3) lack of appreciation of alternative models; and (4) communication barriers. Conclusions: Participants’ low...

  13. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

    2014-01-01

    Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...

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

    Science.gov (United States)

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

    2013-01-01

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

  15. Health care in the Netherlands.

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

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

  17. Activities for the strengthening of Defense Preparedness in formation of radiochemists

    International Nuclear Information System (INIS)

    Lau-González, MSc. Maritza; Hernández-Garcés, MSc. Anel; Corona-Hernández, MSc. José Á.; Ruiz-Machado, Lic. José R.; Zamora-Lugo, Dr.C Luis O.

    2015-01-01

    The discipline Defense Preparedness in Bachelor of Radiochemistry, is complemented by the other subjects of Basic and Specialized Chemistry training through a series of contents that equip the professional greater awareness of their social responsibility in relation to peaceful use of nuclear energy, the prevention of radiological accidents and environmental protection. In this paper examples of learning activities aimed at the independent work of students are introduced, allowing, systemically, a coherent link between the disciplines of General and Inorganic Chemistry and Defense Preparedness, through the study of toxic substances of different nature and risks that can arise for human health during handling and employment, economic resources and the environment; aspects to consider within the dimensions of National Security. (author)

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

    Science.gov (United States)

    Rahmani, Zuhal; Brekke, Mette

    2013-05-06

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

  19. Improving eye care in the primary health care setting

    Directory of Open Access Journals (Sweden)

    M de Wet

    2000-09-01

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

  20. Respiratory Home Health Care

    Science.gov (United States)

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

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

    Science.gov (United States)

    Mascarenhas, O A

    1993-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  3. Application of Fuzzy Theory to Radiological Emergency Preparedness

    International Nuclear Information System (INIS)

    Han, Moon Hee; Jeong, Hyo Joon; Kim, Eun Han; Suh, Kyung Suk; Hwang, Won Tae

    2005-01-01

    Emergency preparedness for nuclear facility is considered as an important part for public health and safety. In an emergency, it is not easy to get the information which is needed for the operation of an emergency system. Even though the lack of the information, decision-maker should make an early decision for the public. And the real situation is often not crisp and deterministic. The concept of fuzzy set provides the mathematical formulations which can characterize the uncertain variables in the models related to radiological emergency preparedness. And it provides a method which can describe the characteristics of uncertain variables represented by the fuzzy membership functions, and the effects of distribution can be handled with the fuzzy relation and the fuzzy reasoning. By the application of linguistic variables and fuzzy algorithms, it is possible to provide an approximate and effective tool to describe the system which is too complex or ill defined to use precise mathematical analysis

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

    Science.gov (United States)

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

    2016-02-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  7. Emergency preparedness for nuclear power plants in the USA

    International Nuclear Information System (INIS)

    Schwartz, S.A.

    1986-01-01

    In the case of an operating reactor, if it is determined that there are such deficiencies that a favourable NRC finding is not warranted and if the deficiencies are not corrected within four months of that determination, the Commission will determine whether the reactor should be shut down or whether some other enforcement action is appropriate. In any case, where the Commission believes that the public health, safety, or interest so requires, the plant will be required to shut down immediately. Emergency planning considerations must be extended to emergency planning zones, and these shall consist of an area of about 10 miles in radius for exposure to the radioactive plume that might result from an accident in a nuclear power reactor and an area of about 50 miles in radius for food that might become contaminated. To evaluate the effectiveness of the licensee programme to implement their emergency plan, a 'management oversight and risk tree' (MORT) approach was developed and used by NRC appraisal teams at all operating facilities and those close to licensing. Since April 1981, over 250 emergency preparedness exercises have been observed and annual inspections conducted at US commercial nuclear power generating facilities. As a result of this experience, licensees have generally progressed from a basic ability to implement their plan to a systematic demonstration of their emergency preparedness capabilities. Almost five years have elapsed since the inception of the upgraded emergency preparedness regulatory programme, and the NRC is evaluating the resources committed to the programme to determine if modifications are appropriate. Our goal is to ensure continued adequate readiness capability to protect the public health and safety in the event of an accident

  8. Radiological emergencies - planning and preparedness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-12-31

    This information and training film in three parts deals with the technical background for emergency planning, emergency planning concepts and emergency preparedness. It describes the technical characteristics of radiological emergencies on which important emergency planning concepts are based and the purpose of those concepts. The film also demonstrates how emergency organizations must work together to ensure adequate preparedness. The programme reflects the standards, guidance and recommendations of the International Atomic Energy Agency

  9. Health care employee perceptions of patient-centered care.

    Science.gov (United States)

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

    2015-03-01

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

  10. A Probabilistic Risk Assessment For Emergency Preparedness

    International Nuclear Information System (INIS)

    Lee, Joomyung; Jae, Moosung; Ahn, Kwangil

    2013-01-01

    The importance of nuclear power plant PSA has grown up all over the world due to this incident. The main concern of this study is to develop a methodology to carry on an emergency preparedness evaluation and to set an exclusive area, or the emergency response area boundary in order to apply it to domestic reference plants. This study also focuses on evaluating the risk parameter of major nuclides through a sensitivity analysis and a safety assessment by calculating the population dose, early fatality, and cancer fatality rates. A methodology for an emergency preparedness, which can be applied to evaluate the damage of the radioactive release as well as to assess the safety of the accident scenario of a nuclear power plant, has been developed and applied for the reference plants in Korea. By applying a source term analysis, an exclusive zone based on the radioactive dose is obtained. And the results of the health effect assessment based on the release fraction of specific nuclides to public with an effective emergency response activity have been simulated. A methodology utilizing the Level 3 PSA with the actual emergency response activities has been developed and applied to typical nuclear accident situations. The plausible standard for performing an emergency plan is suggested and the valuable information regarding emergency preparedness has been produced in this study. For further works, the sensitivity study on important parameters will be performed to simulate the actual severe accident situations such as sheltering, evacuation, and emergency response activities

  11. Salient Public Beliefs Underlying Disaster Preparedness Behaviors: A Theory-Based Qualitative Study.

    Science.gov (United States)

