WorldWideScience

Sample records for prevalence health care

  1. Prevalence of Occupational Accidents/Injuries among Health Care ...

    African Journals Online (AJOL)

    BACKGROUND: Health care workers (HCWs) are prone to occupational accidents and injuries such as needle pricks in the course of their day to day activities in the health care setting. OBJECTIVE: To determine the prevalence of needle sticks and other occupational exposures among HCWs in a Nigerian tertiary hospital.

  2. Change in the prevalence of obesity and use of health care in Denmark: an observational study

    DEFF Research Database (Denmark)

    Nielsen, Cathrine Wildenschild; Kjøller, Mette; Sabroe, Svend

    2011-01-01

    The purpose of this study was to examine the influence of the increasing prevalence of obesity on the development of health care utilization in Denmark in the period 1987-2005.......The purpose of this study was to examine the influence of the increasing prevalence of obesity on the development of health care utilization in Denmark in the period 1987-2005....

  3. Prevalence of health promotion programs in primary health care units in Brazil.

    Science.gov (United States)

    Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

    2014-10-01

    Assessment of prevalence of health promotion programs in primary health care units within Brazil's health system. We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.

  4. Prevalence, characteristics, and associated health and health care of family homelessness among fifth-grade students.

    Science.gov (United States)

    Coker, Tumaini R; Elliott, Marc N; Kanouse, David E; Grunbaum, Jo Anne; Gilliland, M Janice; Tortolero, Susan R; Cuccaro, Paula; Schuster, Mark A

    2009-08-01

    We describe the lifetime prevalence and associated health-related concerns of family homelessness among fifth-grade students. We used a population-based, cross-sectional survey of 5147 fifth-grade students in 3 US cities to analyze parent-reported measures of family homelessness, child health status, health care access and use, and emotional, developmental, and behavioral health and child-reported measures of health-related quality of life and exposure to violence. Seven percent of parents reported that they and their child had experienced homelessness (i.e., staying in shelters, cars, or on the street). Black children and children in the poorest families had the highest prevalence of homelessness (11%). In adjusted analyses, most general health measures were similar for children who had and had not been homeless. Children who had ever experienced homelessness were more likely to have an emotional, behavioral, or developmental problem (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.1, 2.6; P = .01), to have received mental health care (OR = 2.2; 95% CI = 1.6, 3.2; P homeless. Family homelessness affects a substantial minority of fifth-grade children and may have an impact on their emotional, developmental, and behavioral health.

  5. The prevalence of sexual dysfunction in the female health care providers in Jeddah, Saudi Arabia

    OpenAIRE

    Rouzi, Abdulrahim A.; Sahly, Nora; Sawan, Dana; Kafy, Souzan; Alzaban, Faten

    2015-01-01

    The objective of this study was to determine the prevalence of sexual dysfunction in Saudi and non-Saudi female health care providers in Jeddah, Saudi Arabia. One -hundred twenty (60 Saudi and 60 non-Saudi) sexually active female health care professionals in Jeddah, Saudi Arabia, were anonymously surveyed using the English version of the female sexual function index questionnaire. The individual domain scores for pain, arousal, lubrication, orgasm, satisfaction, pain, and overall score for th...

  6. Impact of different approaches of primary care mental health on the prevalence of mental disorders.

    Science.gov (United States)

    Moscovici, Leonardo; de Azevedo-Marques, Joao Mazzoncini; Bolsoni, Lívia Maria; Rodrigues-Junior, Antonio Luiz; Zuardi, Antonio Waldo

    2017-12-05

    Aim To compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model. Findings A total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status. Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

  7. [Administrative Prevalence and Health Care Situation of Dementia Patients in Acute Care Hospitals: An Epidemiological Health Care Study Based on Claims Data of Insured Persons in Saxony].

    Science.gov (United States)

    Motzek, Tom; Werblow, Andreas; Schmitt, Jochen; Marquardt, Gesine

    2018-02-05

    The increasing number of people with dementia will challenge the health care system, especially acute care. Using health insurance claims data, the study objective was to examine the regional patterns of the administrative prevalence of dementia, the prevalence of dementia in hospitals and the care situation in hospitals. We used 2014 claims data from AOK PLUS, the largest statutory health insurance service in Saxony. If dementia was diagnosed either in an outpatient or inpatient setting in 3 of 4 quarters in a year, a person was categorised as a dementia case (n=61,700). The analysis of health care status included 61,239 patients with dementia and 183,477 control subjects. The control group was matched using the criteria of gender, age and region of residence. For those older than 65 years, the overall administrative prevalence rate of dementia was 9.3%. The estimated prevalence for those in hospitals was 16.7%. In 2014, there were 33% more admissions, 36% more hospital days and 18% higher costs per person-year among people diagnosed with dementia than the control subjects. The longer annual hospital stays and the higher costs were primarily caused by the greater number of admissions of people with dementia. Inpatient service use was, compared to people without dementia, characterized by a need for care and assistance, rather than by a need for medical therapeutic and diagnostic procedures. To improve the health care situation of people with dementia, to adapt to the challenges facing hospitals and to reduce the financial burden caused by dementia, more efforts are needed to improve the health care situation. Measures include, among others, improvements in recognition of dementia and reduction of unnecessary hospital stays. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Preventive health care and owner-reported disease prevalence of horses and ponies in Great Britain.

    Science.gov (United States)

    Ireland, J L; Wylie, C E; Collins, S N; Verheyen, K L P; Newton, J R

    2013-10-01

    This study aimed to describe the provision of preventive health care and owner-reported disease prevalence in horses and ponies within Great Britain (GB), and to assess geographical variations in health care provision. A cross-sectional survey was conducted, using a postal questionnaire administered to a random sample of veterinary-registered owners of horses and ponies in GB (n=797). The majority of animals received regular preventive health care: 95.6% had regular hoof care; 71.3% were vaccinated for both influenza and tetanus and median time since last anthelmintic administration was 8.7 weeks. Thirty-one percent of owners indicated their animal was overweight/obese. A new health problem within the previous 7 days was reported for 7.4% of animals, 59.3% of which were veterinary-diagnosed. Thirty-two percent of animals were reported to have a long-term/recurrent condition, of which osteoarthritis (13.9%) was the most prevalent. Obesity, musculoskeletal disorders, and dermatological conditions were the most prevalent conditions affecting veterinary-registered horses/ponies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. prevalence of hepatitis B and C viruses among health care workers in Ain Shams university hospitals

    International Nuclear Information System (INIS)

    El-fouly, A.H.A.

    2005-01-01

    exposure to blood borne pathogens poses a serious risk to health care workers (HCW), since the transmission of viral hepatitis B and C to health care workers has became of worldwide concern. hepatitis B and C viruses are the most frequent occupational disease in health care service workers, HCW are defined as persons (doctors, nurses, employees, students, contractors, attending clinicians, public-safety workers, or volunteers) whose activities involve contact with patients or with blood or other body fluids from patients in a health - care, laboratory, or public-safety setting . the potential exists for blood and body fluid exposure to other workers, and the same principle of exposure management could be applied to other setting.in the united states, the prevalence of HBV and HCV among HCWs range between (6-30%) and (2.7-10%) respectively . in spain HBV prevalence is 11.6% and HCV is 28.8%. while in taiwan 16.7% of HCWs were seropositive to HBsAG and 12.7% were seropositive for HCV. In Egypt, screening of 1485 HCWs in the Ministry of health hospitals, 35% were exposed to needle sticks

  10. Prevalence of HIV infection and median CD4 counts among health care workers in South Africa.

    Science.gov (United States)

    Connelly, Daniela; Veriava, Youssef; Roberts, Sue; Tsotetsi, Josephine; Jordan, Annie; DeSilva, Eliot; Rosen, Sydney; DeSilva, Mary Bachman

    2007-02-01

    To determine the prevalence of HIV infection and the extent of disease progression based on CD4 count in a public health system workforce in southern Africa. Cross-sectional voluntary, anonymous, unlinked survey including an oral fluid or blood sample and a brief demographic questionnaire. Two public hospitals in Gauteng, South Africa. All 2 032 professional and support staff employed by the two hospitals. HIV prevalence and CD4 cell count distribution. Overall prevalence of HIV was 11.5%. By occupation, prevalence was highest among student nurses (13.8%) and nurses (13.7%). The highest prevalence by age was in the 25 - 34-year group (15.9%). Nineteen per cent of HIV-positive participants who provided blood samples had CD4 counts less than or equal to 200 cells/ microl 28% had counts 201 - 350 cells/ microl, 18% had counts 351 - 500 cells/ microl, and 35% had counts above 500 cells/ microl. One out of 7 nurses and nursing students in this public sector workforce was HIV-positive. A high proportion of health care workers had CD4 counts below 350 cells/ microl, and many were already eligible for antiretroviral therapy under South African treatment guidelines. Given the short supply of nurses in South Africa, knowledge of prevalence in this workforce and provision of effective AIDS treatment are crucial for meeting future staffing needs.

  11. Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role of primary health care.

    Science.gov (United States)

    da Silva, L S; Cotta, R M M; Moreira, T R; da Silva, R G; Rosa, C de O B; Machado, J C; da Silva, L S; Bastos, M A P

    2016-11-01

    To identify the hidden prevalence of chronic kidney disease (CKD) in hypertensive patients. Cross-sectional study of individuals with systemic arterial hypertension (SAH) who were registered for primary health care (PHC). In total, 293 individuals participated. Data were collected through interviews, as well as biochemical and anthropometric assessments. The CKD-EPI formula was used to identify the occurrence of CKD. Pearson's chi-squared test or Fisher's exact test were used to compare proportions. Prevalence ratios were estimated with a confidence interval of 95% for associations between the explanatory variables and CKD. Most of the individuals assessed were female (74%), elderly (69%), with a low income (90%), low education levels (84%) and overweight (66.9%). A CKD prevalence of 38.6% (95% CI: 33.0-44.2) was found and approximately 14% were at an advanced stage of the disease. Upon comparison of the variables in the different stages of CKD, statistically significant association could be suggested between CKD and age, education, alcohol intake, overweight individuals, cardiovascular risk, abnormal creatinine and abnormal microalbuminuria. When the prevalence ratio was assessed, association could be suggested between CKD and age, and CKD and creatinine. The high hidden prevalence of CKD confirms the need to train health professionals involved in the treatment of SAH through PHC, enabling the prevention and diagnosis of CKD in its early stages. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Prevalence of burnout among public health nurses in charge of mental health services and emergency care systems in Japan.

    Science.gov (United States)

    Imai, Hirohisa; Nakao, Hiroyuki; Nakagi, Yoshihiko; Niwata, Satoko; Sugioka, Yoshihiko; Itoh, Toshihiro; Yoshida, Takahiko

    2006-11-01

    The Community Health Act came into effect in 1997 in Japan. This act altered the work system for public health nurses (PHNs) in public health centers (PHCs) nationwide from region-specific to service-specific work. Such major changes to working environment in the new system seem to be exposing PHNs to various types of stress. The present study examined whether prevalence of burnout is higher among PHNs in charge of mental health services (psychiatric PHNs) than among PHNs in charge of other services (non-psychiatric PHNs), and whether attributes of emergency mental health care systems in communities are associated with increased prevalence of burnout. A questionnaire including the Pines burnout scale for measuring burnout was mailed to 525 psychiatric PHNs and 525 non-psychiatric PHNs. The 785 respondents included in the final analysis comprised 396 psychiatric PHNs and 389 non-psychiatric PHNs. Prevalence of burnout was significantly higher for psychiatric PHNs (59.2%) than for non-psychiatric PHNs (51.5%). When prevalence of burnout in each group was analyzed in relation to question responses regarding emergency service and patient referral systems, prevalence of burnout for psychiatric PHNs displayed significant correlations to frequency of cases requiring overtime emergency services, difficulties referring patients, and a feeling of "restriction". Prevalence of burnout is high among psychiatric PHNs, and inadequate emergency mental health service systems contribute to burnout among these nurses. Countermeasures for preventing such burnout should be taken as soon as possible.

  13. Prevalence and Determinants of Bullying Among Health Care Workers in Portugal.

    Science.gov (United States)

    Norton, Pedro; Costa, Viviana; Teixeira, Joel; Azevedo, Ana; Roma-Torres, António; Amaro, Joana; Cunha, Liliana

    2017-05-01

    Bullying is defined as systematic exposure to humiliation as well as hostile and violent behaviors against one or more individuals. These behaviors are a serious, growing problem, which affects a significant proportion of health care professionals. To support the hospital's risk management policy, a cross-sectional study was undertaken to determine the prevalence of bullying in this institution and identify the determinants of bullying. Bullying was measured using the Negative Acts Questionnaire-Revised, Portuguese version (NAQ-R), a self-administered tool. The questionnaire was made available in digital format on the hospital's internal network (Intranet) and in hard copy; questionnaires were returned via nonidentified internal mail addressed to the occupational health unit or deposited in suggestion boxes located throughout the hospital. Multiple questionnaire delivery methods guaranteed data anonymity and confidentiality. The prevalence of bullying in this hospital was 8% (95% confidence interval [CI] = [6.2, 10.2]). Reported bullying was predominantly vertical and more frequently occurring among nurses, clerical staff, and health care assistants (12.5%, 7.6%, 6.4%, respectively; p = .005). After adjusting for gender, age, occupation, type of contract, and work schedule, only type of contract was significantly associated with bullying in the workplace; the risk of bullying was twice as high among government employees compared to workers with indefinite duration employment contracts ( p = .038). This study identified a high prevalence of bullying among health professionals; hence a program to prevent and control this phenomenon was implemented in this institution.

  14. Prevalence of mental health and behavioral problems among adolescents in institutional care in Jordan.

    Science.gov (United States)

    Gearing, Robin E; MacKenzie, Michael J; Schwalbe, Craig S; Brewer, Kathryne B; Ibrahim, Rawan W

    2013-02-01

    This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.

  15. Prevalence and characteristics of moral case deliberation in Dutch health care.

    Science.gov (United States)

    Dauwerse, Linda; Stolper, Margreet; Widdershoven, Guy; Molewijk, Bert

    2014-08-01

    The attention for Moral case deliberation (MCD) has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this paper is to provide an overview of the state of the art concerning MCD in the Netherlands. As part of a larger national study on clinical ethics support in the Netherlands, we will focus on the prevalence and characteristics of MCD in Dutch health. A mixed methods design was used in which we combined two survey questionnaires (sent to all health care institutions), two focus groups and 17 individual interviews with top managers or ethics support staff. The findings demonstrate that the prevalence of MCD is relatively high in Dutch health care (44 % has MCD), especially in mental health care (in which MCD is mentioned as present in the organization by 62 % of the respondents). Institutions with MCD differ from institutions without MCD concerning size, kind of problems and importance of ideological background. Characteristic of MCD is that it often exists for 3 years or more, has a high participation of health professionals and middle managers and is both organized scheduled as unscheduled. As well integration in existing policy as key persons emerge as important issues in relation to the positioning of MCD. We conclude that MCD is a part of an integrated ethics policy and serves as a (bottom up) catalyst for such an integrated ethics policy.

  16. The prevalence of sexual dysfunction in the female health care providers in Jeddah, Saudi Arabia.

    Science.gov (United States)

    Rouzi, Abdulrahim A; Sahly, Nora; Sawan, Dana; Kafy, Souzan; Alzaban, Faten

    2015-01-20

    The objective of this study was to determine the prevalence of sexual dysfunction in Saudi and non-Saudi female health care providers in Jeddah, Saudi Arabia. One -hundred twenty (60 Saudi and 60 non-Saudi) sexually active female health care professionals in Jeddah, Saudi Arabia, were anonymously surveyed using the English version of the female sexual function index questionnaire. The individual domain scores for pain, arousal, lubrication, orgasm, satisfaction, pain, and overall score for the Saudi and non-Saudi women were calculated and compared. The two groups were comparable in demographic characteristics. No statistically significant differences were found between Saudi and non-Saudi women in desire (P = .22) and arousal scores (P = .47). However, non-Saudi women had significantly higher lubrication (P Saudi and non-Saudi women were low (23.40 ± 4.50 compared with 26.18 ± 5.97), but non-Saudi women had a significantly higher overall score (P = .005). Taken together, sexual dysfunction is prevalent among Saudi and non-Saudi female health care providers, with Saudi women demonstrating lower scores in four sexual function domains and the overall score.

  17. Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.

    Science.gov (United States)

    Kimerling, Rachel; Iverson, Katherine M; Dichter, Melissa E; Rodriguez, Allison L; Wong, Ava; Pavao, Joanne

    2016-08-01

    The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data. The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social

  18. Prevalence of Tuberculosis Infection Among Health-Care Workers in Hamadan, West of Iran

    Directory of Open Access Journals (Sweden)

    Hashemi

    2014-04-01

    Full Text Available Background The risk of occupationally acquired tuberculosis (TB remains a concern, even now that the infection has been under control to a great extent. Objectives The aim of this study was to ascertain the prevalence of latent TB infection and pulmonary TB, and to assess the risk factors for TB, among health care workers in Hamadan. Patients and Methods Tuberculin skin test was performed on 245 health care workers, in two educational hospitals. The reaction was considered as "positive" if the induration diameter was ≥ 10 mm. Individuals with a positive test > than 15 mm were encouraged to seek further medical evaluation, including a chest-x-ray and a smear and sputum culture of the sputum for acid-fast bacilli, in those with radiographic changes indicating TB. Results Out of 245 health-care workers included in this study, 92 (38% had positive tuberculin test. There was a significant association between aging and tuberculin positivity. There was also a significant association between the length of employment and tuberculin positivity. Ward attendants had higher rates of positive test results, compared with other occupational groups. Conclusions It was concluded that latent TB infection is common among health-care workers in the studied region. Age, occupational group and employment length were found to be strongly associated with tuberculin positivity.

  19. Adjustment disorder with anxiety in old age: comparing prevalence and clinical management in primary care and mental health care.

    Science.gov (United States)

    Arbus, C; Hergueta, T; Duburcq, A; Saleh, A; Le Guern, M-E; Robert, P; Camus, V

    2014-05-01

    Adjustment disorder with anxiety (AjD-A) is a common cause of severe anxiety symptoms, but little is known about its prevalence in old age. This cross-sectional study examined the prevalence of AjD-A in outpatients over the age of 60 who consecutively consulted 34 general practitioners and 22 psychiatrists during a 2-week period. The diagnosis of AjD-A was obtained using the optional module for diagnostic of adjustment disorder of the Mini International Neuropsychiatric Interview (MINI). The study procedure also explored comorbid psychiatric conditions and documented recent past stressful life events, as well as social disability and current pharmacological and non-pharmacological management. Overall, 3651 consecutive subjects were screened (2937 in primary care and 714 in mental health care). The prevalence rate of AjD-A was 3.7% (n=136). Up to 39% (n=53) of AjD-A subjects had a comorbid psychiatric condition, mostly of the anxious type. The most frequently stressful life event reported to be associated with the onset of AjD-A was personal illness or health problem (29%). More than 50% of the AjD-A patients were markedly to extremely disabled by their symptoms. Compared to patients who consulted psychiatrists, patients who were seen by primary care physicians were older, had obtained lower scores at the Hamilton Anxiety Rating Scale, benefited less frequently from non-pharmacological management and received benzodiazepines more frequently. AjD-A appears to be a significantly disabling cause of anxiety symptoms in community dwelling elderly persons, in particular those presenting personal health related problems. Improvement of early diagnosis and non-pharmacological management of AjD-A would contribute to limit risks of benzodiazepine overuse, particularly in primary care settings. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Prevalence of methicillin resistant Staphylococcus aureus [MRSA] colonization or carriage among health-care workers.

    Science.gov (United States)

    Pathare, Nirmal A; Asogan, Harshini; Tejani, Sara; Al Mahruqi, Gaitha; Al Fakhri, Salma; Zafarulla, Roshna; Pathare, Anil V

    2016-01-01

    In Oman, the prevalence of health care associated methicillin resistant Staphylococcus aureus [HA-MRSA] is unknown. Therefore, to estimate the prevalence of HA-MRSA, we collected nasal swabs and swabs from cell phones on sterile polyester swabs and immediately inoculated on the mannitol salt agar containing oxacillin from medical students and hospital health care providers. Antibiotic susceptibility testing of the isolates was then performed using the Kirby Bauer's disc diffusion method. Additionally, a brief survey questionnaire was used to acquire demographic data. Amongst the 311 participants enrolled, nasal colonization with HA-MRSA was found in 47 individuals (15.1%, 95% confidence interval [CI]=11.1%, 19.1%). HA-MRSA was also isolated from the cell phone surfaces in 28 participants (9.0%, 95% CI=8.6%, 9.3%). 5 participants (1.6%) showed positive results both from their nasal swabs and from their cell phones. Antibiotic resistance to erythromycin [48%] and clindamycin [29%] was relatively high. 9.3% HA-MRSA isolates were vancomycin resistant [6.6% nasal carriage]. There was no statistically significant correlation between HA-MRSA isolates and the demographic characteristics or the risk factors namely gender, underlying co-morbidities like diabetes, hypertension, skin/soft tissue infections, skin ulcers/wounds, recent exposure to antibiotics, or hospital visits (p>0.05, Chi-square test). Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  1. The 12-month prevalence of depression and health care utilization in the general population of Latvia.

    Science.gov (United States)

    Vrublevska, Jelena; Trapencieris, Marcis; Snikere, Sigita; Grinberga, Daiga; Velika, Biruta; Pudule, Iveta; Rancans, Elmars

    2017-03-01

    This cross-sectional study aims to assess the 12-month prevalence of major and minor depression in the Latvian population, and to evaluate associated health care utilization. Trained interviewers conducted face-to-face interviews with a multistage stratified probability sample of the Latvian general population, ages 15-64 (n=3003). Participants were interviewed using the depression module of the Mini International Neuropsychiatric Interview. Self-reported health care utilization and somatic illness were also assessed. Multinomial logistic regressions were applied. The 12-month prevalence of major depression was 7.9% (95%CI 7.0-8.9), while for minor depression it was 7.7% (95%CI 6.8-8.7). We did not find a substantial difference in the relative risk ratio (RRR 1.7 for female) for having major depression by gender. RRR of having major depression was higher for those who had used healthcare services six or more times (RRR 2.0), those who had three or more somatic disorders during the past 12 months (RRR 2.3), those who perceived their health status as being below average (RRR 8.3), and those who were occasional smokers (RRR 3.0). RRR of having minor depression was increased for those who had at least three somatic disorders (RRR 2.3), those who received disability pension (RRR 1.9), and those who perceived their health status to be below average (RRR 3.0). The study was cross-sectional. Other psychiatric comorbidity was not assessed. This is the first population based study reporting the 12-month prevalence of depression in Latvia. Certain factors associated with depression have been found. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Prevalence of diabetic macular oedema and related health and social care resource use in England.

    Science.gov (United States)

    Minassian, D C; Owens, D R; Reidy, A

    2012-03-01

    To address the absence from the public health ophthalmology literature of age- and sex-specific prevalence and related resource use for diabetic macular oedema (DMO) in England, UK. Calculation of age- and sex-specific rates from primary source clinical data, and application to the demographic structure of England to estimate the number of cases affected by DMO. A public health commissioner and provider of social care perspective was adopted in a standard cost of illness study. The number of people with diabetes in England in 2010 was estimated at 2,342,951 of which 2,334,550 were aged ≥ 12 years. An estimated 166,325 (7.12%) had DMO in one or both eyes, and of these, 64,725 individuals had clinically significant DMO reducing the visual acuity to poorer than 6/6 in at least one eye. The overall health and social care costs in 2010, on the pathway from screening to rehabilitation and care in the home, are estimated at £116,296,038. The outcomes of this study should alert public health commissioners and clinical providers to the burden of DMO. The methods employed should also encourage the use of clinical ophthalmic data at the interface between local population and hospital-based recording systems.

  3. [Chronic kidney disease in Primary Health Care: prevalence and associated risk factors].

    Science.gov (United States)

    Salvador González, Betlem; Rodríguez Pascual, Mercedes; Ruipérez Guijarro, Laura; Ferré González, Antonia; Cunillera Puertolas, Oriol; Rodríguez Latre, Luisa M

    2015-04-01

    To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). Cross-sectional observational study. Primary Health Care. Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. kidney transplant, home care. Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalencedisease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Common perinatal mental disorders in northern Viet Nam: community prevalence and health care use

    Science.gov (United States)

    Tran, Thach; La, Buoi thi; Kriitmaa, Kelsi; Rosenthal, Doreen; Tran, Tuan

    2010-01-01

    Abstract Objective To establish the prevalence of common perinatal mental disorders their determinants, and their association with preventive health care use among women in one rural and one urban province in northern Viet Nam. Methods We conducted a cross-sectional survey of cohorts of pregnant women and mothers of infants recruited systematically in 10 randomly-selected communes. The women participated in psychiatrist-administered structured clinical interviews and separate structured interviews to assess sociodemographic factors, reproductive health, the intimate partner relationship, family violence and the use of preventive and psychiatric health care. Associations between these variables and perinatal mental disorders were explored through univariate analyses and multivariable logistic regression. Findings Among women eligible for the study (392), 364 (93%) were recruited. Of these, 29.9% (95% confidence interval, CI: 25.20–34.70) were diagnosed with a common perinatal mental disorder (CPMD). The frequency of such disorders during pregnancy and in the postpartum period was the same. Their prevalence was higher among women in rural provinces (odds ratio, OR: 2.17; 95% CI: 1.19–3.93); exposed to intimate partner violence (OR: 2.11; 95% CI: 1.12–3.96); fearful of other family members (OR: 3.36; 95% CI: 1.05–10.71) or exposed to coincidental life adversity (OR: 4.40; 95% CI: 2.44–7.93). Fewer women with a CPMD used iron supplements than women without a CPMD, but the results were not statistically significant (P = 0.05). None of the women studied had ever received mental health care. Conclusion Perinatal depression and anxiety are prevalent in women in northern Viet Nam. These conditions are predominantly determined by social factors, including rural residence, poverty and exposure to family violence. At present the needs of women with common perinatal mental disorders are unrecognized and not attended to and their participation in essential

  5. Prevalence, causes and mental health impact of workplace bullying in the Neonatal Intensive Care Unit environment.

    Science.gov (United States)

    Chatziioannidis, Ilias; Bascialla, Francesca Giuseppina; Chatzivalsama, Panagiota; Vouzas, Fotios; Mitsiakos, Georgios

    2018-02-24

    The aim of this study is to examine the prevalence, to report barriers and mental health impact of bullying behaviours and to analyse whether psychological support at work could affect victims of bullying in the healthcare workplace. Self-administered questionnaire survey. 20 in total neonatal intensive care units in 17 hospitals in Greece. 398 healthcare professionals (doctors, nurses). The questionnaire included information on demographic data, Negative Act Questionnaire-Revised (NAQ-R) behaviour scale, data on sources of bullying, perpetrators profile, causal factors, actions taken and reasons for not reporting bullying, psychological support and 12-item General Health Questionnaire (GHQ-12) scores to investigate psychological distress. Prevalence of bullying measured by the NAQ-R was 53.1% for doctors and 53.6% for nurses. Victims of bullying differed from non-bullied in terms of gender and job experience, among demographic data. Crude NAQ-R score was found higher for female, young and inexperienced employees. Of those respondents who experienced bullying 44.9% self-labelled themselves as victims. Witnessing bullying of others was found 83.2%. Perpetrators were mainly females 45-64 years old, most likely being a supervisor/senior colleague. Common reasons for not reporting bullying was self-dealing and fear of consequences. Bullying was attributed to personality trait and management. Those who were bullied, self-labelled as a victim and witnessed bullying of others had higher GHQ-12 score. Moreover, psychological support at work had a favour effect on victims of bullying. Prevalence of bullying and witnessing were found extremely high, while half of victims did not consider themselves as sufferers. The mental health impact on victims and witnesses was severe and support at work was necessary to ensure good mental health status among employees. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

  6. Prevalence, causes and mental health impact of workplace bullying in the Neonatal Intensive Care Unit environment

    Science.gov (United States)

    Chatziioannidis, Ilias; Bascialla, Francesca Giuseppina; Chatzivalsama, Panagiota; Vouzas, Fotios; Mitsiakos, Georgios

    2018-01-01

    Objectives The aim of this study is to examine the prevalence, to report barriers and mental health impact of bullying behaviours and to analyse whether psychological support at work could affect victims of bullying in the healthcare workplace. Design Self-administered questionnaire survey. Setting 20 in total neonatal intensive care units in 17 hospitals in Greece. Participants 398 healthcare professionals (doctors, nurses). Main outcome measures The questionnaire included information on demographic data, Negative Act Questionnaire-Revised (NAQ-R) behaviour scale, data on sources of bullying, perpetrators profile, causal factors, actions taken and reasons for not reporting bullying, psychological support and 12-item General Health Questionnaire (GHQ-12) scores to investigate psychological distress. Results Prevalence of bullying measured by the NAQ-R was 53.1% for doctors and 53.6% for nurses. Victims of bullying differed from non-bullied in terms of gender and job experience, among demographic data. Crude NAQ-R score was found higher for female, young and inexperienced employees. Of those respondents who experienced bullying 44.9% self-labelled themselves as victims. Witnessing bullying of others was found 83.2%. Perpetrators were mainly females 45–64 years old, most likely being a supervisor/senior colleague. Common reasons for not reporting bullying was self-dealing and fear of consequences. Bullying was attributed to personality trait and management. Those who were bullied, self-labelled as a victim and witnessed bullying of others had higher GHQ-12 score. Moreover, psychological support at work had a favour effect on victims of bullying. Conclusions Prevalence of bullying and witnessing were found extremely high, while half of victims did not consider themselves as sufferers. The mental health impact on victims and witnesses was severe and support at work was necessary to ensure good mental health status among employees. PMID:29478015

  7. Prevalence of Work-Related Asthma and its Impact in Primary Health Care.

    Science.gov (United States)

    Vila-Rigat, Rosa; Panadès Valls, Rafael; Hernandez Huet, Enric; Sivecas Maristany, Joan; Blanché Prat, Xavier; Muñoz-Ortiz, Laura; Torán Monserrat, Pere; Rabell Santacana, Ventura

    2015-09-01

    To determine the prevalence of occupational asthma (OA) and work-exacerbated asthma (WEA) among asthmatic patients diagnosed in Primary Health Care (PHC). To analyze the impact at PHC level caused by under-diagnosis and inappropriate referral of OA. A descriptive, cross-sectional multicenter study in patients aged between 16 and 64years diagnosed with asthma, according to their medical record; all were working or had worked, and were assigned to one of 16 PHC centers in a healthcare district. Based on the responses to the questionnaire completed at the study visit, which included a thorough review of the subject's entire working history, patients were classified into three categories by an expert in occupational asthma: OA, WEA or common asthma (CA). Three hundred and sixty-eight patients completed the questionnaire. The prevalence of OA was 18.2% (25% in men and 14.6% in women, P=.046), and 54 patients (14.7%) were classified as WEA. The proportion of patients with work-related asthma (WRA) was therefore 32.9%. Asthmatic patients with WRA took more sick leave than CA patients (P<.001). A high prevalence of WRA was found, mostly treated in PHC. Under-diagnosis of WRA is widespread in PHC. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Prevalence of pre-diabetes in young Mexican adults in primary health care.

    Science.gov (United States)

    Ureña-Bogarín, Enrique L; Martínez-Ramírez, Héctor R; Torres-Sánchez, José R; Hernández-Herrera, Aurora; Cortés-Sanabria, Laura; Cueto-Manzano, Alfonso M

    2015-04-01

    Pre-diabetes in young people is frequently unrecognized or not treated on time, with the consequent loss of opportunity for diabetes prevention. In Mexico, there is scarce information about the prevalence of pre-diabetes in young adults. To determine the prevalence and risk factors for pre-diabetes in young Mexican adults in primary health care. In a cross-sectional study, 288 subjects, aged 18-30 years, from a primary care unit were included. Pre-diabetes was diagnosed (according to the criteria of the American Diabetes Association) as impaired fasting glucose (8-12 hours fasting plasma glucose level: 100-125 mg/dl) or impaired glucose tolerance (140-199 mg/dl after a 2-hour oral glucose tolerance test). Prevalence of pre-diabetes was 14.6% [95% confidence interval (CI): 10.7-19.2], whereas that of diabetes was 2.4% (95% CI: 1.0-4.9). A high proportion of patients had history of obesity, diabetes, hypertension and consumption of tobacco and alcohol. Pre-diabetic patients were older than normoglycaemics (pre-diabetic patients: 26±4 years versus normoglycaemic subjects: 24±3 years, P = 0.003) and had higher body mass index (BMI; pre-diabetic patients: 29.4±6.8 kg/m(2) versus normoglycaemic subjects: 26.8±5.8 kg/m(2); P = 0.009), particularly in the case of men (pre-diabetic men: 29.3±7.0 kg/m(2) versus normoglycaemic men: 26.4±5.1 kg/m(2); P = 0.03). Although waist circumference showed a trend to be higher among pre-diabetics, no significant differences were found according to gender (among males: pre-diabetics: 99.5±18.8 cm versus normoglycaemics: 93.3±14.4 cm, P = 0.09; among females: pre-diabetics: 91.5±13.8 cm versus normoglycaemics: 85.8±15.9 cm, P = 0.16). Only age and BMI were significantly associated with the presence of pre-diabetes. Almost 15% of these young adults had pre-diabetes. Many modifiable and non-modifiable risk factors were present in these patients, but only age and a higher BMI were independent variables significantly associated with

  9. Prevalence of Hearing Loss Among Noise-Exposed Workers Within the Health Care and Social Assistance Sector, 2003 to 2012.

    Science.gov (United States)

    Masterson, Elizabeth A; Themann, Christa L; Calvert, Geoffrey M

    2018-04-01

    The purpose was to estimate the prevalence of hearing loss for noise-exposed U.S. workers within the Health Care and Social Assistance (HSA) sector. Audiograms for 1.4 million workers (8702 within HSA) from 2003 to 2012 were examined. Prevalences and adjusted risks for hearing loss as compared with a reference industry were estimated for the HSA sector and all industries combined. While the overall HSA sector prevalence for hearing loss was 19%, the prevalences in the Medical Laboratories subsector and the Offices of All Other Miscellaneous Health Practitioners subsector were 31% and 24%, respectively. The Child Day Care Services subsector had a 52% higher risk than the reference industry. High-risk industries for hearing loss exist within the HSA sector. Further work is needed to identify the sources of noise exposure and protect worker hearing.

  10. BRFSS Prevalence And Trends Data: Health Care Access/Coverage for 2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 2011 BRFSS data reflects a change in weighting methodology (raking) and the addition of cell phone only respondents. Shifts in observed prevalence from 2010 to...

  11. Disease Prevalence and Use of Health Care among a National Sample of Black and White Male State Prisoners

    Science.gov (United States)

    Rosen, David L.; Hammond, Wizdom P.; Wohl, David A.; Golin, Carol E.

    2014-01-01

    U.S. prisons have a court-affirmed mandate to provide health care to prisoners. Given this mandate, we sought to determine whether use of prison health care was equitable across race using a nationally-representative sample of Black and White male state prisoners. We first examined the prevalence of health conditions by race. Then, across all health conditions and for each of 15 conditions, we compared the proportion of Black and White male prisoners with the condition who received health care. For most conditions including cancer, heart disease, and liver-related disorders, the age-adjusted prevalence of disease among Blacks was lower than among Whites (p<.05). Blacks were also modestly more likely than Whites to use health care for existing conditions (p<.05), particularly hypertension, cerebral vascular accident/brain injury, cirrhosis, flu-like illness, and injury. The observed racial disparities in health and health care use are different from those among non-incarcerated populations. PMID:22643475

  12. Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care

    Directory of Open Access Journals (Sweden)

    Meyboom-de Jong Betty

    2009-05-01

    Full Text Available Abstract Background Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. Methods The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. Results The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Conclusion Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

  13. Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care.

    Science.gov (United States)

    Oud, Marian J T; Meyboom-de Jong, Betty

    2009-05-09

    Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

  14. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units.

    Science.gov (United States)

    Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

    To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.

  15. Health care-seeking behaviour among people with cough in Tanzania: findings from a tuberculosis prevalence survey

    NARCIS (Netherlands)

    Senkoro, M.; Hinderaker, S. G.; Mfinanga, S. G.; Range, N.; Kamara, D. V.; Egwaga, S.; van Leth, F.

    2015-01-01

    The study was conducted within a nation-wide population-based tuberculosis (TB) prevalence survey in the adult population in Tanzania. To assess the health care-seeking behaviour of coughers presumed to have TB. A survey in which participants were screened for TB using a symptom questionnaire and

  16. Prevalence and correlates of special health care needs in a population cohort of Australian children at school entry.

    Science.gov (United States)

    Goldfeld, Sharon; O'Connor, Meredith; Sayers, Mary; Moore, Tim; Oberklaid, Frank

    2012-05-01

    Children with special health care needs are an important population for educational and health service providers. Accurate information about the prevalence and characteristics of these children and their families is needed to inform the planning and development of systems of care, yet data in Australia are currently lacking. This study utilizes population-level data from the Australian Early Development Index, a teacher-rated checklist, to provide estimates of the prevalence and developmental and demographic characteristics of Australian children with special health care needs on entrance to school. Four percent of children were reported with established special health care needs, and a further 18% were identified by teachers as "of concern." These children showed higher rates of vulnerability across all domains of development. Although children with established special health care needs were represented across demographic profiles, proportions were greater among boys, those from lower socioeconomic status communities, and Indigenous and older children. In contrast, those living in more remote settings were as likely to be identified as "of concern" as their peers but were less likely to have established special health care needs. These findings have important implications for service provision and policy development. There are substantial opportunities to reorient schooling and early childhood systems to better detect and accommodate the needs of these children.

  17. Prevalence of Unmet Health Care needs and description of health care-seeking behavior among displaced people after the 2007 California wildfires.