    Najafi, Mehdi; Ardalan, Ali; Akbarisari, Ali; Noorbala, Ahmad Ali; Elmi, Helen

    2017-04-01

    Introduction Given the increasing importance of disaster preparedness in Tehran, the capital of Iran, interventions encouraging disaster preparedness behavior (DPB) are needed. This study was conducted to show how an elicitation method can be used to identify salient consequences, referents, and circumstances about DPB and provide recommendations for interventions and quantitative research. A theory-based qualitative study using a semi-structured elicitation questionnaire was conducted with 132 heads of households from 22 districts in Tehran, Iran. Following the Theory of Planned Behavior (TPB), six open-ended questions were used to record the opinion of people about DPB: advantages of engaging in DPB; disadvantages of doing so; people who approve; people who disapprove; things that make it easy; and things that make it difficult. Content analysis showed the categories of salient consequences, reference groups, and circumstances. The three most frequently mentioned advantages obtained from inhabitants of Tehran were health outcomes (eg, it helps us to save our lives, it provides basic needs, and it protects us until relief workers arrive); other salient advantages were mentioned (eg, helps family reunification). The main disadvantage was preparedness anxiety. Family members were the most frequently mentioned social referent when people were asked who might approve or disapprove of their DPB. The two main circumstances perceived to obstruct DPB included not having enough knowledge or enough time. The results of this qualitative study suggest that interventions to encourage DPB among Tehran inhabitants should address: perceived consequences of DPB on health and other factors beyond health; barriers of not having enough knowledge and time perceived to hinder DPB; and social approval. More accurate research on salient beliefs with close-ended items developed from these open-ended data and with larger sample sizes of Tehran inhabitants is necessary. Research with other

  12. Exploring the Predictors of Organizational Preparedness for Natural Disasters.

    Science.gov (United States)

    Sadiq, Abdul-Akeem; Graham, John D

    2016-05-01

    There is an extensive body of research on the determinants of disaster preparedness at the individual and household levels. The same cannot be said for the organizational level. Hence, the purpose of this study is to shed light on the predictors of organizational preparedness for natural disasters. Since leaders of organizations have an incentive to overstate their level of preparedness and because surveys of organizational leaders suffer from selection bias and low response rates, we take the novel approach of interviewing employees about the organizations that employ them. Using an online survey, we collected information from a national sample of 2,008 U.S. employees and estimated the predictors of preparedness at the organizational level. We find, among other results, that organization size (facility level) is a consistent predictor of preparedness at the organizational level. We conclude with policy recommendations and outline an agenda for future research on organizational preparedness for natural disasters. © 2015 Society for Risk Analysis.

  13. Controversies in faith and health care.

    Science.gov (United States)

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

    2015-10-31

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

  14. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535).

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

    Science.gov (United States)

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

    2017-06-13

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

  16. Importance ranking of various aspects of offsite radiological emergency preparedness

    International Nuclear Information System (INIS)

    Hockert, J.W.; Carter, T.F.

    1987-01-01

    Under contract to the Edison Electric Institute, IEAL developed a method to assess the relative importance of various aspects of offsite radiological emergency preparedness. The basic approach involved structuring the 35 objectives that the Federal Emergency Management Agency expects offsite emergency planners to demonstrate during nuclear power plant emergency preparedness exercises into a hierarchy based upon the emergency response capabilities they support. The analytical hierarchy process (AHP) was employed to derive the quantitative relative importance of each of the 35 objectives based upon its contribution to the overall capability of offsite agencies to assist in protecting public health and safety in the event of an emergency at a nuclear power plant. The judgments of a cross-section of state and local emergency planners, federal regulators, and intervenors were solicited to rank the 35 objectives

  17. Do anticipatory grief and preparedness affect distress in bereaved caregivers?

    DEFF Research Database (Denmark)

    Nielsen, Mette Kjærgaard

    Objective Family caregivers of terminally ill patients are in a vulnerable position, and previous studies show that bereaved caregivers are at risk of psychological distress. Pre-loss grief symptoms seem to predict post-loss psychological distress, while preparedness for a looming loss tends...... to decrease distress. The aim of this nation-wide study was to investigate the association of both anticipatory grief symptoms and preparedness with psychological distress in bereaved family caregivers. Methods A list of all adult patients in Denmark receiving drug reimbursement for terminal illness...... was retrieved from the Danish Health and Medicines Authority on a weekly basis during 2012. All newly registered patients were requested by letter to pass on an enclosed baseline questionnaire to their closest relative. Responding caregivers bereaved within six months received a follow-up questionnaire six...

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

    Science.gov (United States)

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

    2008-05-01

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

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

    Science.gov (United States)

    King, Michael W

    2017-11-01

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

  20. 78 FR 54743 - National Preparedness Month, 2013

    Science.gov (United States)

    2013-09-06

    ... like hurricanes, tornadoes, and floods to shootings, cyber incidents, and even acts of terrorism. While... Preparedness Month. I encourage all Americans to recognize the importance of preparedness and work together to enhance our national security, resilience, and readiness. [[Page 54744

  1. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

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

  2. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

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

    2017-08-01

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

  3. Terrorism and mental health in the rural Midwest.

    Science.gov (United States)

    Hawley, Suzanne R; Ablah, Elizabeth; Hawley, Gary C; Cook, David J; Orr, Shirley A; Molgaard, Craig A

    2006-01-01

    Since the terrorist attacks of 11 September 2001, the amount of terrorism preparedness training has increased substantially. However, gaps continue to exist in training for the mental health casualties that result from such events. Responders must be aware of the mental health effects of terrorism and how to prepare for and buffer these effects. However, the degree to which responders possess or value this knowledge has not been studied. Multi-disciplinary terrorism preparedness training for healthcare professionals was conducted in Kansas in 2003. In order to assess knowledge and attitudes related to mental health preparedness training, post-test surveys were provided to 314 respondents 10 months after completion of the training. Respondents returned 197 completed surveys for an analysis response rate of 63%. In general, the results indicated that respondents have knowledge of and value the importance of mental health preparedness issues. The respondents who reported greater knowledge or value of mental health preparedness also indicated significantly higher ability levels in nationally recognized bioterrorism competencies (p mental health components to be incorporated into terrorism preparedness training. Further studies to determine the most effective mental health preparedness training content and instruction modalities are needed.

  4. The retailing of health care.

    Science.gov (United States)

    Paul, T; Wong, J

    1984-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    1996-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    Science.gov (United States)

    Petersen, Poul Erik

    2014-01-01

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

  9. Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

    NARCIS (Netherlands)

    Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

    2017-01-01

    The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the

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

    African Journals Online (AJOL)

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

  11. Hope for health and health care.

    Science.gov (United States)

    Stempsey, William E

    2015-02-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  13. Assessment of Emergency Preparedness of Households in Israel for War--Current Status.