    Science.gov (United States)

    Jenkins, J Lee; Hsu, Edbert B; Sauer, Lauren M; Hsieh, Yu-Hsiang; Kirsch, Thomas D

    2009-06-01

    The southern California wildfires in autumn 2007 resulted in widespread disruption and one of the largest evacuations in the state's history. This study aims to identify unmet medical needs and health care-seeking patterns as well as prevalence of acute and chronic disease among displaced people following the southern California wildfires. These data can be used to increase the accuracy, and therefore capacity, of the medical response. A team of emergency physicians, nurses, and epidemiologists conducted surveys of heads of households at shelters and local assistance centers in San Diego and Riverside counties for 3 days beginning 10 days postdisaster. All households present in shelters on the day of the survey were interviewed, and at the local assistance centers, a 2-stage sampling method was used that included selecting a sample size proportionate to the number of registered visits to that site compared with all sites followed by a convenience sampling of people who were not actively being aided by local assistance center personnel. The survey covered demographics; needs following the wildfires (shelter, food, water, and health care); acute health symptoms; chronic health conditions; access to health care; and access to prescription medications. Among the 175 households eligible, 161 (92.0%) households participated. Within the 47 households that reported a health care need since evacuation, 13 (27.7%) did not receive care that met their perceived need. Need for prescription medication was reported by 47 (29.2%) households, and 20 (42.6%) of those households did not feel that their need for prescription medication had been met. Mental health needs were reported by 14 (8.7%) households with 7 of these (50.0%) reporting unmet needs. At least 1 family member per household left prescription medication behind during evacuation in 46 households (28.6%), and 1 family member in 48 households (29.8%) saw a health care provider since their evacuation. Most people sought

  18. Prevalence of Hepatitis B Vaccination among Health Care Workers in Nigeria in 2011–12

    Directory of Open Access Journals (Sweden)

    D Ogoina

    2014-01-01

    Full Text Available Background: Hepatitis B virus (HBV infection is an endemic infection in Nigeria. Health care workers (HCWs are at risk of occupational exposures to HBV-infected blood and body fluids. Objective: To determine the prevalence and determinants of HBV vaccine coverage among HCWs in two teaching hospitals in Nigeria. Methods: This cross-sectional study was undertaken in 2011 and 2012 in two teaching hospitals in Jos, North-Central Nigeria, and Yenagoa, South-South Nigeria. A self-administered structured questionnaire was administered to HCWs to obtain socio-demographic data and history of HBV vaccination. Results: Out of 290 HCWs who participated in the study, 185 (64.5% had received at least one dose of HBV vaccine; 105 (36.2% had full coverage of three doses. Professional category and previous training in infection control were independently associated with HBV vaccination. House officers and laboratory scientists were more likely to be unvaccinated than resident doctors, consultant doctors and nurses. Full vaccine coverage was associated with younger age and shorter years of professional experience. Conclusion: We observed a generally low rate of HBV vaccine coverage among HCWs in Nigeria. Establishment of policies on compulsory HBV vaccination of all HCWs in Nigeria is recommended.

  19. Prevalence and determinants of antenatal depression among women attending primary health care centers in Western Saudi Arabia.

    Science.gov (United States)

    Bawahab, Jamala A; Alahmadi, Jawaher R; Ibrahim, Adel M

    2017-12-01

    To measure the prevalence of antenatal depression among pregnant women attending the primary health care (PHC) antenatal care clinics in Jeddah, Saudi Arabia and to determine associated factors. Following a cross-sectional study design, 320 pregnant women attending the antenatal care clinics in the Ministry of Health PHC Centers in Jeddah, Saudi Arabia between January 1st 2017 and February 15th 2017 were interviewed. A self-administered questionnaire used for data collection asked about socio-demographic variables and included the Edinburgh Postnatal Depression Scale.   The most common contributor was the  harming herself (mean±SD, 2.7±0.60). Factors significantly associated with depression among participants were the number of daughters, previous diagnosis of depression, and financial problems. The prevalence of antepartum depression among pregnant women in Jeddah is 57.5%, and the greatest contributor is the thought of harming herself.

  20. Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators.

    Science.gov (United States)

    Meijers, Judith M M; Halfens, Ruud J G; van Bokhorst-de van der Schueren, Marian A E; Dassen, Theo; Schols, Jos M G A

    2009-05-01

    In most health care organizations there is still insufficient awareness for recognizing and treating malnourished patients. To gain more insight into nutritional care policies in Dutch health care organizations, this study investigated screening, treatment, and other quality indicators of nutritional care. In 2007 a cross-sectional multicenter study was performed that included 20 255 patients (hospitals, n = 6021; nursing homes, n = 11 902; home care, n = 2332). A standardized questionnaire was used to study nutritional screening and treatment at the patient level and quality indicators at institutional and ward levels (e.g., malnutrition guidelines/protocols, nutritional education, and weighing policy). Nutritional screening was performed more often in nursing homes (60.2%) than in hospitals (40.3%) and home care (13.9%, P hospitals, and home care. At ward level nursing homes focused more on the quality of nutritional care than did hospitals and home care, especially with respect to controlling the use of nutritional guidelines (54.6%, P malnutrition is still a considerable problem in one of every five patients in all participating health care settings. It furthermore demonstrates that recognizing and treating malnutrition continues to be problematic. To target the problem of malnutrition adequately, more awareness is needed of the importance of nutritional screening, appropriate treatment, and other nutritional quality indicators.

  1. Estimating the prevalence of comorbid conditions and their effect on health care costs in patients with diabetes mellitus in Switzerland

    Directory of Open Access Journals (Sweden)

    Huber CA

    2014-10-01

    Full Text Available Carola A Huber,1 Peter Diem,2 Matthias Schwenkglenks,3 Roland Rapold,1 Oliver Reich1 1Department of Health Sciences, Helsana Group, Zürich, Switzerland; 2Department of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; 3Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland Background: Estimating the prevalence of comorbidities and their associated costs in patients with diabetes is fundamental to optimizing health care management. This study assesses the prevalence and health care costs of comorbid conditions among patients with diabetes compared with patients without diabetes. Distinguishing potentially diabetes- and nondiabetes-related comorbidities in patients with diabetes, we also determined the most frequent chronic conditions and estimated their effect on costs across different health care settings in Switzerland. Methods: Using health care claims data from 2011, we calculated the prevalence and average health care costs of comorbidities among patients with and without diabetes in inpatient and outpatient settings. Patients with diabetes and comorbid conditions were identified using pharmacy-based cost groups. Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs. Results: A total of 932,612 persons, including 50,751 patients with diabetes, were enrolled. The most frequent potentially diabetes- and nondiabetes-related comorbidities in patients older than 64 years were cardiovascular diseases (91%, rheumatologic conditions (55%, and hyperlipidemia (53%. The mean total health care costs for diabetes patients varied substantially by comorbidity status (US$3,203–$14,223. Patients with diabetes and more than two comorbidities incurred US$10,584 higher total costs than patients without comorbidity. Costs were significantly higher in patients with

  2. Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review.

    Science.gov (United States)

    Elbarazi, I; Loney, T; Yousef, S; Elias, A

    2017-07-17

    Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population. Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries. Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0-81.0%), high Depersonalization (9.2-80.0%), and low Personal Accomplishment (13.3-85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout. Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.

  3. PREVALENCE OF HEALTH CARE ASSOCIATED INFECTIONS IN A TERTIARY CARE HOSPITAL IN DAKSHINA KANNADA, KARNATAKA: A HOSPITAL BASED CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Animesh Gupta, Divya C V, Diwakar K Singh, Krutarth B, Maria N, Srinivas R

    2015-04-01

    Full Text Available Background: Health Care-Associated Infections (HCAI affect millions of people each year and raise a great risk for patients in health care settings, leading to high rates of morbidity and mortality. Objective: To estimate the prevalence of HCAI and to explore the association between certain socio-demographic factors, invasive procedures and mean duration of hospital stay with HCAI in a tertiary-care hospital. Materials and Methods: Data was obtained from the patients who were admitted for more than 48 hours in the general wards and their records in tertiary-care hospital for duration of 3 months (February 2014 to April 2014. Results: Among 290 patients, the prevalence of HCAI was estimated to be 11.7%. The prevalence of HCAI was proportionately less among men (10.2% than in women (14.2%, was more (15.6% among patients who underwent invasive procedures after admission and with mean duration of hospital stay of 12.47 days. Conclusion: Health Care-Associated Infections (HCAIs were found to be significantly associated with increased duration of hospital stay and invasive procedures done after admission. Prevalence was higher in patients aged more than 40 years.

  4. Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting.

    Science.gov (United States)

    Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M; Deodhar, Atul; Salman, Craig; Gelfand, Joel M; Wu, Jashin J; Herrinton, Lisa J

    2016-01-01

    Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings. We used computerized diagnoses to estimate the prevalence of axSpA and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). We identified persons aged 18 years or older with 1 or more International Classification of Diseases, Ninth Revision (ICD-9) diagnosis Code 720.X (ankylosing spondylitis and other inflammatory spondylopathies) in clinical encounter data from 1996 through 2009 to estimate the prevalence of axSpA and ankylosing spondylitis. We reviewed medical records to confirm the diagnosis in a random sample and estimated the positive predictive value of computerized data to identify confirmed cases using various case definitions. In the computerized data, 5568 adults had diagnostic codes indicating axSpA. On the basis of our case-finding approach using a single physician diagnosis code for ICD-9 720.X, the point prevalence of these conditions, standardized to the 2000 US Census, was 2.26 per 1000 persons for axSpA and 1.07 per 1000 for ankylosing spondylitis. Less than half of suspected cases saw a rheumatologist. The most specific algorithm for confirmed ankylosing spondylitis required 2 or more computerized diagnoses assigned by a rheumatologist, with 67% sensitivity (95% confidence interval, 64%-69%) and 81% positive predictive value (95% confidence interval, 79%-83%). Observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests there is substantial underrecognition of these conditions in routine clinical practice. However, use of computerized data is able to identify true cases of ankylosing spondylitis, facilitating population-based research.

  5. Depression and anxiety among migrants in Austria: a population based study of prevalence and utilization of health care services.

    Science.gov (United States)

    Kerkenaar, Marlies M E; Maier, Manfred; Kutalek, Ruth; Lagro-Janssen, Antoine L M; Ristl, Robin; Pichlhöfer, Otto

    2013-10-01

    Although migrants form a large part of the Austrian population, information about mental health of migrants in Austria is scarce. Therefore, we compared the prevalence of dysphoric disorders (depression and anxiety) and the corresponding utilization of health care services of Eastern European, western and other migrants with the non-migrant population in Austria. We performed a telephone survey on a random sample of the general population of Austria aged 15 years and older (n=3509) between October 2010 and September 2011. Depression and anxiety were measured with the Patient Health Questionnaire-4 and utilization of health care services in the last 4 weeks was inquired. 15.0% of our sample had a migration background. Female migrants from Eastern Europe, first and second generation, had a higher prevalence of dysphoric disorders (29.7% and 33.4% respectively) than Austrian women (15.2%) (p<0.001). The prevalence in the other migrant groups did not differ significantly from the Austrian population. There was no gender difference in dysphoric disorders in the Austrian population. After adjustment for age and chronic diseases, having a dysphoric disorder was associated with a higher utilization of health care services among migrant and Austrian women, but not among men. Because of the explorative nature of the study multiple testing correction was not performed. The reason for health care utilization was not assessed. Mental health of female migrants from Eastern Europe should be studied in more detail; men could be an underserved group, both in migrants and Austrians. © 2013 Elsevier B.V. All rights reserved.

  6. Prevalence and Risk Factors Associated with Low Back Pain Among Health Care Providers in a District Hospital

    Directory of Open Access Journals (Sweden)

    TS Wong

    2010-07-01

    Full Text Available STUDY DESIGN: A cross-sectional study among health care providers working at one hospital. OBJECTIVE: To investigate the prevalence, the consequences and the risk factors associated with low back pain (LBP among hospital staff. MATERIALS AND METHODS: The study sample consisted of 931 health care providers who answered a pre-established questionnaire including 30 items in two languages. RESULTS: The cumulative life-prevalence of LBP was 72.5% and the yearly prevalence was 56.9%. Chronic LBP prevalence was noted 5.1% of the cases. Treatment was sought in 34.1% of LBP sufferers and 7.3% required sick leave or absence from work due to LBP. Risk factors associated with LBP were professional categories, bad body posture, lifting objects or patients and the increased levels of lifting, levels of job satisfaction and stressful job demands. CONCLUSION: There was a high prevalence of LBP among hospital staff, resulting in significant medical and socio-professional consequences. Many risk factors were identified that would necessitate multidisciplinary involvement to reduce the LBP incidence and related costs.

  7. Prevalence of injuries and reporting of accidents among health care workers at the University Hospital of the West Indies.

    Science.gov (United States)

    Vaz, Kurt; McGrowder, Donovan; Crawford, Tazhmoye; Alexander-Lindo, Ruby Lisa; Irving, Rachael

    2010-01-01

    This study investigated the knowledge, awareness and practices of health care workers towards universal precautions at the University Hospital of the West Indies. The study also examined the prevalence of injuries experienced by health care workers, as well as incidence of accidents and compliance with post-exposure prophylaxis. A cross sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to two hundred health care workers including medical doctors, medical technologists, nurses and porters to assess knowledge and practices regarding universal precautions, prevalence of injuries and incidence of accidents. Almost two-thirds (62.3%) of the respondents were aware of policies and procedures for reporting accidents while one-third (33.2%) were unsure. All nurses were aware of policies and procedures for reporting accidents, followed by medical doctors (88%) and medical technologists (61.2%). The majority (81.5%) of the respondents experienced splashes from bodily fluid. Over three-quarters of medical doctors (78%) and two-thirds of nurses (64%) reported having experienced needle stick injuries, while the incidence among medical technologists was remarkably lower (26%). The majority of the respondents (59%) experienced low accident incidence while just over one-tenth (14%) reported high incidence. Eighty four respondents reported needle stick injuries; just under two-thirds (59.5%) of this group received post-exposure treatment. The study found that majority of health care workers were aware of policies and procedures for reporting accidents. Splashes from body fluids, needle stick injuries and cuts from other objects were quite prevalent among health care workers. There is a need for monitoring systems which would provide accurate information on the magnitude of needle stick injuries and trends over time, potential risk factors, emerging new problems, and the effectiveness of interventions at The

  8. Risk factors and prevalence of newborn hearing loss in a private health care system of Porto Velho, Northern Brazil

    OpenAIRE

    Oliveira, Juliana Santos de; Rodrigues, Liliane Barbosa; Aurélio, Fernanda Soares; Silva, Virgínia Braz da

    2013-01-01

    OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively a...

  9. Prevalence and determinants of workplace violence of health care workers in a psychiatric hospital in Taiwan.

    Science.gov (United States)

    Chen, Wen-Ching; Hwu, Hai-Gwo; Kung, Shou-Mei; Chiu, Hsien-Jane; Wang, Jung-Der

    2008-01-01

    Workplace violence, a possible cause of job stress, has recently become an important concern in occupational health. This study determined the prevalence of workplace violence and its risk factors for employees at a psychiatric hospital in Taiwan. A questionnaire developed by ILO/ICN/WHO/PSI was first translated and validated. It was then used to survey the prevalence of workplace violence in the last 12 months experienced by all nursing aides, nurses, and clerks at the hospital. Multiple logistic regression models were constructed to discover the determinants of violence. A total of 222 out of 231 surveyed workers completed a valid questionnaire. The one-year prevalence rates of physical violence (PV), verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 35.1, 50.9, 15.8, 9.5, and 4.5%, respectively. The prevalence of PV at this hospital was higher than that reported by other countries for the health sector. A high anxiety level was associated with the occurrence of PV. These results need to be corroborated by future investigation. A training program may be required for high risk groups to reduce workplace violence.

  10. The prevalence, management and outcome for acute wounds identified in a wound care survey within one English health care district.

    Science.gov (United States)

    Vowden, Kathryn R; Vowden, Peter

    2009-02-01

    This paper reports the characteristics and local management of 826 acute wounds identified during an audit across all health care providers serving the population of Bradford, UK. Of the wounds encountered 303 were traumatic wounds and 237 primary closures with smaller numbers of other acute wound types. Of the 303 traumatic wounds 174 occurred in women (57.4%). Men predominated in the under 45s (65M:26F), this being largely accounted for by hand and finger trauma (n = 62) particularly in patients of working age (M32:F12). Women predominated in the over 65s (50M:130F), this being largely accounted for by lower limb traumatic wounds (M24:F91), the majority of these being in patients 65 and over (M14:F82). In this sub-group of 96 patients 25 had wounds of 6 weeks or longer duration, only 3 had undergone Doppler assessment and only 2 received compression bandaging. Typically these wounds were of recent origin and small in size (under 1 week and less than 5 cm2 in surface area) however exceptions occurred where 10 people had wounds over 25 cm2 in area while 3 wounds had been present for over 5 years. 101 (12.2%) of the encountered wounds were considered to be infected although the practice of wound swabbing in the presence of presumed infection seemed inadequate with 37.6% of all infected acute wounds not being swabbed while 97 non-infected wounds were swabbed. Where wounds were swabbed 4.5% were found to be MRSA positive. Across all acute wound types (with the sole exception of primary closures) antimicrobial wound dressings were the most prevalent form of dressing and covered 56 (55.4%) of all infected wounds.

  11. Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism

    Directory of Open Access Journals (Sweden)

    Konstantinou Eleni

    2006-11-01

    Full Text Available Abstract Background It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. Methods A cross-sectional study was conducted among 853 shipyard employees. Data were collected by questionnaire on physical and psychosocial workload, need for recovery, perceived general health, occurrence of musculoskeletal complaints, and health care use during the past year. Retrospective data on absenteeism were also available from the company register. Results In total, 37%, 22%, and 15% of employees reported complaints of low back, shoulder/neck, and hand/wrist during the past 12 months, respectively. Among all employees with at least one MSD, 27% visited a physician at least once and 20% took at least one period of sick leave. Various individual and work-related factors were associated with the occurrence of MSD. Health care use and absenteeism were strongest influenced by chronicity of musculoskeletal complaints and comorbidity with other musculoskeletal complaints and, to a lesser extent, by work-related factors. Conclusion In programmes aimed at preventing the unfavourable consequences of MSD in terms of sickness absence and health care use it is important to identify the (individual factors that determine the development of chronicity of complaints. These factors may differ from the well-know risk factors for the occurrence of MSD that are targeted in primary prevention.

  12. Prevalence and characteristics of moral case deliberation in Dutch health care

    NARCIS (Netherlands)

    Dauwerse, L.; Stolper, M.M.; Widdershoven, G.; Molewijk, A.C.

    2014-01-01

    The attention for Moral case deliberation (MCD) has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this

  13. Musculoskeletal disorders in shipyard industry: Prevalence, health care use, and absenteeism

    NARCIS (Netherlands)

    E.C. Alexopoulos (Evangelos); D. Tanagra (Dimitra); E.C. Konstantinou (Eleni); A. Burdorf (Alex)

    2006-01-01

    textabstractBackground: It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD) also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. Methods: A cross-sectional study was conducted among

  14. Prevalence, awareness, and management of CKD and cardiovascular risk factors in publicly funded health care

    NARCIS (Netherlands)

    Verhave, J.C.; Troyanov, S.; Mongeau, F.; Fradette, L.; Bouchard, J.; Awadalla, P.; Madore, F.

    2014-01-01

    BACKGROUND AND OBJECTIVES: It is uncertain how many patients with CKD and cardiovascular risk factors in publicly funded universal health care systems are aware of their disease and how to achieve their treatment targets. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CARTaGENE study evaluated

  15. Prevalence of breast-related symptoms, health care seeking behaviour and diagnostic needs among women in Burkina Faso.

    Science.gov (United States)

    Ströbele, Leonie; Kantelhardt, Eva Johanna; Traoré Millogo, Timongo Francoise Danielle; Sarigda, Maurice; Wacker, Jürgen; Grosse Frie, Kirstin

    2018-04-04

    The prevalence of breast cancer has been increasing in sub-Saharan Africa over the last few years. Patients often present with late stage disease, resulting in a high mortality rate. This study aims to estimate the prevalence of breast -related symptoms in the female population of Burkina Faso. The findings can be used to advise on adequate diagnostic health services for breast symptoms to ensure early detection and down-staging of breast cancer. A cross-sectional, population based study of 996 women was conducted to investigate the proportion of women with breast-related symptoms. A semi-structured questionnaire was used to collect sociodemographic data, information about breast cancer knowledge and details about breast-related symptoms, health care seeking and medical care. Breast-related symptoms were categorised as currently present/not currently present to estimate the current prevalence of women requiring a diagnostic service. Among the 996 women, 120 reported having had a breast-related symptom in their life. Only 36 women sought medical advice and eight women had diagnostic confirmation by histological or imaging techniques. Current breast-related symptoms were reported by 33 women (3.3% of the sample). An extrapolation to Burkina Faso's female population suggests that 184,562 women are in current need of diagnostic services due to any breast-related symptoms. Imaging techniques at the community and referral level are needed in order to triage women with breast-related symptoms. Specialised services need to be strengthened to ensure appropriate diagnosis and treatment of breast diseases. Education campaigns among the general population and among health care professionals are required to increase awareness of breast cancer and improve prompt health care seeking and referral.

  16. Prevalence of Staphylococcus Aureus Colonizing the Health Care Personnel of a Hospital in the City of Cali

    Directory of Open Access Journals (Sweden)

    Leidy Catherine Arteaga Delgado

    2016-01-01

    Full Text Available Objecitve: The aim of this study was to determine the prevalence of isolates of Staphylococcus aureus in workers at a hospital in Cali. Materials and methods: A descriptive study was conducted with samples of nasal swabs, skin smears to 30 health care workers. Phenotypic characterization of isolates was based on susceptibility antibiogram testing and pcr amplification of the identified mecA and agr genes. The origin of isolates was established by analysis of agr gene, identifying the agr groups. Results: Eleven (26.7 % workers were colonized with S. aureus. The frequency of S. aureus was higher in health care personnel who were in the operating room (20 %; OR = 2.077; P> 0.05. Four antibiotypes were identified, this feature is compatible with community clones that have proven to be highly diverse with a large capacity to spread in the community. 36.4 % of the isolates were resistant to cefotaxime and/or oxacillin, suggestive mrsa phenotype in these isolated the mecA gene was identified. Agr i was found primarily among isolates metillicin-sensitive S. aureus (mssa, compatible with community origin, and mrsa isolates belong to agr ii, with hospital waste. Conclusion: The prevalence of S. aureus resistant to antibiotics that colonize health care personnel was demonstrated, mainly in those working in the operating room. Regu­lar monitoring of personnel should be regularly conducted to prevent the spread of pathogens.

  17. Disparities in Alcohol, Drug Use, and Mental Health Condition Prevalence and Access to Care in Rural, Isolated, and Reservation Areas: Findings From the South Dakota Health Survey.

    Science.gov (United States)

    Davis, Melinda M; Spurlock, Margaret; Dulacki, Kristen; Meath, Thomas; Li, Hsin-Fang Grace; McCarty, Dennis; Warne, Donald; Wright, Bill; McConnell, K John

    2016-06-01

    Research on urban/rural disparities in alcohol, drug use, and mental health (ADM) conditions is inconsistent. This study describes ADM condition prevalence and access to care across diverse geographies in a predominantly rural state. Multimodal cross-sectional survey in South Dakota from November 2013 to October 2014, with oversampling in rural areas and American Indian reservations. Measures assessed demographic characteristics, ADM condition prevalence using clinical screenings and participant self-report, perceived need for treatment, health service usage, and barriers to obtaining care. We tested for differences among urban, rural, isolated, and reservation geographic areas, controlling for participant age and gender. We analyzed 7,675 surveys (48% response rate). Generally, ADM condition prevalence rates were not significantly different across geographies. However, respondents in isolated and reservation areas were significantly less likely to have access to primary care. Knowledge of treatment options was significantly lower in isolated regions and individuals in reservation areas had significantly lower odds of reporting receipt of all needed care. Across the sample there was substantial discordance between ADM clinical screenings and participant self-reported need; 98.1% of respondents who screened positive for alcohol or drug misuse and 63.8% of respondents who screened positive for a mental health condition did not perceive a need for care. In a predominantly rural state, geographic disparities in ADM conditions are related to differences in access as opposed to prevalence, particularly for individuals in isolated and reservation areas. Educational interventions about ADM condition characteristics may be as important as improving access to care. © 2015 National Rural Health Association.

  18. Prevalence and determinants of depression among patients under the care of traditional health practitioners in a Kenyan setting: Policy implications.

    Science.gov (United States)

    Musyimi, Christine W; Mutiso, Victoria N; Musau, Abednego M; Matoke, Lydia K; Ndetei, David M

    2017-06-01

    In Kenya, there is paucity of information on depression among traditional health practitioner (THP) patients, particularly in rural areas. The aim of this study was to estimate prevalence and identify determinants of major depressive disorder (MDD) among patients of THP in rural Kenya using the World Health Organization (WHO) Mental Health Gap Action Programme Intervention Guideline (mhGAP-IG). All adult patients seeking care from trained THPs (either traditional healers such as diviners and herbalists or faith healers, who use treatments such as prayers, laying hands on patients, or providing holy water and ash to their patients) over a period of 3 months (September 2014 to November 2014) were screened for depression using mhGAP-IG and their sociodemographic characteristics recorded. Overall, the prevalence of depression among THP patients was 22.9%. Being older, female, single, divorced or separated, as well as unemployment and lack of education were found to be significant determinants of depression. Patients with MDD frequently presented with suicidal behavior (32.9%, OR = 5.94, p < .0001) compared to those that had at least one psychotic symptom (26.3%, OR = 3.65, p < .0001). A measure of the accuracy of THPs' assessment of MDD showed 86% specificity and 46% sensitivity and the area under receiver operating characteristics (ROC) curve was 0.686. Our findings shed light on the prevalence of depression among THP patients and thus highlight the need for further research on diagnostic tools for use among THPs in order to avoid substandard care and promote reliance on more evidence-based methods of care.

  19. Socioeconomic status and prevalence of congenital heart defects: does universal access to health care system eliminate the gap?

    Science.gov (United States)

    Agha, Mohammad M; Glazier, Richard H; Moineddin, Rahim; Moore, Aideen M; Guttmann, Astrid

    2011-12-01

    A twofold increase in the prevalence of congenital heart defects (CHDs) has been reported since the early 1970s with higher rates among children from low socioeconomic status (SES). This increase and the observed SES gap are postulated to be reflective of higher ascertainment, especially increased use of ultrasound and echography. The purpose of this study was to examine if trends over time in the prevalence of CHD were the same for high and low SES groups. Using the child's health number as a unique identifier and through record linkage, children born in Ontario between 1994 and 2007 were followed for the diagnosis of CHD. Using postal codes and census information, SES quintiles were assigned to each child. We used adjusted rates and used multivariate models to compare trends in the prevalence rate among children born in different SES groups. Children born in low SES areas (23% of all births) had significantly higher rates of CHDs (rate ratio = 1.20; 95% confidence interval [CI] = 1.15-1.24). While prevalence of nonsevere CHDs declined in all SES groups since 2000, severe CHDs, especially atrial septal defects were on the rise during the study period. It is assumed that increased ascertainment is responsible for observed increase in the prevalence of CHD, especially minor defects. While the trend and pattern over time changed for severe and nonsevere CHDs, the SES gap remained consistent during the study period. Our results indicate that even free and universal access to a health care system does not eliminate the SES gap observed in the prevalence of CHD. Copyright © 2011 Wiley Periodicals, Inc.

  20. Risk factors and prevalence of newborn hearing loss in a private health care system of Porto Velho, Northern Brazil

    Science.gov (United States)

    de Oliveira, Juliana Santos; Rodrigues, Liliane Barbosa; Aurélio, Fernanda Soares; da Silva, Virgínia Braz

    2013-01-01

    OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively analyzed. Newborns cared in rooming in with their mothers were compared to those admitted to the Intensive Care Unit regarding risk factors for hearing loss. RESULTS: Among 1,146 (100%) enrolled newborns, 1,064 (92.8%) passed and 82 (7.2%) failed the hearing screening. Among all screened neonates, 1,063 (92.8%) were cared in rooming and 83 (7.2%) needed intensive care; 986 (86.0%) were considered at low risk and 160 (14.0%) at high risk for hearing problems. Of the 160 patients identified as having high risk for hearing loss, 83 (37.7%) were admitted to an hospitalized in the Intensive Care Unit, 76 (34.5%) used ototoxic drugs and 38 (17.2%) had a family history of hearing loss in childhood. Hearing loss was diagnosed in two patients (0.2% of the screened sample). CONCLUSIONS: The prevalence of hearing loss in newborns from private hospitals was two cases per 1,000 evaluated patients. The use of ototoxic drugs, admission to Intensive Care Unit and family history of hearing loss were the most common risk factors for hearing loss in the studied population. PMID:24142311

  1. The prevalence of body dysmorphic disorder and its clinical correlates in a VA primary care behavioral health clinic.

    Science.gov (United States)

    Kelly, Megan M; Zhang, Jinxin; Phillips, Katharine A

    2015-07-30

    We examined the prevalence of body dysmorphic disorder (BDD) in a Veterans Affairs (VA) primary care behavioral health clinic. Of 100 Veterans, 11% (95% CI = 6.3-18.6%) had current BDD and 12% (95% CI = 7.0-19.8%) had lifetime BDD. However, only 8.3% of these Veterans had been diagnosed with BDD. BDD was significantly associated with a substantially elevated rate of suicide attempts, major depression, and obsessive-compulsive disorder. This severe disorder appears to be underdiagnosed in VA settings. Published by Elsevier Ireland Ltd.

  2. Prevalence of Hypertension and its optimal management issues in Rural India: An unmet health care need

    Directory of Open Access Journals (Sweden)

    Prashanth HR

    2015-03-01

    Full Text Available Cardiovascular diseases are the number one cause of death globally. They account for approximately 17 million deaths in the world each year (1.Of these deaths, complications of high blood pressure account for more than nine million, including about half of all deaths from heart disease and stroke(2.The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1•56 billion (1•54–1•58 billion(3. In India too, overall morbidity and mortality from non-communicable diseases (NCDs is rising rapidly which will have severe impact on the already frail economy (4. Many studies done in different settings in India have shown that the prevalence of hypertension ranges from as high as 20-50 percent in both rural and urban population (Table 1 (5. Contradictory to the earlier reports that the prevalence of hypertension is low in rural areas, the recent studies have shown that the rural-urban differences have largely disappeared and the hypertension and other risk factors for cardiovascular diseases are only equal or slightly greater in the rural population (6. A recent study done by the authors in a rural population in Tamilnadu found that 27.2% of adults between 18 to 60 years have hypertension (7. Also the studies show that more than 50% of the men and women above 60 years old are hypertensive in rural South India (8. This observation has major repercussion on India’s health system and health expenditure in the context of improved life expectancy and a significant increase in the proportion of people living in the age group of 60 years and above in India.

  3. The prevalence and burden of psychiatric disorders in primary health care visits in Qatar: Too little time?

    Directory of Open Access Journals (Sweden)

    Abdulbari Bener

    2015-01-01

    Full Text Available Background: Psychiatric disorders including anxiety, depression, somatization, obsessive compulsive, and bipolar disorders are recognized as causing the biggest burden of disease worldwide. Aim: In this study, we aimed to assess the prevalence and burden of common mental disorders at Primary Health Care Centers (PHCC using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI in the Qatari population, aged 18-65 who attended Primary Health Care (PHC settings. Design: A prospective cross-sectional study conducted during November 2011 to October 2012. Setting: Primary Health Care Centers of the Supreme Council of Health, Qatar. Subjects: A total of 2,000 Qatari subjects aged 18-65 years were approached; 1475 (73.3% agreed to participate. Methods: Prevalence and severity of International Classification of Disease-10 disorders were assessed with the WHO-CIDI (Version 3.0. Results: Of the 1475 participants, 830 (56.3% were females and 645 (43.7% was males. One-third were aged 35-49 years 558 (37.8%. The three most common disorders were major depression disorders (18.31%, any anxiety disorders (17.3%, any mood disorders (16.95%, followed by separation anxiety disorders (15.25%, personality disorder (14.1%. In the present study, prevalence in women was significantly higher than men for the most common psychiatric disorders, specifically generalized anxiety disorder, panic disorder, social phobia, specific phobias, obsessive compulsive disorders, posttraumatic disorder, somatization, major depressive disorder, bipolar disorder, dysthymia, and oppositional defiant disorder. Of the total 20% had only one psychiatric diagnosis and 12% had two disorders, 9.7% respondents with three diagnoses, and finally 4.3% of respondents had four or more diagnoses. Conclusion: One-fifth of all adults who attended the PHCC (20% had at least one psychiatric diagnosis. The CIDI is a useful instrument for psychiatric diagnosis in community

  4. Prevalence of Hepatitis B Antibodies in Health-Care Workers in Yasuj Hospitals

    Directory of Open Access Journals (Sweden)

    B Sarkari

    2007-01-01

    Full Text Available ABSTRACT: Introduction & Objective: Hepatitis B is a common infection in the world and one of the main health problems in our country. Over 350 million people are infected with Hepatitis B virus in the world and are chronic carriers of this infection. Health care workers are at risk of infection with blood born viruses including hepatitis B (HBV. This study was conducted to find out the rate of anti-HBs antibodies among the health-care workers (HCW in Yasuj hospitals, Southwest of Iran. Materials & Methods: This is a cross sectional descriptive study in which 212 staff was randomly selected from different wards of the hospitals in Yasuj. Blood samples were taken from each individual and tested for hepatitis B surface antibody (anti-HBs by ELISA. Those who had anti-HBs titer > 10 IU/ml were considered as positive. Collected data were analyzed by SPSS software using descriptive data analysis and chi-square test. Results: 61.3% of the subjects were female and 38.7% were male. 93.9% of the subjects had a history of one to three doses of hepatitis B vaccination. Results of this study showed that 185 (87.3% of the staff have anti hepatitis B antibodies (Anti-HBs. Among the staff that was negative for anti-HBs antibody, 12 had a history of hepatitis B vaccination (at least one dose. Female employees were more positive than males (93% vs. 78% and this difference was statistically significant (p<0.05. Moreover, a positive correlation was found between the titer of antibody and sex where females had a higher titer of antibody in comparison with males (p<0.05. No correlation was found between the workplace of HCW and positive anti-HBS. Conclusion: Result of this study indicates that more than 85 percent of the health-care workers in Yasuj have reasonable immunity against hepatitis B infection. A small proportion of HCWs had no immunity against HBV. The second course of hepatitis B vaccine should be delivered to those who had no immunity against hepatitis B

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    Early detection and treatment of these morbidities could prevent deterioration. The aim of the survey was to determine and compare the prevalence of ..... interventions. Increasing the detection rate of mental morbidity in the community is fundamental. The inclusion of mental health care as a component of primary health ...

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    catastrophic health expenditures (CHE) and risk of being impoverished as a result of cost of care were assessed. Statistical ... Study found a high prevalence of catastrophic health expenditure and near absence of financial risk protection for patients with long term ... services especially for the target group in Nigeria.

  7. Blood borne viral infections among Danish Health Care Workers - frequent blood exposure but low prevalence of infection

    International Nuclear Information System (INIS)

    Fisker, Niels; Mygind, Lone H.; Krarup, Henrik B.; Licht, Dorthe; Georgsen, Jorgen; Christensen, Peer B.

    2004-01-01

    Denmark is a country with low prevalence and incidence of blood borne viral infections. Among health care workers (HCWs) vaccination for hepatitis B is only offered to high-risk groups. The aims of this cross sectional survey were to determine the prevalence of hepatitis B, -C, and human immunodeficiency virus (HIV) among the staff at a Danish University hospital and to correlate this with risk factors for transmission. Additionally, we wanted to examine the current frequency of blood exposure, reporting habits and hepatitis B vaccination status in the staff. Of 1439 eligible hospital staffs included, 960 (67%) were HCWs. The overall human immunodeficiency virus (HIV)-, hepatitis C Virus (HCV)- and hepatitis B Virus (HBV)-prevalence was 0% (0/1439), 0.14% (2/1439) and 1.6% (23/1439), respectively. Twenty-three percent of HCWs were vaccinated against HBV. Age, blood transfusion and stay in endemic areas were associated independently to HBV infection as opposed to job-category, duration of employment, HBV vaccination status and blood exposure. Based on a 4-week recall period, the incidence of percutaneous blood exposure was 1.5/person-year. In conclusion the HIV and hepatitis prevalence was low despite frequent blood exposure and the principal risk factors were unrelated to work. Danish HCWs do not seem to be at increased risk of hepatitis B even though universal HBV vaccination has not been implemented

  8. Prevalence of Low Back Pain in Health Care Workers and Comparison with other Occupational Categories in Iran: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ramin Mehrdad

    2016-11-01

    Full Text Available Background: There are few research studies evaluating the significance of low back pain (LBP in Iran, even though the majority of locally published surveys are written in the Persian language. In the present review study, we aimed at appraising published articles related to the burden of LBP and its divergence among different jobs. Methods: A comprehensive search was conducted in all accessible national and international electronic databases from 1948 to mid-2012. The international electronic databases were MEDLINE (PubMed, Web of Sciences, Google Scholar, Scopus, CINAHL, and the Iranian equivalents were SID, IRANDOC, IranMedex, and Magiran. The main search terms were musculoskeletal disorders, musculoskeletal symptoms, low back pain, back pain, and Iran. All keywords were searched electronically by three Boolean operators. The inclusion criteria were age ≥10 years, study focus on LBP prevalence, inclusion of both genders, and no limitation to the study design. A dedicated STROBE questionnaire was developed as a critical appraisal tool and the quality of the identified literature was examined according to the 5-point Linker scale. Articles scoring ≥3 on the Linker scale were appraised. Each literature was screened by four reviewers independently and possible disagreements were streamlined in a joint review meeting. The extracted data were entered into a dedicated table using Microsoft Office Excel program. Data were analyzed for homogeneity using the STATA software (version 11. Results: Of the 51 articles that were included in the present review study, 35 articles reported 1-year LBP with Nordic questionnaire and 3 articles reported point prevalence of LBP. The calculated global prevalence of 1-year LBP in workers was 25% and LBP was the most prevalent issue among health care workers. There was no association between the prevalence of LBP and job classification among workers. Conclusion: LBP is the most common issue among health care workers

  9. Health care utilization and access to human immunodeficiency virus (HIV) testing and care and treatment services in a rural area with high HIV prevalence, Nyanza Province, Kenya, 2007.