    Science.gov (United States)

    Bodas, Moran; Siman-Tov, Maya; Kreitler, Shulamith; Peleg, Kobi

    2015-08-01

    In recent decades, many efforts have been made, both globally and locally, to enhance household preparedness for emergencies. In the State of Israel in particular, substantial investment has been made throughout the years in preparing the population for one of the major threats to the civilian population--a rapidly deteriorating regional conflict that involves high-trajectory weapons (ie, rocket and missile fire) launched at the home front. The purpose of this study was to examine the current preparedness level of the Israeli public for this threat and determine the correlates of such preparedness with known factors. A telephone-based, random sampling of 503 households representative of the Israeli population was carried out during October 2013. The questionnaire examined the level of household preparedness as well as attitudes towards threat perception, responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the level of preparedness in the general population and to find correlates to this preparedness in attitudes and demographic variables. More than half of the sample reported complying with 50% or fewer of the actions recommended by the Israeli Home Front Command. Having an increased sense of preparedness and willingness to search for related information were positively correlated with actual household preparedness, and the latter was also found to be the most predictive variable of household preparedness. Although the overall household preparedness reported is mediocre, the level of preparedness found in this study suggests better preparedness of the population in Israel for its primary threat. The findings suggest that in order to promote preparedness of the Israeli public for war, emphasis should be put on increasing the public demand for information and encouraging people to evaluate their sense of preparedness.

  14. Evaluation of a Tabletop Emergency Preparedness Exercise for Pharmacy Students

    OpenAIRE

    Pate, Adam; Bratberg, Jeffrey P.; Robertson, Courtney; Smith, Gregory

    2016-01-01

    Objective. To describe the implementation and effect of an emergency preparedness laboratory activity on student knowledge, willingness to participate in emergency preparedness training, current level of preparedness, and the importance of a pharmacist’s role in disaster response.

  15. Engaging men in health care.

    Science.gov (United States)

    Malcher, Greg

    2009-03-01

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

  16. Study of dynamics of level of physical preparedness of students.

    Directory of Open Access Journals (Sweden)

    Коvalenko Y.A.

    2010-12-01

    Full Text Available The dynamics of level of physical preparedness of students is studied in the article. A tendency is marked to the decline of level of physical preparedness of students of 1-3 courses. Methodical recommendations are presented on the improvement of the system of organization of physical education of students of the Zaporizhzhya national university. The dynamics of indexes of physical preparedness of students 1, 2, 3 courses of different years of teaching is studied. Principal reasons of decline of level of physical preparedness of students are certain. There are recommendations the department of physical education in relation to physical preparedness of students.

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

    Science.gov (United States)

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

    2018-04-01

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

  18. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Emergency Preparedness Education for Nurses: Core Competency Familiarity Measured Utilizing an Adapted Emergency Preparedness Information Questionnaire.

    Science.gov (United States)

    Georgino, Madeline M; Kress, Terri; Alexander, Sheila; Beach, Michael

    2015-01-01

    The purpose of this project was to measure trauma nurse improvement in familiarity with emergency preparedness and disaster response core competencies as originally defined by the Emergency Preparedness Information Questionnaire after a focused educational program. An adapted version of the Emergency Preparedness Information Questionnaire was utilized to measure familiarity of nurses with core competencies pertinent to first responder capabilities. This project utilized a pre- and postsurvey descriptive design and integrated education sessions into the preexisting, mandatory "Trauma Nurse Course" at large, level I trauma center. A total of 63 nurses completed the intervention during May and September 2014 sessions. Overall, all 8 competencies demonstrated significant (P < .001; 98% confidence interval) improvements in familiarity. In conclusion, this pilot quality improvement project demonstrated a unique approach to educating nurses to be more ready and comfortable when treating victims of a disaster.

  1. Organizing emotions in health care.

    Science.gov (United States)

    Mark, Annabelle

    2005-01-01

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

  2. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

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

  3. Estimation of functional preparedness of young handballers in setup time

    Directory of Open Access Journals (Sweden)

    Favoritоv V.N.

    2012-11-01

    Full Text Available The dynamics of level of functional preparedness of young handballers in setup time is shown. It was foreseen to make alteration in educational-training process with the purpose of optimization of their functional preparedness. 11 youths were plugged in research, calendar age 14 - 15 years. For determination of level of their functional preparedness the computer program "SVSM" was applied. It is set that at the beginning of setup time of 18,18% of all respondent functional preparedness is characterized by a "middle" level, 27,27% - below the "average", 54,54% - "above" the average. At the end of setup time among sportsmen representatives prevailed with the level of functional preparedness "above" average - 63,63%, with level "high" - 27,27%, sportsmen with level below the average were not observed. Efficiency of the offered system of trainings employments for optimization of functional preparedness of young handballers is well-proven.

  4. Effect of Village Health Team Home Visits and Mobile Phone Consultations on Maternal and Newborn Care Practices in Masindi and Kiryandongo, Uganda: A Community-Intervention Trial.

    Directory of Open Access Journals (Sweden)

    Richard Mangwi Ayiasi

    Full Text Available The World Health Organisation recommends home visits conducted by Community Health Workers (in Uganda known as Village Health Teams--VHTs in order to improve maternal and newborn health. This study measured the effect of home visits combined with mobile phone consultations on maternal and newborn care practices.In a community intervention trial design 16 health centres in Masindi and Kiryandongo districts, Uganda were randomly and equally allocated to one of two arms: control and intervention arms. Eight control health centres received the usual maternal and newborn educational messages offered by professional health workers and eight intervention health centres that received an intervention package for maternal care and essential newborn care practices. In the intervention arm VHTs made two prenatal and one postnatal home visit to households. VHTs were provided with mobile phones to enable them make regular telephone consultations with health workers at the health centre serving the catchment area. The primary outcome was health facility delivery. Other outcomes included antenatal attendances, birth preparedness, cord and thermal care and breastfeeding practices. Analysis was by intention-to-treat.A total of 1385 pregnant women were analysed: 758 and 627 in the control and intervention arms respectively. Significant post-intervention differences were: delivery place [adjusted Odds Ratio aOR: 17.94(95%CI: 6.26-51.37; p<0.001], cord care [aOR: 3.05(95%CI: 1.81-5.12; p<0.001] thermal care [aOR: 7.58(95%CI: 2.52-22.82; p<0.001], and timely care-seeking for newborn illness [aOR: 4.93(95%CI: 1.59-15.31; p = 0.006].VHTs can have an effect in promoting proper cord and thermal care for the newborn and improve timely care-seeking for health facility delivery and newborn illness, because they could answer questions and refer patients correctly. However, VHTs should be supported by professional health workers through the use of mobile phones