    Science.gov (United States)

    Ackers, Marta-Louise; Hightower, Allen; Obor, David; Ofware, Peter; Ngere, Lilian; Kubaje, Adazu; Laserson, Kayla F

    2014-02-01

    We present health and demographic surveillance system data to assess associations with health care utilization and human immunodeficiency virus (HIV) service receipt in a high HIV prevalence area of western Kenya. Eighty-six percent of 15,302 residents indicated a facility/clinician for routine medical services; 60% reported active (within the past year) attendance. Only 34% reported a previous HIV test, and self-reported HIV prevalence was 6%. Active attendees lived only slightly closer to their reported service site (2.8 versus 3.1 km; P < 0.001) compared with inactive attendees. Multivariate analysis showed that younger respondents (< 30 years of age) and active and inactive attendees were more likely to report an HIV test compared with non-attendees; men were less likely to report HIV testing. Despite traveling farther for HIV services (median distance = 4.4 km), 77% of those disclosing HIV infection reported HIV care enrollment. Men and younger respondents were less likely to enroll in HIV care. Socioeconomic status was not associated with HIV service use. Distance did not appear to be the major barrier to service receipt. The health and demographic surveillance system data identified patterns of service use that are useful for future program planning.

  10. The Prevalence of Needlestick and Sharps Injuries among Health Care Workers in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    S.H. Hashemi

    2012-01-01

    Full Text Available Introduction & Objective: Needlestick and sharps injuries (NSSIs is an important occupational risk among health care workers (HCWs; and it is an important cause of transmission of blood-borne pathogens to this population. The aim of this study was to determine the rate of NSSI among HCWs in the teaching hospitals in Hamadan. Materials & Methods: This cross-sectional study was carried out on 700 HCWs between 2009 and 2010. A questionnaire was designed for data collection. Questionnaires were distributed in 5 hospitals to collect self-reported NSSI in the past 12- months. Results: The rate of accidental NSSI was 24.1% for one year prior the study. Totally, 83.6% of the participants had a full vaccination course against hepatitis B. The majority of NSSIs occurred in the 30-34 age group (33.3% and most of them were female. Also, 48.5% of NSSIs were during blood sampling or IV catheter insertion.Conclusion: Developing appropriate educational programs regarding prophylactic tasks, disposal of medical wastes, and using safe needle devices can reduce the risk of NSSIs among HCWs. (Sci J Hamadan Univ Med Sci 2012;18(4:41-46

  11. Hepatitis B virus prevalence and vaccination response in health care workers and students at the Federal University of Bahia, Brazil.

    Science.gov (United States)

    Carvalho, Patrícia; Schinoni, Maria Isabel; Andrade, Jacy; Vasconcelos Rêgo, Marco Antônio; Marques, Patrícia; Meyer, Roberto; Araújo, Alex; Menezes, Thomaz; Oliveira, Carolina; Macêdo, Rodrigo Sousa; Macêdo, Lucas Sousa; Leal, Júlio César; Matos, Betânia; Schaer, Robert; Simones, Juçara M; Freire, Songeli M; Paraná, Raymundo

    2012-01-01

    BACKGROUND AND RATIONALE FOR THE STUDY: Hepatitis B (HB) is one of the most prevalent occupational infections in health attendance environments. According to the Brazil Ministry of Health, health professionals must be vaccinated against the hepatitis B virus (HBV) and provide laboratory proof of immunization. To evaluate the seroprevalence of HBV infection and to analyze the response to vaccine by measuring serum antibodies against HBV surface antigen (anti-HBs) levels in a sample of students and health professionals at the Federal University of Bahia. As part of this cross-sectional study, a campaign against occupational HB was launched in 2007 and vaccination and blood samples were collected for analysis of the following serological markers: HBV surface antigen (HBsAg) and anti-HBs (measured by enzyme-linked immunoassay) and total antibodies against HBV core antigen (anti-HBc). The study sample comprised 766 people. Global seropositivity for HBV was 1.7%: 0.5% in the students and 8.8% in the professionals. In a group of volunteers, a serological profile compatible with postvaccine immunity was shown by 95% of volunteers with proof of vaccination and by 81.8% of volunteers without proof of vaccination. In conclusion, this study shows that it is important to promote vaccination campaigns and improve knowledge and awareness about HB among health care workers and higher education students.

  12. The prevalence of prescribing antibiotics by primary health care physicians in Turkey: A multi-centered survey

    International Nuclear Information System (INIS)

    Acimis, N.M.; Yazici, A.C.; Gocmen, L.; Mas, R.

    2009-01-01

    Objective: Antibiotics are widely used in the treatment of infections and for empirical treatment purposes. Despite this common consumption of antibiotics, it is difficult to state that antibiotics are chosen and used consciously. This study was planned to determine the prevalence of prescribing antibiotics in Turkey. Methodology: This cross-sectional study was conducted in November 2003. The study was carried out in a total of 46 primary care health centers of the following cities; Central Anatolian, Western Anatolian, Eastern Anatolian regions. Results: Two hundred sixty seven physicians participated in the study, 38.9% (104) of which were women and 61.1% (163) were men. The proportion of antibiotic prescription was by 22,6%, and the most frequently chosen antibiotics were 15.6% (3301) Amoxycilline + Clavulanic acid (Amox/Clav), 15.1% (3184) Ampicilline + Sulbactam 12.84% (2711), respectively. When prescriptions with antibiotics were evaluated according to diagnosis, the most frequent diagnoses were found to be as follows: 53.3% (11430) Acute Upper Respiratory Infections, 16.4% (3516) Urinary Tract Infections. Conclusions: The findings of the study suggest that primary health care physicians most often prescribe for acute respiratory tract infections, and prescribe Amoxycilline + Clavunic the most. It may be argued that more extensive studies are needed in this field. (author)

  13. Prevalence of obesity among diabetics seen in a tertiary health care ...

    African Journals Online (AJOL)

    Background: Obesity is a leading determinant for diabetes mellitus. The objective of this study was to assess the prevalence of overweight/obesity among diabetic patients seen at a tertiary hospital in South-South Nigeria. Methods: A retrospective study of 244 diabetic patients seen between January 2010 and June 2012.

  14. [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.

  15. Somatic diseases in patients with schizophrenia in general practice : their prevalence and health care

    NARCIS (Netherlands)

    Oud, Marian J. T.; Meyboom-de Jong, Betty

    2009-01-01

    Background: Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their

  16. Dementia prevalence, care arrangement, and access to care in Lebanon

    DEFF Research Database (Denmark)

    Phung, Kieu T T; Chaaya, Monique; Prince, Martin

    2017-01-01

    .0%, respectively. People with dementia were mainly cared for by relatives at home. Access to formal care was very limited. DISCUSSION: Dementia prevalence in Lebanon ranks high within the global range of estimates. These first evidence-based data about disease burden and barriers to care serve to raise awareness...... care arrangement and access to care. METHODS: A random sample of 502 persons older than 65 years and their informant were recruited from Beirut and Mount Lebanon governorates through multistage cluster sampling. RESULTS: The crude and age-standardized dementia prevalences were 7.4% and 9...... and call for social and health care reform to tackle the dementia epidemic in Lebanon and in North Africa and the Middle East....

  17. Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence.

    Science.gov (United States)

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2013-02-01

    To systematically review empirical evidence on the prevalence and nature of medication administration errors (MAEs) in health care settings. Ten electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts, Scopus, Applied Social Sciences Index and Abstracts, PsycINFO, Cochrane Reviews and Trials, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, and Health Management Information Consortium) were searched (1985-May 2012). English-language publications reporting MAE data using the direct observation method were included, providing an error rate could be determined. Reference lists of all included articles were screened for additional studies. In all, 91 unique studies were included. The median error rate (interquartile range) was 19.6% (8.6-28.3%) of total opportunities for error including wrong-time errors and 8.0% (5.1-10.9%) without timing errors, when each dose could be considered only correct or incorrect. The median rate of error when more than 1 error could be counted per dose was 25.6% (20.8-41.7%) and 20.7% (9.7-30.3%), excluding wrong-time errors. A higher median MAE rate was observed for the intravenous route (53.3% excluding timing errors (IQR 26.6-57.9%)) compared to when all administration routes were studied (20.1%; 9.0-24.6%), where each dose could accumulate more than one error. Studies consistently reported wrong time, omission, and wrong dosage among the 3 most common MAE subtypes. Common medication groups associated with MAEs were those affecting nutrition and blood, gastrointestinal system, cardiovascular system, central nervous system, and antiinfectives. Medication administration error rates varied greatly as a product of differing medication error definitions, data collection methods, and settings of included studies. Although MAEs remained a common occurrence in health care settings throughout the time covered by this review, potential targets for intervention to minimize MAEs were identified

  18. Prevalence and risk factors for Staphylococcus aureus in health care workers at a University Hospital of Recife-PE

    Directory of Open Access Journals (Sweden)

    Eduardo Caetano Brandão Ferreira da Silva

    Full Text Available Staphylococcus aureus is the main human pathogen that colonizes individuals in general population. The objective of the study was evaluate the epidemiological and sensitivity profile of S. aureus lineage, isolated in health care workers (HCW of a University Hospital in Pernambuco state, Brazil. Biological samples of hands and nasal cavities were sown in agar sheep blood. Colonies under suspicion of being S. aureus were identified using Gram staining, catalase test and coagulase, mannitol-salty agar fermentation and DNAse agar. The resistance to mupirocin was analyzed through the Kirby Bauer technique. In relation to methicillin and vancomycin the determination was by the minimum inhibitory concentration method (E-test. From the 202 HCW evaluated, 52 were colonized by S. aureus (25,7%. The factors associated to the colonization by S. aureus were: age-group, professional category, use of individual protection equipments (frequency and numbers. All S. aureus isolate lineages were sensitive to mupirocin and vancomycin, and three of them were identified as methicillin-resistant. The prevalence of MSSA and MRSA among HCW was considered low and was below the results described in the literature. The isolate S. aureus lineages have shown low resistance profile.

  19. Prevalence of Childhood and Adolescent Overweight and Obesity from 2003 to 2010 in an Integrated Health Care Delivery System

    Directory of Open Access Journals (Sweden)

    Scott Gee

    2013-01-01

    Full Text Available An observational study of the Kaiser Permanente Northern California (KPNC BMI coding distributions was conducted to ascertain the trends in overweight and obesity prevalence among KPNC members aged 2–19 between the periods of 2003–2005 and 2009-2010. A decrease in the prevalence of overweight (−11.1% change and obesity (−3.6% change and an increase in the prevalence of healthy weight (+2.7% change were demonstrated. Children aged 2–5 had the greatest improvement in obesity prevalence (−11.5% change. Adolescents aged 12–19 were the only age group to not show a decrease in obesity prevalence. Of the racial and ethnic groups, Hispanics/Latinos had the highest prevalence of obesity across all age groups. The KPNC prevalence of overweight and obesity compares favorably to external benchmarks, although differences in methodologies limit our ability to draw conclusions. Physician counseling as well as weight management programs and sociodemographic factors may have contributed to the overall improvements in BMI in the KPNC population. Physician training, practice tools, automated BMI reminders and performance feedback improved the frequency and quality of physician counseling. BMI screening and counseling at urgent visits, in addition to well-child care visits, increased the reach and dose of physician counseling.

  20. Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

    Science.gov (United States)

    Sareen, Jitender; Cox, Brian J; Afifi, Tracie O; Stein, Murray B; Belik, Shay-Lee; Meadows, Graham; Asmundson, Gordon J G

    2007-07-01

    Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use. To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality. Cross-sectional, population-based survey. Canadian military. A total of 8441 currently active military personnel (aged 16-54 years). The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed. The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders. This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides

  1. Prevalence of mental disorders in a population requesting health services at a primary health care center and its association with suicidal ideation and perceived disability

    Directory of Open Access Journals (Sweden)

    Mérida R. Rodríguez

    2012-10-01

    Full Text Available Objective: this study’s goal was to determine the most prevalent mental disorders and the impact on the perception of disability and suicidal ideation among the population from a primary health care center in the city of Cali. Methodology: a cross sectional study was conducted on 254 patients who were screened with the prime-md instrument. Descriptive statistics was used in the analysis to determine the most frequent disorders. Similarly, a multiple analysis with logistic and Poisson regressions using robust variance was conducted to determine the influence of mental disorders on disability and suicidal ideation. Results: most patients were female, young, and mature adults. Depression was present in 66.8% of all cases, followed by somatization disorder and anxiety. Half of the patients had had suicidal ideations at some point in their lives, and three out of four patients claimed to suffer from some kind of disability. Upon adjusting for the covariables, depression and anxiety disorders had a strong association with suicidal ideation and perceived disability that was overestimated by the logistic regression. Conclusion: depression and anxiety were the most common disorders and showed a strong association with suicidal ideation and disability. This is why it is necessary to screen for those disorders among adults using primary health care services. Likewise, we suggest considering Poisson regression with robust variance in cross-sectional studies in health services.

  2. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units

    Directory of Open Access Journals (Sweden)

    Tatiana Mota Xavier de Meneses

    2017-07-01

    Conclusions: Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation.

  3. [Prevalence and characteristics of children and youth with special health care needs (CSHCN) in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

    Science.gov (United States)

    Scheidt-Nave, C; Ellert, U; Thyen, U; Schlaud, M

    2007-01-01

    In order to arrive at population-based estimates on the prevalence and characteristics of children and adolescents with specific health care needs (CSHCN), screening instruments focussing on the consequences of physical, mental and behavioral problems rather than on medical diagnoses have been developed. One of the most feasible and widely tested instruments, the CSHCN screener was added to the self-administered questionnaire for parents of children participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The overall weighted prevalence of CSHCN was 16.0% among boys and 11.4% among girls. Children at kindergarten or school age were more than 2-3 times more likely to screen positive compared to toddlers. Up to 14 years, the sex difference persisted through all age groups and was most pronounced between the ages of 3 and 10 years. Children with a migrant background had significantly lower rates of CSHCN compared to non-migrants. This was particularly true for boys (8.0% vs. 17.1%). CSHCN status was not related to social status, urbanization or residence in former West vs. former East Germany. Except for the lack of association with social status, these results are in good accordance with observations from the US National Survey of CSHCN.

  4. Prevalence of transfusion-transmitted viral pathogens among health-care workers and risk mitigation programme in a paediatric tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Charu Nayyar

    2017-01-01

    Full Text Available The health-care workers (HCWs are at an occupational risk of exposure to blood-borne pathogens, mainly, HIV, hepatitis B virus (HBV and hepatitis C virus. HBV is currently the only blood-borne virus for which a vaccine is available. All health-care institutions must encourage the HCWs to undergo screening for blood-borne pathogens.

  5. Prevalence of hypertension and prehypertension in a community-based primary health care program villages at central India.

    Science.gov (United States)

    Premkumar, Ramaswamy; Pothen, John; Rima, Jeeva; Arole, Shobha

    2016-01-01

    The objective of this study is to evaluate the effects of a community-based effort in a rural area of central India to decrease the prevalence of hypertension among the middle-aged and older population by using multiple blood pressure measurements. With a prevalence of 16.8% (error of 3.36, and 95% confidence interval) from a recent study in a nearby district, the sample size required for this study was 495 subjects. A proportionally stratified random sample design was used. With maps of ten villages, where in a community-based health project had been in place for many years, 20 households and 20 backups were randomly selected from a list of all households. Multiple BP measurements were obtained and categorized and one-month period prevalence was calculated. Statistical analyses of frequency and percentage were performed. Approximately one-fifth of the population above 40 years of age in central India where a community-based approach is in place was hypertensive. This is significantly lower than the previously documented prevalence rate of one-third or even more prevalence rate in India. The attribute of caste and religion, a specific rural Indian characteristic did not have any significant bearing on the above results. The prevalence tended to increase progressively with age until 70 years, after which it declined. Multiple blood pressure measurements may yield an accurate prevalence of hypertension. With the documented evidences from India, the current reduced prevalence of hypertension could have been influenced by the community-based interventions in this population. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  6. Prevalence of Blood-Borne Viruses in Health Care Workers of a Northern District in Pakistan: Risk Factors and Preventive Behaviors

    Directory of Open Access Journals (Sweden)

    Muhammad Zuhaib Khan

    2016-01-01

    Full Text Available Background. Blood-borne viral infections like viral hepatitis are highly prevalent in Pakistan. There is also a potential threat of human immunodeficiency virus (HIV spread in the country. Health care workers (HCWs are a high risk population for acquiring such viral infections and potential spread to the patients. This study aimed to determine the frequency of three blood-borne viruses: HCV, HBV, and HIV in HCWs of district Malakand in northern Khyber Pakhtunkhwa (KPK province of Pakistan. Moreover, risk factors and preventive behaviors among HCWs were investigated in detail. Materials and Methods. Prevalence was investigated using serological assays followed by real time polymerase chain reaction (RT-PCR based characterization. A total of 626 health care workers working at 17 different health care units, belonging to 6 different job categories, were included in this study. Results. HIV was not detected in the HCWs while rate of prevalence of HCV and HBV was far less (0.8 % and 0.64 %, resp. as compared to general population (4.7%–38%. The majority of HCWs were aware of the mode of spread of these viruses and associated risk factors. Needle stick injury was found to be the most important risk factor for possible acquisition of these infections.

  7. Prevalence and Factors Associated with the Use of Eye Care Services in South Korea: Korea National Health and Nutrition Examination Survey 2010-2012.

    Science.gov (United States)

    Park, Yong Seok; Heo, Hwan; Ye, Byeong Jin; Suh, Young-Woo; Kim, Seung-Hyun; Park, Shin Hae; Lim, Key Hwan; Lee, Sung Jin; Park, Song Hee; Baek, Seung-Hee

    2017-02-01

    To estimate the factors and prevalence of eye care service utilization in the South Korean population. This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence interval, 58.1%-64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37-6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea.

  8. Prevalence of Anemia and Associated Risk Factors among Pregnant Women Attending Antenatal Care in Azezo Health Center Gondar Town, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Meseret Alem

    2013-06-01

    Full Text Available ABSTRACT Background: Anemia is a global public health problem affecting both developing and developed countries; approximately 1.3 billion individuals suffer from it. Pregnant women are the most vulnerable groups to anemia. The aim of this study was to assess the prevalence and risk factors for anemia in pregnant women attending antenatal care in Azezo Health Center, Gondar town, Northwest Ethiopia. Method: A cross-sectional study was conducted at Azezo Health Center from February to May 2011. Red blood cell morphology, Hgb level determination and intestinal parasites were assessed following the standard procedures. Socio-demographic data was collected by using a structured questionnaire. The data entered and analyzed by using the SPSS version 16.0 statistical software. P34, rural residence, history of malaria attack, hookworm infection and absence of iron supplements are significantly associated with increased risk of anemia. The most prevalent intestinal parasite among pregnant women was hookworm 18 (4.7%. Conclusion: In the present study, the prevalence of anemia was low when compared with the previous studies carried out in different countries including Ethiopia. More should be done in respect to the importance of regular visit to maternal care centres and health education promotion programs to succeed more. [J Interdiscipl Histopathol 2013; 1(3.000: 137-144

  9. Prevalence of alcohol misuse among men and women undergoing major noncardiac surgery in the Veterans Affairs health care system

    DEFF Research Database (Denmark)

    Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili

    2012-01-01

    Patients who screen positive for alcohol misuse on the Alcohol Use Disorder Identification Test Consumption Questionnaire (AUDIT-C ≥5 points) have significantly increased postoperative complications. Severe alcohol misuse (AUDIT-C ≥9 points) is associated with increased postoperative health care ...

  10. [Comparison of the prevalence of molar incisor hypomineralization among children with different health care coverage in the cities of Buenos Aires (Argentina) and Montevideo (Uruguay)].

    Science.gov (United States)

    López Jordi, María del Carmen; Cortese, Silvina G; Álvarez, Licet; Salveraglio, Inés; Ortolani, Andrea M; Biondi, Ana M

    2014-08-01

    The aim of this study was to compare the prevalence of molar incisor hypomineralization (MIH) among children with different health care coverage in Buenos Aires and Montevideo. An observational, cross-sectional and descriptive study was designed, considering children born from 1993-2003 who were seen in the Chairs of Comprehensive Children's Dentistry (Universidad de Buenos Aires) and of Pediatric Dentistry (Universidad de la República) and at five private dental offices between April and December 2010. Two groups were defined: A (Buenos Aires; n=1,090) and B (Montevideo; n=626). The clinical diagnosis was carried out with calibrated examiners (Kappa: 0.94) using the Mathu-Muju and Wright criteria. The prevalence of MIH was found to be 16.1% in A and 12.3% in B (p=0.03), with statistically significant differences between the public and private care sectors in both groups (A p=0.0008; B p=0.0004) and a positive correlation between MIH and year of birth (A p=0.001; B p=0.005). The results show that MIH is an emerging pathology and that MIH prevalence is related to year of birth and access to health care.

  11. Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden – an investigation of 2000 randomly selected patient records

    Science.gov (United States)

    Fahlström, Martin; Djupsjöbacka, Mats

    2016-01-01

    Abstract Rationale, aims and objectives The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Methods Patient records (2000) for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3‐year period was reviewed retrospectively. For all patient records' background data, cause to the visit and diagnosis were registered. For visits due to MSD, type and location of symptoms and actions to resolve the patients problems were registered. Data was analysed using cross tabulation, multidimensional chi‐squared. Results The prevalence of MSD was high; almost 60% of all patients were seeking care due to MSD. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age groups. The patients got a variety of different diagnoses, and between 13 and 35% of the patients did not receive a MSD diagnose despite having MSD symptoms. There was a great variation in how the cases were handled. Conclusions The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. PMID:27538347

  12. Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden - an investigation of 2000 randomly selected patient records.

    Science.gov (United States)

    Wiitavaara, Birgitta; Fahlström, Martin; Djupsjöbacka, Mats

    2017-04-01

    The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Patient records (2000) for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3-year period was reviewed retrospectively. For all patient records' background data, cause to the visit and diagnosis were registered. For visits due to MSD, type and location of symptoms and actions to resolve the patients problems were registered. Data was analysed using cross tabulation, multidimensional chi-squared. The prevalence of MSD was high; almost 60% of all patients were seeking care due to MSD. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age groups. The patients got a variety of different diagnoses, and between 13 and 35% of the patients did not receive a MSD diagnose despite having MSD symptoms. There was a great variation in how the cases were handled. The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  13. Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq.

    Science.gov (United States)

    Cetorelli, Valeria; Burnham, Gilbert; Shabila, Nazar

    2017-01-01

    The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq. The study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1300 households with a total of 8360 members were interviewed between November and December 2015. Respondents were asked whether any household members had been previously diagnosed by a health provider with one or more of four common NCDs: hypertension, diabetes, cardiovascular disease and musculoskeletal conditions. For each household member with an NCD diagnosis, access to health care and medications were queried. Nearly one-third of households had at least one member who had been previously diagnosed with one or more of the four NCDs included in this study. Hypertension had the highest prevalence (19.4%; CI: 17.0-22.0), followed by musculoskeletal conditions (13.5%; CI: 11.4-15.8), diabetes (9.7%; CI: 8.0-11.7) and cardiovascular disease (6.3%; CI: 4.8-8.1). Individual NCD prevalence and multimorbidity increased significantly with age. Of those with an NCD diagnosis, 92.9% (CI: 88.9-95.5) had seen a health provider for this condition in the 3 months preceding the survey. In the majority of cases, care was sought from private clinics or hospitals rather than from the camp primary health care clinics. Despite the frequent access to health providers, 40.0% (CI: 34.4-46.0) were not taking prescribed medications, costs being the primary reason cited. New strategies are needed to strengthen health care provision for displaced persons with NCDs and ensure access to affordable medications.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    com. +234 803 5837179. KEYWORDS. Disease surveillance, notification, resident doctors,. Edo State journal of. COMMUNITY HEALTH. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care. 26(2) 107-115 ...

  15. Prevalence of childhood and early adolescence mental disorders among children attending primary health care centers in Mosul, Iraq: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al-Jawadi Asma A

    2007-10-01

    Full Text Available Abstract Background Children and adolescents are more vulnerable to the affects of war and violence than adults. At the time of initiation of this study, nothing was known about the prevalence of childhood and early adolescence mental disorders. The aim of the present study is to measure the point prevalence of mental disorders among children of 1–15 years age in the city of Mosul, Iraq. Methods A cross-sectional study design was adopted. Four primary health care centers were chosen consecutively as a study setting. The subjects of the present study were mothers who came to the primary health care center for vaccination of their children. The chosen mothers were included by systematic sampling randomization. All children (aged 1–15 that each mother had were considered in the interview and examination. Results Out of 3079 children assessed, 1152 have childhood mental disorders, giving a point prevalence of 37.4%, with a male to female ratio of to 1.22:1. The top 10 disorders among the examined children are post-traumatic stress disorder (10.5%, enuresis (6%, separation anxiety disorder (4.3%, specific phobia (3.3% stuttering and refusal to attend school (3.2% each, learning and conduct disorders (2.5% each, stereotypic movement (2.3% and feeding disorder in infancy or early childhood (2.0%. Overall, the highest prevalence of mental disorders was among children 10–15 years old (49.2% while the lowest was among 1–5 year olds (29.1%. Boys are more affected than girls (40.2% and 33.2%, respectively. Conclusion Childhood mental disorders are a common condition highly prevalent amongst the children and early adolescents in Mosul. Data from the present study mirrors the size of the problem in local community. Several points deserve attention, the most important of which include giving care at the community level, educating the public on mental health, involving communities and families, monitoring community mental health indicators, and

  16. Prevalence of hyponatremia in palliative care patients

    Directory of Open Access Journals (Sweden)

    Shoba Nair

    2016-01-01

    Conclusions: Prevalence of hyponatremia is significant in palliative care patients. A prospective study looking at the causes and clinical outcomes associated with hyponatremia in palliative care patients is needed.

  17. Prevalence of mobile phones and factors influencing usage by caregivers of young children in daily life and for health care in rural China: a mixed methods study.

    Science.gov (United States)

    van Velthoven, Michelle Helena; Li, Ye; Wang, Wei; Chen, Li; Du, Xiaozhen; Wu, Qiong; Zhang, Yanfeng; Rudan, Igor; Car, Josip

    2015-01-01

    To capitalise on mHealth, we need to understand the use of mobile phones both in daily life and for health care. To assess the prevalence and factors that influence usage of mobile phones by caregivers of young children. A mixed methods approach was used, whereby a survey (N=1854) and semi-structured interviews (N=17) were conducted concurrently. The quantitative and qualitative data obtained were compared and integrated. Participants were caregivers of young children in Zhao County, Hebei Province, China. Four main themes were found: (i) trends in mobile phone ownership; (ii) usage of mobile phone functions; (iii) factors influencing replying to text messages; and (iv) uses of mobile phones for health care. The majority of 1,854 survey participants (1,620; 87.4%) used mobile phones, but usage was much higher among mothers (1,433; 92.6%) and fathers (41; 100.0%) compared to grandparents (142; 54.6%). Parents were able to send text messages, grandparents often not. Factors influencing the decision to reply to text messages in daily life were checking the mobile phone, trusting the sender, emotion or feeling when receiving a text message, the importance of replying and ease of use of text messages. Of 1,620 survey participants who used a mobile phone, about one in four (432; 26.7%) had used it for health care in the past three months and most (1,110; 93.5%) of 1,187 who had not wished to use their phone to receive health information. We found that usage of mobile phones is high, several factors influencing usage and an interest of caregivers to use phones for health care in Zhao County, rural China, which can be used to inform studies in settings with similar characteristics. Future work needs to assess factors influencing mobile phone usage in-depth to optimize experiences of users for specific mHealth-based interventions.

  18. Health Care Team

    Science.gov (United States)

    ... Events Advocacy Donate A to Z Health Guide Health Care Team Print Email Good health care is always a team effort - especially for people ... chronic kidney failure. Since each member of the health care staff contributes to your care, it is important ...

  19. Respiratory Home Health Care

    Science.gov (United States)

    ... Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition ... Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at home can contribute to improved ...

  20. Prevalence, care-seeking, and health service utilization for non-communicable diseases among Syrian refugees and host communities in Lebanon.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Hanquart, Baptiste; Woodman, Michael

    2016-01-01

    Given the large burden of non-communicable diseases (NCDs) among both Syrian refugees and the host communities within which they are settled, humanitarian actors and the government of Lebanon face immense challenges in addressing health needs. This study assessed health status, unmet needs, and utilization of health services among Syrian refugees and host communities in Lebanon. A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling. To obtain information on chronic NCDs, respondents were asked a series of questions about hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis. Differences in household characteristics by care-seeking for these conditions were examined using chi-square, t-test, and adjusted logistic regression methods. Over half (50.4 %) of refugee and host community households (60.2 %) reported a member with one of the five NCDs. Host community prevalence rates were significantly higher than refugees for all conditions except chronic respiratory diseases ( p  = 0.08). Care-seeking for NCDs among refugees and host community households was high across all conditions with 82.9 and 97.8 %, respectively, having sought care in Lebanon for their condition. Refugees utilized primary health care centers (PHCC) (57.7 %) most often while host communities sought care most in private clinics (62.4 %). Overall, 69.7 % of refugees and 82.7 % of host community members reported an out-of-pocket consultation payment ( p  = 0.041) with an average payment of US$15 among refugees and US$42 for the host community ( p Syrian crisis and the burden on the Lebanese health system, implications for both individuals with NCDs and Lebanon's health system are immense. The burden of out of pocket expenses on persons with NCDs are also substantial, especially given the tenuous economic status of many refugees

  1. Prevalence and temporal trends of physical activity counselling in primary health care in Germany from 1997-1999 to 2008-2011.

    Science.gov (United States)

    Gabrys, Lars; Jordan, Susanne; Schlaud, Martin

    2015-10-26

    For patients, usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year. Therefore, physical activity counselling strategies delivered by a physician seem to be a promising approach for physical activity improvement. The aim of this work is to show prevalence and time trends in physical activity counselling by primary health care physicians from 1997-1999 to 2008-2011 in Germany. Data from two representative cross-sectional health interview and examination surveys of the Robert Koch Institute were used. Prevalence proportions of physicians' physical activity counselling and patients' utilisation of health promotion programmes in relation to physical activity counselling were analysed. Strengths of associations were calculated by using binary logistic regression models. Overall, 11,907 persons aged 18-64 years were included in the analyses. Physical activity counselling prevalence decreased from 11.1 to 9.4% in men and from 9.3 to 7.7% in women over ten years. Only persons with accumulated health risks (OR 5.33; 95% CI 1.89-15.00) and persons with diagnosed diabetes mellitus (OR 3.42; 95% CI 1.68-6.69) showed significantly higher counselling proportions in 2008-2011 compared to 1997-1999. Men were more often counselled on physical activity than women, but women showed significantly higher participation rates in physical activity promotion programmes in both surveys. In both sexes significantly higher participation rates could be observed in persons who had received some activity counselling by a physician. Although, evidence underlines the positive health effects of regular physical activity; overall, physicians counselling behaviour on physical activity decreased over time. However, it is positive to note that a trend towards a disease-specific counselling behaviour in terms of a tailored intervention could be observed.

  2. 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

  3. Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience.

    Science.gov (United States)

    Dorfman, Karina; Komargodski, Olga; Magnezi, Racheli; Lifshitz, Stanislav; Tzur, Dorit; Yavnai, Nirit; Ifergane, Gal

    2017-06-01

    Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.

  4. The Use of Communication Apps by Medical Staff in the Australian Health Care System: Survey Study on Prevalence and Use.

    Science.gov (United States)

    Nikolic, Amanda; Wickramasinghe, Nilmini; Claydon-Platt, Damian; Balakrishnan, Vikram; Smart, Philip

    2018-02-09

    widespread use. Communication app use by medical personnel in Victorian hospitals is pervasive. These apps contribute to enhanced communication between medical staff, but their use raises compliance issues, most notably with Australian privacy legislation. Development of privacy-compliant apps such as MedX needs to prioritize a user-friendly interface and market the product as a privacy-compliant comparator to apps previously adapted to health care settings. ©Amanda Nikolic, Nilmini Wickramasinghe, Damian Claydon-Platt, Vikram Balakrishnan, Philip Smart. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 09.02.2018.

  5. Prevalence and health care seeking behaviour for sexually transmitted infections among in-school adolescents in Ado-Ekiti, South-Western Nigeria.

    Science.gov (United States)

    Adegun, Patrick T; Amu, Eyitope O

    2016-06-07

    In Nigeria, adolescents are highly vulnerable to sexually transmitted infections (STIs) which have the potential of jeopardising their future reproductive lives if poorly treated. To determine the prevalence and health care seeking behaviour for STIs among secondary school adolescents in Ado, South-Western Nigeria. Male and female adolescents aged 10-19 years. The study employed a descriptive cross-sectional design. A pre-tested, self-administered, semi-structured questionnaire was used to elicit information from 560 adolescents selected from public and private secondary schools in Ado Local Government Area (LGA) of Ekiti State, using a multistage sampling technique. The data were analyzed using descriptive and inferential statistics. Analyzed data were presented in the form of tables and charts. Two hundred and fifty-one (47.1%) respondents had previous symptoms of STIs. The commonest symptoms among the males were penile discharge (30.5%), painful micturition (30.5%) and stomach pain with swollen testes (25.4%). The commonest symptoms among the females were genital itching (27.6%), genital sores (14.1%) and painful micturition (13.1%). Only 26.7% sought treatment from a health facility; 37.0% did nothing; 15.9% went to patent medicine stores, 10.0% used herbs; the rest did self-medication or prayed. The prevalence of STI symptoms among adolescents in Ado-Ekiti is high but their health care seeking behaviour is poor. Health education about the dangers of untreated STI and the importance of seeking treatment early, targeted at adolescents, should be intensified.

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... Journal of Community Medicine and Primary Health Care. 27 (1) 27-36. KEYWORDS out-of-pocket payment, user fees, quality, tertiary health services;. Nigeria. .... and research committee of the Delta State .... Methods of funding and perceived satisfaction patient's waiting time, attitude of health care.

  7. Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010

    Science.gov (United States)

    Mbaisi, Everline Muhonja; Ng'ang'a, Zipporah; Wanzala, Peter; Omolo, Jared

    2013-01-01

    Introduction Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. Methods A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. Results Twenty five percent of health-care workers interviewed (N = 305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n = 305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR= 3.7; 95% CI = 1.08-9.13) while previous training in infection prevention was protective (OR= 0.52; 95% CI = 0.03-0.90). Forty eight percent (n = 83) reported the incidents with 20% (n = 83) taking PEP against HIV. Conclusion Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers. PMID:23504245

  8. Unplanned health care tourism.

    Science.gov (United States)

    Powell, Suzanne K

    2015-01-01

    Health care tourism is often a preplanned event carefully laying out all the details. Sometimes, when one least expects it, medical care is needed outside of the mainland. This Editorial speaks to an unplanned experience.

  9. Prevalence of Influenza A (H1N1) Sero positivity in Unvaccinated Health care Workers in Scotland at the Height of the Global Pandemic

    International Nuclear Information System (INIS)

    Smith, K.; Katikireddi, S.V.; Mackenzie, D.G.; Warner, P.; Williams, L.J.; Adamson, W.E.; Carman, W.F.; Dewart, P.; Templeton, K.; Denison, F.C.

    2011-01-01

    Background. We set out to identify the level of previous exposure to influenza A (H1N1) in unvaccinated health care workers (HCWs) at the peak of the pandemic outbreak in the UK, with control samples collected prior to the outbreak. Methods. Cross-sectional study (sero prevalence assessed before and at pandemic peak, with questionnaire data collected at peak of outbreak) in HCWs in Scotland. Results. The prevalence of sero positivity in 493 HCWs at pandemic peak was 10.3%, which was higher than the pre pandemic level by 3.7 percentage points (95% CI 0.3% to 7.3%, P=0.048). Sero positivity rates for front line and non front line HCWs were similar. Conclusion. At pandemic peak, only 10.3% of HCWs were seropositive for influenza A (H1N1), so the great majority were still susceptible to infection at the introduction of the vaccination programme. Few studies have reported on sero prevalence in unvaccinated and asymptomatic participants, so our findings may have relevance to the wider population

  10. Vacation health care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  11. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  12. Health care agents

    Science.gov (United States)

    ... do not want these treatments. Order sterilization or abortion. Choosing Your Health Care Agent Choose a person ... working well. A health care proxy is a legal paper that you fill out. You can get ...