  5. Civil emergency preparedness at the Ignalina nuclear power plant

    International Nuclear Information System (INIS)

    1998-12-01

    Workshop was held in the frame of Lithuania's cooperation with NATO on disasters management subject and was concentrated on the preparation of management of nuclear accident at Ignalina NPP. The following topics were covered: emergency preparedness inside Ignalina NPP, preparedness for nuclear accidents at national level, experience in Nordic countries and IAEA activities in harmonization of nuclear emergency preparedness in different countries

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

    OpenAIRE

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

    2015-01-01

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

  7. Social capital and disaster preparedness among low income Mexican Americans in a disaster prone area.

    Science.gov (United States)

    Reininger, Belinda M; Rahbar, Mohammad H; Lee, Minjae; Chen, Zhongxue; Alam, Sartaj R; Pope, Jennifer; Adams, Barbara

    2013-04-01

    Examination of social capital and its relationship to disaster preparedness has grown in prominence partially due to world-wide need to effectively respond to terrorist attacks, viral epidemics, or natural disasters. Recent studies suggested that social capital may be related to a community's ability to plan for and respond to such disasters. Few studies, however, have examined social capital constructs among low income populations living in disaster prone areas and accounted for the influence of social capital at the individual and community level. We examined social capital as measured by perceived fairness, perceived civic trust, perceived reciprocity and group membership. We undertook a multistage random cluster survey in three coastal counties in Texas (U.S.) noted for their high levels of poverty. Individuals from 3088 households provided data on social capital, socioeconomic and demographic characteristics, and self-reported level of preparedness for a hurricane. We used multivariable logistic regression to test potential associations between social capital measures and disaster preparedness. After adjusting for age, gender, marital status, ethnicity, education, employment, household income, acculturation, self-reported health, special needs persons in household, household size, and distance to the shore we found a higher prevalence of preparedness among individuals who reported the highest perception of fairness [AOR = 3.12, 95% CI: (1.86, 5.21)] compared to those individuals who reported lowest perceptions of fairness. We also found a higher prevalence of preparedness [AOR = 2.06; 95% CI: (1.17, 3.62)] among individuals who reported highest perceptions of trust compared to individuals who reported lowest perceptions of trust. Perceived reciprocity and group membership were not associated with preparedness. These results extend previous findings on social capital and disaster preparedness and further characterize social capital's presence among a low

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

    Directory of Open Access Journals (Sweden)

    Frida Eek

    2009-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  11. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

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

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

    Science.gov (United States)

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

    1998-01-01

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

  13. Using Pop Culture to Teach Youths Conflict Resolution, Healthful Lifestyles, Disaster Preparedness, and More

    Science.gov (United States)

    Torretta, Alayne; Black, Lynette Ranney

    2017-01-01

    Adolescents learn sustainable production techniques, civic engagement, leadership, public speaking, food safety practices, conflict resolution, disaster preparedness, and other life skills through Extension programming. Educators can increase participant interest in such programming by applying a creative pop culture twist, such as a zombie…

  14. Health care reforms

    Directory of Open Access Journals (Sweden)

    Marušič Dorjan

    2016-09-01

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

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

    Science.gov (United States)

    Caicedo, Carmen

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

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

    Science.gov (United States)

    Shaw, Susan J; Armin, Julie

    2011-06-01

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

  17. What is the health care product?

    Science.gov (United States)

    France, K R; Grover, R

    1992-06-01

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

  18. Resource mapping and emergency preparedness to infectious diseases in human and animal populations in Kibaha and Ngorongoro districts, Tanzania

    Directory of Open Access Journals (Sweden)

    E.D. Karimuribo

    2012-06-01

    Full Text Available A rapid situation analysis was conducted in Kibaha and Ngorongoro districts in Tanzania to map resources as well as analysing emergency preparedness to infectious diseases in animal (domestic and wild and human populations. Kibaha was chosen as a district close to a commercial city (Dar es Salaam while Ngorongoro represented a remote, border district with high interactions between humans, domestic and wild animals. In this study, data on resources and personnel as well as emergency preparedness were collected from all wards (n = 22, human health facilities (n = 40 and livestock facilities in the two districts using interview checklists and questionnaires. Descriptive statistics for resources were calculated and mapped by district. Kibaha district had a higher human population density, more health workers, better equipped health facilities and better communication and transport systems. On the other hand, Ngorongoro had a higher population of livestock and more animal health facilities but a poorer ratio of animal health workers to livestock. The average ratio of health personnel to population in catchment areas of the health facilities was 1:147 (range of 1:17−1:1200. The ratio of personnel to human population was significantly higher in Kibaha (1:95 than in Ngorongoro (1:203 district (p = 0 < 0.001. Considering the limited resources available to both human and animal health sectors and their different strengths and weaknesses there are opportunities for greater collaboration and resource-sharing between human and animal health for improved surveillance and emergency-preparedness.

  19. Optimizing Health Care Environmental Hygiene.

    Science.gov (United States)

    Carling, Philip C

    2016-09-01

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

  20. Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness.

    Science.gov (United States)

    Walsh, John; Swan, Allan Graeme

    2016-02-01

    The process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems.

  1. Research on evacuation planning as nuclear emergency preparedness

    International Nuclear Information System (INIS)

    Yamamoto, Kazuya

    2007-10-01

    The International Atomic Energy Agency (IAEA) has introduced new concepts of precautionary action zone (PAZ) and urgent protective action planning zone (UPZ) in 'Preparedness and Response for a Nuclear or Radiological Emergency' (GS-R-2 (2002)), in order to reduce substantially the risk of severe deterministic health effects. Open literature based research was made to reveal problems on evacuation planning and the preparedness for nuclear emergency arising from introduction of PAZ into Japan that has applied the emergency planning zone (EPZ) concept currently. In regard to application of PAZ, it should be noted that the requirements for preparedness and response for a nuclear or radiological emergency are not only dimensional but also timely. The principal issue is implementation of evacuation of precautionary decided area within several hours. The logic of evacuation planning for a nuclear emergency and the methods of advance public education and information in the U.S. is effective for even prompt evacuation to the outside of the EPZ. As concerns evacuation planning for a nuclear emergency in Japan, several important issues to be considered were found, that is, selection of public reception centers which are outside area of the EPZ, an unique reception center assigned to each emergency response planning area, public education and information of practical details about the evacuation plan in advance, and necessity of the evacuation time estimates. To establish a practical evacuation planning guide for nuclear emergencies, further researches on application of traffic simulation technology to evacuation time estimates and on knowledge of actual evacuation experience in natural disasters and chemical plant accidents are required. (author)

  2. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

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

  3. Integrated primary health care in Australia.

    Science.gov (United States)

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

    2009-10-14

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

  4. AAGP position statement: disaster preparedness for older Americans: critical issues for the preservation of mental health.