  13. Prevalence of Mobile Phones and Factors Influencing Usage by Caregivers of Young Children in Daily Life and for Health Care in Rural China: A Mixed Methods Study

    Science.gov (United States)

    Wang, Wei; Chen, Li; Du, Xiaozhen; Wu, Qiong; Zhang, Yanfeng; Rudan, Igor; Car, Josip

    2015-01-01

    Introduction To capitalise on mHealth, we need to understand the use of mobile phones both in daily life and for health care. Objective To assess the prevalence and factors that influence usage of mobile phones by caregivers of young children. Materials and Methods A mixed methods approach was used, whereby a survey (N=1854) and semi-structured interviews (N=17) were conducted concurrently. The quantitative and qualitative data obtained were compared and integrated. Participants were caregivers of young children in Zhao County, Hebei Province, China. Results Four main themes were found: (i) trends in mobile phone ownership; (ii) usage of mobile phone functions; (iii) factors influencing replying to text messages; and (iv) uses of mobile phones for health care. The majority of 1,854 survey participants (1,620; 87.4%) used mobile phones, but usage was much higher among mothers (1,433; 92.6%) and fathers (41; 100.0%) compared to grandparents (142; 54.6%). Parents were able to send text messages, grandparents often not. Factors influencing the decision to reply to text messages in daily life were checking the mobile phone, trusting the sender, emotion or feeling when receiving a text message, the importance of replying and ease of use of text messages. Of 1,620 survey participants who used a mobile phone, about one in four (432; 26.7%) had used it for health care in the past three months and most (1,110; 93.5%) of 1,187 who had not wished to use their phone to receive health information. Conclusion We found that usage of mobile phones is high, several factors influencing usage and an interest of caregivers to use phones for health care in Zhao County, rural China, which can be used to inform studies in settings with similar characteristics. Future work needs to assess factors influencing mobile phone usage in-depth to optimize experiences of users for specific mHealth-based interventions. PMID:25789477

  14. HIV/AIDS prevalence among South African health workers

    African Journals Online (AJOL)

    expected that HIV prevalence among health workers will ... HIV I AIDS. In Malawi,' researchers reported that in 1999 2% of health care workers died of AIDS (60 deaths out of 2 979). Among female health care workers, the highest death rates were among ..... Ministry needs to conduct an in-depth investigation into the·.

  15. Prevalence of adherence to treatment in homebound elderly people in primary health care: a descriptive, cross-sectional, multicentre study.

    Science.gov (United States)

    Cárdenas-Valladolid, Juan; Martín-Madrazo, Carmen; Salinero-Fort, Miguel A; Carrillo de-Santa Pau, Enrique; Abánades-Herranz, Juan C; de Burgos-Lunar, Carmen

    2010-08-01

    Adherence to the therapeutic plan is one of the most important health issues in terms of treatment efficacy, healthcare costs and patient safety. Unfortunately, homebound elderly patients are especially vulnerable to nonadherence because they have higher morbidity rates combined with cognitive and social problems that hinder their correct use of drugs. The level of therapeutic adherence in homebound elderly people has not been adequately studied. To estimate the prevalence of therapeutic adherence, using the Morisky-Green test, in homebound elderly patients taking polypharmacy (defined as use of four or more drugs), and to study the factors associated with adherence. This was a descriptive, cross-sectional, multicentre study. A total of 327 patients were selected by random start systematic sampling from the total number of homebound patients taking four or more drugs in Healthcare Area 4 of the Madrid Autonomous Region, Spain. Through an in-home survey of patients and their caregivers, information was gathered on sociodemographic data, co-morbidities, number of hospital admissions, responsibility for purchasing and preparation of the medication, level of cognitive impairment (Pfeiffer questionnaire), functional dependence in activities of daily living (Katz Index), knowledge of the disease (Batalla test), adherence to treatment (Morisky-Green test), visual and auditory perception, and caregiver burden (Zarit interview). Of the homebound patients, 65.7% (95% CI 60.6, 70.9) had good adherence to treatment. The variables most negatively associated with therapeutic adherence, after adjustment for age, sex, number of drugs, knowledge of the disease, and cognitive function, were a large caregiver burden (odds ratio [OR] 3.09; 95% CI 1.75, 5.48) and impaired hearing (OR 2.00; 95% CI 1.17, 3.40). There was also a trend toward a positive association between nonadherence and patients aged <85 years (OR 1.57; 95% CI 0.93, 2.65) and patients who had nine or more drug

  16. Detecting a low prevalence of latent tuberculosis among health care workers in Denmark detected by M. tuberculosis specific IFN-gamma whole-blood test

    DEFF Research Database (Denmark)

    Soborg, Bolette; Andersen, Aase B; Larsen, Helle K

    2007-01-01

    The study was designed to estimate prevalence of tuberculosis infection among health care workers, using the tuberculin skin test (TST) and the new M. tuberculosis specific diagnostic whole-blood test and to identify possible risk factors. Employees at 2 departments of infectious diseases...... in Copenhagen were invited to enter the study. All attendants completed a questionnaire, had a TST and blood drawn for detection of interferon-gamma produced after stimulation with M. tuberculosis specific antigens ESAT-6 and CFP-10 (QuantiFERON-TB-Gold, Cellestis). 47 of 139 (34%) participants had a positive...... TST whereas only 2 of 139 (1%) had a positive QuantiFERON TB-Gold test (QFT-TB). 42 of 106 (40%) BCG vaccinated had positive TST (> or =12 mm) compared with 2 of 27 (7%) unvaccinated persons. Among 47 persons with positive TST, 42 (89%) were BCG- vaccinated. The 2 QFT-TB positive participants as well...

  17. 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 ... health policy makers. Irrespective of the option, the choice of health care financing should mobilize resources for health and provide financial protection. 1 ..... Opportunities for Sub-Saharan African.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    ABSTRACT. Background: The well-being of women and children is one of the major determinants of the health of any nation and can ... preconception care, the result showed that majority (65.9%, n=247) of the respondents have not sought the care before pregnancy ... women have optimal health in order to give birth to.

  19. Health Care in China.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    China has recently emerged as an important global partner. However, like other developing nations, China has experienced dramatic demographic and epidemiologic changes in the past few decades. Population discontent with the health care system has led to major reforms. China's distinctive health care system, including its unique history, vast infrastructure, the speed of health reform, and economic capacity to make important advances in health care, nonetheless, has incomplete insurance coverage for urban and rural dwellers, uneven access, mixed quality of health care, increasing costs, and risk of catastrophic health expenditures. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care

    NARCIS (Netherlands)

    De Hert, Marc; Correll, Christoph U.; Bobes, Julio; Cetkovich-Bakmas, Marcelo; Cohen, Dan; Asai, Itsuo; Detraux, Johan; Gautam, Shiv; Moeller, Hans-Jurgen; Ndetei, David M.; Newcomer, John W.; Uwakwe, Richard; Leucht, Stefan

    The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic

  1. Day care health risks

    Science.gov (United States)

    ... as head lice and scabies are other common health problems that occur in day care centers. You can do a number of ... for the child How to contact your child's health care provider ... sure your child's day care staff knows how to follow that plan.

  2. Indian Health Service: Find Health Care

    Science.gov (United States)

    ... IHS Home for Patients Find Health Care Find Health Care IMPORTANT If you are having a health emergency ... services, continuous nursing services and that provides comprehensive health care including diagnosis and treatment. Health Locations An ambulatory ...

  3. Diabetes prevalence and hospital and pharmacy use in the Veterans Health Administration (1994). Use of an ambulatory care pharmacy-derived database.

    Science.gov (United States)

    Pogach, L M; Hawley, G; Weinstock, R; Sawin, C; Schiebe, H; Cutler, F; Zieve, F; Bates, M; Repke, D

    1998-03-01

    To develop a diabetes registry from an outpatient pharmacy database to systematically analyze the prevalence of diabetes, patterns of glycemic medication and glucose monitoring, pharmacy costs, and hospital use related to diabetes care in the Veterans Health Administration (VHA) in fiscal year (FY) 1994. Veterans with diabetes were identified using a software program that extracted the social security number (SSN) of patients receiving insulin, sulfonylurea agents, or glucose-monitoring supplies. The cumulative FY94 cost for a drug was calculated by multiplying the units dispensed times the unit cost for each fill, using the actual drug cost that was in effect at the time of dispensing. Admission data were obtained by crossmatching the SSN registry with the VHA Austin Mainframe Patient Treatment Files to retrieve associated diagnosis-related groups (DRG), Physicians' Current Procedural Terminology (CPT), and International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes. From among 1,180,260 unique patients, 139,646 veterans with diabetes receiving insulin, oral agents, or glucose-monitoring strips were identified, accounting for a prevalence of 11.83% from 62 Veterans Administration medical centers. There were 63,078 individuals (52%) who received oral agents, of whom 26.3% also received blood glucose-monitoring supplies; 46,664 individuals (39%) received insulin, of whom 53.2% received blood glucose-monitoring supplies; and 9,440 individuals (8%) received both oral agents and insulin during FY94, with 64.4% receiving blood glucose-monitoring supplies. Only 1,482 (1.2%) individuals received monitoring supplies alone, and 129 patients (0.1%) were provided with an insulin pump. Using an adjusted data set, 12% of veterans accounted for 24% of all outpatient pharmacy costs, with an average expenditure of $622 for veterans with diabetes compared with $276 for veterans without diabetes. There was $454 (73%) for non

  4. Resilient health care

    DEFF Research Database (Denmark)

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

    . Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue...... rights reserved....

  5. 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,

  6. 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.

  7. Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study.

    Science.gov (United States)

    Laelago, Tariku; Yohannes, Tadele; Lemango, Fiseha

    2016-01-01

    The use of herbal medicine has been on increase in many developing and industrialized countries. More pregnant women use herbal remedies to treat pregnancy related problems due to cost-effectiveness of therapy and easy access of these products. We sought to assess the prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinics of public health facilities. Facility based cross sectional study was conducted among 363 pregnant women attending antenatal clinics from May to June 2015 at public health facilities in Hossana town, Hadiya zone, Southern Ethiopia. Pretested structured questionnaire was used to collect data from each study subject. Bivariate logistic regression analysis was used to see significance of association between the outcome and independent variables. Odds ratios at 95 % CI were computed to measure the strength of the association between the outcome and the independent variables. P-value herbal medicine during current pregnancy . The herbal medicines commonly taken during current pregnancy were ginger (55.8 %), garlic (69.8 %), eucalyptus (11.6 %), tenaadam (rutachalenssis) (26.4 %), damakesse (ocimumlamiifolium) (22.8 %), feto (3.5 %) and omore (3.1 %). Being students (AOR: (5.68, 95 % CI: (1.53, 21.13), second trimester of pregnancy (AOR: 0.22, 95 % CI: (0.08, 0.76), sufficient knowledge on herbal medicine (AOR: 0.37, 95 % CI: (0.19, 0.79), no formal education (AOR: 4.41, 95 % CI: (1.11, 17.56), primary education (AOR: 4.15, 95 % CI: (1.51, 11.45) and secondary education (AOR: 2.55, 95 % CI: (1.08,6.03) were significantly associated with herbal medicine use. The findings of this study showed that herbal medicine use during pregnancy is a common experience. Commonly used herbal medicines during current pregnancy were garlic, ginger, tenaadam, damakasse and eucalyptus. Educational status, occupation, knowledge on herbal medicine and second trimester of pregnancy were the major factors

  8. The Prevalence Of Careers And Microbial Spectrum Of Health Care Worker,s Hand And Relation Between Detergent Used For Washing

    Directory of Open Access Journals (Sweden)

    Khodada A

    2004-09-01

    Full Text Available Background: Many of hospital acquired infections that cause so much morbidity and mortality and have great economical burden are transmitted via contaminated hands of health care workers (HCW.Prevalence of these infections can decrease up to 30% with hygienic measures. In this study we assessed the prevalence of careers and microbial spectrum of HCW,s hand and relation between detergent used for washing and reduction of microbial load of HCW, s hand. Materials and Methods: This study was done in two part: Descriptive part (cross sectional and analytical part (before –after. Cases were Consist of all staff Working in wards of center of pediatrics hospital (Including attends, residents, interns, nurses and workers. In first part ,we assess hand microbial spectrum and contamination load of 72 staff and in second part, we assessed and compared hand microbial spectrum and load before and after of washing with four detergent : plain soap (60 staff , liquid soap (60 staff , betadin scrub in ward (60 staff and betadin scrub in operating room manner (26 staff. Results: %87.5 of personnel had positive cultures-.The most prevalent bacteria were staph. epidermidis (%79.4, staph. oreus (%42.9, klebsiella (%12.7, E-coli (%12.7. The rate of reduction or negative cultures in groups used betadin were greater than the first two group (P-value <0/05.Thirty staff (10 with plain soap,10 with liquid soap and 10 with operating room betadin scrub dried their hands after washing. Forty percent of first, fifty percent of second and ninety percent of third group have negative culture after drying. Also 11 samples were drawn from faucets that all of them were positive. Conclusion: Prevalence of careers is high among HCWS and drying of hands can an important role in hospital infection rate. Faucets have heavy contamination and can transmit bacteria to hands after washing. For theses reasons education and of staff to correct hand washing and drying before every contact

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Background. The availability of drugs on a continuous basis is paramount to the success of any health care system. The Bamako Initiative (BI) had provision of essential drugs as one of its key thrusts in order to improve the utilization of health facilities. This study compared the perceived availability of essential drugs and ...

  10. Prevalence of wounds in a community care setting in Ireland.

    Science.gov (United States)

    McDermott-Scales, L; Cowman, S; Gethin, G

    2009-10-01

    To establish the prevalence of wounds and their management in a community care setting. A multi-site, census point prevalence wound survey was conducted in the following areas: intellectual disability, psychiatry, GP practices, prisons, long-term care private nursing homes, long-term care, public nursing homes and the community/public health (district) nursing services on one randomly selected day. Acute services were excluded. Formal ethical approval was obtained. Data were collected using a pre-piloted questionnaire. Education was provided to nurses recording the tool (n=148). Descriptive statistical analysis was performed. A 97.2% response rate yielded a crude prevalence rate of 15.6% for wounds across nursing disciplines (290/1,854 total census) and 0.2% for the community area (290/133,562 population statistics for the study area). Crude point prevalence ranged from 2.7% in the prison services (7/262 total prison population surveyed) to 33.5% in the intellectual disability services (72/215 total intellectual disability population surveyed). The most frequent wounds recorded were pressure ulcers (crude point prevalence 4%, 76/1,854 total census; excluding category l crude point prevalence was 2.6%, 49/1,854 total census), leg ulcers (crude point prevalence 2.9%, 55/1,854 total census), self-inflicted superficial abrasions (crude point prevalence 2.2%, 41/1,854 total census) and surgical wounds (crude point prevalence 1.7%, 32/1,854 total census). These results support previous international research in that they identify a high prevalence of wounds in the community. The true community prevalence of wounds is arguably much higher, as this study identified only wounds known to the nursing services and excluded acute settings and was conducted on one day.

  11. Prevalence of inappropriate prescribing in primary care

    DEFF Research Database (Denmark)

    Bregnhøj, Lisbeth; Thirstrup, Steffen; Kristensen, Mogens Brandt

    2007-01-01

    OBJECTIVE: To describe the prevalence of inappropriate prescribing in primary care in Copenhagen County, according to the Medication Appropriateness Index (MAI) and to identify the therapeutic areas most commonly involved. SETTING: A cross-sectional study was conducted among 212 elderly ( >65 years...

  12. Regional Outcome Evaluation Program (P.Re.Val.E.): Reduction of inequality in access to effective health care in the Lazio region of Italy (2012-2015).

    Science.gov (United States)

    Ventura, Martina; Fusco, Danilo; Bontempi, Katia; Colais, Paola; Davoli, Marina

    2018-01-01

    Inequalities in health among groups of various socio-economic status (as measured by education, occupation, and income) constitute one of the main challenges for public health. Since 2006, the Lazio Regional Outcome Evaluation Program (P.Re.Val.E.), presents a set of indicators of hospital performance based on quality standards driven by strong clinical recommendations, and measures the variation in the access to effective health care for different population groups and providers in the Lazio Region. One of the aims of the program was to compare population subgroups in order to promote equity in service provision. Since June 2013, a new management strategy has been put in place that assigned specific goals based on performance assessment to the chief executive officers of the hospitals. To evaluate whether, in recent years, there has been a reduction in the differential access to effective health care, among individuals with different educational levels. We enrolled all patients discharged from both public and private hospitals of the Lazio region between 2012 and 2015, living in Lazio region. We analysed the proportion of patients with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention within 90 minutes (primary PCI), the proportion of patients with hip fracture (HF) who underwent surgery within 2 days, and the proportion of women with primary C-section. We applied multivariate logistic regression models to assess the effect of educational level on health outcomes, adjusting for demographic characteristics and comorbidities that could affect the outcomes. For each year of the study period, we compared adjusted proportions of outcomes for the highest and the lowest level of education by using percentage differences. In the Lazio region, 44.6% of STEMI patients (N = 3,299) were treated with primary PCI, 54.4% of patients with hip fractures (N = 6,602) underwent surgery within 2 days, and 27.7% of women without a previous C

  13. Prevalence of depression among health workers in Enugu, South ...

    African Journals Online (AJOL)

    Aims: Determination of the prevalence and distribution of depression among health workers at tertiary level of health care delivery in Enugu South East Nigeria. Settings and Design: A cross‑sectional descriptive survey of depression in health workers at tertiary level. Subjects and Methods: By proportional quota sampling, ...

  14. Health care of hunting dogs

    Directory of Open Access Journals (Sweden)

    Spasojević-Kosić Ljubica

    2013-01-01

    Full Text Available There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunters about dangers which both humans and hunting dogs are exposed to, evaluation of preventive measures implementation in dogs by hunters, the prevalence of certain infections in dogs and determination of health risk for dogs and people related to hunting. This paper shows the results of a survey conducted among hunters with the objective to perceive their awareness of medical risks that hunters and hunting dogs could possibly be exposed to during hunting. [Projekat Ministarstva nauke Republike Srbije, br. TR 31084

  15. 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 were...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p HIV health care utilization...

  16. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice....... This chapter offers an ethnographic description of health as an issue in a Hebei township and it focuses on a popular and a statist response to the perceived inadequacy of the rural health care system. The revival of religious practices in rural China is obviously motivated by many factors, but in the township...... roads to healing. The recent introduction of new rural cooperative medicine in the township represents an attempt to bring the state back in and address popular concern with the cost and quality of health care. While superficially reminiscent of the traditional socialist system, this new state attempt...

  17. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice...... roads to healing. The recent introduction of new rural cooperative medicine in the township represents an attempt to bring the state back in and address popular concern with the cost and quality of health care. While superficially reminiscent of the traditional socialist system, this new state attempt...

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    sexual intercourse under the influence of alcohol or adolescents and younger adults. psychoactive substances. Respondents were. Risky sexual behaviour among young people has categorized as engaging in risky sexual behaviour if. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 2 ...

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    replaced in January 2000, with free health service, which involves supplying free drugs from the state medical store to local government areas. This study aimed to ... The drug revolving fund initiative as a strategic opportunity to support local ... Iwajowa Local Government in symbols of quality care to consumers; in Nigeria,.

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    campaigns; use of cigarette (nicotine). Information was collected on socio- substitutes and alternative approaches like demographic characteristics of respondents, acupuncture, aromatherapy, hypnosis and knowledge and attitude of the health care. 9-12 herbs. Often times, combinations of workers about smoking cessation ...

  1. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    order words, it refers to any abusive treatment to women, thus violating the law of basic human ... JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 27, NO 2, SEPTEMBER 2015. 20 journal of ... Some women victims, for the fear of repeated attacks by perpetrators, refused to even to report to. 3.

  2. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings - Report from the World Health Organization collaborative study on Psychological Problems in General Health Care

    NARCIS (Netherlands)

    Gater, R; Tansella, M; Korten, A; Tiemens, BG; Mavreas, VG; Olatawura, MO

    Background: Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures. Method: Prevalence rates of depressive and anxiety disorders

  3. 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...... are important, but that economics cannot alone explain the differences in health care utilization....

  4. [Analysis of prevalence and risk factors of pelvic organ prolapse of women underwent gynecologic health care in Peking Union Medical College Hospital].

    Science.gov (United States)

    Zhu, Lan; Wang, Jing-yi; Lang, Jing-he; Xu, Tao; Li, Lin

    2010-07-01

    To investigate prevalence and risk factors of pelvic organ prolapse in women underwent routine gynecologic health care in Peking Union Medical College Hospital (PUMCH). From Jan. 2008 to Aug. 2009, 972 women underwent gynecological health care in PUMCH were enrolled in this study. Questionnaires and pelvic examinations were given. The pelvic organ prolapse quantitive examination (POP-Q) system was used as the assessment tool. (1) Among all participants, the mean ages were (42 ± 10) years (range 22 to 78 years), the mean height were (162 ± 5) cm (range 142 to 180 cm), and the mean weight were (59 ± 8) kg (range 42 to 91 kg). 83.8% (815/972) of women were multipara. The mean total vaginal length (TVL) of 972 women was 8.20 cm. No women met the standard of pelvic organ prolapse, while 35.5% (345/972) of women presented mild posterior vaginal descent and 96.7% (940/972) presented mild anterior vaginal descent, all of them were asymptomatic. (2) The length of genital hiatus (gh), TVL and C, D proximal to the hymen in nullipara were (2.26 ± 0.32), (8.08 ± 0.30), (-7.08 ± 0.24) and (-8.08 ± 0.30) cm, which were significantly less than (2.33 ± 0.39), (8.22 ± 0.35), (-7.14 ± 0.28) and (-8.22 ± 0.35) cm in multipara (P 0.05). However, those in women at group of 22 - 34 years and 35 - 49 years showed statistical difference when compared with women at group of more than 50 years (P < 0.05). When compared with women at group of 22 - 34 years, the incidence of posterior and anterior vaginal wall protrusion were increased (OR = 1.713, 3.765). (4) Menopause status was associated with severities of all kinds of descent (P < 0.05) and presence of posterior vaginal protrusion (OR = 3.354). Mild anterior and posterior vaginal descent by POP-Q were common among women in China. The risk of anterior vaginal descent is relatively higher than posterior vaginal descent. However, most of the women with descent are asymptomatic and need no treatment. The most important factors

  5. Mental Health Care

    OpenAIRE

    Švab, Vesna; Zaletel-Kragelj, Lijana

    2008-01-01

    Mental health conceptualize a state of well-being, perceived self efficacy, competence, autonomy, intergenerational dependence and recognition of the ability to realize one's intellectual and emotional potential. Mental health care are services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore mental health. Students will become familiar with extensiveness of the problem, and levels of preventing it. It is illustra...

  6. Prevalence of obesity recorded in Primary Care.

    Science.gov (United States)

    Gutiérrez Angulo, María Luisa; Amenabar Azurmendi, Miren Dolores; Cuesta Solé, María Lourdes; Prieto Esteban, Irene; Mancebo Martínez, Sara; Iglesias Alonso, Amparo

    2014-11-01

    To ascertain the prevalence of obesity and overweight recording in primary care (PC) clinical records. A descriptive, cross-sectional study. The study was conducted in three urban, primary care centers in Gipuzkoa. 620 computerized clinical records randomly selected from a population of 63,820. Patient age older than 14 years was the only inclusion criterion. Recording of the clinical episode referring to obesity and/or overweight. Other variables included age, sex, body mass index (BMI), waist circumference, comorbidity (diabetes, hypertension, heart failure, among others), and variability of the record made by healthcre professionals at each center. Statistical analysis included a Chi-square test or a Fisher's test for low frequencies. A value of P<.05 was considered significant. Analysis was performed using SPSS(®) v.21 software. Prevalence of recorded obesity was 6%, and 78.4% of those with recorded obesity were women. Overweight was recorded in 3% of subjects, of which 33.2% were women. BMI was recorded in 170 cases (27%). At least one comorbidity was found in 241 subjects (39%). Association of BMI with presence of comorbidity was statistically significant (P=.0001). Recording of obesity was associated to presence of comorbidity (P =.0002). This study confirmed that prevalence of obesity is underestimated, mainly because it is inadequately recorded in clinical histories; that prevalence increases in the presence of other risk factors; and that there is a significant variability in data collection between healthcare professionals. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  7. Types of health care providers

    Science.gov (United States)

    ... article describes health care providers involved in primary care, nursing care, and specialty care. ... MD) or a Doctor of Osteopathic Medicine (DO). NURSING CARE Licensed practical nurses (LPNs) are state-licensed caregivers ...

  8. American Health Care Association

    Science.gov (United States)

    ... for more information reguarding Please take a moment today to speak out, stay informed and spread. Looking for more information reguarding Prefered Provider Program Quality ... Nursing Home Administrator | Benedictine Health System US - MO - St. Louis, Qualifications Required: Bachelor’s degree in business, marketing, health care administration or a related field ...

  9. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  10. Prevalence and Predictors of Gaps in Care Among Adult Congenital Heart Disease Patients (The Health, Education and Access Research Trial: HEART-ACHD)

    Science.gov (United States)

    Gurvitz, Michelle; Valente, Anne Marie; Broberg, Craig; Cook, Stephen; Stout, Karen; Kay, Joseph; Ting, Jennifer; Kuehl, Karen; Earing, Michael; Webb, Gary; Houser, Linda; Opotowsky, Alexander; Harmon, Amy; Graham, Dionne; Khairy, Paul; Gianola, Ann; Verstappen, Amy; Landzberg, Michael

    2013-01-01

    Objective The goal of this project was to quantify the prevalence of gaps in cardiology care, identify predictors of gaps, and assess barriers to care among adult congenital heart disease (ACHD) patients. Background ACHD patients risk interruptions in care that are associated with undesired outcomes. Methods Patients (≥18years) with first presentation to an ACHD clinic completed a survey regarding gaps in, and barriers to, care. Results Among 12 ACHD centers, 922 subjects (54% female) were recruited. A >3 year gap in cardiology care was identified in 42%, with 8% having gaps longer than a decade. Mean age at first gap was 19.9 years. The majority of respondents had more than high school education, and knew their heart condition. Most common reasons for gaps included feeling well, unaware follow-up required, and complete absence from medical care. Disease complexity was predictive of gap in care with 59% of mild, 42% of moderate and 26% of severe disease subjects reporting gaps (p<0.0001). Clinic location significantly predicted gaps (p<0.0001) while gender, race, and education level did not. Common reasons for returning to care were new symptoms, referral from provider, and desire to prevent problems. Conclusions ACHD patients have gaps in cardiology care; the first lapse commonly occurred around 19 years, a time when transition to adult services is contemplated. Gaps were more common among subjects with mild and moderate diagnoses and at particular locations. These results provide a framework for developing strategies to decrease gaps and address barriers to care in the ACHD population. PMID:23542112

  11. Prevalence of prenatal zinc deficiency and its association with socio-demographic, dietary and health care related factors in Rural Sidama, Southern Ethiopia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gebremedhin Samson

    2011-11-01

    Full Text Available Abstract Background Several studies witnessed that prenatal zinc deficiency (ZD predisposes to diverse pregnancy complications. However, scientific evidences on the determinants of prenatal ZD are scanty and inconclusive. The purpose of the present study was to assess the prevalence and determinants of prenatal ZD in Sidama zone, Southern Ethiopia. Methods A community based, cross-sectional study was conducted in Sidama zone in January and February 2011. Randomly selected 700 pregnant women were included in the study. Data on potential determinants of ZD were gathered using a structured questionnaire. Serum zinc concentration was measured using Atomic Absorption Spectrometry. Statistical analysis was done using logistic regression and linear regression. Results The mean serum zinc concentration was 52.4 (+/-9.9 μg/dl (95% CI: 51.6-53.1 μg/dl. About 53.0% (95% CI: 49.3-56.7% of the subjects were zinc deficient. The majority of the explained variability of serum zinc was due to dietary factors like household food insecurity level, dietary diversity and consumption of animal source foods. The risk of ZD was 1.65 (95% CI: 1.02-2.67 times higher among women from maize staple diet category compared to Enset staple diet category. Compared to pregnant women aged 15-24 years, those aged 25-34 and 35-49 years had 1.57 (95% CI: 1.04-2.34 and 2.18 (95% CI: 1.25-3.63 times higher risk of ZD, respectively. Women devoid of self income had 1.74 (95% CI: 1.11-2.74 time increased risk than their counterparts. Maternal education was positively associated to zinc status. Grand multiparas were 1.74 (95% CI: 1.09-3.23 times more likely to be zinc deficient than nulliparas. Frequency of coffee intake was negatively association to serum zinc level. Positive association was noted between serum zinc and hemoglobin concentrations. Altitude, history of iron supplementation, maternal workload, physical access to health service, antenatal care and nutrition education were

  12. 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.

  13. 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 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...

  14. Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Naidoo, Pamela; Matseke, Gladys; Louw, Julia; McHunu, Gugu; Tutshana, Bomkazi

    2013-01-01

    High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.

  15. Estimating Local Prevalence of Mental Health Problems

    OpenAIRE

    Steven Stern

    2011-01-01

    Provision of mental health services is in a state of ?ux as the Patient Protection and A¤ordable Care Act a¤ects provision and cost of medical care and state policymakers grapple with di¢ cult tradeo¤s between budget balance and provi- sion of public medical care. Mental health care provision is actually a relatively small part of the total cost of medical care provision.

  16. Prevalence of common mental disorders among Dutch medical students and related use and need of mental health care: a cross-sectional study

    NARCIS (Netherlands)

    Gaspersz, Roxanne; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2012-01-01

    The purpose of the study was to assess common mental disorders and the related use and need for mental health care among clinically not yet active and clinically active medical students. All medical students (n=2266) at one Dutch medical university were approached. Students from study years 1-4 were

  17. Prevalence of physical inactivity and barriers to physical activity among obese attendants at a community health-care center in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Khuwaja Ali Khan

    2011-06-01

    Full Text Available Abstract Background Overweight and obesity are significant public health problems worldwide with serious health consequences. With increasing urbanization and modernization there has been an increase in prevalence of obesity that is attributed to reduced levels of physical activity (PA. However, little is known about the prevalence of physical inactivity and factors that prohibit physical activity among Pakistani population. This cross-sectional study is aimed at estimating the prevalence of physical inactivity, and determining associated barriers in obese attendants accompanying patients coming to a Community Health Center in Karachi, Pakistan. Findings PA was assessed by using international physical activity questionnaire (IPAQ. Barriers to PA were also assessed in inactive obese attendants. A pre-tested questionnaire was used to collect data from a total of 350 obese attendants. Among 350 study participants 254 (72.6% were found to be physically inactive (95% CI: 68.0%, 77.2%. Multivariable logistic regression analysis indicated that age greater than 33 years, BMI greater than 33 kg/m2 and family history of obesity were independently and significantly associated with physical inactivity. Moreover, there was a significant interaction between family structure and gender; females living in extended families were about twice more likely to be inactive, whereas males from extended families were six times more likely to be inactive relative to females from nuclear families. Lack of information, motivation and skills, spouse & family support, accessibility to places for physical activity, cost effective facilities and time were found to be important barriers to PA. Conclusions Considering the public health implications of physical inactivity it is essential to promote PA in context of an individual's health and environment. Findings highlight considerable barriers to PA among obese individuals that need to be addressed during counseling sessions

  18. Prevalence and risk factors of frailty among home care clients.

    Science.gov (United States)

    Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

    2017-11-17

    Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. ClinicalTrials.gov: NCT02214758 .

  19. Nursing care community health

    Directory of Open Access Journals (Sweden)

    Diana Acosta-Salazar

    2016-07-01

    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  20. Accountability in Health Care

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Byrkjeflot, Haldor

    2016-01-01

    adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...

  1. Health Care Industry

    Science.gov (United States)

    2007-01-01

    technology. Advanced medical technologies are abundant in the U.S., especially computed tomography (CT) scanners and magnetic resonance imaging (MRI...Science) degree and practice general or specialized dentistry or dental surgery (IBISWorld, 2007, March 26). Health care practitioners include a wide

  2. High prevalence of alpha- and beta-thalassemia in the Kadazandusuns in East Malaysia: challenges in providing effective health care for an indigenous group.

    Science.gov (United States)

    Tan, Jin-Ai Mary Anne; Lee, Ping-Chin; Wee, Yong-Chui; Tan, Kim-Lian; Mahali, Noor Fadzlin; George, Elizabeth; Chua, Kek-Heng

    2010-01-01

    Thalassemia can lead to severe transfusion-dependent anemia, and it is the most common genetic disorder in Malaysia. This paper aims to determine the prevalence of thalassemia in the Kadazandusuns, the largest indigenous group in Sabah, East Malaysia. α- and β-thalassemia were confirmed in 33.6% and 12.8%, of the individuals studied respectively. The high prevalence of α- and β-thalassemia in the Kadazandusuns indicates that thalassemia screening, genetic counseling, and prenatal diagnosis should be included as part of their healthcare system. This preliminary paper serves as a baseline for further investigations into the health and genetic defects of the major indigenous population in Sabah, East Malaysia.

  3. Prevalence of and risk factors associated with the presence of Staphylococcus aureus in the chronic wounds of patients treated in primary health care settings in Brazil

    Directory of Open Access Journals (Sweden)

    Eliane Patricia Lino Pereira-Franchi

    Full Text Available Abstract INTRODUCTION: Wounds can be colonized by methicillin-resistant Staphylococcus aureus (MRSA. METHODS: We evaluated the prevalence of S. aureus and MRSA in the wounds of patients treated at Basic Health Units in Brazil and identified risk factors associated with their presence. RESULTS: The prevalence rates of S. aureus and MRSA were 51.5% and 8.7%, respectively. There was a correlation between the presence of S. aureus in wounds and nostrils (p<0.01. A positive association was detected between S. aureus infection and previous benzylpenicillin use (p=0.02. No associations were observed for MRSA. CONCLUSIONS: Multidrug-resistant pathogens are present in primary healthcare settings in Brazil.

  4. High Prevalence of Alpha- and Beta-Thalassemia in the Kadazandusuns in East Malaysia: Challenges in Providing Effective Health Care for an Indigenous Group

    Directory of Open Access Journals (Sweden)

    Jin-Ai Mary Anne Tan

    2010-01-01

    Full Text Available Thalassemia can lead to severe transfusion-dependent anemia, and it is the most common genetic disorder in Malaysia. This paper aims to determine the prevalence of thalassemia in the Kadazandusuns, the largest indigenous group in Sabah, East Malaysia. α- and β-thalassemia were confirmed in 33.6% and 12.8%, of the individuals studied respectively. The high prevalence of α- and β-thalassemia in the Kadazandusuns indicates that thalassemia screening, genetic counseling, and prenatal diagnosis should be included as part of their healthcare system. This preliminary paper serves as a baseline for further investigations into the health and genetic defects of the major indigenous population in Sabah, East Malaysia.

  5. 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 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......, the three interpretations provide a starting-point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs-based priority setting to social welfare maximisation...

  6. Prevalence of chronic kidney disease in Peruvian primary care setting.

    Science.gov (United States)

    Herrera-Añazco, Percy; Taype-Rondan, Alvaro; Lazo-Porras, María; Alberto Quintanilla, E; Ortiz-Soriano, Victor Manuel; Hernandez, Adrian V

    2017-07-19

    Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR 30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI). We evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 - 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 - 22.8) in patients with HTN, and 23.9% (95% CI 19.4 - 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 - 1.04), DM2 (PR = 3.37, 95% CI 1.09 - 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 - 9.88), and uric acid from 5 to DM2, older age and hyperuricemia have higher prevalence of CKD.

  7. Managing diversity in the health care workplace.

    Science.gov (United States)

    Davidhizar, R; Dowd, S; Newman Giger, J

    1999-03-01

    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.

  8. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    systems deteriorated in parallel with the deepening the gross inequalities in health care system, many economic crisis, while the subsequent introduction countries adopted the National Health Insurance of user fees further impeded access to care and. Scheme (NHIS) as a way of health care financing. 1 aggravated inequity ...

  9. Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes

    Science.gov (United States)

    Katerndahl, David A.; Bell, Iris R.; Palmer, Raymond F.; Miller, Claudia S.

    2012-01-01

    PURPOSE This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use. METHODS A total of 400 patients were recruited from 2 family medicine clinic waiting rooms in San Antonio, Texas. Patients completed the validated Quick Environmental Exposure and Sensitivity Inventory (QEESI) to assess chemical intolerance; the Primary Care Evaluation of Mental Disorders (PRIME-MD) screen for possible psychiatric disorders; the Dartmouth–Northern New England Primary Care Cooperative Information Project (Dartmouth COOP) charts for functional status; and the Healthcare Utilization Questionnaire. RESULTS Overall, 20.3% of the sample met criteria for chemical intolerance. The chemically intolerant group reported significantly higher rates of comorbid allergies and more often met screening criteria for possible major depressive disorder, panic disorder, generalized anxiety disorder, and alcohol abuse disorder, as well as somatization disorder. The total number of possible mental disorders was correlated with chemical intolerance scores (P intolerance were significantly more likely to have poorer functional status, with trends toward increased medical service use when compared with non–chemically intolerant patients. After controlling for comorbid psychiatric conditions, the groups differed significantly only regarding limitations of social activities. CONCLUSIONS Chemical intolerance occurs in 1 of 5 primary care patients yet is rarely diagnosed by busy practitioners. Psychiatric comorbidities contribute to functional limitations and increased health care use. Chemical intolerance offers an etiologic explanation. Symptoms may resolve or improve with the avoidance of salient chemical, dietary (including caffeine and alcohol), and drug triggers. Given greater medication

  10. Redirecting health care spending: consumer-directed health care.

    Science.gov (United States)

    Nolin, JoAnn; Killackey, Janet

    2004-01-01

    In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession.

  11. Prevalence and severity of gingivitis in school students aged 6?11?years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman?s Health Care Center

    OpenAIRE

    Rodan, Rania; Khlaifat, Feryal; Smadi, Leena; Azab, Reem; Abdalmohdi, Asma

    2015-01-01

    Background A cross-sectional census was conducted on 994 public school students aged 6-11?years living in 3 different parts of Tafeleh Governorate?South of Jordan, to determine the prevalence, and severity of gingivitis and to evaluate the oral hygiene habits among them as a part a survey executed by National Woman?s Health Care Center. All students were examined for gingival index (GI) and plaque index (PI), information about oral hygiene habits was recorded. Results Only 29.8?% had healthy ...

  12. Health care engineering

    CERN Document Server

    Frize, Monique

    2013-01-01

    Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-

  13. A note on health care productivity with uncertain data

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Overgård, Christian

    2006-01-01

    The present paper suggests extending the FDH-method, known from the efficiency measurement literature, to cover interval production data. Interval data represent a direct way to handle data uncertainty and problems with data comparability which seem particularly prevalent concerning health care...... applications. We illustrate the method using a simple 1-input-2-output model on health care data from the OECD health statistics...

  14. Improving oral health for individuals with special health care needs.

    Science.gov (United States)

    Crall, James J

    2007-01-01

    The purpose of this paper was to highlight information and issues raised in a keynote address for the American Academy of Pediatric Dentistry's Symposium on Lifetime Oral Health Care for Patients with Special Needs held in November, 2006. Topics include: (1) relevant statistics and definitions; (2) the prevalence and impact of common oral diseases in individuals with special health care needs (ISHCN); (3) an overview of oral health care delivery for ISHCN; (4) key delivery system and policy issues; and (5) a synopsis of major contextual initiatives related to ISHCN. In light of the Academy's primary interest in infants, children, and adolescents--including children with special health care needs--the major focus is on children. Significant oral health and oral health care issues for adults with special needs, however, generally parallel those for children and are of interest to the Academy, particularly as they relate to the transition from pediatric care to adult care, a critical period for extending the level of oral health and health trajectory established during childhood.

  15. Prevalence of mental health problem during first-half pregnancy at Siriraj Hospital.

    Science.gov (United States)

    Wingwontham, Surapol; Thitadilok, Wiboolphan; Singhakant, Supachoke

    2008-04-01

    To study the prevalence of mental health problem during first-half pregnancy. Cross-sectional descriptive study. The 255 singleton pregnant women mental health problem screening tool) and frequent psychosocial stressor forms. The prevalence and factors associated with mental health problem were evaluated. The prevalence of mental health problem. The prevalence of mental health problem was 17.3%. Factors independently associated with mental health problem included worrying about health, stress of taking care of other family members and financial problem with adjusted OR 3.5 (95% CI 1.16, 10.74), 3.8 (95% CI 1.80, 7.89) and 3.2 (95% CI 1.34, 7.53) respectively. The prevalence of mental health problem was 17.3%. Screening of mental health problem should be included in antenatal care service especially in the risk group.

  16. 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.

  17. Primary health care practitioners' tools for mental health care.

    Science.gov (United States)

    Hyvonen, S; Nikkonen, M

    2004-10-01

    The purpose of this study was to describe and analyse the content of mental health care from the practitioner's point of view. The specific aim of this paper was to outline the types of mental health care tools and the ways in which they are used by primary health care practitioners. The data were derived from interviews with doctors and nurses (n = 29) working in primary health care in six different health care centres of the Pirkanmaa region in Finland. The data were analysed by using qualitative content analysis. The tools of mental health care used in primary health care were categorized as communicative, ideological, technical and collaborative tools. The interactive tools are either informative, supportive or contextual. The ideological tools consist of patient initiative, acceptance and permissiveness, honesty and genuineness, sense of security and client orientation. The technical tools are actions related to the monitoring of the patient's physical health and medical treatment. The collaborative tools are consultation and family orientation. The primary health care practitioner him/herself is an important tool in mental health care. On the one hand, the practitioner can be categorized as a meta-tool who has control over the other tools. On the other hand, the practitioner him/herself is a tool in the sense that s/he uses his/her personality in the professional context. The professional skills and attitudes of the practitioner have a significant influence on the type of caring the client receives. Compared with previous studies, the present informants from primary health care seemed to use notably versatile tools in mental health work. This observation is important for the implementation and development of mental health practices and education.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    In the industrialized countries and Japan leukemia and brain tumors are. 6-9 the commonest causes of cancers in children. In the developing countries, lymphomas are. 9 the most prevalent tumors seen. The reason for this geographic variation in the types of tumor seen is not readily known and environmental and genetic.

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    diarrhea include: virus, bacteria and protozoa, this is prevalent in communities with poor food hygiene,. 1 water and sanitation. 2. Clinically there are four types of diarrhea : acute watery diarrhea (including cholera) usually lasts for several hours or days and the major complication is dehydration with significant weight loss ...

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    The observed differences may be due to the methodology and settings of the studies which in this case focused on ear discharge. The tendency among mothers to link ear discharge with teething may be due to the prevalence of ear discharge among children in their teething years. As noted by Browning, acute otitis media ...

  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. Federalism and Health Care

    Directory of Open Access Journals (Sweden)

    G. Alan Tarr

    2011-10-01

    Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.

  3. Primary health care models

    Science.gov (United States)

    Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric

    2012-01-01

    Abstract Objective To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Design Qualitative study using semistructured interviews. Setting The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Methods Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Main findings Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Conclusion Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models. PMID:22518904

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Health may be seen as “a state of complete as stated in the United Nations Charter on physical, mental, and social well-being and not. 6. Human Rights. Although, health may seem merely the absence of disease or infirmity” idealistic, healthy living can best be achieved according to the World Health Organization. 1.

  5. Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco.

    Science.gov (United States)

    Robbins, Jonathan Leserman; Wenger, Lynn; Lorvick, Jennifer; Shiboski, Caroline; Kral, Alex H

    2010-12-01

    Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N = 340). We examined sociodemographic characteristics, drug use patterns, HIV status via oral fluid testing, physical health using the Short Form 12 Physical Component Score, self-reported needs for physical and oral health care, and the self-reported frequency of seeking medical and oral health care. The sample had a lower health status as compared to the general population and reported a frequent need for physical and oral health care. In bivariate analysis, being in methadone treatment was associated with care-seeking behavior. In addition, being enrolled in Medi-Cal, California's state Medicaid program, was associated with greater odds of seeking physical and oral health care. Methamphetamine use was not associated with higher odds of needing oral health care as compared to people who reported using other illicit drugs. Homeless IDUs in San Francisco have a large burden of unmet health and oral health needs. Recent cuts in Medi-Cal's adult dental coverage may result in a greater burden of oral health care which will need to be provided by emergency departments and neighborhood dental clinics.

  6. Spiritual Care Education of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino

    2015-05-01

    Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.

  7. The health care learning organization.

    Science.gov (United States)

    Hult, G T; Lukas, B A; Hult, A M

    1996-01-01

    To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed.

  8. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    1,2. Organization, the community health worker was health system when the country adopted the PHC introduced into the health system for various strategy to achieve the goal of health for all. 76. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 25, NO 2, SEPTEMBER 2013. Correspondence to.

  9. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

  10. Prevalence and severity of gingivitis in school students aged 6-11 years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman's Health Care Center.

    Science.gov (United States)

    Rodan, Rania; Khlaifat, Feryal; Smadi, Leena; Azab, Reem; Abdalmohdi, Asma

    2015-11-09

    A cross-sectional census was conducted on 994 public school students aged 6-11 years living in 3 different parts of Tafeleh Governorate-South of Jordan, to determine the prevalence, and severity of gingivitis and to evaluate the oral hygiene habits among them as a part a survey executed by National Woman's Health Care Center. All students were examined for gingival index (GI) and plaque index (PI), information about oral hygiene habits was recorded. Only 29.8 % had healthy gingiva, 38.5 % had mild gingivitis, 31.4 % had moderate gingivitis, and 0.3 % had severe gingivitis. The difference between both genders was not statistically significant P > 0.05. 36.8 % of the examined students never brushed their teeth. Average gingival index (GI) and average plaque index (PI) were 0.77 and 0.61 respectively. Fair oral hygiene with mild to moderate gingivitis is highly prevalent among Tafelah school children. This study indicated that oral health status among schoolchildren in Tafelah is poor and needs to be improved. Long-term school based oral health education programme is highly recommended.

  11. Dental health awareness, attitude, and dental health-care seeking practices as risk indicators for the prevalence of periodontal disease among 15–17-year-old school children in Kozhikode district, Kerala, India

    Directory of Open Access Journals (Sweden)

    Uma Mohan Das

    2017-01-01

    Full Text Available Background: Periodontal disease prevalence in children is an indicator of future disease burden in the adult population. Knowledge about the prevalence and risk status of periodontal disease in children can prove instrumental in the initiation of appropriate preventive and therapeutic measures. Aim: This school-based cross-sectional survey estimated the prevalence and severity of periodontal disease among 15–17-year-old children in Kozhikode district and assessed the risk factors. Materials and Methods: Multistage stratified random sampling and randomized cluster sampling were used in the selection of schools and study participants, respectively, in three educational districts of Kozhikode. Periodontal disease was assessed among 2000 school children aged 15–17 years, by community periodontal index. A content validated questionnaire was used to evaluate the sociodemographic characteristics and other risk factors. Results: The prevalence of periodontal disease was estimated as 75% (72% gingivitis and 3% mild periodontitis. The prevalence was higher in urban population (P = 0.049 and males had significantly (P = 0.001 higher prevalence. Lower socioeconomic strata experienced slightly more periodontal disease burden. Satisfactory oral hygiene practices (material and frequency were observed, but oral hygiene techniques were erroneous. Unhealthy dental treatment-seeking practices and unfavorable attitude toward dental treatment (ATDT significantly influenced periodontal health status. Overall awareness about dental treatment was poor in this study population. Conclusion: The prevalence of periodontal disease among 15–17-year-old school children in Kozhikode district is 75% and is influenced by sociodemographic characteristics. Other risk factors identified were unhealthy dental treatment-seeking practices and unfavorable ATDT. Implementation of well-formulated oral health education programs is thus mandatory.

  12. Dental health awareness, attitude, and dental health-care seeking practices as risk indicators for the prevalence of periodontal disease among 15–17-year-old school children in Kozhikode district, Kerala, India

    Science.gov (United States)

    Das, Uma Mohan; Vadakkekuttical, Rosamma Joseph; Kanakkath, Harikumar; Shankunni, Smitha Pathiyari

    2017-01-01

    Background: Periodontal disease prevalence in children is an indicator of future disease burden in the adult population. Knowledge about the prevalence and risk status of periodontal disease in children can prove instrumental in the initiation of appropriate preventive and therapeutic measures. Aim: This school-based cross-sectional survey estimated the prevalence and severity of periodontal disease among 15–17-year-old children in Kozhikode district and assessed the risk factors. Materials and Methods: Multistage stratified random sampling and randomized cluster sampling were used in the selection of schools and study participants, respectively, in three educational districts of Kozhikode. Periodontal disease was assessed among 2000 school children aged 15–17 years, by community periodontal index. A content validated questionnaire was used to evaluate the sociodemographic characteristics and other risk factors. Results: The prevalence of periodontal disease was estimated as 75% (72% gingivitis and 3% mild periodontitis). The prevalence was higher in urban population (P = 0.049) and males had significantly (P = 0.001) higher prevalence. Lower socioeconomic strata experienced slightly more periodontal disease burden. Satisfactory oral hygiene practices (material and frequency) were observed, but oral hygiene techniques were erroneous. Unhealthy dental treatment-seeking practices and unfavorable attitude toward dental treatment (ATDT) significantly influenced periodontal health status. Overall awareness about dental treatment was poor in this study population. Conclusion: The prevalence of periodontal disease among 15–17-year-old school children in Kozhikode district is 75% and is influenced by sociodemographic characteristics. Other risk factors identified were unhealthy dental treatment-seeking practices and unfavorable ATDT. Implementation of well-formulated oral health education programs is thus mandatory. PMID:29398860

  13. Prevalência de hipertensão do avental branco na atenção primária de saúde Prevalence of white coat hypertension in primary health care

    Directory of Open Access Journals (Sweden)

    Leila Maria Marchi Alves

    2007-07-01

    Full Text Available OBJETIVO: Avaliar a prevalência de hipertensão do avental branco no município de Dumont, Estado de São Paulo, caracterizando os participantes da pesquisa em relação a fatores demográficos e a alterações tanto fisiológicas como metabólicas. MÉTODOS: Foram selecionados 109 usuários da Unidade de Saúde municipal, divididos em três grupos (normotensão, hipertensão essencial e hipertensão do avental branco, após medidas de pressão arterial com aparelho oscilométrico e exame de monitorização ambulatorial da pressão arterial. Foram realizadas entrevista, mensuração de dados e coleta de exames laboratoriais para comparação das variáveis encontradas entre os grupos. Para o tratamento estatístico, foram utilizados os testes ANOVA e Tukey. Os resultados foram expressos como médias ± erros padrão das médias. As diferenças foram consideradas estatisticamente significativas para p OBJECTIVE: Assess the prevalence of white coat hypertension in the municipality of Dumont, in São Paulo State, and map study participants' demographics, and physiologic and metabolic changes. METHODS: One hundred and nine (109 users of the Municipal Health Service were selected and then divided into three groups: normotension, essential hypertension, and white coat hypertension after blood pressure was measured through oscilometry and blood pressure monitoring exam at outpatient unit. Variables found between the groups were compared based on interview, data measurements, and laboratory exams. ANOVA and Tukey tests were used for statistical data. Results were expressed as means ± standard error of means. p<0.05 was considered statistically significant. RESULTS: The prevalence of white coat hypertension was 34.1%. Females were predominant: mean age 45.3 years, increased body mass index, waist/hip ratio, plasma glucose level and creatinine when compared to hypertensives and/or normotensives. No correlation was found between white coat hypertension

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    and occupational infections among staff of in ward rounds, in operation theatres and. 1. 3,4 ... 2Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, ... the mobile phones of health workers and subjected to microbiology analysis.

  15. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    1Department of Paediatrics and Child Health, Faculty of Clinical Sciences, College of Health Sciences,. Obafemi Awolowo ... Younger parents less than 35years, parents with lower educational attainments and low .... staffing, availability of immunization consumables was estimated using the Computer Programme for.

  16. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Background/Objective: There is some evidence that weak leadership in health institutions contributes to underutilization of health services, resulting in high levels of morbidities and mortalities. Employee-rated leadership gaps in a hospital, as done in this study, can promote employee engagement in leadership capacity ...

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    share of the total burden due to mental illness is 70-75% compared with 5% in developed countries, primarily due to the disproportionate burden of communicable, maternal, prenatal and nutritional. 9 conditions. Globally, the findings from the first of a series of World Health Organization. (WHO) World Mental Health Surveys.

  18. Assessing the prevalence of the Metabolic Syndrome according to NCEP ATP III in Germany: feasibility and quality aspects of a two step approach in 1550 randomly selected primary health care practices

    Directory of Open Access Journals (Sweden)

    Jöckel, Karl-Heinz

    2006-10-01

    Full Text Available Objective: Metabolic Syndrome (MetSyn describes a cluster of metabolic disorders and is considered a risk factor for development of cardiovascular disease. Although a high prevalence is commonly assumed in Germany data about the degree of its occurrence in the population and in subgroups are still missing. The aim of this study was to assess the prevalence of the MetSyn according to the NCEP ATP-III (National Cholesterol Education Program Adult Treatment Panel III criteria in persons aged ≥18 years attending a general practitioner in Germany. Here we describe in detail the methods used and the feasibility of determining the MetSyn in a primary health care setting. Research design and methods: The German-wide cross-sectional study was performed during two weeks in October 2005. Blood samples were analyzed in a central laboratory. Waist circumference and blood pressure were assessed, data on smoking, life style, fasting status, socio-demographic characteristics and core information from non-participants collected. Quality control procedures included telephone-monitoring and random on-site visits. In order to achieve a maximal number of fasting blood samples with a minimal need for follow-up appointments a stepwise approach was developed. Basic descriptive statistics were calculated, the Taylor expansion method used to estimate standard errors needed for calculation of confidence intervals for clustered observations. Results: In total, 1511 randomly selected general practices from 397 out of 438 German cities and administrative districts enrolled 35,869 patients (age range: 18-99, women 61.1%. More than 50,000 blood samples were taken. Fasting blood samples were available for 49% of the participants. Of the participating patients 99.3% returned questionnaires to the GP, only 12% were not filled out completely. The overall prevalence of the MetSyn (NCEP/ATP III 2001 was found to be 19.8%, with men showing higher prevalence rates than women (22

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Methodology. A cross-sectional survey of patients at the antiretroviral clinic of the Federal Medical Centre,. Makurdi, Nigeria, was conducted between June and August 2008. An adapted version of the RAND. Patient Satisfaction Questionnaire Long Form was used to assess seven dimensions of care: general satisfaction ...

  20. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

    .... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

  1. Space age health care delivery

    Science.gov (United States)

    Jones, W. L.

    1977-01-01

    Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

  2. [Coverage of a screening program and prevalence of diabetic retinopathy in primary careç].

    Science.gov (United States)

    Covarrubias, Trinidad; Delgado, Iris; Rojas, Daniel; Coria, Marcelo

    2017-05-01

    Diabetic retinopathy is the first cause of blindness during working years. Provide knowledge of screening coverage, prevalence and level of diabetic retinopathy in patients that belong to the Cardiovascular Health Program in primary care. Analysis of retinographies performed to 9076 diabetic patients aged 61 ± 13 years (61% women) adscribed to a Cardiovascular Health program in primary care centers of South-East Metropolitan Santiago. The examination was carried out by the evaluation of retinographies by trained optometrists. The coverage of the screening program was 21%. The prevalence of sight threatening diabetic retinopathy was 3,1%. The prevalence of these entities was 45% higher in people aged between 18 and 44 years than in older people. Their prevalence in urban communities was 32% higher than in rural locations. The coverage of the screening program is low. Diabetic patients aged 18 to 44 years and those coming from urban communities have a higher prevalence of severe non-proliferative and proliferative diabetic retinopathy.

  3. Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants.

    Science.gov (United States)

    Bryant, Allison S; Worjoloh, Ayaba; Caughey, Aaron B; Washington, A Eugene

    2010-04-01

    Wide disparities in obstetric outcomes exist between women of different race/ethnicities. The prevalence of preterm birth, fetal growth restriction, fetal demise, maternal mortality, and inadequate receipt of prenatal care all vary by maternal race/ethnicity. These disparities have their roots in maternal health behaviors, genetics, the physical and social environments, and access to and quality of health care. Elimination of the health inequities because of sociocultural differences or access to or quality of health care will require a multidisciplinary approach. We aim to describe these obstetric disparities, with an eye toward potential etiologies, thereby improving our ability to target appropriate solutions. Copyright 2010 Mosby, Inc. All rights reserved.

  4. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.

  5. 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.

  6. Foster Care and Child Health.

    Science.gov (United States)

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. The Politics of Health Care.

    Science.gov (United States)

    Anderson, John B.

    Before the mid-1960's the Federal role in health care was extremely limited, but technological breakthroughs, the new importance of hospitals, and the recognition that the poor and elderly have been underserved prompted Congress to pass the Medicare and Medicaid package in 1966. Since then the Federal share of the health care dollar has risen by…

  8. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Department of Community Medicine,. Ahmadu Bello University,Zaria. +234 803 705 3845. Email: firstmsibrahim@yahoo.com. Department of Community Medicine, Ahmadu Bello University, Zaria journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care.

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Patients attending the sexually transmitted disease clinic of the Lagos State University Teaching Hospital,. Ikeja, Lagos were ... psychological disturbances and also work with mental health experts to provide psychological services for identified .... Another study from also facilitate change in risk behaviour.24 This. Pakistan ...

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2011-10-07

    Oct 7, 2011 ... which are quite common in human populations. These infections are of major public health concern in sub-Saharan Africa because of existing predisposing factors in the region. These factors include poor environmental and personal hygiene, poverty, malnutrition, unsafe water supply and. 1, 2 ignorance.

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    of Dust Mask among Crushers of Selected Quarry (Crushed. Stone) Industry in Ebonyi State: Effect of Health Education. 1. 2. 2. 2. 3. 1. Uwakwe K.A , Agu A.P , Ogbonnaya L.U , Nwonwu E.U , Aguwa E.N , Duru C.B. INTRODUCTION. Occupational exposure to respirable crystalline silica in dust from stone quarrying has. 1,2.

  12. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Intestinal parasites are among the most common infection of school age-children worldwide and remain a major cause of morbidity and ... There is need to improve sanitation and peoples' living conditions, provide clean water, health education, chemotherapy ... other domestic activities and also as refuse children in Ilesha ...

  13. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    mania) and anxiety disorders (General anxiety, agoraphobia, social phobia, obsessive-compulsive disorder and post traumatic stress disorder). ... understaffed, and underutilized in both developed and developing settings despite the growing burden of mental health. 16,17,18 illness. Compared to developed settings,.

  14. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    effects. Others are illiteracy; power imbalance among couples; socio-cultural, religion and. 13 gender related issues. The use of contraceptives reduces maternal mortality and improves the woman's health by preventing unwanted and high risk pregnancies and therefore the need for unsafe abortion. Some of these.

  15. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    could afford to pay for the cost of the vaccine at the prevailing market price. Most health .... At present there are two types of Pneumococcus Nigeria still has a high under-five mortality of. 14 vaccine which .... parent's characteristics and willingness to accept PCV. parents with higher income significantly reported. Parents who ...

  16. Health Care in South Africa.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    The South African health care system is embedded in a background of racial subordination and sexual violence against girls and women and of hierarchical male authority from youth to adulthood. Low wages, unemployment, urban overcrowding, inadequate sanitation, malnutrition, crime, and violence have contributed to economic and health inequality. With more health-insured whites than blacks and the proportion of gross national product spent on health care slowly increasing, two-thirds of health expenditures have been consumed by the private sector at a time when the cost of health insurance has risen to more than 3 times the rate of the consumer price index. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Integrating sustainability and health care.

    Science.gov (United States)

    Podein, Rian J; Hernke, Michael T

    2010-03-01

    Unsustainable development around the world has contributed to ecological degradation and human suffering while compromising the ability of ecosystems and social institutions to support human life. The United States health care system and its institutions are significant contributors to unsustainable development, but leaders of change are emerging from the health care arena. Health professionals, including primary care providers, are poised to serve as models for sustainability and to facilitate the necessary transformation toward more sustainable practices. Health professionals must, within a practical framework, embrace an objective definition of sustainability and then act to achieve it. Copyright 2010 Elsevier Inc. All rights reserved.

  18. THE PREVALENCE OF DEPRESSION AND ITS RISK FACTORS AMONG MALAY ELDERLY IN RESIDENTIAL CARE

    OpenAIRE

    R. Normala; C. Azlini; M. J. Nurul Jannah; Z. M. Lukman

    2014-01-01

    The motivation for the study is to improve the quality of life for elderly in residential care particularly the mental health aspect. Hence, the aim of this study is to examine the prevalence of depression and to identify risk factors related to depression among Malay elderly in residential care. Changes in social structure and economic status have shifted the direction of care for elderly people, as the value of filial piety has gradually declined among the modern Malays. The researchers hyp...

  19. Health care of hunting dogs

    OpenAIRE

    Spasojević-Kosić, Ljubica; Savić, Sara

    2013-01-01

    There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunte...

  20. Finding Health Care Services

    Science.gov (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment hospital for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  1. 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.

  2. Universal health insurance and health care access for homeless persons.

    Science.gov (United States)

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

    Science.gov (United States)

    Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

    2018-01-01

    Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

  5. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Objective: The study aimed at involving adolescents in school-based health promotion activities as a strategy to improve ... Adolescents, perception of risk, sexual behaviour, active participation, health promotion. journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE .... behaviour, importance of self esteem and.

  6. Health Care for the Homeless.

    Science.gov (United States)

    Altman, Drew; And Others

    1989-01-01

    This supplementary statement, prepared by 10 members of the Institute of Medicine's Committee on Health Care for the Homeless, expands upon the Committee's report, "Homelessness, Health and Human Needs." Argues that the only broad, long-term solution to the health problems of the homeless is immediate action to provide decent, affordable…

  7. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    CHILDREN,. SCHOOL HEALTH. Correspondence to. Dr Kofoworola A Odeyemi. Department of Community Health, University of Lagos . Lagos. Nigeria. Email kofoodeyemi@yahoo.com. Journal of Community Medicine and Primary Health Care. 25 (1) 51-57. Background: Visual impairment is usually due to conditions that ...

  8. DOD Health Care: Domestic Health Care for Female Servicemembers

    Science.gov (United States)

    2013-01-01

    established in order to provide for medical recovery from childbirth and to allow additional time to prepare family care plans and child care. However...affect both men and women, and with the exception of postpartum depression , are not easily distinguished by gender. Consequently, behavioral health...disorder (PTSD), postpartum depression , parenting, and general female servicemember issues. With respect to privacy when providing behavioral health

  9. Prevalence of different modes of parental care in birds

    Science.gov (United States)

    Cockburn, Andrew

    2006-01-01

    Estimates of the incidence of major classes of parental care by birds are drawn from classical studies that preceded both the publication of a massive secondary literature and the revolution driven by molecular approaches to avian phylogeny. Here, I review this literature in the light of new phylogenetic hypotheses and estimate the prevalence of six distinct modes of care: use of geothermal heat to incubate eggs, brood parasitism, male only care, female only care, biparental care and cooperative breeding. Female only care and cooperative breeding are more common than has previously been recognized, occurring in 8 and 9% of species, respectively. Biparental care by a pair bonded male and female is the most common pattern of care but at 81% of species, the pattern is less common than once believed. I identify several problems with existing hypotheses for the evolution of parental care and highlight a number of poorly understood contrasts which, once resolved, should help elucidate avian social evolution. PMID:16777726

  10. Improving access to health care.

    Science.gov (United States)

    Peters, B; Haynes, K

    2001-01-01

    It is a problem that has plagued the American health care system for years, and it is not getting any better. While the majority of our population enjoys ready access to the finest health care in the world, a steadily growing number are joining the ranks of the uninsured. Despite a strong economy throughout the last decade, the uninsured rate in Michigan is at a higher level today than it was in 1990, and more than one million residents currently have no health care insurance.

  11. Conscientious objection in health care

    Directory of Open Access Journals (Sweden)

    Kuře Josef

    2016-12-01

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

  12. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  13. Occupational exposure to HIV amongst health care workers in the ...

    African Journals Online (AJOL)

    The increasing HIV sero-prevalence amongst pregnant women places health care workers in busy labour wards at high risk of occupational exposure to HIV. Aim: The aim of this study was to determine whether there has been a change in the prevalence of needle-stick and sharps injuries at King Edward VIII Hospital, ...

  14. 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

  15. Urinary infection in patients of public health care of Campo Mourão-PR, Brazil: bacterial prevalence and sensitivity profile

    Directory of Open Access Journals (Sweden)

    Josiane dos Santos Bitencourt

    2014-10-01

    Full Text Available Introduction: Cases of bacterial resistance in urinary tract infections (UTIs have increased significantly, mainly due to indiscriminate use of antimicrobials. Objective: Objective: To evaluate the prevalence and antimicrobial susceptibility of microorganisms isolated in urine cultures of patients of Consórcio Intermunicipal de Saúde da Comunidade dos Municípios da Região de Campo Mourão (CISCOMCAM clinical laboratory. Method: We performed a retrospective study of data from urine culture and sensitivity done between January 2012 and December 2013. Results: The most prevalent bacteria were Escherichia coli; women were the most affected gender and people 16-45 years, the most affected age group. The sensitivity profile showed that the antimicrobial combination trimethoprim/ sulfamethoxazole was not associated with the highest rate of bacterial resistance (59.7% and the combination of amoxicillin/clavulanic acid showed the lowest resistance rate (15.3%. For most antimicrobials, including ciprofloxacin and norfloxacin, the rates of bacterial resistance have increased from 2012 to 2013 with statistical significance (p < 0.05 in some cases. Discussion: The prevalence of Gram-negative bacilli in urinary infections is due to the fact that intestinal flora is rich in enterobacteria, and women are most affected by anatomical factors. The development of bacterial resistance to antimicrobials probably arises from their indiscriminate use. Conclusion: The rate of microbial resistance has risen, showing the need for a more effective control of antimicrobial use.

  16. 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.

  17. Health care for people with disability

    Directory of Open Access Journals (Sweden)

    Francisco Javier Leturia Arrazola

    2014-06-01

    Full Text Available Although the majority of disabled people aren’t or don’t feel ill, and despite that they should be taken care of by the general medical services as many other citizens, most of them need a more intense and frequent health care. This is explained by a higher prevalence of some medical conditions as well as a higher risk of comorbidity among the people with disabilities (in comparison to the general population. At the moment there are many problems concerning accessibility, underdiagnose and overtreatment. National health systems should be able to offer all their services adapted to disabled people in order to obtain results for this group that are similar to those of the rest of the population. To achieve this objective it is necessary to improve professional competencies and skills and develop some specific health programmes.

  18. Will Boeing Change Health Care?

    Science.gov (United States)

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate.

  19. Understanding your health care costs

    Science.gov (United States)

    ... ency/patientinstructions/000878.htm Understanding your health care costs To use the sharing features on this page, ... on out-of-pocket costs. Out-of-Pocket Costs The good news is there is a limit ...

  20. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  1. Violência na gestação entre usuárias de serviços públicos de saúde da Grande São Paulo: prevalência e fatores associados Violence during pregnancy among public health care users in the Greater São Paulo area: prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Julia Garcia Durand

    2007-09-01

    Full Text Available O objetivo desta investigação é estimar a prevalência da violência por parceiro íntimo na gestação entre usuárias de serviços públicos de saúde da Grande São Paulo e verificar sua associação com fatores sociodemográficos, de saúde reprodutiva, sexual e mental. A estratégia metodológica deste estudo consistiu na realização de entrevistas estruturadas (questionário com 1.922 usuárias, entre 15 e 49 anos, em 14 serviços públicos de saúde. A análise dos dados revelou que 20% das usuárias que já engravidaram (IC95% 18,2 a 21,8 referem algum episódio de violência por parceiro íntimo na gestação. Em análise multivariada, observou-se que 'ter sofrido violência psicológica e física perpetrada por familiar', 'início da vida sexual antes dos 19 anos', 'recusa de uso de camisinha pelo parceiro', 'Transtorno Mental Comum' e 'não coabitar com parceiro' são fatores associados à violência na gestação. Conclui-se que a alta prevalência da violência por parceiro íntimo na gestação, sua associação com diversos fatores de saúde sexual, reprodutiva e mental são resultados que indicam a relevância de se tomar a violência como questão de saúde.OBJECTIVES: To examine the prevalence of IPV (intimate partner violence during pregnancy and its association with demographic and reproductive, sexual and mental health factors among public health care users in São Paulo, Brazil. METHODS: a interview with 1,922 health care users, ages 15 to 49, in 14 public healthcare services. RESULTS: 20% (CI95% 18.2 to 21.8 reported IPV during pregnancy. Multiple logistic regression indicated that frequent family violence, having more than 2 pregnancies, beginning sexual life before 19 years of age, partner's refusal to wear condom, mental health problems, and being single are factors associated with IPV during pregnancy. CONCLUSION: The high prevalence rate for IPV during pregnancy indicates that this issue should be regarded as a

  2. Obesity prevalence in Mexico: impact on health and economic burden.

    Science.gov (United States)

    Rtveladze, Ketevan; Marsh, Tim; Barquera, Simon; Sanchez Romero, Luz Maria; Levy, David; Melendez, Guillermo; Webber, Laura; Kilpi, Fanny; McPherson, Klim; Brown, Martin

    2014-01-01

    Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs. Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population. Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006. Mexican adults. In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of $US 806 million are estimated for 2010, projected to increase to $US 1·2 billion and $US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save $US 43 million in health-care costs in 2030 and $US 85 million in 2050. Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.

  3. 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.

  4. Intestinal Parasites Prevalence in Children from Day Care Centers in Sinop City-MT

    Directory of Open Access Journals (Sweden)

    B. Muchiutti

    2013-03-01

    Full Text Available Abstract: The aim of this study was to investigate the intestinal parasitosis prevalence of children from municipal day care centers in Sinop MT. Respecting ethical principles established by Resolution 196/96 of Health National Council/Ministry of Health of quantitative research, the anonymity of participants, as well accept and signature of parents of the Term of Free and Enlightened Consent were performed. Between Junes to October 2012 were applied coproparasitological methods for investigation. Fecal samples were analyzed by Hoffmans methods. From 103 students examined observed the prevalence rate of 19.42% of intestinal parasites. The intestinal parasites with highest prevalence rate were: Giardia lamblia (9.70% and Endolimax nana (5.82%. The results of this study demonstrate the need for sensitization of the population front of diagnosis importance, treatment and monitoring of positive cases and the necessity of more health professionals attention, especially with children.Key-words: Intestinal parasites, day care centers, children.

  5. Helping You Choose Quality Behavioral Health Care

    Science.gov (United States)

    Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...

  6. Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.

    Science.gov (United States)

    Lulebo, Aimée M; Mapatano, Mala A; Mutombo, Paulin B; Mafuta, Eric M; Samba, Gédéon; Coppieters, Yves

    2017-04-08

    In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine. A cross-sectional study was carried out at the Kinshasa Primary Health-care (KPHC) facilities network in November 2014. A structured interview questionnaire was administrated to a total of 280hypertensive patients. Complementary and alternative medicine were defined according to the National Institute of Health classification as a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Data were summarized using proportion and mean (with standard deviation). The student's t test and χ 2 test were used respectively for mean and proportion comparison. Logistic regression analysis identified determinants of the use of complementary and alternative medicine. The prevalence of use of complementary and alternative medicine was 26.1% (95% CI: 20.7% - 31.8%).Determinants of use of complementary and alternative medicine included misperception about hypertension curability (OR = 2.1; 95%CI: 1.1-3.7) and experience of medication side effects (OR = 2.9; 95%CI: 1.7-5.1). The use of CAM for hypertensive patients is a major problem; antihypertensives with fewer side effects must be emphasized. Religious leaders must become involved in the communication for behavioral change activities to improve the quality of life for hypertensive patients.

  7. Home Health Care

    Science.gov (United States)

    ... content Skip Navigation Department of Health and Human Services Your Browser does not support javascript, so the search function on this page is disabled 1-800-677-1116 Home > Resources > Factsheets > Home ...

  8. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  9. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role...

  10. primary health care in nigeria

    African Journals Online (AJOL)

    user1

    2014-07-31

    Jul 31, 2014 ... The Alma Ata declaration on Primary Health Care (PHC) which was made in 1978 is meant to address the main health problems in communities by providing promotive, preventive, curative and rehabilitative services. Nigeria was among the 134 signatories to this invaluable idea. Subsequently, several ...

  11. Health care's 100 most wired.

    Science.gov (United States)

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key."

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    population of the big cities live urban slums. our environment are diarrhea diseases, pneumonia,. Urban slums pose special health problems due to. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 1, MARCH 2014. 1. 1Department of Paediatrics, University of Nigeria Teaching Hospital, ...

  13. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Nigeria has one of the largest stocks of. In all situations, volunteers add to the quality and human resources for ... profit making enterprise by the partners the health care objectives, including the involved.Rather, it is a health ..... Investing in volunteerism: The impact of service initiatives in selected state agencies. Austin, TX: ...

  14. Health care transition for youth with special health care needs.

    Science.gov (United States)

    Bloom, Sheila R; Kuhlthau, Karen; Van Cleave, Jeanne; Knapp, Alixandra A; Newacheck, Paul; Perrin, James M

    2012-09-01

    Youth with special health care needs (YSHCN) increasingly live into adulthood, and approximately 500,000 U.S. youth transition from pediatric to adult health care systems annually. Through a systematic literature review, we sought to (1) determine adult outcomes for YSHCN who have no special transition interventions and (2) identify evidence for strategies that lead to better outcomes, in particular, access to adult health care. We searched the medical, nursing, psychology, and social science literature and reviewed selected articles' reference lists. Transition experts also recommended relevant articles. Search criteria included health conditions, transition-related activities, and health care and related outcomes. We selected English-language articles published from 1986 to 2010, with an abstract, description of transition-related interventions (objective 2), and posttransition outcomes. Investigators abstracted study design, population, sample size, description of intervention, data collection methods, and findings. The search yielded 3,370 articles, of which 15 met study criteria. Although many YSHCN appear to make the transition to adult health providers successfully, some experience serious gaps in outcomes; those with more complex conditions or with conditions affecting the nervous system appear to have less good transitions. Some evidence supports introducing YSHCN to adult providers before leaving the pediatric system; one study supports using care coordinators to improve outcomes. Evidence regarding programs to facilitate transition for YSHCN is inconclusive. Weak evidence suggests that meeting adult providers before transfer may facilitate posttransition access to care. We recommend additional studies with strong research designs to guide best practice in preparing YSHCN for adulthood. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Determinants of increased primary health care use in cancer survivors.

    NARCIS (Netherlands)

    Heins, M.; Schellevis, F.; Rijken, M.; Hoek, L. van der; Korevaar, J.

    2012-01-01

    Purpose: The number of cancer survivors is increasing, and patients with cancer often experience long-lasting consequences of cancer and its treatment. Because of the variety of health problems and high prevalence of comorbidity, primary care physicians (PCPs) seem obvious candidates to take care of

  16. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?......The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...

  17. Health Care in India

    Directory of Open Access Journals (Sweden)

    BM Hegde

    2010-05-01

    Full Text Available The modern medical facilities in India are of such good quality that the National Health Service of the UK is negotiating with many corporate hospitals in India to get their patients on the long waiting lists to be flown to India for elective surgery. Be that as it may, health is not contigent on the availability of medical technology but contigent on basic provisions; clean water, three square meals a day, freedom from the effects of pollution and the skills to earn a living.

  18. Health Care Wide Hazards

    Science.gov (United States)

    ... Other Hazards (Lack of) PPE Slips/Trips/Falls Stress Tuberculosis Universal Precautions Workplace Violence Use of Medical Lasers Health Effects Use ... Needlesticks Noise Mercury Inappropriate PPE Slips/Trips/Falls ... of Universal Precautions Workplace Violence For more information, see Other Healthcare Wide ...

  19. The health care home model: primary health care meeting public health goals.

    Science.gov (United States)

    Grant, Roy; Greene, Danielle

    2012-06-01

    In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

  20. 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 behavioral health screenings; brief intervention rates nearly doubled to 83% ( P behavioral health care coordination.

  1. The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Tadele Teshome Woimo

    2017-03-01

    Full Text Available Abstract Background Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient tuberculosis control in developing countries. Many tuberculosis (Tb patients do not complete their six-month course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health care facilities of South Ethiopia. Methods This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics, bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the qualitative data. Results The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6, cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4, having of health information at every visit (AOR = 3, 95% CI: 1.1-8.4 and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8 showed statistically significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that distance, lack of awareness about importance of treatment completion and cost of transportation were the major barriers for adherence. Conclusions A quarter of Tb patients interrupted their treatment due to knowledge

  2. Health Care Provider Initiative Strategic Plan

    Science.gov (United States)

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  3. Privatizing health care: caveat emptor.