    Science.gov (United States)

    Sakauye, Kenneth M; Streim, Joel E; Kennedy, Gary J; Kirwin, Paul D; Llorente, Maria D; Schultz, Susan K; Srinivasan, Shilpa

    2009-11-01

    The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.

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

    Science.gov (United States)

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

    2015-01-01

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

  6. Ebola in the Netherlands, 2014–2015 : Costs of preparedness and response

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; Swaan, C.M.; Mangen, M.J.J.; Polder, J.J.; Timen, A.; Ruijs, W.L.M.

    2018-01-01

    The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the

  7. Measuring disaster preparedness of local emergency medical services agencies

    OpenAIRE

    Elliott, Ross W.

    2010-01-01

    CHDS State/Local Approved for public release; distribution is unlimited Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipmen...

  8. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

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

  9. Planning and preparedness for radiological emergencies at nuclear power stations

    International Nuclear Information System (INIS)

    Thomson, R.; Muzzarelli, J.

    1996-01-01

    The Radiological Emergency Preparedness (REP) Program was created after the March 1979 accident at the Three Mile Island nuclear power station. The Federal Emergency Management Agency (FEMA) assists state and local governments in reviewing and evaluating state and local REP plans and preparedness for accidents at nuclear power plants, in partnership with the US Nuclear Regulatory Commission (NRC), which evaluates safety and emergency preparedness at the power stations themselves. Argonne National Laboratory provides support and technical assistance to FEMA in evaluating nuclear power plant emergency response exercises, radiological emergency plans, and preparedness

  10. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    AlBuhairan FS

    2014-09-01

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

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

    Science.gov (United States)

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

    2011-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Lacreisha Ejike-King

    2014-04-01

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

  14. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

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

  15. OEM Emergency Preparedness Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management compiles a wide variety of information in support of Emergency Preparedness, including certain elements of the System for Risk...

  16. Health Care Reform: a Socialist Vision

    Directory of Open Access Journals (Sweden)

    Martha Livingston

    2010-04-01

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

  17. Gender disparities in health care.

    Science.gov (United States)

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

    2012-01-01

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

  18. Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

    Science.gov (United States)

    Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

    2015-01-01

    As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance

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

    NARCIS (Netherlands)

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

    1998-01-01

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

  20. Health care law versus constitutional law.

    Science.gov (United States)

    Hall, Mark A

    2013-04-01

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

  1. Proceedings of the REMPAN 97: 7. Coordination meeting of World Health Organization collaborating centers in radiation emergency medical preparedness and assistance network

    International Nuclear Information System (INIS)

    1997-01-01

    Special reports and panels are presented in these proceedings covering the following subjects: emergency planning and preparedness, biology, biological effects, radiation effects and therapy, internal contamination and irradiation, and national programs and activities related to radiation accident preparedness and assistance

  2. 75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Science.gov (United States)

    2010-10-01

    ...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

  3. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

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

    2017-11-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  5. Health care and equity in India.

    Science.gov (United States)

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

    2011-02-05

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

  6. Health care of youth aging out of foster care.

    Science.gov (United States)

    2012-12-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2016-02-01

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

  9. Challenges in mental health care in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas

    2011-06-01

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

  10. Health Care Performance Indicators for Health Information Systems.

    Science.gov (United States)

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

    2016-01-01

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

  11. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

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

  12. Off-site preparedness and nuclear-power-plant licensing

    International Nuclear Information System (INIS)

    Perry, S.W.

    1983-01-01

    The first year and a half in which off-site emergency preparedness issues have been litigated before the Atomic Safety and Licensing Boards of the NRC have surfaced unique problems of proof for the applicant as well as the staff. These problems seem to be abating as the boards and the parties become more comfortable with the field and its issues, and as FEMA-NRC emergency management expertise gains credibility. Emergency preparedness presentations have also improved as the parties have become more sensitive to the seasonality of the preparedness case, and have increasingly attempted to raise it at a time when a fully developed set of facts is available for the record. Off-site preparedness issues are only now beginning to be raised on appeal to the NRC appeals board, the full commission, and the courts. Helpful guidance on what constitutes an adequate record in this area will undoubtedly be forthcoming in decisions handed down by these bodies in the months ahead

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

    Science.gov (United States)

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

    2016-06-01

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

  14. Diaspora, disease, and health care.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2007-03-01

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

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

    Science.gov (United States)

    Pallegedara, Asankha; Grimm, Michael

    2018-04-26

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

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

    Science.gov (United States)

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

    2013-09-30

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

  17. Health care entrepreneurship: financing innovation.

    Science.gov (United States)

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  18. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

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

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

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  1. Rationalising health care in india : Challenges & strategies

    Directory of Open Access Journals (Sweden)

    K I Mathai

    2014-01-01

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

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

    Science.gov (United States)

    Dulal, R K

    2009-01-01

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

  3. Health care need

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  4. Disaster Preparedness, Adaptive Politics and Lifelong Learning: A Case of Japan

    Science.gov (United States)

    Kitagawa, Kaori

    2016-01-01

    Preparedness for disaster scenarios is progressively becoming an educational agenda for governments because of diversifying risks and threats worldwide. In disaster-prone Japan, disaster preparedness has been a prioritised national agenda, and preparedness education has been undertaken in both formal schooling and lifelong learning settings. This…

  5. Strengthening flood warning systems: the benefits of encouraging social preparedness

    Science.gov (United States)

    Girons Lopez, Marc; Di Baldassarre, Giuliano; Seibert, Jan

    2017-04-01

    Flood warning and response have normally been focused on the technical aspects and disregarded the connections and feedbacks between the hydrological and social dimensions. An increasing body of research, however, points at the importance of considering socio-hydrological aspects to improve flood damage mitigation. One of the key factors is the preparedness of the public and first responders during flood situations, which is influenced by many behavioural traits such as perceived benefits, risk awareness, or denial. In this study, we investigate the impact of social preparedness on the efficiency of flood early warning systems by using the recency of flood experience as a proxy for social preparedness. To this end, we developed a stylised model and a synthetic data-set to perform a hypothetical analysis. The main findings point to the importance of social preparedness for flood loss mitigation, especially when the technical forecasting and warning capabilities are limited. More specifically, efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings from this study provide insights into the importance of considering social preparedness in decision-making for disaster risk reduction.