    Science.gov (United States)

    Young, D W

    1990-01-01

    Many Western European countries are moving toward privatization of their health care systems. The United States' health care system, since it is almost entirely privatized, is therefore worthy of study. Doing so raises several questions. How is privatization being managed in the US? How could its management be improved? What management lessons must be kept in mind if it is to be used effectively? What potential pitfalls should European countries consider as they move toward greater privatization? With operating costs, European countries must avoid the mistakes that have led to dramatic increases in annual health care costs in the US, simultaneous with reductions in access and quality. Doing so requires designing systems that promote hospital behavior consistent with a country's health objectives. With capital costs, an approach must be designed that allows policy-makers to work closely with both managers and physicians in order to make strategically sound choices about access and quality. Such an approach will require physicians to incorporate their clinical judgments into community standards of care, and to adopt a regional (rather than an institutional or personal) perspective in the determination of any incremental capital expenditures. By making regulation proactive and strategic, rather than punitive, health policymakers in Western Europe can achieve the best privatization has to offer without feeling the sting of its unintended consequences. In so doing they can help to move their health systems toward achieving the multiple and illusive goals of access, quality and reasonable cost.

  4. Transgender Veterans' Satisfaction With Care and Unmet Health Needs.

    Science.gov (United States)

    Lehavot, Keren; Katon, Jodie G; Simpson, Tracy L; Shipherd, Jillian C

    2017-09-01

    Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. We used data from transgender Veterans collected in 2014 through an online, national survey. In total, 298 transgender Veterans living in the United States. We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.

  5. Health Care Utilization and Costs Associated with Pediatric Chronic Pain.

    Science.gov (United States)

    Tumin, Dmitry; Drees, David; Miller, Rebecca; Wrona, Sharon; Hayes, Don; Tobias, Joseph D; Bhalla, Tarun

    2018-03-30

    The population prevalence of pediatric chronic pain is not well characterized, in part due to lack of nationally representative data. Previous research suggests that pediatric chronic pain prolongs inpatient stay and increases costs, but the population-level association between pediatric chronic pain and health care utilization is unclear. We use the 2016 National Survey of Children's Health to describe the prevalence of pediatric chronic pain, and compare health care utilization among children ages 0-17 years according to the presence of chronic pain. Using a sample of 43,712 children, we estimate the population prevalence of chronic pain to be 6%. On multivariable analysis, chronic pain was not associated with increased odds of primary care or mental health care use, but was associated with greater odds of using other specialty care (OR=2.01, 95% CI: 1.62, 2.47; pcomplementary and alternative medicine (OR=2.32, 95% CI: 1.79, 3.03; pchronic pain were more likely to use specialty care but not mental health care. The higher likelihood of emergency care use in this group raises the question of whether better management of pediatric chronic pain could reduce emergency department use. Copyright © 2018. Published by Elsevier Inc.

  6. Nanotechnology in health care

    CERN Document Server

    Sahoo, Sanjeeb K

    2012-01-01

    Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C

  7. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    2010-11-09

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.  Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/9/2010.

  8. Barriers to health care for undocumented immigrants: a literature review

    Science.gov (United States)

    Hacker, Karen; Anies, Maria; Folb, Barbara L; Zallman, Leah

    2015-01-01

    With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net) was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial) to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase access to health care for undocumented immigrants, providing novel insurance options, expanding safety net services, training providers to better care for immigrant populations, and educating undocumented immigrants on navigating the system. There are numerous barriers to health care for undocumented immigrants. These vary by country and frequently change. Despite concerns that access to health care attracts

  9. Health care clinics in Cambodia.

    Science.gov (United States)

    Wollschlaeger, K

    1995-04-01

    Under the Pol Pot Khmer Rouge regime, most physicians with clinical experience were either killed or fled the country. The few practitioners who managed to survive were forced to hide their knowledge; much of that knowledge and experience is now lost. As part of a general process of national rehabilitation, Cambodia has trained since the 1980s hundreds of physicians and physician assistants. There were 700 physicians, 1300 physician assistants, and 4000 nurses in the country by 1992. Problems do, however, remain with medical education in Cambodia. In particular, the medical texts and lectures are in French, a language which very few of the younger generation speak; instructional texts are designed to meet the needs of developing nations, not a rehabilitating one like Cambodia; emphasis is upon curative health care, hospitals, and vertical programs instead of primary and preventive health care; Cambodian physicians are used to a system based upon the division of patients by ability to pay instead of by age, disease, or need; corruption has grown as the cost of living has outstripped the level of official salaries; and there is neither professional contact, feedback, nor program evaluation within health care programs. The authors is a resident in obstetrics and gynecology at the University of Chicago who worked at two clinics during a stay in Phnom Penh. She recommends that instead of simply training more doctors, these training-related problems should be addressed, including a revision of the curriculum to include both primary health care medicine and psychiatry. Moreover, people in Cambodia need to be taught the importance of preventive health care, which should then reduce the number of visits to physicians. This process will be accomplished more effectively with the cooperation of physicians, the government, nongovernmental organizations, and international organizations associated with health care.

  10. Good Health Before Pregnancy: Preconception Care

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients ... Pregnancy: Preconception Care FAQ056, April 2017 PDF Format Good Health Before Pregnancy: Preconception Care Pregnancy What is ...

  11. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  12. Phytotherapy in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Damian Antonio

    2014-06-01

    Full Text Available OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population.

  13. Phytotherapy in primary health care.

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanele; Moretti-Pires, Rodrigo Otavio

    2014-06-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population.

  14. Primary health care services for effective health care development in ...

    African Journals Online (AJOL)

    This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...

  15. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  16. Prevalence of Dementia in a Geriatric Palliative Care Unit.

    Science.gov (United States)

    Lo, Amanda T; Karuza, Jurgis; Berall, Anna; Perri, Giulia-Anna

    2017-01-01

    To determine the prevalence of dementia in a palliative care unit (PCU) and to determine whether there is a difference between length of stay (LOS) and Palliative Performance Scale (PPS) score in individuals admitted with a primary diagnosis of dementia compared to individuals admitted with other noncancer and cancer diagnoses. Descriptive retrospective chart review. Geriatric PCU in an academic community geriatric hospital. All individuals admitted to the Baycrest Health Sciences PCU from January 1, 2014, to September 1, 2016. Individuals with an admission diagnosis of cancer, noncancer, and dementia and their corresponding PPS scores were identified. Data were analyzed using descriptive statistics. A total of 780 patients were admitted to the PCU during the study period: 32 (4.1%) individuals had advanced dementia, 121 (15.5%) had a noncancer diagnosis, and 627 (80.4%) had cancer as the primary reason for admission. In the cancer and noncancer groups, 113 patients had a comorbid dementia diagnosis. The mean admission PPS score in patients with cancer was 36%, noncancer was 32.6%, and dementia was 23.8% ( P dementia was 33.3 days ( P = .90). Individuals with an admission diagnosis of advanced dementia had a lower mean PPS score than individuals admitted with other noncancer and cancer diagnoses. There was no difference in the mean LOS between the 3 groups. Individuals with an admission diagnosis of advanced dementia should not be refused admission because of fear of outliving their prognosis.

  17. Mental illness related disparities in diabetes prevalence, quality of care and outcomes: a population-based longitudinal study

    OpenAIRE

    Mai, Qun; Holman, C D'Arcy J; Sanfilippo, Frank M; Emery, Jonathan D; Preen, David B

    2011-01-01

    Abstract Background Health care disparity is a public health challenge. We compared the prevalence of diabetes, quality of care and outcomes between mental health clients (MHCs) and non-MHCs. Methods This was a population-based longitudinal study of 139,208 MHCs and 294,180 matched non-MHCs in Western Australia (WA) from 1990 to 2006, using linked data of mental health registry, electoral roll registrations, hospital admissions, emergency department attendances, deaths, and Medicare and pharm...

  18. Health Care Workers' Experiences of Aggression.

    Science.gov (United States)

    Kerr, Katelyn; Oram, Joanne; Tinson, Helen; Shum, David

    2017-10-01

    To identify the prevalence of patient aggression against health care workers, the consequences and coping mechanisms. Retrospective cross-sectional design. 50 participants comprised 37 nurses, 1 ward staff, 12 allied health staff employed in two brain injury wards with experience ranging from 3months to 34years. Neurosciences and Brain Injury Rehabilitation wards of a metropolitan tertiary hospital in Brisbane. Researcher designed self-report questionnaire. 98% of respondents had experienced aggression during their health care careers with an average of 143.93 events. Physical injuries had been sustained by 40% of staff, psychological injury by 82%, but only 12% sought treatment. Verbal aggression related to receiving a psychological injury (r=0.305, paggression made it more likely the person would also experience the other types of aggression. Verbal aggression was correlated with physical aggression (r=0.429, paggression (r=0.286, paggression was correlated with non-verbal aggression (r=0.333, paggression is prevalent and of serious concern for staff working in hospital settings. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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

  20. National Health-Care Reform

    Science.gov (United States)

    2009-03-24

    Federal Hospital Insurance (HI) Trust Fund, or Medicare Part A, called for decisive policy action to achieve long-term solvency of the trust fund. For the... insurance companies . To prevent a loss of income, these groups have used tactics such as stoking fears of socialism and communism to thwart reform.33...the next most expensive country in the world, Switzerland.9 Health-care insurance costs exceed the national average inflation. From 2000 to 2007, health

  1. Phytotherapy in primary health care

    OpenAIRE

    Gisele Damian Antonio; Charles Dalcanele Tesser; Rodrigo Otavio Moretti-Pires

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the ...

  2. Prevalence of antibiotic prescription in pediatric outpatients in Italy: the role of local health districts and primary care physicians in determining variation. A multilevel design for healthcare decision support

    Directory of Open Access Journals (Sweden)

    Mirko Di Martino

    2017-11-01

    Full Text Available Abstract Background According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy, to identify physicians’ characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics. Methods We enrolled all children aged 13 years or less in 2014. Antibiotic prescription patterns were analyzed during a one-year follow-up period. The main outcome measures were the antibiotic prescription prevalence, and the geographic variation in antibiotic prescribing. Multilevel models were performed to analyze variation. Variation was expressed as Median Odds Ratios (MORs. If the MOR is 1.00, there is no variation between clusters. If there is considerable between-cluster variation, the MOR will be large. Results We enrolled 636,911 children. Most of them were aged 6–13 years (57.3%. In 2015, the antibiotic prescription prevalence was 46% in the 0–13, 58% in the 0–5, and 37% in the 6–13 age group. Overall, penicillins were the most prescribed antibiotics, their consumption increased from 43% to 52% during the 2007–2015 period. In 2015, the antibiotic prescription prevalence ranged from 30% to 62% across local health districts (LHDs of the region. Moreover, a significant (p < 0.001 variation was observed between physicians working in the same LHD: MORs were equal to 1.52 (1.48–1.56 and 1.46 (1.44–1.48 in the 0–5 and 6–13 age groups, respectively. The probability of prescribing antibiotics was significantly (p < 0.001 lower for more-experienced physicians. Conclusions Pediatric antibiotic

  3. Prevalence of antibiotic prescription in pediatric outpatients in Italy: the role of local health districts and primary care physicians in determining variation. A multilevel design for healthcare decision support.

    Science.gov (United States)

    Di Martino, Mirko; Lallo, Adele; Kirchmayer, Ursula; Davoli, Marina; Fusco, Danilo

    2017-11-17

    According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics. We enrolled all children aged 13 years or less in 2014. Antibiotic prescription patterns were analyzed during a one-year follow-up period. The main outcome measures were the antibiotic prescription prevalence, and the geographic variation in antibiotic prescribing. Multilevel models were performed to analyze variation. Variation was expressed as Median Odds Ratios (MORs). If the MOR is 1.00, there is no variation between clusters. If there is considerable between-cluster variation, the MOR will be large. We enrolled 636,911 children. Most of them were aged 6-13 years (57.3%). In 2015, the antibiotic prescription prevalence was 46% in the 0-13, 58% in the 0-5, and 37% in the 6-13 age group. Overall, penicillins were the most prescribed antibiotics, their consumption increased from 43% to 52% during the 2007-2015 period. In 2015, the antibiotic prescription prevalence ranged from 30% to 62% across local health districts (LHDs) of the region. Moreover, a significant (p < 0.001) variation was observed between physicians working in the same LHD: MORs were equal to 1.52 (1.48-1.56) and 1.46 (1.44-1.48) in the 0-5 and 6-13 age groups, respectively. The probability of prescribing antibiotics was significantly (p < 0.001) lower for more-experienced physicians. Pediatric antibiotic use in the Lazio region is much higher than in other European countries. The

  4. Organizational Climate and Employee Mental Health Outcomes -- A Systematic Review of Studies in Health Care Organizations

    NARCIS (Netherlands)

    Bronkhorst, B.A.C.; Tummers, L.G.|info:eu-repo/dai/nl/341028274; Steijn, A.J.; Vijverberg, D.

    2015-01-01

    Background: In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees’ perceptions of their work environment can play a role in explaining mental health outcomes. Purposes: We conducted a

  5. Presenteeism among emergency health care staff.

    Science.gov (United States)

    Sánchez-Zaballos, Marta; Baldonedo-Mosteiro, María; Mosteiro-Díaz, Mª Pilar

    2018-02-01

    To estimate the prevalence of presenteeism among different categories of hospital and pre-hospital emergency health care professionals in the Principality of Asturias, Spain, and to define the sociodemographic characteristics and workplace factors associated with presenteeism in all categories. Cross-sectional descriptive study carried out during the last half of 2014 and first half of 2015. A self-administered questionnaire was used to collecta data on sociodemographic and work-related variables and perception of work as stressful. The respondents, who answered voluntarily and anonymously, assessed themselves on the Stanford Presenteeism Scale-6 adapted for use in Spain. The prevalence of presenteeism was 52.9% among the 323 respondents. Presenteeism was associated with stress (P<.01), place of work (P=.004), and bearing responsibility for dependent persons (P=.034) in the group overall. The association between stress and presenteeism was clearly present in emergency physicians (P=.049) and in nurses with dependents under their care (P=.016). The prevalence of presenteeism is high among emergency staff in the Principality of Asturias. Presenteeism is associated with diverse factors.

  6. Is emotional dissonance more prevalent in oncology care? Emotion work, burnout and coping.

    Science.gov (United States)

    Kovács, Mariann; Kovács, Eszter; Hegedus, Katalin

    2010-08-01

    Emotional burden on oncology care workers is considerable. These workers develop confidential relationship with the patient through interpersonal communication, which entails managing their own emotions as well as the emotions displayed by their patients, and it involves a great deal of emotion work. The objectives in our study were to assess the prevalence of burnout and emotional dissonance and to investigate the interrelationship among burnout, emotion work and coping in oncology care. A cross-sectional survey with anonymous questionnaires was conducted among oncology health care workers (N = 48) and non-oncology health care workers (N = 151). The comparison revealed differences primarily in emotion work and coping. Emotional dissonance as stress factor was more prevalent among oncology health care workers. Caregivers dealing with cancer patients felt that they have to display negative emotions less frequently, yet at the same time they frequently have to show understanding and express sympathy to the patient. When certain coping strategies were examined, we found that humour as potential resource in coping is used less frequently among oncology health care workers. In order to devise effective interventions to oncology personnel, we need to focus on the interaction between the carer and the cancer patient and have more evidence on emotional dissonance in oncology staff. (c) 2009 John Wiley & Sons, Ltd.

  7. Intercultural Health Care and Welfare

    DEFF Research Database (Denmark)

    Nielsen, Ben

    2014-01-01

    Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...

  8. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    attitudes towards Basic Cardiopulmonary Resuscitation (CPR) among Community Nurses in Remo Area of. Ogun State, Nigeria with ... Knowledge of basic CPR amongst nurses at primary health care level is generally poor with the young ones having better performance. ..... Fetuga, B. Okeniyi, A. Neonatal. Knowledge and ...

  9. Mental health care in Cambodia.

    Science.gov (United States)

    Somasundaram, D J; van de Put, W A

    1999-01-01

    An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization.

  10. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    determine the awareness, willingness and use of. Voluntary HIV testing and counseling services by. One of the priorities of national HTC students of Niger Delta University. programmes is to ensure that at least 80% of. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 25, NO 2, SEPTEMBER ...

  11. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    the stigmatization of people living with HIV/AIDS among traders in model markets in Lagos State. Methodology: ... traders, Pre- intervention and post- intervention. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 24, NO 1&2, MARCH 2013. 34 ..... Oladele J, Adeiga ZA, Ricketts F, Goodluck H.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    microeconomic costs data are useful in assessing. 12 for treatment. the ability of individuals and households to afford health care services. Nigeria receives donor support for malaria control. Global Fund is currently its largest funding partner. This study was conducted to assess the direct cost. Through the Global Fund, SFH ...

  13. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    2013-09-02

    Sep 2, 2013 ... Incidence and reasons for Discharge Against Medical Advice in a tertiary health care facility in Port Harcourt, south-south Nigeria. Ordinioha B. Community Medicine Department. University of Port Harcourt Teaching Hospital,Port Harcourt. Email: ruralhealthforum@yahoo.com. +2348037075300.

  14. The epidemiology of skin care provided by nurses at home: a multicentre prevalence study.

    Science.gov (United States)

    Kottner, Jan; Boronat, Xavier; Blume-Peytavi, Ulrike; Lahmann, Nils; Suhr, Ralf

    2015-03-01

    The aim of this study was to estimate the frequencies and patterns of skin care and applied skin care products in the home care nursing setting in Germany. Skin care belongs to the core activities of nursing practice. Especially in aged and long-term care settings, clients are vulnerable to various skin conditions. Dry skin is one of the most prevalent problems. Using mild skin cleansers and the regular application of moisturizing leave-on products is recommended. Until today, there are no quantitative empirical data about nursing skin care practice at home in the community. A multicentre cross-sectional study was conducted in July 2012. Home care clients from the German home care nursing setting were randomly selected. Instructed nurse raters performed the data collection using standardized forms. Variables included demographics, skin care needs and skin caring activities. Approximately 60% of home care clients received skin care interventions. The majority were washed and two-thirds received a leave-on product once daily. There was large heterogeneity in cleansing and skin care product use. Most often the product labels were unknown or product types were selected haphazardly. Skin care interventions play a significant role in home care and nurses have a considerable responsibility for skin health. Skin care provided does not meet recent recommendations. The importance of targeted skin cleansing and care might be underestimated. There are a confusing variety of skin care products available and often the labels provide little information regarding the ingredients or guidance about how they affect skin health. © 2014 John Wiley & Sons Ltd.

  15. Prevalence and correlates of internalizing mental health symptoms among CSHCN.

    Science.gov (United States)

    Ghandour, Reem M; Kogan, Michael D; Blumberg, Stephen J; Perry, Deborah F

    2010-02-01

    This study provides nationally representative prevalence estimates of internalizing mental health symptoms among children with special health care needs (CSHCN) and identifies significant covariates of these symptoms by using multivariate regression. Internalizing symptoms include feeling anxious and depressed. Data were obtained from the 2005-2006 National Survey of Children with Special Health Care Needs, a nationally representative, parent-reported, cross-sectional survey of 40 465 CSHCN. The presence of internalizing mental health symptoms was assessed by using 2 binary items capturing whether a child had or experienced difficulty with depression, anxiety, disordered eating, or other emotional problems. The odds of experiencing internalizing symptoms were assessed by using multivariate regression, controlling for sociodemographic, health-related, and burden-related covariates. A total of 31.9% of CSHCN 3 to 17 years of age experienced internalizing mental health symptoms. Multivariate logistic regression showed internalizing symptoms to be strongly associated with female gender, older age, and frequent activity limitations, as well as externalizing mental health symptoms and conditions with behavioral components. Children with behavior problems had 6 times the odds of internalizing symptoms (adjusted odds ratio [aOR]: 5.95 [95% confidence interval [CI]: 5.30-6.69]), whereas children with autism spectrum disorder had 3 times the odds (aOR: 3.00 [95% CI: 2.39-3.77]). Increased odds of symptoms also were associated with frequent headaches (aOR: 1.76 [95% CI: 1.45-2.13]) and chronic pain (aOR: 1.46 [95% CI: 1.22-1.75]). Odds of symptoms were greater for children living in households that experienced employment changes or financial burdens resulting from the children's needs. Internalizing mental health symptoms are common among CSHCN. Findings may help caregivers focus screening and prevention efforts for high-risk groups in this heterogeneous population.

  16. 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...

  17. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  18. Association of socio-economic status with diabetes prevalence and utilization of diabetes care services

    Directory of Open Access Journals (Sweden)

    Svenson Lawrence W

    2006-10-01

    Full Text Available Abstract Background Low income appears to be associated with a higher prevalence of diabetes and diabetes related complications, however, little is known about how income influences access to diabetes care. The objective of the present study was to determine whether income is associated with referral to a diabetes centre within a universal health care system. Methods Data on referral for diabetes care, diabetes prevalence and median household income were obtained from a regional Diabetes Education Centre (DEC database, the Canadian National Diabetes Surveillance System (NDSS and the 2001 Canadian Census respectively. Diabetes rate per capita, referral rate per capita and proportion with diabetes referred was determined for census dissemination areas. We used Chi square analyses to determine if diabetes prevalence or population rates of referral differed across income quintiles, and Poisson regression to model diabetes rate and referral rate in relation to income while controlling for education and age. Results There was a significant gradient in both diabetes prevalence (χ2 = 743.72, p 2 = 168.435, p Conclusion Low income is associated with a higher prevalence of diabetes and a higher population rate of referral to this regional DEC. After accounting for diabetes prevalence, however, the equal proportions referred to the DEC across income groups suggest that there is no access bias based on income.

  19. Prevalence of mental health risk factors among students in lithuania

    OpenAIRE

    Pranckevičiūtė, Lina

    2017-01-01

    Prevalence of Mental Health Risk Factors among Students in Lithuania There are a numberof studiesin Lithuania and whole world about depression among young people. However, the prevalence of several risk factors (mental health literacy, sense of coherence, depressiveness, suicidal thoughts, social support) among universities, colleges, vocational studentsin Lithuania has not been studied. Aim of the study – to assess mental health risk factors prevalence among Lithuanian students. Objectives: ...

  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

  1. People In Sub-Saharan Africa Rate Their Health And Health Care Among Lowest In World

    Science.gov (United States)

    Deaton, Angus S.; Tortora, Robert

    2017-01-01

    The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans’ perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second lowest perception of personal health, after only the former Soviet Union and its satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in sub-Saharan Africa toward health. PMID:25715657

  2. 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.

  3. Ageing world: Health care challenges

    Directory of Open Access Journals (Sweden)

    Vinay Mahishale

    2015-01-01

    Full Text Available The world population reached 7 billion in 2012, which is 6 billion more than in 1800. This remarkable population growth is the result of several factors like advances in the medical, technological and public health systems resulting in the control and treatment of communicable diseases, the control of pandemics, the end of large-scale wars, improvements in living conditions and the revolutions in the field of agriculture. Because of all these factors, there has been a considerable improvement in the life expectancy of human beings. There is also an alarming reduction in fertility rates. The combination of declining fertility rate and augmented life expectancies has led to a change in the demographics of the population with the strata of older individuals growing faster than the younger individuals. The aging of populations is poised to become the next global public health challenge. Advances in medicine and socioeconomic development have substantially reduced mortality and morbidity rates due to infectious conditions and, to some extent, non-communicable diseases. These demographic and epidemiological changes, coupled with rapid urbanization, modernization, globalization, and accompanying changes in risk factors and lifestyles, have increased the prominence of chronic non-infective conditions. Health systems need to find effective strategies to extend health care and to respond to the needs of older adults. This review highlights the pathophysiology of aging, biological and physiological changes, impact of aging on health, epidemiological transitions, multi-morbidity in elderly and challenges for health care system.

  4. [Managing diversity in Swiss Health care].

    Science.gov (United States)

    Bodenmann, P; Bossart, R; Di Bernardo, N; Dominice Dao, M; Durieux, S; Faucherre, F; Hudelson, P; Keller, M; Schuster, S; Zellweger, E; Houmard, S

    2014-11-19

    The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients.

  5. 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.

  6. Improving oral health and oral health care delivery for children.

    Science.gov (United States)

    Crall, James J

    2011-02-01

    National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery.

  7. Prevalência de Streptococcus β-hemolítico em crianças portadoras de necessidades especiais Prevalence of β-hemolytic Streptococcus in children with special health care needs

    Directory of Open Access Journals (Sweden)

    Viviane Martha Santos de Morais

    2012-10-01

    Full Text Available Faringotonsilite causada por Streptococcus β-hemolítico afeta principalmente crianças e imunocomprometidos, sendo Streptococcus pyogenes (Grupo A o agente mais comum em faringotonsilites bacterianas. OBJETIVO: Este trabalho objetivou a busca por Streptococcus β-hemolítico do Grupo A (SBHGA e Não A (SBHGNA na orofaringe de indivíduos com necessidades especiais da APAE (Maceió-AL. MÉTODO:Estudo prospectivo com amostras da orofaringe de pacientes com síndrome de Down e outras desordens mentais (teste e estudantes de escola privada (controle de 5-15 anos. Culturas em ágar sangue (5% foram identificadas através dos testes de Gram/catalase e o método de disco difusão com bacitracina/sulfametoxazol-trimetoprim, aplicando-se o teste Chi-quadrado em análises estatísticas. RESULTADOS: Um total de 222 colônias bacterianas foram isoladas em 74 indivíduos da APAE e 65 no grupo controle. No grupo teste, episódios prévios de faringotonsilites foram relatados por 36,49% (27/74 e 9,46% (7/74 foram diagnosticados com sintomas e/ou sinais sugestivos de infecção orofaríngea. Nenhuma amostra de S. pyogenes foi confirmada na APAE, sendo todas identificadas como SBHGNA, com cinco SBHGA no grupo controle. CONCLUSÃO:A identificação precoce de Streptococcus β-hemolítico é importante para o tratamento rápido de faringotonsilites e a ausência de S. pyogenes evita futuras sequelas supurativas ou não supurativas no grupo da APAE.Pharyngotonsillitis by β-hemolytic Streptococcus mostly affects children and imunocompromissed, being Streptococcuspyogenes (Group A the most common agent in bacterial pharyngotonsillitis. AIM:This work targeted the research of β-hemolytic Streptococcus Group-A (SBHGA and No-A (SBHGNA in the oropharynx of individuals with special health needs from the APAE (Maceió-AL. METHOD: A prospective study with oropharynx samples from patients with Down syndrome and other mental disorders (test and students from a private

  8. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    Science.gov (United States)

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  9. Integrating Primary Oral Health Care into Primary Care.

    Science.gov (United States)

    Isman, Robert E.

    1993-01-01

    Primary oral health care, and the scope of services it includes, are defined. The proposed scope of services is a set of basic dental services used by the Indian Health Service. Policy recommendations for improving the integration of primary oral health services with primary health care and delivery are offered. (Author/MSE)

  10. Binge drinking: Health impact, prevalence, correlates and interventions

    NARCIS (Netherlands)

    Kuntsche, E.N.; Kuntsche, S.; Thrul, J.; Gmel, G.

    2017-01-01

    Objective: Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and

  11. Barriers to health care for undocumented immigrants: a literature review

    Directory of Open Access Journals (Sweden)

    Hacker K

    2015-10-01

    Full Text Available Karen Hacker,1,2 Maria Anies,2 Barbara L Folb,2,3 Leah Zallman4–6 1Allegheny County Health Department, Pittsburgh, PA, USA; 2Graduate School of Public Health, 3Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA; 4Institute for Community Health, Cambridge, MA, USA; 5Cambridge Health Alliance, Cambridge, MA, USA; 6Harvard School of Medicine, Boston, MA, USA Abstract: With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase

  12. Teaching tomorrow's health care leaders.

    Science.gov (United States)

    Mitchell, W

    1993-01-01

    Business school curricula have traditionally emphasized functional skills for people who will work in functional departments and general management skills for people who will organize interdepartmental work. Recently, some business schools have begun to develop programs that teach cross-functional work and team skills to functional specialists. Students educated in such programs will be well prepared to meet the new challenges that health care organizations will face.

  13. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...... these to a discussion of future challenges in the form of an aging population, increased privatization and increased inequity...

  14. Choosing a health care provider.

    Science.gov (United States)

    Harris, Katherine M; Beeuwkes Buntin, Melinda

    2008-05-01

    In a consumer-driven health care model, consumers, armed with information, would select providers based on quality and cost, thus increasing competition. This synthesis examines the availability of quality information and the evidence of how consumers use such information to choose a provider. Key findings include: information is publicly available from multiple sources regarding hospitals, but not individual doctors. Hospital information is predominantly made available online; but this limits awareness and access. Awareness is low overall, but highest among well-educated, healthy people. Even when consumers are aware of the data available, they rarely use it because they do not find it relevant: they do not foresee needing a hospital soon; are happy with their current provider; or did not find information pertinent to their specific health condition or hospital. While there is some evidence that hospitals that do poorly on public quality scorecards lose market share, there is better evidence that the providers themselves react to the quality scores by addressing care problems. Studies consistently show that consumers value health care quality and want information, but instead they rely on input from friends, family and their personal physicians about the quality of providers.

  15. Oncology in primary health care

    International Nuclear Information System (INIS)

    Mendoza del Pino, Mario Valentín

    2009-01-01

    The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

  16. 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...... 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...

  17. How Do Health Care Providers Diagnose Endometriosis?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose endometriosis? Surgery is currently the only ... larger incision—is used to make a diagnosis. Health care providers may also use imaging methods to produce ...

  18. Accreditation Association for Ambulatory Health Care

    Science.gov (United States)

    ... Press Release Archives learn more » For Patients Your health care choices matter. Whether you're anticipating a surgical ... certificate of accreditation is a sign that a health care organization meets or exceeds nationally-recognized Standards. Learn ...

  19. Job satisfaction in health-care organizations

    Directory of Open Access Journals (Sweden)

    Kavita Bhatnagar

    2012-01-01

    Full Text Available Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

  20. Job satisfaction in health-care organizations

    OpenAIRE

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

  1. Medicaid Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

  2. The Cultural Geography of Health Care Delivery.

    Science.gov (United States)

    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  3. Passion in today's health care leaders.

    Science.gov (United States)

    Piper, Llewellyn E

    2005-01-01

    Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others.

  4. Pegasus Health Pastoral Care Programme.

    Science.gov (United States)

    Christie, Caroline; Wynn-Thomas, Simon; McKinnon, Bianca

    2017-09-01

    INTRODUCTION In New Zealand, 41% of general practitioners (GPs) intend to retire by 2025. Increasing workforce shortages and other stressors are putting doctors at risk of burnout, which in turn can put patients at risk of harm. Offering a range of resources can signal an organisation's commitment to physician wellness while improving patient safety and organisational stability. AIM To replace the current reactive approach to impaired doctors with a proactive system of monitoring performance with the goal of identifying problems early. METHODS This paper reports on an initiative of Pegasus Health Charitable to provide pastoral care to GPs in Canterbury experiencing increased stress, burnout or problems leading to impaired performance. RESULTS The pastoral care programme has been running successfully for 9 years and has helped 32 GPs. Because of the low numbers, the programme needs to be individualised and confidential. CONCLUSION Recent developments have seen Pegasus Health adopt a systematic approach to monitoring and supporting health practitioners. This includes the monitoring of available data on GPs at risk. Data collection is being used to manage the "psychological health" of doctors, including complaints, prescribing, referral data and attendance at education sessions.

  5. [Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

    Science.gov (United States)

    Грузева, Татьяна С; Дуфинец, Василий А; Замкевич, Виктория Б

    2016-01-01

    Harmful alcohol consumption constitutes a significant cause of the global burden of disease, causing more than 200 different diseases, 5.9% of all deaths worldwide, causing substantial medical and social costs, major economic loss, slowing progress towards the strategic goals of human development. to substantiate approaches to the formation of a national strategy to combat the harmful use of alcohol in Ukraine based on the analysis of the prevalence of alcohol consumption and related health and social problems and international experience and recommendations of WHO. The study was based on analysis of the extent and patterns of alcohol consumption in Ukraine, levels, structure and dynamics of morbidity and mortality from diseases associated with alcohol abuse; investigation of preventive activities in primary healthcare, the existing problems and doctors' needs for prevention alcohol abuse, national and international experience on this problem.This work usesbibliosemantic, medical, statistical, sociological, epidemiological methods. The information base are: European Health for All Database (HFA-DB)for 2000-2012,Center of Medical Statistics, Ministry of Health of Ukraine for 2000-2015, questionnaire survey of physicians in primary care, strategic and policy documents of WHO, WHO Regional Office for Europe. In Ukraine, as in most countries in the WHO European Region prevalence of alcohol is high. In the ranking of the WHO European Region Ukraine ranks fifth in alcohol consumption per capita. The structure of consumption of alcoholic drinks is dominated by strong spirits (48%). There has been a negative trend for this indicator from 5.4 liters in 2002 to 15.6 liters in 2012.The dominant pattern of alcohol consumption is characterized by early onset of alcohol consumption, significant frequency, large doses, mostly strong alcohol beverages, with significant share of low-quality alcohol. This factor contributes to high levels of morbidity. A total of546.3 thousandpeople

  6. Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations

    NARCIS (Netherlands)

    B.A.C. Bronkhorst (Babette); L.G. Tummers (Lars); A.J. Steijn (Bram); D. Vijverberg (Dominique)

    2014-01-01

    markdownabstract__Abstract__ Background: In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees’ perceptions of their work environment can play a role in explaining mental

  7. Poverty, Access to Health Care Services and Human Capital ...

    African Journals Online (AJOL)

    FIRST LADY

    Health care consultation showed a majority of the people sought the services of modern medicine. In the first quintile 25.56 percent used modern medical services with an increasing trend to 55.96percent for the least poor or the fifth quintile. Although not as prevalent, it is important to note that both the non- poor and the ...

  8. Drug interactions in primary health care in the George subdistrict ...

    African Journals Online (AJOL)

    Drug interactions in primary health care in the George subdistrict, South Africa: a cross-sectional study. PA Kapp, AC Klop, LS Jenkins. Abstract. Objectives: To investigate the prevalence of potential drug-drug interactions in primary healthcare clinics in the George subdistrict, to determine which drugs were involved, and to ...

  9. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of

  10. Teaching Health Care in Introductory Economics

    Science.gov (United States)

    Cutler, David M.

    2017-01-01

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

  11. Prevalência e fatores associados a sintomas de ansiedade em uma coorte de gestantes atendidas em um centro de saúde do município do Rio de Janeiro Prevalence of anxiety symptoms and associated factors in a cohort of pregnant women attending a health care center in the municipality of Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Daniele Marano Rocha Araújo

    2008-09-01

    socio-demographic, obstetric and nutritional data obtained using a questionnaire were treated as independent variables. The statistical analysis was performed using a multivariate Poisson regression with robust variance. RESULTS: the mean age was 25 years and mean level of schooling nine years. The prevalence of anxiety was 64.9% (95%CI: 56.7-72.5. The anxiety trait was associated with age between 18 and 24.9 years (PR=1.35; 95%CI: 1.06-1.71 and 1-8 years of schooling (PR=1.39; 95%CI: 1.11-1.73. CONCLUSIONS: it was observed that the anxiety trait was highly prevalent in this sample of pregnant women whose progress was followed at a health care center. Knowledge of the factors associated with the anxiety is of fundamental importance in allowing the health team to intervene in a timely and appropriate fashion in a pregnant woman's treatment.

  12. Health care under the Taliban.

    Science.gov (United States)

    Faiz, A

    1997-04-26

    When the Taliban swept into Kabul, Afghanistan in September 1996, they began a reign of terror over the people of that city, especially the women. Adhering to a fundamentalist interpretation of Islamic law, the group has severely restricted women's freedom of movement and access to health care, education, and employment. Some female physicians and nurses have been able to continue working because the Taliban has decreed that male doctors can not treat women patients unless they are their relatives. Female physicians and nurses have been subjected to beatings by armed Taliban guards who enforce "morals." Male and female doctors are viewed with suspicion by the Taliban and are routinely ridiculed in public. Women are attacked when they venture into the streets to seek medical care for themselves or their children, and a pregnant woman recently delivered her baby in the street while her husband was being beaten for trying to take her to the hospital. This interference with the delivery of health care has occurred at a time when many people require treatment for injuries inflicted in connection with the war and when the public utility system has collapsed. Few physicians are willing to discuss the patients they treat for injuries inflicted by the torturous Taliban, especially since some physicians have collaborated with the Taliban in order to avoid reprisals.

  13. Prevalência da amamentação em crianças menores de dois anos vacinadas nos centros de saúde escola Breastfeeding prevalence among children less than two years old immunized in primary health care school services

    Directory of Open Access Journals (Sweden)

    Daniella Fernandes Camilo

    2004-03-01

    Full Text Available OBJETIVO: Neste trabalho foi desenvolvido estudo transversal com o objetivo de verificar a prevalência da amamentação em 1 708 crianças menores de dois anos em Campinas, São Paulo. MÉTODOS: As informações sobre idade, sexo, serviço de saúde utilizado e alimentação foram obtidas por entrevistas com mães ou responsáveis durante a Campanha de Multivacinação de 2001. A amamentação foi classificada como exclusiva, predominante (incluindo outros líquidos, exceto leites, complementar (incluindo outros alimentos e/ou leites e total (soma de exclusivo, predominante e complementar. RESULTADOS: A análise demonstrou que a mediana de amamentação exclusiva foi de 68 dias e a de amamentação total foi de 6,4 meses. No primeiro semestre de vida, 38,1% das crianças estavam em amamentação exclusiva; 23,0% em predominante e 14,9% em complementar. No segundo semestre, 36,5% das crianças recebiam leite materno; no terceiro 26,4% e no quarto 13,9%. Crianças usuárias dos serviços públicos e das unidades locais de saúde apresentaram menor risco de desmame do que as usuárias dos serviços privados e de serviços não locais (pOBJECTIVE: A cross-sectional survey was developed aiming to identify the prevalence of breastfeeding among children aged 0-2 years living in Campinas, Sao Paulo state, Brazil. METHODS: Data on age, sex, health care service used and feeding were obtained by interviewing the mothers or caregivers of 1,708 children during the National Immunization Campaign in 2001. Breastfeeding was classified as exclusive, predominant (including others liquids, except milks, complementary (including others foods and/or others milks and total (sum of exclusive, predominant and complementary. RESULTS: The median exclusive breastfeeding was 68 days and median total breastfeeding was 6.4 months. In the first semester of life, 38.1% of the children were exclusively breastfed, 23.0 predominantly and 14.9% complementary breastfed. In the

  14. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    LENUS (Irish Health Repository)

    Skerritt, Louise

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  15. 78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...

    Science.gov (United States)

    2013-11-19

    ... conditions or procedures of significant prevalence and importance (for example, heart disease or breast... incorporate changes in measures and methodologies as medical treatments and technology evolve and the... health care areas such as diabetes care or preventive health care. Sampling and Attribution would...

  16. Let's put "care" back into health care.

    Science.gov (United States)

    Wesolowski, C E

    1990-01-01

    Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?

  17. The prevalence and usage of mobile health applications among mental health patients in Saudi Arabia.

    Science.gov (United States)

    Atallah, Nora; Khalifa, Mohamed; El Metwally, Ashraf; Househ, Mowafa

    2018-03-01

    Mobile health (mHealth) applications provide new methods of engagement with patients and can help patients manage their mental health condition. The main objective of this study is to explore the prevalence of the use of mobile health applications for mental health patients in Saudi Arabia. A total of 376 participants with depression and/or anxiety completed an online survey distributed by social networks which asked questions relating to mobile phone ownership, uses of health applications, and utilization patterns to track mental health related issues. Approximately, 46% of the participants reported running one or two healthcare related applications on their mobile phones. In all age groups, 64% of the participants used their mobile phones to access information related to their own health. Also, 64% of the participants expressed interest in using their own mobile phones to track and follow the progression of their depression and/or anxiety. Developing mobile health applications for Saudi mental health patients is needed since it can offer opportunities for patients, researchers, caregivers, and legislators to work together to improve the state of mental health care in Saudi Arabia. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Building health care system capacity: training health care professionals in disaster preparedness health care coalitions.

    Science.gov (United States)

    Walsh, Lauren; Craddock, Hillary; Gulley, Kelly; Strauss-Riggs, Kandra; Schor, Kenneth W

    2015-04-01

    This study aimed to learn from the experiences of well-established, disaster preparedness-focused health care coalition (HCC) leaders for the purpose of identifying opportunities for improved delivery of disaster-health principles to health professionals involved in HCCs. This report describes current HCC education and training needs, challenges, and promising practices. A semi-structured interview was conducted with a sample of leaders of nine preparedness-focused HCCs identified through a 3-stage purposive strategy. Transcripts were analyzed qualitatively. Training needs included: stakeholder engagement; economic sustainability; communication; coroner and mortuary services; chemical, biological, radiological, nuclear, and explosives (CBRNE); mass-casualty incidents; and exercise design. Of these identified training needs, stakeholder engagement, economic sustainability, and exercise design were relevant to leaders within HCCs, as opposed to general HCC membership. Challenges to education and training included a lack of time, little-to-no staff devoted to training, and difficulty getting coalition members to prioritize training. Promising practices to these challenges are also presented. The success of mature coalitions in improving situational awareness, promoting planning, and enabling staff- and resource-sharing suggest the strengths and opportunities that are inherent within these organizations. However, offering effective education and training opportunities is a challenge in the absence of ubiquitous support, incentives, or requirements among health care professions. Notably, an online resource repository would help reduce the burden on individual coalitions by eliminating the need to continually develop learning opportunities.

  19. Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients.

    Science.gov (United States)

    Cavero, Victoria; Diez-Canseco, Francisco; Toyama, Mauricio; Flórez Salcedo, Gustavo; Ipince, Alessandra; Araya, Ricardo; Miranda, J Jaime

    2018-01-01

    Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients' feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases

  20. Children--The Effect of Rural Residence on Dental Unmet Need for Children with Special Health Care Needs

    Science.gov (United States)

    Skinner, Asheley Cockrell; Slifkin, Rebecca T.; Mayer, Michelle L.

    2006-01-01

    Background: Unmet need for dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN), even though these children are at a greater risk for dental problems. The combination of rural residence and special health care needs may leave rural CSHCN particularly vulnerable to high levels of unmet…

  1. Sexual harassment in health care: a major productivity problem.

    Science.gov (United States)

    Decker, P J

    1997-09-01

    Sexual harassment in health care is a problem because of exorbitant legal costs, lost productivity, poor morale, and nonproductive absenteeism or turnover. Sexual harassment is more prevalent in health care. Health care organizations often do little to prevent it and do not respond properly when it occurs. In this article, legal precedents are reviewed, and a model of sexual harassment is developed to illustrate the phenomenon and identify interventions. Harassing and stereotyping behavior can be changed. Victims' responses and willingness to report incidents can be changed. Policies, sanctions, accountability, training, the type of investigations, and changed organizational culture help reduce sexual harassment. It is argued that reduction of sexual harassment in health care is important because it is a major productivity issue.

  2. Dental care and children with special health care needs: a population-based perspective.

    Science.gov (United States)

    Lewis, Charlotte W

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.

  3. Hurdles to health: immigrant and refugee health care in Australia.

    Science.gov (United States)

    Murray, Sally B; Skull, Sue A

    2005-02-01

    Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian government migration and settlement policy also impacts on access to health and health status. An adequate understanding of these 'hurdles to health' is a prerequisite for health providers and health service managers if they are to tailor health care and services appropriately. We include tables of available resources and entitlements to health care according to visa category to assist providers and managers.

  4. Health savings accounts and health care spending.

    Science.gov (United States)

    Lo Sasso, Anthony T; Shah, Mona; Frogner, Bianca K

    2010-08-01

    The impact of consumer-driven health plans (CDHPs) has primarily been studied in a small number of large, self-insured employers, but this work may not generalize to the wide array of firms that make up the overall economy. The goal of our research is to examine effects of health savings accounts (HSAs) on total, medical, and pharmacy spending for a large number of small and midsized firms. Health plan administrative data from a national insurer were used to measure spending for 76,310 enrollees over 3 years in 709 employers. All employers began offering a HSA-eligible plan either on a full-replacement basis or alongside traditional plans in 2006 and 2007 after previously offering only traditional plans in 2005. We employ difference-in-differences generalized linear regression models to examine the impact of switching to HSAs. DATA EXTRACTION METHODS; Claims data were aggregated to enrollee-years. For total spending, HSA enrollees spent roughly 5-7 percent less than non-HSA enrollees. For pharmacy spending, HSA enrollees spent 6-9 percent less than traditional plan enrollees. More of the spending decrease was observed in the first year of enrollment. Our findings are consistent with the notion that CDHP benefit designs affect decisions that are at the discretion of the consumer, such as whether to fill or refill a prescription, but have less effect on care decisions that are more at the discretion of the provider.

  5. Children with Special Health Care Needs

    Science.gov (United States)

    ... I Waiting So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Health Tips Share this! Home » Health Tips » Child Emergencies Children With Special Health Care Needs Parents ...

  6. [Motivational interviewing in health care].

    Science.gov (United States)

    Lev-Ran, Shaul; Nitzan, Uri

    2011-09-01

    Harmful behaviors and low adherence to medical treatment significantly contribute to an increased rate of hospitalizations, mortality and morbidity. Leading health organizations worldwide are making great efforts to find and develop efficient strategies in order to recruit patients to adhere to medical treatment and adopt a healthier lifestyle. Motivational interviewing is an evidence-based approach that the physician can apply in numerous health care situations in order to increase patients' adherence to treatment. It is a patient-centered approach, based on principles of collaboration, autonomy and evocation. Research indicates that the patient's verbal commitment towards change is directly correlated to future behavioral change. Therefore, the approach includes learnable techniques which assist in allowing the patient to speak about the advantages of behavioral change and treatment. Thus, motivational interviewing helps patients adopt a healthier lifestyle while contributing to the professionalism of physicians and their sense of satisfaction from work.

  7. Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care.

    Science.gov (United States)

    Deutsch, Stephanie Anne; Fortin, Kristine

    2015-10-01

    Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed. Copyright © 2015 Mosby, Inc. All rights reserved.

  8. Socio-cultural factors influencing the prevalence, care and support ...

    African Journals Online (AJOL)

    Poverty, low literacy capacity, the urbanization process, inadequate health care facilities, the location of tertiary institutions, and certain contesting issues in ... of rural communities in HIV/AIDS programmes, despite the fact that PLWAs often return to their rural communities after contracting HIV/AIDS in their urban residence.

  9. Prevalence and Determinants of Early Antenatal Care Visit among ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Antenatal care (ANC), which is given to pregnant women, is widely used for prevention, early diagnosis and treatment of general medical and .... of Ethiopia. The town has 9 kebeles - the smallest administrative units in Ethiopia. There are two hospitals (one government and one private), two health centers, ten private clinics,.

  10. The prevalence ofpsychiatric disorders at a primary care clinic in ...

    African Journals Online (AJOL)

    major mood disorders and organic mental disorders. The remaining 90 - 95% have minor psychiatric dis- orders such as anxiety and depressive disorders and, if they present to health services at all, they present to general practitioners (GPs) or other primary care (PC) workers. A number of other studies have shown that 10.

  11. Prenatal Care for Adolescents and attributes of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Cristina Barbaro

    2014-01-01

    Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

  12. Prevalence and predictors of late presentation for HIV care in South Africa.

    Science.gov (United States)

    Fomundam, H N; Tesfay, A R; Mushipe, S A; Mosina, M B; Boshielo, C T; Nyambi, H T; Larsen, A; Cheyip, M; Getahun, A; Pillay, Y

    2017-11-27

    Many people living with HIV in South Africa (SA) are not aware of their seropositive status and are diagnosed late during the course of HIV infection. These individuals do not obtain the full benefit from available HIV care and treatment services. To describe the prevalence of late presentation for HIV care among newly diagnosed HIV-positive individuals and evaluate sociodemographic variables associated with late presentation for HIV care in three high-burden districts of SA. We used data abstracted from records of 8 138 newly diagnosed HIV-positive individuals in 35 clinics between 1 June 2014 and 31 March 2015 to determine the prevalence of late presentation among newly diagnosed HIV-positive individuals in selected high-prevalence health districts. Individuals were categorised as 'moderately late', 'very late' or 'extremely late' presenters based on specified criteria. Descriptive analysis was performed to measure the prevalence of late presentation, and multivariate regression analysis was conducted to identify variables independently associated with extremely late presentation. Overall, 79% of the newly diagnosed cases presented for HIV care late in the course of HIV infection (CD4+ count ≤500 cells/µL and/or AIDS-defining illness in World Health Organization (WHO) stage III/IV), 19% presented moderately late (CD4+ count 351 - 500 cells/µL and WHO clinical stage I or II), 27% presented very late (CD4+ count 201 - 350 cells/µL or WHO clinical stage III), and 33% presented extremely late (CD4+ count ≤200 cells/µL and/or WHO clinical stage IV) for HIV care. Multivariate regression analysis indicated that males, non-pregnant women, individuals aged >30 years, and those accessing care in facilities located in townships and inner cities were more likely to present late for HIV care. The majority of newly diagnosed HIV-positive individuals in the three high-burden districts (Gert Sibande, uThukela and City of Johannesburg) presented for HIV care late in the

  13. Prevalence and predictors of late presentation for HIV care in South Africa

    Science.gov (United States)

    Fomundam, H N; Tesfay, A R; Mushipe, S A; Mosina, M B; Boshielo, C T; Nyambi, H T; Larsen, A; Cheyip, M; Getahun, A; Pillay, Y

    2018-01-01

    Background Many people living with HIV in South Africa (SA) are not aware of their seropositive status and are diagnosed late during the course of HIV infection. These individuals do not obtain the full benefit from available HIV care and treatment services. Objectives To describe the prevalence of late presentation for HIV care among newly diagnosed HIV-positive individuals and evaluate sociodemographic variables associated with late presentation for HIV care in three high-burden districts of SA. Methods We used data abstracted from records of 8 138 newly diagnosed HIV-positive individuals in 35 clinics between 1 June 2014 and 31 March 2015 to determine the prevalence of late presentation among newly diagnosed HIV-positive individuals in selected high-prevalence health districts. Individuals were categorised as ‘moderately late’, ‘very late’ or ‘extremely late’ presenters based on specified criteria. Descriptive analysis was performed to measure the prevalence of late presentation, and multivariate regression analysis was conducted to identify variables independently associated with extremely late presentation. Results Overall, 79% of the newly diagnosed cases presented for HIV care late in the course of HIV infection (CD4+ count ≤500 cells/ μL and/or AIDS-defining illness in World Health Organization (WHO) stage III/IV), 19% presented moderately late (CD4+ count 351 – 500 cells/μL and WHO clinical stage I or II), 27% presented very late (CD4+ count 201 – 350 cells/μL or WHO clinical stage III), and 33% presented extremely late (CD4+ count ≤200 cells/μL and/or WHO clinical stage IV) for HIV care. Multivariate regression analysis indicated that males, non-pregnant women, individuals aged >30 years, and those accessing care in facilities located in townships and inner cities were more likely to present late for HIV care. Conclusions The majority of newly diagnosed HIV-positive individuals in the three high-burden districts (Gert Sibande, u

  14. Health care: a brave new world.

    Science.gov (United States)

    Morrisette, Shelley; Oberman, William D; Watts, Allison D; Beck, Joseph B

    2015-03-01

    The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health.

  15. Health Seeking Behaviour and Access to Health Care Facilities at ...

    African Journals Online (AJOL)

    Context: Health care at the primary level is accepted as the model for delivering basic health care to low income populations especially in developing countries such as Nigeria. Despite all the efforts and strategiesadapted in Nigeria, there is still high level of morbidity and mortality from the diseases primary health care ...

  16. 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 ...

  17. 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...

  18. 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.

  19. Fostering health in the foster care maze.

    Science.gov (United States)

    Sobel, A; Healy, C

    2001-01-01

    The fastest growing population of children in foster care today is quite young, and many of these children have significant health care needs. The General Accounting Office (GAO) reported that children in foster care "are among the most vulnerable individuals in the welfare population" (GAO, 1995, p. 1). Poverty, increased homelessness, substance abuse, and a rise in the incidence of persons with HIV all contribute to the problems faced by these children. The Caring Communities for Children in Foster Care Project, funded by the Maternal Child Health Bureau Integrated Services Medical Home Initiative with the American Academy of Pediatrics (AAP), investigated the availability of comprehensive health care services for children in foster care. The AAP recommends that pediatricians serve as the primary health care provider for children in foster care and also as consultants to child welfare agencies. Pediatric nurses play a crucial role in providing health care services to children in foster care. With an increased understanding of the potential physical and mental health care needs of children in foster care and the important role of foster parents, pediatric nurses can increase the likelihood of positive health outcomes for children in foster care.

  20. 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.

  1. Delegation within municipal health care.

    Science.gov (United States)

    Bystedt, Maria; Eriksson, Maria; Wilde-Larsson, Bodil

    2011-05-01

    To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  2. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  3. Latex allergy in health care

    Directory of Open Access Journals (Sweden)

    Tina Virtič

    2012-11-01

    Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.

  4. Reforming health care in Hungary.

    Science.gov (United States)

    Császi, L; Kullberg, P

    1985-01-01

    Over the past two decades Hungary has initiated a series of social and economic reforms which have emphasized decentralization of control and the reintroduction of market mechanisms into the socialized economy. These reforms both reflect and reinforce a changing social structure, in particular the growing influence of upper class special interest groups. Market reforms are an expression of concurrent ideological shifts in Hungarian society. We examined the political significance of three recent proposals to reform health services against the backdrop of broader social and economic changes taking place. The first proposes a bureaucratic reorganization, the second, patient co-payments, and the third, a voucher system. The problems each proposal identifies, as well as the constituency each represents, reveal a trend toward consolidation of class structure in Hungary. Only one of these proposals has any potential to democratize the control and management of the heath care system. Moreover, despite a governmental push toward decentralization, two of these proposals would actually increase centralized bureaucratic control. Two of the reforms incorporate market logic into their arguments, an indication that the philosophical premises of capitalism are re-emerging as an important component of the Hungarian world-view. In Hungary, as well as in other countries, social analysis of proposed health care reforms can effectively illuminate the social and political dynamics of the larger society.

  5. Not your father's health care.

    Science.gov (United States)

    Flower, J

    1999-01-01

    We in health care are living and working in a world that, for all its technical changes, differs little in its basic assumptions, structures, payment systems, beliefs, expectations, and job titles from the world of health care a generation back. How much change can we expect over the coming years? A lot more than we are prepared for. Look at the array of new technologies headed our way, from genomic sciences to customized vaccinations. Many of the breakthroughs promise incredible abilities to prevent disease, to profile our proclivities, and to manage our genetic predispositions over long periods of time, rather than merely wait until the disease manifests in an acute phase, then treat the symptoms. Digital technologies bring physicians executives enormous opportunities for new ways of gathering, storing, and mining information, for new types of communication between medical professionals, for new communications with customers, and new ways of steering large, complex enterprises. Unprecedented opportunities for change keep piling in through the door. Vast pressures for change keep building from every side. And the rewards for anyone who can lead the change keep compounding.

  6. Prevalence of health risk factors among fishermen

    DEFF Research Database (Denmark)

    Frantzeskou, Elpida; Jensen, Olaf; Linos, Athena

    2014-01-01

    AND fisherman OR fishing and only those with precise prevalence estimation were included. Results One Turkish, Scottish, Spanish, Greek and a Danish study were found. The prevalence rate for current smoking varied from 40 % - 82 % in the countries. Daily alcohol use also varied with 80%, 78% and 68 % among...... and accompanied by moderate–high alcohol consumption. On many vessels, food was limited to coffee, sandwiches and occasionally fruit on board. 66% of the Greek fishing workers did not perform any kind of exercise outside work. Obesity (Body mass index > 30.0) was found for 33 % of the Greek fishermen...

  7. Correlation of Electronic Health Records Use and Reduced Prevalence of Diabetes Co-Morbidities

    Science.gov (United States)

    Eller, James D.

    2013-01-01

    The general problem is Native American tribes have high prevalence rates of diabetes. The specific problem is the failure of IHS sites to adopt EHR may cause health care providers to miss critical opportunities to improve screening and triage processes that result in quality improvement. The purpose of the quantitative correlational study was to…

  8. 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.

  9. Health care in the 2004 presidential election.

    Science.gov (United States)

    Blendon, Robert J; Altman, Drew E; Benson, John M; Brodie, Mollyann

    2004-09-23

    We examined the importance for voters of health care as an issue in the presidential election of 2004, how this ranking compares with the importance of health care in past elections, and which issues voters regard as the most important health care issues in the months before the election. We studied data from 22 national opinion surveys, 9 of them conducted as telephone surveys during the 2004 presidential campaign, 10 conducted as telephone surveys during the previous three presidential elections, and 3 conducted as national exit polls of voters. Voters ranked health care as the fourth most important issue in deciding their vote for president in 2004. The top health care issues for voters were the costs of health care and prescription drugs, prescription-drug benefits for the elderly, the uninsured, and Medicare. Bioterrorism and abortion were also important issues for voters. The voters most concerned about health care were older persons and those who identified themselves as Democrats. Four issues less salient to voters were racial disparities in health care, aid to developing countries to prevent and treat human immunodeficiency virus infection and the acquired immunodeficiency syndrome, medical malpractice, and the quality of care. Although health care ranks higher in importance among voters than most other domestic issues, it is only fourth in importance in deciding their vote for president. The health care issues of greatest concern are the affordability of health care and health care insurance. Health care issues do not appear likely to play a decisive role in the presidential election in 2004, but they might make a difference in some swing states if the race is close. Copyright 2004 Massachusetts Medical Society

  10. Caring for Children with Special Health Care Needs: Profiling Pediatricians and Their Health Care Resources.

    Science.gov (United States)

    Okumura, Megumi J; Knauer, Heather A; Calvin, Kris E; Takayama, John I

    2018-03-01

    Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers. We performed a logistic regression model on having an "above average proportion" of CSHCN in practice, adjusting for demographics, practice type (rural vs. suburban/urban) and medical resources, care satisfaction, and ease of subspecialty access. Results Our response rate was 50.2% (n = 1290); 75% of respondents reported providing some primary care services, with many primary care pediatricians caring for a high proportion of CSHCN. Pediatricians reported an average of 28% CSHCN in their practices. Rural pediatricians lacked subspecialty access (10-59% reporting no access to the various subspecialties). Factors relating to higher CSHCN in practice included being in academic medical centers and satisfaction in caring for CSHCN. Conclusions Pediatricians report lack of access to mental health services, care coordination and case management. Academic medical centers and higher physician satisfaction in care delivery for CSHCN are associated with more CSHCN in practice. Promoting ways to support pediatricians, such as practice collaboration with behavioral specialists, may be necessary to encourage primary care pediatricians to provide medical homes for CSHCN.

  11. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies.

    Directory of Open Access Journals (Sweden)

    Concepció Violan

    Full Text Available Multimorbidity is a major concern in primary care. Nevertheless, evidence of prevalence and patterns of multimorbidity, and their determinants, are scarce. The aim of this study is to systematically review studies of the prevalence, patterns and determinants of multimorbidity in primary care.Systematic review of literature published between 1961 and 2013 and indexed in Ovid (CINAHL, PsychINFO, Medline and Embase and Web of Knowledge. Studies were selected according to eligibility criteria of addressing prevalence, determinants, and patterns of multimorbidity and using a pretested proforma in primary care. The quality and risk of bias were assessed using STROBE criteria. Two researchers assessed the eligibility of studies for inclusion (Kappa= 0.86.We identified 39 eligible publications describing studies that included a total of 70,057,611 patients in 12 countries. The number of health conditions analysed per study ranged from 5 to 335, with multimorbidity prevalence ranging from 12.9% to 95.1%. All studies observed a significant positive association between multimorbidity and age (odds ratio [OR], 1.26 to 227.46, and lower socioeconomic status (OR, 1.20 to 1.91. Positive associations with female gender and mental disorders were also observed. The most frequent patterns of multimorbidity included osteoarthritis together with cardiovascular and/or metabolic conditions.Well-established determinants of multimorbidity include age, lower socioeconomic status and gender. The most prevalent conditions shape the patterns of multimorbidity. However, the limitations of the current evidence base means that further and better designed studies are needed to inform policy, research and clinical practice, with the goal of improving health-related quality of life for patients with multimorbidity. Standardization of the definition and assessment of multimorbidity is essential in order to better understand this phenomenon, and is a necessary immediate step.

  12. Health Care, capabilities and AI assistive technologies.

    NARCIS (Netherlands)

    Coeckelbergh, Mark

    2009-01-01

    Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them

  13. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

    Science.gov (United States)

    Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A

    2017-10-01

    Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO ® (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

  14. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  15. Primary Health Care and Narrative Medicine.

    Science.gov (United States)

    Murphy, John W

    2015-01-01

    Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery.

  16. Prevalência de sinais/sintomas sugestivos de sensibilização ao látex em profissionais de saúde Prevalencia de señales/síntomas sugestivos de sensibilidad al l átex en profesionales de la salud Prevalence of signs/symptoms suggestive of latex sensitization in health care workers

    Directory of Open Access Journals (Sweden)

    Lígia Andrade da Silva Telles Mathias

    2006-04-01

    rea de la salud. El objetivo de este estudio fue el de evaluar la prevalencia de señales/síntomas sugestivos de sensibilidad al látex en profesionales del área de la salud. MÉTODO: Después de aprobado por el Comité de Ética, se seleccionaron individuos pertenecientes a la plantilla de la institución: funcionarios del Sector de Limpieza, Contabilidad y División de Enfermería del Centro Quirúrgico; Médicos de Cirugía, Ginecología, Obstetricia, Anestesiología, Unidad de Terapia Intensiva y Clínica Médica. Después de recibir la información y consentir con la pesquisa, los individuos fueron sometidos a un cuestionario sobre: edad, sexo, categoría profesional; tipo y tiempo de contacto profesional con los derivados del látex; tipo de guante utilizado; señales/síntomas sugestivos de sensibilidad al látex dentro y fuera del ambiente hospitalario; señales/síntomas sugestivos de atopia y de alergia a alimentos. RESULTADOS: Fueron evaluados 326 cuestionarios (193 mujeres y 133 hombres, con edad entre 30 y 73 años. Un 75% de los encuestados tenían 10 años de profesión. La prevalencia de los señales/síntomas sugestivos de sensibilidad al látex dentro del ambiente hospitalario con relación a los grupos compuestos por los funcionarios del Sector de Contabilidad (no expuestos a derivados del látex en el ambiente de trabajo, y el resto de los individuos (expuestos a derivados del látex en el ambiente de trabajo, evidenció una diferencia significativa (p BACKGROUND AND OBJECTIVES: In the literature, the references on adverse reactions to latex products have been significantly increasing for the last few years. However, it lacks Brazilian data regarding the prevalence of latex-related sensitization in health care workers. The objective of this study was to evaluate the prevalence of signs and symptoms suggestive of latex-related sensitization in health care workers. METHODS: Upon approval by the Ethics Committee it were selected a population of

  17. What is the impact of disease prevalence upon health technology assessment?

    Science.gov (United States)

    Rotily, Michel; Roze, Stéphane

    2013-12-01

    As national budgets for health care will remain under stress for the foreseeable future, health technology assessment (HTA) aimed at offering guidance to policy-making will have an increasing role to play in optimizing resources. The emergence of new treatment paradigms and health technologies, and the prevalence studies which determine when a disease is a current or future burden for patients and the community are in the roots of the HTA process. Analysing studies on screening test strategies and health care policy, this paper revisits two key concepts in epidemiology, prevalence and incidence, in order to show their major impact upon HTA. Utilization of the predictive values of screening tests that include prevalence in their calculations, and analysing all options for screening strategies are necessary in HTA. Cost-effectiveness analyses and statistical models should include potential externalities, especially the impact of prevention and treatment on infectious disease prevalence. Beyond estimates of cost-effectiveness ratios, decision makers also need to know by how much their annual health care budget is likely to increase or decrease in the years following the emergence of new technologies: hence the importance of incidence- or prevalence-based economic evaluations. As new paradigms are occurring, especially in the field of oncology, with treatments targeted to 'small' groups of patients identified through genetic testing, prevalence data are strongly needed. Precise estimates of disease prevalence, in general populations as well as in risk or targeted groups, will therefore be necessary to improve HTA process. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Knowledge of Health Insurance Among Primary Health-Care ...

    African Journals Online (AJOL)

    Background: The National Health Insurance Scheme (NHIS) was formally launched in Nigeria in 2005 as an option to help bridge the evident gaps in health care financing, with the expectation of it leading to significant improvement in the country's dismal health status indices. Primary Health Care (PHC) is the nation's ...

  19. Prevalence of Weight Problems among Youth with High-Incidence Disabilities in Residential Care

    Science.gov (United States)

    Trout, Alexandra L.; Lambert, Matthew C.; Nelson, Timothy D.; Thompson, Ronald W.

    2014-01-01

    The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of…

  20. Prevalência de constipação intestinal crônica em crianças atendidas em unidade básica de saúde Prevalence of chronic constipation in children at a primary health care unit

    Directory of Open Access Journals (Sweden)

    Ieda Regina Lopes Del Ciampo

    2002-12-01

    Full Text Available Objetivos: estudar a prevalência de constipação intestinal crônica funcional na infância, em uma unidade básica de saúde, e observar as suas principais características clínicas nessa população. Casuística e métodos: 313 crianças, pacientes da unidade básica de saúde Centro de Saúde Escola de Vila Tibério, Ribeirão Preto (SP, com idades entre 1 a 10 anos incompletos, compuseram a amostra. Destas, foram selecionadas 84 constipadas por critérios instituídos pelos autores. O teste do qui-quadrado foi aplicado para a comparação entre os grupos de constipados e não constipados (nível de significância = 0,01. Resultados: a prevalência de constipação intestinal crônica funcional foi de 26,8%. Das crianças constipadas, 85,7% tinham fezes endurecidas, 25% volume fecal diminuído, 17,9% intervalos às evacuações maiores que 2 dias (todas as crianças que apresentavam intervalo maior que 2 dias eram constipadas, 14,3% escape fecal, e 21,4% sangramento às evacuações. Conclusões: a prevalência de constipação intestinal foi elevada, e o intervalo entre as evacuações foi um critério diagnóstico importante para a seleção das crianças constipadas.Objective: to study the frequency of chronic constipation in childhood at a Primary Health Care Unit and to observe its characteristics in this population. Methods: The sample consisted of 313 children aged between one and 10 years treated at the Centro de Saúde Escola, in the district of Tibério, in the town of Ribeirão Preto. Among these, 84 children with chronic constipation were selected. The chi-squared test was used to compare the groups of constipated and nonconstipated children (p = 0.01. Results: The prevalence of chronic constipation was 26.8%. In the group of chronic constipation, 85.7% of the children had hardened stools, 25% showed reduction in fecal mass, 17.9% had an interval between evacuations longer than 2 days (constipated children, 14.3% revealed fecal

  1. [Trends in health care expenditures in Lithuania].

    Science.gov (United States)

    Jankauskiene, Danguole; Zemguliene, Jolanta; Gaizauskiene, Aldona

    2002-01-01

    The aim of the study was to analyze the tendencies of public and private health care expenditure in Lithuania during 1994-1999. Crude examination of statistical data show, that the growth rate of health care spending per capital is largely determined by growth of national gross domestic product (GDP). We have estimated that health care spending in Lithuania have risen twice faster than GDP during 1994-1999. (Percentage of rise in health care spending, divided by percentage rise of GDP, is +2.26). The introduction of compulsory health insurance in 1997, and the development of private health care sector in Lithuania, led to increase health care expenditure in total, and has influenced changes in public-private spending proportions. A source of private spending in national health account has increased from 15 per cent in 1994-1995 to 24 percent in 1996-1999. The tendency of increasing private spending shows, the evidence, that households are facing more financial risk of purchasing health care. This should be an implication for health care policy makers. Further decisions to increase private payments have to be based on evidence after detailed analysis of impact of consequences on health care access for various social economic groups of population.

  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. Beijing Eye Public Health Care Project.

    Science.gov (United States)

    Xu, Liang; Jonas, Jost B; Cui, Tong Tong; You, Qi Sheng; Wang, Ya Xing; Yang, Hua; Li, Jian Jun; Wei, Wen Bin; Liang, Qing Feng; Wang, Shuang; Yang, Xiao Hui; Zhang, Li

    2012-06-01

    The Beijing Eye Public Health Care Project was designed to screen all elderly subjects (age 55-85 years) of the rural region of Greater Beijing. It was developed as a preparatory step for a telemedicine-based public health care system in ophthalmology in China. Population-based public health care project. Elderly subjects (age 55-85 years) of the rural region of Greater Beijing. Project participants were visited, interviewed, and examined by 2500 high school graduates trained as ophthalmic technicians. If visual acuity was telemedicine, the photographs were transmitted to a reading center and causes for visual impairment were diagnosed. Practicability of a mass screening system in ophthalmology; prevalence of visual impairment and causes for it. Out of 692 323 eligible inhabitants, 562 788 (81.3%) subjects participated. Visual impairment in ≥1 eye was detected in 54 155 (9.62%) subjects, and among them, 30 164 (5.36%) subjects had bilateral visual impairment. Ocular fundus photographs were taken for 37 281 subjects. Cause for visual impairment was cataract in 19 163 (3.41%) of all screened subjects, glaucoma in 1606 (0.29%) subjects, diabetic retinopathy in 905 (0.16%) subjects, other macular diseases in 2700 (0.48%) subjects, pterygium in 1381 (0.25%) subjects, and corneal leukoma in 283 (0.05%) subjects. For 5853 (1.04%) subjects, a diagnosis of premature or mature cataract was made showing the urgent need of cataract surgery. After cataract surgery, visual acuity was ≥0.30 in 1464 (91.7%) of 1596 postoperatively reexamined subjects. Using a telemedicine approach, the Beijing Eye Public Health Care Project developed, applied and tested an infrastructure for ophthalmic mass screening of >500 000 elderly inhabitants with a response rate of >80%. Beside cataract, retinal diseases including diabetic retinopathy and glaucoma were major causes for visual impairment. The authors have no proprietary or commercial interest in any of the materials discussed in this

  4. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    Science.gov (United States)

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer. © The Author(s) 2016.

  5. Distributed leadership in health care

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette

    2018-01-01

    Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...

  6. Spirulina in health care management.

    Science.gov (United States)

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management.

  7. 8 ways to cut health care costs

    Science.gov (United States)

    ... care include strep throat, bladder infection, or a dog bite. You will save both time and money ... health services. www.healthcare.gov/coverage/preventive-care-benefits . Accessed October 18, 2016. U.S. Preventive Services Taskforce ...

  8. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...

  9. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of

  10. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  11. 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.

  12. Prevalence and Health Care–Seeking Behavior for Childhood Diarrheal Disease in Bangladesh

    Directory of Open Access Journals (Sweden)

    Abdur Razzaque Sarker MHE, MSS

    2016-11-01

    Full Text Available In Bangladesh, the burden of diarrheal diseases is significant among children <5 years old. The objective of this study is to capture the prevalence of and health care–seeking behavior for childhood diarrheal diseases (CDDs and to identify the factors associated with CDDs at a population level in Bangladesh. We use a logistic regression approach to model careseeking based on individual characteristics. The overall diarrhea prevalence among children <5 years old was found to be 5.71%. Some factors found to significantly influence the health care–seeking pattern were age and sex of the children, nutritional score, age and education of mothers, wealth index, and access to electronic media. The health care service could be improved through working in partnership with public facilities, private health care practitioners, and community-based organizations, so that all strata of the population get equitable access in cases of childhood diarrhoea.

  13. Understanding a Value Chain in Health Care.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2015-10-01

    As the US health care system transitions toward a value-based system, providers and health care organizations will have to closely scrutinize their current processes of care. To do this, a value chain analysis can be performed to ensure that only the most efficient steps are followed in patient care. Ultimately this will produce a higher quality or equal quality product for less cost by eliminating wasteful steps along the way.

  14. Prevalence of Mental Health Disorders Among Caregivers of Patients With Alzheimer Disease.

    Science.gov (United States)

    Sallim, Adnaan Bin; Sayampanathan, Andrew Arjun; Cuttilan, Amit; Chun-Man Ho, Roger

    2015-12-01

    The overall prevalence of mental health disorders among caregivers of patients with Alzheimer disease (AD) remains unclear. This meta-analysis aims to evaluate the prevalence of various mental health disorders among caregivers of patients with AD globally and to determine factors that predispose to development of the aforementioned, namely gender of caregiver, gender of patient, and caregiver-patient relationship. A total of 17 studies were eligible for systematic review and meta-analysis. A meta-analysis of published work was performed using the random effect model. Data analysis was done with RevMan 5.3. A total of 10,825 caregivers were assessed. The aggregate prevalence of depression among caregivers was 34.0%, anxiety at 43.6%, and use of psychotropic drugs at 27.2%. Meta-analysis revealed the odds of having of depression was 1.53 times higher in female caregivers (95% confidence interval [CI] 1.29-1.83; I(2) = 7%; Z = 4.78; P caregivers to male care-recipients (95% CI 1.66-2.08; I(2) = 40%; Z = 10.86; P caregivers (95% CI 1.68-3.76; I(2) = 55%; Z = 4.49; P Caregivers of patients with AD have a higher prevalence of mental health disorders, particularly depression and anxiety, as compared with the general population and with their counterparts caring for patients with other illnesses. The higher prevalence is mainly observed in female caregivers, caregivers with male care-recipients, and caregivers who have a spousal relationship with care-recipients. Prevalence of anxiety was also notably higher in this cohort but more research needs to be done in this area. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. Study of internet addiction: Prevalence, pattern, and psychopathology among health professional undergraduates

    OpenAIRE

    Sachin R Gedam; Santanu Ghosh; Lipsy Modi; Arvind Goyal; Himanshu Mansharamani

    2017-01-01

    Background: Internet has become an essential part of our daily life, especially among adolescents and youth. It is mainly used for education, entertainment, social networking, and information sharing. Its excessive use among health care providers is becoming a major concern. Aims: The aim of our study was to estimate the prevalence, understand the pattern, and to determine the association between psychopathology and internet addiction among health profession undergraduates. Materials and Meth...

  17. Poor housing quality: Prevalence and health effects.

    Science.gov (United States)

    Baker, Emma; Lester, Laurence H; Bentley, Rebecca; Beer, Andrew

    2016-01-01

    Housing is a central component of productive, healthy, and meaningful lives, and a principle social determinant of health and well-being. Surprisingly, though, evidence on the ways that housing influences health in Australia is poorly developed. This stems largely from the fact that the majority of the population are accommodated in good quality housing. The dominance of a "good housing paradigm" means that households living in poor quality and unhealthy housing are doubly disadvantaged-by the quality of their housing and because policy makers in Australia do not acknowledge the health effects of housing. In this article, we examine the relationship between health outcomes and quality of housing. We base our analysis on data from the Household Income and Labour Dynamics in Australia (HILDA) survey, a panel dataset that is representative across Australia. We find a sizeable, policy-important, and to date under-acknowledged cohort of Australians whose health is influenced by poor-condition dwellings.

  18. Patient involvement in Danish health care

    DEFF Research Database (Denmark)

    Vrangbaek, Karsten

    2015-01-01

    for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. FINDINGS: Patient involvement is important in Denmark...... implications for the development of patient involvement in health care. ORIGINALITY/VALUE: This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies....

  19. Robotics Technology in Mental Health Care

    OpenAIRE

    Riek, Laurel D.