  6. Health care utilization

    DEFF Research Database (Denmark)

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

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

  7. Solidarity as a national health care strategy.

    Science.gov (United States)

    West-Oram, Peter

    2018-05-02

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

  8. The Future of Home Health Care

    Science.gov (United States)

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

    2016-01-01

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

  9. Importance of International Cooperation for Emergency Preparedness

    International Nuclear Information System (INIS)

    Gregoric, M.; Grlicarev, I.

    1998-01-01

    The paper contains a brief review of reactor accidents and their consequences. The bilateral, regional and interregional agreements on early exchange of information and mutual assistance in case of a nuclear and radiological accident are presented in a table and discussed. The international projects in emergency preparedness are briefly outlined and the situation in the field of emergency preparedness in Slovenia is given for the comparison. (author)

  10. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs.

    Science.gov (United States)

    Martin, Shelly D; Bush, Anneke C; Lynch, Julia A

    2006-09-01

    Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.

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

    Directory of Open Access Journals (Sweden)

    Douangvichit Daovieng

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  13. Health Literacy and Communication Quality in Health Care Organizations

    Science.gov (United States)

    Wynia, Matthew K.; Osborn, Chandra Y.

    2011-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2004-09-01

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

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

    Science.gov (United States)

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

    2018-04-23

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

  17. Preventing intentional food contamination: a survey to assess restaurant preparedness.

    Science.gov (United States)

    Xirasagar, Sudha; Kanwat, C P; Qu, Haiyan; Smith, Lillian U; Patterson, Nathaniel J; Shewchuk, Richard M

    2010-01-01

    In the age of preparedness, public health agencies are concerned with intentional acts of food contamination in restaurants, in addition to food safety. Food safety consists of applying standard norms of practice and infrastructure, which, if violated, cause food-borne illness. In contrast, food defense requires an institutionalized mindset of informed alertness to unusual variations from the norms, combined with preemptive practices best suited to each restaurant. Therefore, while food safety lends itself to regulation to ensure standard practices, food defense is best served by advisory guidelines for autonomous application, preserving the restaurant industry's core values of hospitality and customer service. To address this challenge, public health agencies need survey tools that can yield action-relevant data on the knowledge and practice gaps in food defense preparedness and on educational messages and support services to be developed for maximum impact potential. This article presents a mail survey instrument, developed using qualitative research to ensure content and face validity. Instrument development involved drafting the survey on the basis of expert consultations, validating its content by using focus groups (representing all restaurant categories and geographic regions), and ensuring face validity through cognitive interviews. The resulting survey remains sensitive to the hospitality industry while encompassing all vulnerable points.

  18. Self-care as a health resource of elders

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

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

  20. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

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

  1. [The ethics of health care organization].

    Science.gov (United States)

    Goic, Alejandro

    2004-03-01

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

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

    Science.gov (United States)

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

    2012-10-01

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

  3. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

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

  4. Antenatal counseling in maternal and newborn care: use of job aids to improve health worker performance and maternal understanding in Benin.

    Science.gov (United States)

    Jennings, Larissa; Yebadokpo, André Sourou; Affo, Jean; Agbogbe, Marthe

    2010-11-22

    Antenatal care provides an important opportunity to improve maternal understanding of care during and after pregnancy. Yet, studies suggest that communication is often insufficient. This research examined the effect of a job aids-focused intervention on quality of counseling and maternal understanding of care for mothers and newborns. Counseling job aids were developed to support provider communication to pregnant women. Fourteen health facilities were randomized to control or intervention, where providers were trained to use job aids and provided implementation support. Direct observation of antenatal counseling sessions and patient exit interviews were undertaken to assess quality of counseling and maternal knowledge. Providers were also interviewed regarding their perceptions of the tools. Data were collected before and after the job aids intervention and analyzed using a difference-in-differences analysis to quantify relative changes over time. Mean percent of recommended messages provided to pregnant women significantly improved in the intervention arm as compared to the control arm in birth preparedness (difference-in-differences [ΔI-C] = +17.9, 95%CI: 6.7,29.1), danger sign recognition (ΔI-C = +26.0, 95%CI: 14.6,37.4), clean delivery (ΔI-C = +21.7, 95%CI: 10.9,32.6), and newborn care (ΔI-C = +26.2, 95%CI: 13.5,38.9). Significant gains were also observed in the mean percent of communication techniques applied (ΔI-C = +28.8, 95%CI: 22.5,35.2) and duration (minutes) of antenatal consultations (ΔI-C = +5.9, 95%CI: 3.0,8.8). No relative increase was found for messages relating to general prenatal care (ΔI-C = +8.2, 95%CI: -2.6,19.1). The proportion of pregnant women with correct knowledge also significantly improved for birth preparedness (ΔI-C = +23.6, 95%CI: 9.8,37.4), danger sign recognition (ΔI-C = +28.7, 95%CI: 14.2,43.2), and clean delivery (ΔI-C = +31.1, 95%CI: 19.4,42.9). There were no significant changes in maternal knowledge of general

  5. Investments and costs of oral health care for Family Health Care

    Directory of Open Access Journals (Sweden)

    Márcia Stefânia Ribeiro Macêdo

    2016-01-01

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

  6. Investments and costs of oral health care for Family Health Care

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abbas Abbaszadeh, RN, BSCN, PhD

    2013-03-01

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

  8. Collaborative and Bidirectional Feedback Between Students and Clinical Preceptors: Promoting Effective Communication Skills on Health Care Teams.

    Science.gov (United States)

    Myers, Kara; Chou, Calvin L

    2016-11-01

    Current literature on feedback suggests that clinical preceptors lead feedback conversations that are primarily unidirectional, from preceptor to student. While this approach may promote clinical competency, it does not actively develop students' competency in facilitating feedback discussions and providing feedback across power differentials (ie, from student to preceptor). This latter competency warrants particular attention given its fundamental role in effective health care team communication and its related influence on patient safety. Reframing the feedback process as collaborative and bidirectional, where both preceptors and students provide and receive feedback, maximizes opportunities for role modeling and skills practice in the context of a supportive relationship, thereby enhancing team preparedness. We describe an initiative to introduce these fundamental skills of collaborative, bidirectional feedback in the nurse-midwifery education program at the University of California, San Francisco. © 2016 by the American College of Nurse-Midwives.

  9. Public Health and Medical Preparedness for a Nuclear Detonation: The Nuclear Incident Medical Enterprise

    Science.gov (United States)

    Coleman, C. Norman; Sullivan, Julie M.; Bader, Judith L.; Murrain-Hill, Paula; Koerner, John F.; Garrett, Andrew L.; Weinstock, David M.; Case, Cullen; Hrdina, Chad; Adams, Steven A.; Whitcomb, Robert C.; Graeden, Ellie; Shankman, Robert; Lant, Timothy; Maidment, Bert W.; Hatchett, Richard C.

    2014-01-01

    Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. PMID:25551496

  10. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

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

  11. Lower Costs, Better Care- Reforming Our Health Care Delivery

    Data.gov (United States)

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

  12. Effect of Village Health Team Home Visits and Mobile Phone Consultations on Maternal and Newborn Care Practices in Masindi and Kiryandongo, Uganda: A Community-Intervention Trial

    Science.gov (United States)

    Mangwi Ayiasi, Richard; Kolsteren, Patrick; Batwala, Vincent; Criel, Bart; Orach, Christopher Garimoi

    2016-01-01

    Introduction The World Health Organisation recommends home visits conducted by Community Health Workers (in Uganda known as Village Health Teams—VHTs) in order to improve maternal and newborn health. This study measured the effect of home visits combined with mobile phone consultations on maternal and newborn care practices. Method In a community intervention trial design 16 health centres in Masindi and Kiryandongo districts, Uganda were randomly and equally allocated to one of two arms: control and intervention arms. Eight control health centres received the usual maternal and newborn educational messages offered by professional health workers and eight intervention health centres that received an intervention package for maternal care and essential newborn care practices. In the intervention arm VHTs made two prenatal and one postnatal home visit to households. VHTs were provided with mobile phones to enable them make regular telephone consultations with health workers at the health centre serving the catchment area. The primary outcome was health facility delivery. Other outcomes included antenatal attendances, birth preparedness, cord and thermal care and breastfeeding practices. Analysis was by intention-to-treat. Results A total of 1385 pregnant women were analysed: 758 and 627 in the control and intervention arms respectively. Significant post-intervention differences were: delivery place [adjusted Odds Ratio aOR: 17.94(95%CI: 6.26–51.37); pcare [aOR: 3.05(95%CI: 1.81–5.12); pcare [aOR: 7.58(95%CI: 2.52–22.82); pcare-seeking for newborn illness [aOR: 4.93(95%CI: 1.59–15.31); p = 0.006]. Conclusion VHTs can have an effect in promoting proper cord and thermal care for the newborn and improve timely care-seeking for health facility delivery and newborn illness, because they could answer questions and refer patients correctly. However, VHTs should be supported by professional health workers through the use of mobile phones. Trial Registration Clinical

  13. Health promotion in connection to the health care students

    Directory of Open Access Journals (Sweden)

    S. Kyuchukova

    2017-09-01

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

  14. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

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

  15. The Child Health Care System in Italy.

    Science.gov (United States)

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

    2016-10-01

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

  16. Attending unintended transformations of health care infrastructure

    Directory of Open Access Journals (Sweden)

    Helle Wentzer

    2007-11-01

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

  17. Child Health Care Services in Austria.

    Science.gov (United States)

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

    2016-10-01

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

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

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2008

    2008-01-01

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

  19. Emergency preparedness and response

    International Nuclear Information System (INIS)

    Griffiths, M.

    1996-01-01

    After the Chernobyl accident, it became painfully obvious to the international community that there was an urgent need to establish a system for the coordination of international disaster assistance. It became the task of the United Nations Office for Disaster Relief (UNDRO) to develop such a system. The former UNDRO was subsumed into the Department of Humanitarian Affairs (DHA), established in January 1992 on the basis of UN General Assembly Resolution 46/182 adopted in December 1991, and the disaster relief system presently found in DHA is a further evolution of the system established by UNDRO. One particular importance in relation to nuclear accidents is the fact that UNDRO and the International Atomic Energy Agency (IAEA) signed a Memorandum of Understanding defining their respective responsibilities and the need for cooperation in case of accidents involving the unintentional release of nuclear radiation. In essence, the MOU makes it clear that the responsibilities of the IAEA, in connection with accidents at Nuclear Power Plants, related to the technical and radiological aspects, in particular to accident prevention, to the on-site preparedness, and to remedial measures within the 30-km zone outside the NPP. DHA's responsibilities, on the other hand, relate to the general preparedness and the rescue efforts outside the 30 km zone. In this respect, the preparedness and emergency response system is no different from the system employed in any other type of sudden-onset emergency

  20. Health Literacy and Access to Care

    Science.gov (United States)

    Janke, Alex

    2016-01-01

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

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

    OpenAIRE

    Perianayagam, Arokiasamy; Goli, Srinivas

    2013-01-01

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

  2. A qualitative analysis of trainer/coach experiences of changing care home practice in the Well-being and Health in Dementia randomised control trial.

    Science.gov (United States)

    Fossey, Jane; Garrod, Lucy; Guzman, Azucena; Testad, Ingelin

    2018-01-01

    Objectives This study explored the experiences of a range of health and social care professionals employed in the role of trainer/coaches to support care home staff to implement a psychosocial intervention for residents living with dementia. It aimed to identify the factors which are pertinent to these roles, in the context of a cascade model of training. Method A focus group was convened involving dementia trainer/coaches and supervisors who had worked on Well-being and Health for people with Dementia randomised control trial. Twelve participants explored their preparedness for and experiences of their role as 'Well-being and Health for people with Dementia therapists'. They reflected on their perceptions of the resources and support required. The data were transcribed verbatim and subjected to inductive thematic analysis. Results Three main themes emerged from the data. Within the theme of 'skills in relationship building' were two subthemes of developing trust and getting to know individual staff and each care home. In the second main theme of 'making use of tangible resources' two subthemes relating to using the Well-being and Health for people with Dementia manuals and the supervision of the therapists arose. The third theme, 'being an agent for change' contained three subthemes: effective training methods, creating opportunities for Dementia Champions to reflect and therapists' perceived rewards of their role. Conclusion The findings provide new insights into the trainer/coach role applicable to the practices of services recruiting, training and providing ongoing professional support to practitioners in-reaching into care homes.

  3. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

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

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

    Science.gov (United States)

    Spilsbury, Karen; Meyer, Julienne

    2004-11-01

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

  5. Health care: economic impact of caring for geriatric patients.

    Science.gov (United States)

    Rich, Preston B; Adams, Sasha D

    2015-02-01

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

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

    Science.gov (United States)

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

    2000-01-01

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

  7. Health care consumerism movement takes a step forward.

    Science.gov (United States)

    Thompson, Michael; Cutler, Charles M

    2010-01-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  9. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

    Science.gov (United States)

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

  10. Emergency preparedness and response plan for nuclear facilities in Indonesia

    International Nuclear Information System (INIS)

    Nur Rahmah Hidayati; Pande Made Udiyani

    2009-01-01

    All nuclear facilities in Indonesia are owned and operated by the National Nuclear Energy Agency (BATAN). The programs and activities of emergency planning and preparedness in Indonesia are based on the existing nuclear facilities, i.e. research reactors, research reactor fuel fabrication plant, radioactive waste treatment installation and radioisotopes production installation. The assessment is conducted to learn of status of emergency preparedness and response plan for nuclear facilities in Indonesia and to support the preparation of future Nuclear Power Plant. The assessment is conducted by comparing the emergency preparedness and response system in Indonesia to the system in other countries such as Japan and Republic of Korea, since the countries have many Nuclear Power Plants and other nuclear facilities. As a result, emergency preparedness response plan for existing nuclear facility in Indonesia has been implemented in many activities such as environmental monitoring program, facility monitoring equipment, and the continuous exercise of emergency preparedness and response. However, the implementation need law enforcement for imposing the responsibility of the coordinators in National Emergency Preparedness Plan. It also needs some additional technical support systems which refer to the system in Japan or Republic of Korea. The systems must be completed with some real time monitors which will support the emergency preparedness and response organization. The system should be built in NPP site before the first NPP will be operated. The system should be connected to an Off Site Emergency Center under coordination of BAPETEN as the regulatory body which has responsibility to control of nuclear energy in Indonesia. (Author)

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

    Science.gov (United States)

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

    2006-01-01

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

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

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

  13. Survey of Emergency Department staff on disaster preparedness and training for Ebola virus disease.

    Science.gov (United States)

    Siddle, Jennica; Tolleson-Rinehart, Sue; Brice, Jane

    2016-01-01

    In the domestic response to the outbreak of Ebola virus disease from 2013 to 2015, many US hospitals developed and implemented specialized training programs to care for patients with Ebola. This research reports on the effects of targeted training on Emergency Department (ED) staff's Ebola-related perceptions and attitudes. One hundred fifty-nine members of the UNC Health Care System ED staff participated in a voluntary cross-sectional, anonymous Web survey administered using a one-time "post then pre" design. Participants responded to questions about risk, roles, willingness to provide care, preparedness, and the contributions of media, training, or time to opinion change using a Likert agree-disagree scale. The authors conducted t test comparisons of Likert responses to pretraining and post-training attitudes about Ebola preparedness. The authors conducted multinomial logistic regression analyses of index scores of change and positivity of responses, controlling for the effects of independent variables. ED staff's opinions supported training; 73 percent felt all workers should receive Ebola education, 60 percent agreed all hospitals should prepare for Ebola, 66 percent felt UNC was better prepared, and 66 percent felt it had done enough to be ready for an Ebola case. Most staff (79 percent) said they had gotten more training for Ebola than for other disease outbreaks; 58 percent had experienced prior epidemics. After training, workers' attitudes were more positive about Ebola preparation including perceived risk of transmission, readiness and ability to manage a patient case, understanding team roles, and trust in both personal protective equipment and the hospital system's preparations (13 measures, p training period (Mean Difference [MD] = 17.45, SD = 9.89) and in the intended positive direction (MD = 15.80, SD = 0.91, p training (p = 0.003). Despite different occupations, mean scores were similar. Staff rated training most important and media least important

  14. Promoting coordination in Norwegian health care

    Directory of Open Access Journals (Sweden)

    Tor I. Romøren

    2011-10-01

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

  15. Nigerian health care: A quick appraisal

    Directory of Open Access Journals (Sweden)

    Yau Zakari Lawal

    2017-01-01

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

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

    Science.gov (United States)

    Gould, Stephen J.

    1988-01-01

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

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

    Science.gov (United States)

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

    2001-09-01

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

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

    Science.gov (United States)

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

    2009-05-01

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

  19. Ready or not: does household preparedness prevent absenteeism among emergency department staff during a disaster?

    Science.gov (United States)

    Mercer, Mary P; Ancock, Benedict; Levis, Joel T; Reyes, Vivian

    2014-01-01

    dependents at home was only a significantly associated with predicted absenteeism among women as opposed to men (OR 0.07-0.59 versus OR 0.41-1.02). Personal household preparedness, while an admirable goal, appears to have no effect on predicted absenteeism among ED staff following a disaster. Having responsibilities for dependents is the most consistent factor associated with predicted absenteeism among female staff. Hospital and ED disaster planners should consider focusing preparedness efforts less toward household preparedness for staff and instead concentrate on addressing dependent care needs in addition to professional preparedness.

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

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

  1. Occupational Health for Health Care Providers

    Science.gov (United States)

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

  2. eHealth and quality in health care: implementation time

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2001-01-01

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

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

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

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

  5. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

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

  6. National Health-Care Reform

    Science.gov (United States)

    2009-03-24

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

  7. Can Completing a Mental Health Nursing Course Change Students' Attitudes?

    Science.gov (United States)

    Hastings, Todd; Kroposki, Margaret; Williams, Gail

    2017-05-01

    Nursing program graduates rarely choose mental health nursing as a career. A quasi-experimental study was conducted to examine attitudes of 310 nursing students towards persons with mental illness. Students completed surveys on the first and last days of their program's psychiatric mental health nursing course. The pre- and post-test survey analysis indicated that students improved their attitude, knowledge and preparedness to care for persons with mental illness. However, students maintained little interest in working as a mental health nurse. Modifications in mental health nursing courses could be made to improve students' interest in choosing a career in mental health nursing.

  8. Care of children with disabilities in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Thaís Giudice Schultz

    2016-07-01

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

  9. Using appreciative inquiry to transform health care.

    Science.gov (United States)

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

    2013-08-01

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

  10. Discrimination against older women in health care.

    Science.gov (United States)

    Belgrave, L L

    1993-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  12. Boundaries and e-health implementation in health and social care

    Directory of Open Access Journals (Sweden)

    King Gerry

    2012-09-01

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

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

    Science.gov (United States)

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

    2017-05-03

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  15. [Calculation of workers' health care costs].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

    Spears, Amanda P

    2010-05-01

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

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

    Science.gov (United States)

    Duke, Naomi N; Scal, Peter B

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  20. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

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