    2015-01-01

    This chapter discusses the existing and future use of robotics and intelligent sensing technology in mental health care. While the use of this technology is nascent in mental health care, it represents a potentially useful tool in the practitioner's toolbox. The goal of this chapter is to provide a brief overview of the field, discuss the recent use of robotics technology in mental health care practice, explore some of the design issues and ethical issues of using robots in this space, and fi...

  20. Feasibility of an intervention to enhance preventive care for people with low health literacy in primary health care.

    Science.gov (United States)

    Faruqi, Nighat; Lloyd, Jane; Ahmad, Raghib; Yeong, Lin-Lee; Harris, Mark

    2015-01-01

    The objective of the study was to explore the feasibility of an intervention that enhances preventive care for primary care patients with low health literacy. A mixed method study was conducted in four Sydney general practices in areas of socioeconomic disadvantage. The intervention included screening for low health literacy in patients aged 40-69 years, clinical record audits of care for prevention of diabetes and cardiovascular disease, and provider training and meetings. Surveys and interviews were conducted to identify providers' approaches to, and delivery of, preventive care for people with low health literacy. Our study found variable response rates and prevalence of low health literacy. Of the eligible patients screened, 29% had low health literacy. Providers described three approaches to preventive care, which remained largely unchanged. However, they demonstrated recognition of the importance of better communication and referral support for patients with low health literacy. Fewer patients with low health literacy were identified than expected. Despite improved awareness of the need for better communication, there was limited evidence of change in providers' approach to providing preventive care, suggesting a need for more attention towards providers' attitudes to support these patients.

  1. Blogging and the health care manager.

    Science.gov (United States)

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  2. Celiac Disease Testing (for Health Care Professionals)

    Science.gov (United States)

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying ...

  3. Immigrants and health care: sources of vulnerability.

    Science.gov (United States)

    Derose, Kathryn Pitkin; Escarce, José J; Lurie, Nicole

    2007-01-01

    Immigrants have been identified as a vulnerable population, but there is heterogeneity in the degree to which they are vulnerable to inadequate health care. Here we examine the factors that affect immigrants' vulnerability, including socioeconomic background; immigration status; limited English proficiency; federal, state, and local policies on access to publicly funded health care; residential location; and stigma and marginalization. We find that, overall, immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations; however, there are differences among subgroups. We conclude with policy options for addressing immigrants' vulnerabilities.

  4. 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.

  5. Attending unintended transformations of health care infrastructure

    Science.gov (United States)

    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 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. PMID:18043725

  6. Public expenditures and health care in Africa.

    Science.gov (United States)

    Ogbu, O; Gallagher, M

    1992-03-01

    Unfavorable economic conditions in most of Africa (in this paper Africa refers to Sub-Saharan Africa only) have meant public austerity and a deceleration in government health spending. Given the dominant role of government in providing health services in Africa there is a need to investigate the links between public spending and the provision of health care. Analyzing information from five Sub-Saharan African countries, namely Botswana, Burkina Faso, Cameroon, Ethiopia and Senegal, we investigate the impacts of shifting expenditure patterns and levels on the process of providing health services as well as on delivery of health care. The country analyses indicate that in addition to the level of public spending, the expenditure mix (i.e. salaries, drugs, supplies etc.), the composition of the health infrastructure (hospitals, clinics, health posts etc.), community efforts, and the availability of private health care all influence health care delivery. Consequently, per capita public expenditure (the most important indicator in a number of related studies) alone as a measure of the availability of health care and especially for cross-country comparisons is inadequate. Reductions in government resources for health care often result in less efficient mixing of resources and hence less health care delivery, in quality and quantity terms. With the recent trends in health care spending in Africa there should be greater effort to increase the efficient use of these increasingly scarce resources, yet the trend in resource mix has been in the opposite direction. Given the input to public health care of local communities, as well as the provision of private health care, it would seem that government spending on health care should be counter-cyclical, i.e. government health spending should accelerate during periods of economic down turns. Such counter-cyclical spending would tend to offset the difficulties facing local communities and the declining ability of individuals to

  7. Prevalence of depression among women attending a primary urban care clinic in Malaysia.

    Science.gov (United States)

    Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

    2012-07-01

    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic. A cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language). A total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p history of serious illness (OR 2.4, 95% CI 1.1-5.2), unhappiness in family relationships (OR 2.3, 95% CI 1.1-4.7) and unhappiness at work (OR 2.2, 95% CI 1.1-4.3) (p Malaysia should be aware of this prevalence when making diagnoses in primary care.

  8. Health care process and workflow in continuity of care.

    Science.gov (United States)

    Mennerat, François; Lundell, Karl-Henrik; Fogelberg, Magnus; Hofdijk, Jacob; Braga, Silviu

    2009-01-01

    Basically, the workshop aims to raise and collect input to Part 2 ("Health care process and workflow"), currently under development, of the European standard EN 13940 "Health informatics - System of concepts to support continuity of care", the general objective of which is to enable communication at the semantic level between information systems in health care in the perspective of continuity of care. Its scope encompasses identifying the various processes and process objects involved, taking into consideration resource management aspects, responsibilities of health care providers, and means for patients' participation. While the process description and concept system model is meant as a tool for the development of information systems, it may also be used for enterprise analysis and form the basis for organizational decisions and more widely organizational developments that are not inherently tied to the use of ICT.

  9. Operationalization of biopsychosocial case complexity in general health care : the INTERMED project

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Sollner, W; Stiefel, FC

    Objective: Lack of operationalization of the biopsychosocial model hinders its effective application to the increasingly prevalent problems of comorbidities in clinical presentations. Here, we describe the INTERMED, an instrument to assess biopsychosocial case complexity in general health care, and

  10. Policy challenges in modern health care

    National Research Council Canada - National Science Library

    Mechanic, David

    2005-01-01

    ... for the Obesity Epidemic KENNETH E. WARNER 99 8 Patterns and Causes of Disparities in Health DAVID R. WILLIAMS 115 9 Addressing Racial Inequality in Health Care SARA ROSENBAUM AND JOEL TEITELBAU...

  11. Savings account for health care costs

    Science.gov (United States)

    ... patientinstructions/000864.htm Savings account for health care costs To use the sharing features on this page, ... JavaScript. As health insurance changes, out-of-pocket costs continue to grow. With special savings accounts, you ...

  12. The digital transformation of health care.

    Science.gov (United States)

    Coile, R C

    2000-01-01

    The arrival of the Internet offers the opportunity to fundamentally reinvent medicine and health care delivery. The "e-health" era is nothing less than the digital transformation of the practice of medicine, as well as the business side of the health industry. Health care is only now arriving in the "Information Economy." The Internet is the next frontier of health care. Health care consumers are flooding into cyberspace, and an Internet-based industry of health information providers is springing up to serve them. Internet technology may rank with antibiotics, genetics, and computers as among the most important changes for medical care delivery. Utilizing e-health strategies will expand exponentially in the next five years, as America's health care executives shift to applying IS/IT (information systems/information technology) to the fundamental business and clinical processes of the health care enterprise. Internet-savvy physician executives will provide a bridge between medicine and management in the adoption of e-health technology.

  13. 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

  14. Prevalence and seasonality of common health problems in Sokoto ...

    African Journals Online (AJOL)

    The prevalence and seasonality of animal health problems encountered in Sokoto Gudali cattle over a 10 year period (1988- 1998) is reported. ... This study gins an indication of some of the common animal health problems usually encountered under a semi-intensive cattle production system and the need for effective ...

  15. Prevalence of depression among health workers in Enugu, South ...

    African Journals Online (AJOL)

    2014-11-11

    Nov 11, 2014 ... Abstract. Aims: Determination of the prevalence and distribution of depression among health workers at tertiary level of health ... Departments of Community Medicine and 1Psychological Medicine, College of Medicine, University of Nigeria Enugu .... conditions[1,3] and workplace bullying among hospital.

  16. Assessment of health impacts of decreased smoking prevalence in Copenhagen

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Brønnum-Hansen, Henrik; Robinson, Kirstine Magtengaard

    2014-01-01

    Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities......, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. Methods: The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data......, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re...

  17. 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

  18. [The role of management in health care].

    Science.gov (United States)

    Güntert, Bernhard J

    2007-01-01

    The situation in the health care sector is affected by a shortage of public funds on the one hand and, on the other hand, by rapid developments in medicine and nursing with an enormous expansion of both diagnostic and therapeutic possibilities. This and the aging population are generating a steadily increasing demand for health care services. The result is an increased cost consciousness in society calling for more professional management in health care organizations. However, the traditional administration of health care organizations, which is closely aligned with health professionals and production processes, was not able to cope with these dynamics or did so only unsatisfactorily. An improved management would surely lead to an optimization of health care delivery processes and a more effective use of resources. The question, however, is whether the effectiveness of the total system can be improved and whether patients' and society's needs can actually be met by classical management approaches.

  19. The authoritarian reign in American health care.

    Science.gov (United States)

    Ballou, Kathryn A; Landreneau, Kandace J

    2010-02-01

    The aim of this article is to increase understanding of the mechanisms of the continuation of elite hegemonic control of a highly valued social system--American health care. White, male physicians and administrators achieved control of the health care industry and its workers, including nurses, at the start of the 20th century. Using critical theorists' work on authoritarianism and incorporating gender analysis, the authors describe the health care system from a critical social- psychological perspective. The authors discuss the meaning and presence of authoritarian hierarchy and gender effects in today's health system through a critical analysis of the profession of medicine, the profession of nursing, corporate and bureaucratic health care, and patients or consumers. It is concluded that the social-psychological behavior of the American health care system has profound implications that must be taken into account in any recommendations for change.

  20. An eHealth Application in Head and Neck Cancer Survivorship Care: Health Care Professionals' Perspectives.

    Science.gov (United States)

    Duman-Lubberding, Sanne; van Uden-Kraan, Cornelia F; Peek, Niels; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

    2015-10-21

    Although many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors' needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process. The aim of this study was to investigate health care professionals' perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care. Health care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders. Health care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients' perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but indicated that it should be incorporated in the

  1. 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

  2. Disparities in children's oral health and access to dental care.

    Science.gov (United States)

    Mouradian, W E; Wehr, E; Crall, J J

    Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.

  3. Unmet demands for health care among patients with rheumatoid arthritis: Indications for underuse?

    NARCIS (Netherlands)

    Jacobi, Catharina E.; Rupp, Ines; Boshuizen, Hendriek C.; Triemstra, Mattanja; Dinant, Huibert J.; van den Bos, Geertrudis A. M.

    2004-01-01

    Objective. To assess the prevalence of unmet health care demands among rheumatoid arthritis (RA) patients, and to determine if these unmet demands indicate underuse. Methods. A total of 679 patients with RA participated in a questionnaire survey and clinical examination. Unmet health care demands

  4. Knowledge of Alzheimer's Disease among Norwegian Undergraduate Health and Social Care Students: A Survey Study

    Science.gov (United States)

    Kada, Sundaran

    2015-01-01

    With an aging general population and a concurrent increase in the prevalence of dementia, health and social care professional students are increasingly exposed to this group of patients during their clinical placements and after graduation. A sound dementia-related knowledge base among health and social care students is important in providing…

  5. [Prevalence and predisposing factors of methicillin-resistant Staphylococcus aureus in long-term care facilities. An international view].

    Science.gov (United States)

    Szabó, Rita

    2016-07-03

    Methicillin-resistant Staphylococcus aureus is one of the most important pathogens of healthcare and long-term care-associated infections over the world, resulting high morbidity, mortality and extra costs in these settings. The authors analyze the prevalence and predisposing factors of methicillin-resistant Staphylococcus aureus in long-term care facilities. Systematic review using PubMed, ScienceDirect and Cochrane Library CENTRAL databases between January 1, 2006 and December 31, 2015 was performed. In the past ten years methicillin-resistant Staphylococcus aureus prevalence in European long-term care facilities (12.6%) was lower than in North America (33.9%). The most frequent predisposing factor was previous antimicrobial therapy, hospital admission and infection/colonisation, chronic wounds, and high care need. Based on the results, the prevention and control of methicillin-resistant Staphylococcus aureus is an important public health priority in the European and Hungarian long-term care facilities.

  6. Cognitive Decline and Hearing Health Care for Older Adults.

    Science.gov (United States)

    Pichora-Fuller, M Kathleen

    2015-06-01

    The purpose of this article is to consider the implications of age-related cognitive decline for hearing health care. Recent research and current thinking about age-related declines in cognition and the links between auditory and cognitive aging are reviewed briefly. Implications of this research for improving prevention, assessment, and intervention in audiologic practice and for enhancing interprofessional teamwork are highlighted. Given the important connection between auditory and cognitive aging and given the high prevalence of both hearing and cognitive impairments in the oldest older adults, health care services could be improved by taking into account how both the ear and the brain change over the life span. By incorporating cognitive factors into audiologic prevention, assessment, and intervention, hearing health care can contribute to better hearing and communication as well as to healthy aging.

  7. Governance in health care delivery : raising performance

    OpenAIRE

    Lewis, Maureen; Pettersson, Gunilla

    2009-01-01

    The impacts of health care investments in developing and transition countries are typically measured by inputs and general health outcomes. Missing from the health agenda are measures of performance that reflect whether health systems are meeting their objectives; public resources are being used appropriately; and the priorities of governments are being implemented. This paper suggests tha...

  8. Health Training Needs of Child Care Professionals.

    Science.gov (United States)

    Caulfield, Rick; Kataoka-Yahiro, Merle

    2001-01-01

    Child care professionals in Hawaii were surveyed to assess health training needs. Respondents reported a high degree of comfort in managing common health conditions. The most commonly requested health services involved speech/language testing and vision/hearing screening. The most requested health/safety workshop topic was behavioral problems. The…

  9. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

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

  10. 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.

  11. Lack of access and continuity of adult health care: a national population-based survey.

    Science.gov (United States)

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2015-01-01

    OBJECTIVE To describe the lack of access and continuity of health care in adults. METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas. RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care. CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce.

  12. Dutch health care performance report 2008.

    NARCIS (Netherlands)

    Westert, G.P.; Berg, M.J. van den; Koolman, X.; Verkleij, H.

    2008-01-01

    This is the second national report on the performance of the Dutch health care system. Its focus is on quality, access and costs in 2006/7. The Dutch Health Care Performance Report presents a broad picture based on 110 indicators. Where possible, comparisons in time and between countries are

  13. Online Health Care Communication in Denmark

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Agger Nielsen, Jeppe; Kim, Soonhee

    2013-01-01

    This paper brings forward five propositions on the use of online communication in health care, its potential impacts on efficiency and effectiveness in health care, and which role government should play in moving forward the use of online communication. In the paper, each of the five propositions...

  14. Future health care technology and the hospital

    NARCIS (Netherlands)

    Banta, H.D.

    1990-01-01

    The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to

  15. Performance analysis of online health care system

    African Journals Online (AJOL)

    user

    This paper deals with selection of appropriate indexing techniques applied on MySQL database for a health care system and its related performance issues. The proposed Smart Card based Online Health Care System deals with frequent data storage, exchange and retrieval of data from the database servers. Speed and ...

  16. 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

  17. Flipping primary health care: A personal story.

    Science.gov (United States)

    Mate, Kedar S; Salinas, Gilbert

    2014-12-01

    There is considerable interest in ideas borrowed from education about "flipping the classroom" and how they might be applied to "flipping" aspects of health care to reach the Triple Aim of improved health outcomes, improved experience of care, and reduced costs. There are few real-life case studies of "flipping health care" in practice at the individual patient level. This article describes the experience of one of the authors as he experienced having to "flip" his primary health care. We describe seven inverted practices in his care, report outcomes of this experiment, describe the enabling factors, and derive lessons for patient-centered primary care redesign. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 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.

  19. [Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

    Science.gov (United States)

    Wimmer-Puchinger, B; Wolf, H; Engleder, A

    2006-09-01

    Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them.

  20. Prevalence of overweight preschool children in public day care centers: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Viviane Gabriela Nascimento

    Full Text Available CONTEXT AND OBJECTIVE: Brazil is undergoing a period of epidemiological transition associated with demographic and nutritional changes. The prevalence of obesity is also increasing in children and is causing numerous health problems that are becoming public health issues. The aim here was to evaluate the prevalence of overweight among children of two and three years of age. DESIGN AND SETTING: Cross-sectional study in municipal day care centers in Taubaté, state of São Paulo, Brazil. METHODS: Weight and height measurements were made on 447 preschool children forming a probabilistic randomized sample. Their body mass index (BMI was calculated. Their nutritional status was classified using the World Health Organization reference cutoff points (2006. Their mean weight, height and BMI were compared according to their age and sex. RESULTS: The mean values for the final sample (n = 447 were as follows: mean age: 38.6 months (± 3.5 and Z scores for: weight/height (W/H: 0.50 (± 1.22; height/age: -0.03 (± 1.07; weight/age (W/A: 0.51 (± 1.23; and BMI: 0.51(± 1.23. The prevalence of overweight children (BMI > 1 z was 28.86%, while the prevalence of underweight children (BMI < -2 z was 0.89%. There were no differences in mean BMI among the two and three-year age groups (P = 0.66. CONCLUSION: A high prevalence of overweight was observed in the sample of two and three-year-old children, with practically no malnutrition, thus showing that a significant nutritional transition may already be occurring, even in medium-sized cities of developing countries.

  1. Medical imaging and alternative health care organizations

    International Nuclear Information System (INIS)

    Levy, E.

    1987-01-01

    Imaging is not easy to measure in economic terms for France to day. The impact of innovation process is no more clear and especially the substitutions expected between different techniques. Nevertheless, these new techniques could provoque big changes in medical practices and health care organizations. They should probably increase the proportion of ambulatory patients in total examinations and encourage the development of extra-hospital health care. But, in France, alternative health care organizations (day hospital, home care, etc...) are under developed because of many non technical factors (behavioural managerial and institutional). Perhaps major potential change shall come from imaging networks. But can imaging development contribute to moderate health expanses growth rate. Economic evaluations of each new technique are difficult and ambiguous but necessary to maximize health care system efficiency [fr

  2. Health care enters the real world.

    Science.gov (United States)

    Schroeder, N J

    1987-01-01

    The U.S. health care system is undergoing restructuring as a result of a complex interplay of social, political, and economic forces. Where once the medical profession had a monopoly position in the health care system, its position has been challenged by the Federal Trade Commission under the Sherman Antitrust Act. More and more, the health care field is characterized by entrepreneurialism, a concept that is at odds with the traditional tenets of the medical profession. The restructuring of health care in the U.S. has the potential to allow the entrepreneur to function to the benefit of patients, despite the fact that this is a change resisted by those providing health care services.

  3. Future developments in health care performance management

    Directory of Open Access Journals (Sweden)

    Crema M

    2013-11-01

    Full Text Available Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Abstract: This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. Keywords: health care, lean management, clinical risk management, quality, health care processes

  4. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

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

  5. Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial

    Science.gov (United States)

    Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.

    2009-01-01

    The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…

  6. Health care without managed care in Hong Kong.

    Science.gov (United States)

    Yuen, P P

    1995-10-01

    Although managed care may be more effective than fee-for-service in containing health care costs in the United States, it is less effective in countries with a national health service. In Hong Kong, costs have been contained despite the fact that 95% of general practitioners still practice on a solo, fee-for-service basis. The author describes in detail how the system of tax-based hospitals guarantees universal access without escalating costs.

  7. The new frontier of strategic alliances in health care: New partnerships under accountable care organizations.

    Science.gov (United States)

    Lewis, Valerie A; Tierney, Katherine I; Colla, Carrie H; Shortell, Stephen M

    2017-10-01

    Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form. We find that a striking percentage of ACOs - 81% - involve new partnerships between independent health care organizations. These "partnership ACOs" generally report lower capabilities on care management, care coordination, and health information technology. Additionally, under Medicare ACO programs partnership ACO achieved somewhat lower quality performance. Qualitative interviews revealed that providers are motivated to partner for resource complementarity, risk reduction, and legislative requirements, and are using a variety of formal and informal accountability mechanisms. Most partnership ACOs were formed out of existing, positive relationships, but a minority of ACOs formed out of previously competitive or conflictual relationships. Our findings suggests that the success of the ACO model will hinge in large part upon the success of new partnerships, with important implications for understanding ACO readiness and capabilities, the relatively small savings achieved to date by ACO programs, and the path to providers bearing more risk for population health management. In addition, ACO partnerships may provide an important window to monitor a potential wave of health care consolidation or, in contrast, a new model of independent providers successfully coordinating patient care. Copyright © 2017 Elsevier Ltd

  8. Collaboration in the provision of mental health care services

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  9. Health Education and Health Promotion Skills of Health Care Professionals Working in Family Health Centres

    Directory of Open Access Journals (Sweden)

    Esma Kabasakal

    2017-03-01

    Full Text Available Preventable diseases pose a serious problem worldwide. The role of primary healthcare professionals is especially significant in promoting health. Aim: It is aimed to determine the health care professionals working in family health centres have on health education and health promotion skills. Method: The study sample included 144 health care professionals employed in one of 33 family health centres in Ankara Province. The study data were collected using a survey developed on the health education and health promotion skills included in the family medicine specialty education and curriculum from 2008. Results: It was found that 33.3% of the health care professionals had planned to receive health education, and that approximately half of the health care professionals had actively practiced health education and health promotion skills. Considering that time constraints were reported to be the most significant barriers to health promotion, primary health care professionals, most particularly the nurses, should be provided with comprehensive continuing educative training on health promotion and health education skills to foster their professional development. Health promotion and health education trainings shall serve to help them become more active and take on the responsibility of assuming counselling and training roles in health education.

  10. Implementing the obesity care model at a community health center in Hawaii to address childhood obesity.

    Science.gov (United States)

    Okihiro, May; Pillen, Michelle; Ancog, Cristeta; Inda, Christy; Sehgal, Vija

    2013-01-01

    Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive project based on the Obesity Care Model initiated at a rural community health center in Hawaii to address childhood obesity including: (1) the health care delivery changes constituting the quality improvement project; (2) capacity and team-building activities; (3) use of the project community level data to strengthen community engagement and investment; and (4) the academic-community partnership providing the project framework. We anticipate that these efforts will contribute to the long-term goal of reducing the prevalence of obesity and obesity associated morbidity in the community.

  11. Community Care for People with Complex Care Needs: Bridging the Gap between Health and Social Care

    Directory of Open Access Journals (Sweden)

    Kerry Kuluski

    2017-07-01

    Full Text Available Introduction: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community. Methods: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted. Patient vignettes illustrating significant health and social care needs were presented to participants. The vignettes prompted discussions on i how best to meet complex care needs in the community and ii the barriers to delivering care to this population.  Results: Categories to support care needs of complex patients and their families included i relationships as the foundation for care, ii desired processes and structures of care, and iii barriers and workarounds for desired care.  Discussion and Conclusions: Meeting the needs of the population who require health and social care requires time to develop authentic relationships, broadening the membership of the care team, communicating across sectors, co-locating health and social care, and addressing the barriers that prevent providers from engaging in these required practices.

  12. 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.

  13. [Access to health care for migrants].

    Science.gov (United States)

    Nørredam, Marie L; Nielsen, Annette Sonne; Krasnik, Allan

    2006-09-04

    Migrants include a broad category of individuals moving from one place to another, either forced or voluntarily. Ethnicity and migration are interacting concepts which may act as determinants for migrants' health and access to health care. This access to health care may be measured by studying utilisation patterns or clinical outcomes like morbidity and mortality. Migrants' access to health care may be affected by several factors relating to formal and informal barriers. Informal barriers include economic and legal restrictions. Formal barriers include language and psychological and sociocultural factors.

  14. Transition care for children with special health care needs.

    Science.gov (United States)

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

    2014-11-01

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

  15. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

    NARCIS (Netherlands)

    Odusola, A.O.; Stronks, K.; Hendriks, M.E.; Schultsz, C.; Akande, T.; Osibogun, A.; van Weert, H.; Haafkens, J.A.

    2016-01-01

    Background: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective: We explored perspectives of primary care staff and health insurance managers on enablers and

  16. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

    NARCIS (Netherlands)

    Odusola, Aina O.; Stronks, Karien; Hendriks, Marleen E.; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; Weert, Henk van; Haafkens, Joke A.

    2016-01-01

    Background Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective We explored perspectives of primary care staff and health insurance managers on enablers and

  17. Patterns of health care utilization for low back pain

    Directory of Open Access Journals (Sweden)

    Stewart WF

    2015-08-01

    Full Text Available Walter F Stewart,1 Xiaowei Yan,1 Joseph A Boscarino,1 Daniel D Maeng,1 Jack Mardekian,2 Robert J Sanchez,3 Michael R Von Korff41Geisinger Center for Health Research, 2Pfizer, Inc., 3Regeneron Pharmaceuticals, Inc., 4Group Health Research Institute, Seattle, WA, USABackground: The purpose of this study was to determine if primary care patients with low back pain (LBP cluster into definable care utilization subgroups that can be explained by patient and provider characteristics.Materials and methods: Adult primary care patients with an incident LBP encounter were identified from Geisinger Clinic electronic health records over 5 years. Two-thirds of the cohort had only one to two encounters. Principal component analysis was applied to the data from the remaining one-third on use of ambulatory, inpatient, emergency department, and surgery care and use of magnetic resonance imaging, injections, and opioids in 12 months following the incident encounter. Groups were compared on demographics, health behaviors, chronic and symptomatic disease burden, and a measure of physician efficiency.Results: Six factors with eigenvalues >1.5 explained 71% of the utilization variance. Patient subgroups were defined as: 1–2 LBP encounters; 2+ surgeries; one surgery; specialty care without primary care; 3+ opioid prescriptions; laboratory dominant care; and others. The surgery and 3+ opioid subgroups, while accounting for only 10.4% of the cohort, had used disproportionately more magnetic resonance imaging, emergency department, inpatient, and injectable resources. The specialty care subgroup was characterized by heavy use of inpatient care and the lowest use of injectables. Anxiety disorder and depression were not more prevalent among the surgery patients than in the others. Surgery patients had features in common with specialty care patients, but were older, had higher prevalence of Fibromyalgia, and were associated primary care physicians with worse efficiency

  18. People in sub-Saharan Africa rate their health and health care among the lowest in the world.

    Science.gov (United States)

    Deaton, Angus S; Tortora, Robert

    2015-03-01

    The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans' perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second-lowest perception of personal health, after only the former Soviet Union and its Eastern European satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in the region toward health. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Strategic service quality management for health care.

    Science.gov (United States)

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes.

  20. Prevalence of obesity in an intensive care unit patient population.

    Science.gov (United States)

    Dennis, Diane M; Trevenen, Michelle

    2016-08-01

    The Australian health survey (2011-2012) reported that 63.4% of Australian adults were overweight or obese. Critical care medicine is expensive, with intensive care unit (ICU) services accounting for a substantial proportion of total hospital costs. These costs may be multiplied in the overweight cohort. The primary aim was to compare the body mass index (BMI) of a critically ill ICU patient cohort to Australian population norms in order to see if overweight people were over-represented. The secondary aim was to identify if any medical specialty was associated with overweight patients. A retrospective observational case note audit of 230 ICU patients between November 2012 and August 2013, with BMI as the primary outcome measure. Approximately 75% of the cohort were overweight or obese (median BMI 28.7; IQR 25.0-32.7) representing a rate 12% higher than Australian normative data. Based on population, this equates to an estimated additional 5279 unanticipated overweight or obese ICU patients at our facility during 2013. This study has shown that Australian ICU patients may have higher BMI than those of the general Australian population, and therefore there may be unanticipated costs associated with their care. No medical specialty was associated with higher BMI than another. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. [Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].

    Science.gov (United States)

    Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Solsona, Sofía; Sartolo, M Teresa; Rabanaque, M José

    2016-04-01

    to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. cross sectional study in two phases. Spain. people surveyed in the National Health Surveys 2006 and 2011-12. Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. 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.

  3. [Prevalence of neurodevelopmental, behavioural and learning disorders in Pediatric Primary Care].

    Science.gov (United States)

    Carballal Mariño, Marta; Gago Ageitos, Ana; Ares Alvarez, Josefa; Del Rio Garma, Mercedes; García Cendón, Clara; Goicoechea Castaño, Ana; Pena Nieto, Josefina

    2017-11-20

    To determine the prevalence of psychiatric disorders in primary care pediatrics in Atlantic Galicia. An observational, descriptive, cross-sectional prevalence study was carried out in 9 outpatient clinics in A Coruña and Pontevedra with a population of 8293 children between September and November 2015. A total of 1286 randomly selected patients from 0 to 14 years of age were included. From the medical history was registered: age, sex, psychiatric diagnosis established by DSM-IV-TR criteria in its five axes, professionals who participated in the diagnosis and treatment of the process and what type of treatment was received. Authorization was obtained from the Research Ethics Committee of Galicia number 2015/427. 148 of 1286 patients presented psychiatric pathology (11,5% IC 95% 9.73-13,29), 68% male. Between 0 and 5years, the prevalence was 4.5%; between 6y and 10y, 18.5% and between 11y and 14y 22%. Symptoms lasted a median of 25 months. The most frequent pathologies in 1286 patients were ADHD (5.36%), language disorders (3.42%), learning disorders (3.26%), anxiety-depressive disorders (2.4%) and behavior disorders (1.87%). Of the 148 cases, 47% had comorbidity with another mental disorder. Most of them required attention by multiple social, health and educational professionals; 33% received psychopharmacological treatment. The prevalence of psychiatric disorders in pediatric primary care is frequent, chronic and complex, increases with age and requires many health, educational and social resources. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  4. Primary mental health care: Indications and obstacles

    Directory of Open Access Journals (Sweden)

    Y.G. Pillay

    1992-09-01

    Full Text Available This paper considers indications and obstacles for the development of primary mental health care practice in both developed and under-developed countries. Both are considered as this represents the South African reality. While a significant body of literature has documented the need for primary mental health care, the obstacles (especially in terms of the commodification of health to its fruition are seldom addressed.

  5. Managing complaints in health and social care.

    Science.gov (United States)

    Holmes-Bonney, Kathy

    2010-04-01

    An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

  6. 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

  7. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  8. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  9. Climate change & infectious diseases in India: implications for health care providers.

    Science.gov (United States)

    Dhara, V Ramana; Schramm, Paul J; Luber, George

    2013-12-01

    Climate change has the potential to influence the earth's biological systems, however, its effects on human health are not well defined. Developing nations with limited resources are expected to face a host of health effects due to climate change, including vector-borne and water-borne diseases such as malaria, cholera, and dengue. This article reviews common and prevalent infectious diseases in India, their links to climate change, and how health care providers might discuss preventive health care strategies with their patients.

  10. Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program.

    Science.gov (United States)

    Finlay, Andrea K; Stimmel, Matthew; Blue-Howells, Jessica; Rosenthal, Joel; McGuire, Jim; Binswanger, Ingrid; Smelson, David; Harris, Alex H S; Frayne, Susan M; Bowe, Tom; Timko, Christine

    2017-03-01

    The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care. Prevalence of mental health disorders was 57 %; of whom 77 % entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49 %; of whom 37 % entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

  11. Increased health-care utilisation in international adoptees.

    Science.gov (United States)

    Graff, Heidi J; Siersma, Volkert D; Kragstrup, Jakob; Petersson, Birgit

    2015-08-01

    Several studies have documented that international adoptees have an increased occurrence of health problems and contacts to the health-care system after arriving to their new country of residence. This may be explained by pre-adoption adversities, especially for the period immediately after adoption. Our study aimed to the assess health-care utilisation of international adoptees in primary and secondary care for somatic and psychiatric diagnoses in a late post-adoption period. Is there an increased use of the health-care system in this period, even when increased morbidity in the group of international adoptees is taken into consideration? This was a Danish register-based cohort study examining health-care utilisation in a multivariable two-part model. The prevalence of selected outcomes and the quantity of use were assessed in a late (year three, four and five) post-adoption period. The cohort comprised internationally adopted children (n = 6,820), adopted between 1994 and 2005, and all non-adopted children (n = 492,374) who could be matched with the adopted children on sex, age, municipality and family constellation at the time of adoption. International adoption increased the use of all services in primary care, while in secondary care only few areas showed an increased long-term morbidity. International adoptees use medical services in primary care at a higher rate than non-adoptees some years after adoption. Excess use of services in secondary care is also present, but only exists in selected areas. none. not relevant.

  12. Development and testing of the health care system distrust scale.

    Science.gov (United States)

    Rose, Abigail; Peters, Nikki; Shea, Judy A; Armstrong, Katrina

    2004-01-01

    physicians. Initial testing suggests that we developed an instrument with valid and reliable scores in order to measure distrust of the health care system. Future research is needed to evaluate the validity and reliability of the Health Care System Distrust scale among diverse populations. This instrument can facilitate the investigation of the prevalence, causes, and effects of health care system distrust in the United States.

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

    African Journals Online (AJOL)

    Health insurance, in addition to being a technique for controlling and managing health risks, helps in placing the insured in a position for accessing health care delivery ahead of an illness. This instrument, which has been well utilized in developed economies, is what the National Health Insurance Scheme (NHIS) in Nigeria ...

  14. Subjective experienced health as a driver of health care behavior

    NARCIS (Netherlands)

    Bloem, S.; Stalpers, J.

    2012-01-01

    This paper describes the key role of the subjective experience of health as the driver of health related behavior. Individuals vary greatly in terms of behaviors related to health. Insights into these interindividual differences are of great importance for all parties involved in health care,

  15. Organizational Learning in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Savithiri Ratnapalan

    2014-02-01

    Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.

  16. Immigration and health care reform: shared struggles.

    Science.gov (United States)

    Gardner, Deborah B

    2007-01-01

    The connection between health care and immigration share overlaping key areas in policy reform. General concern, anger, and fear about immigration has been spreading nationwide. While illegal immigrants' use of expensive emergency department services does add to the cost for uncompensated care, this expenditure is not a primary cost driver but more a symptom of little or no access to preventative or primary health care. As a result of federal inaction, more state politicians are redefining how America copes with illegal residents including how or whether they have access to health care. The overlap of immigration and health care reform offers an opportunity for us to enter the next round of debate from a more informed vantage point.

  17. Cardiovascular Health and Related Health Care Use of Moluccan-Dutch Immigrants.

    Science.gov (United States)

    de Back, Tim R; Bodewes, Adee J; Brewster, Lizzy M; Kunst, Anton E

    2015-01-01

    Studies regularly show a higher incidence, prevalence and mortality of cardiovascular disease among immigrant groups from low-income countries. Despite residing in the Netherlands for over 60 years, the Moluccan-Dutch cardiovascular disease profile and health care use are still unknown. We aimed to compare (a) the clinical prevalence of cardiovascular diseases and (b) the use of health care services by cardiovascular disease patients of 5,532 Moluccan-Dutch to an age-sex matched control group of 55,320 native Dutch. We performed a cross-sectional analysis of data of the Achmea health insurance company for the period of 1 January 2009 to 31 December 2010. We collected information on health care use, including diagnostic information. Linear and logistic regression models were used for comparison. Moluccans had a higher clinical prevalence of ischemic heart diseases (odds ratio 1.26; 95% confidence interval 1.03-1.56), but tended to have a lower prevalence of cerebrovascular accidents (0.79; 0.56-1.11) and cardiac failure (0.67; 0.44-1.03). The clinical prevalence of cardiovascular diseases together tended to be lower among Moluccans (0.90; 0.80-1.00). Consultation of medical specialists did not differ. Angiotensin II inhibitors (1.42; 1.09-1.84), antiplatelet agents (1.27; 1.01-1.59) and statins (1.27; 1.00-1.60) were prescribed more frequently to Moluccans, as were cardiovascular agents in general (1.27; 0.94-1.71). The experience of Moluccans in the Netherlands suggests that, in the long run, cardiovascular risk and related health care use of ethnic minority groups may converge towards that of the majority population.

  18. Health care and equity in India

    Science.gov (United States)

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

    2011-01-01

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

  19. Illusions of team working in health care.

    Science.gov (United States)

    West, Michael A; Lyubovnikova, Joanne

    2013-01-01

    The ubiquity and value of teams in healthcare are well acknowledged. However, in practice, healthcare teams vary dramatically in their structures and effectiveness in ways that can damage team processes and patient outcomes. The aim of this paper is to highlight these characteristics and to extrapolate several important aspects of teamwork that have a powerful impact on team effectiveness across healthcare contexts. The paper draws upon the literature from health services management and organisational behaviour to provide an overview of the current science of healthcare teams. Underpinned by the input-process-output framework of team effectiveness, team composition, team task, and organisational support are viewed as critical inputs that influence key team processes including team objectives, leadership and reflexivity, which in turn impact staff and patient outcomes. Team training interventions and care pathways can facilitate more effective interdisciplinary teamwork. The paper argues that the prevalence of the term "team" in healthcare makes the synthesis and advancement of the scientific understanding of healthcare teams a challenge. Future research therefore needs to better define the fundamental characteristics of teams in studies in order to ensure that findings based on real teams, rather than pseudo-like groups, are accumulated.

  20. Acute mental health care and South African mental health legislation ...

    African Journals Online (AJOL)

    Objective: This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of ...

  1. Acute mental health care and South African mental health legislation

    African Journals Online (AJOL)

    Introduction. Reliable data is necessary to facilitate the effective planning, management and restructuring of mental health care facilities. Access to accurate information on clinical conditions, treatment outcomes and expenditure is essential to ensure accountability, quality and cost-effective mental health care. This article is ...

  2. Improving educational preparation for transcultural health care.

    Science.gov (United States)

    Le Var, R M

    1998-10-01

    There is increasing evidence that the health care needs of people from black and ethnic minority groups in England are not being met. A growing number of initiatives are being undertaken to remedy the situation. Many of them are focused on health care delivery at local and national levels. However, unless the preparation of health care professionals in the area of multi-cultural health care is appropriate and effective, a great deal of corrective action will continue to have to be taken. Despite 1997 having been the European Year Against Racism, it is still necessary to consider what educational preparation should be like. The article draws on identified inadequacies in health care provision as well as examples of initiatives taken to improve care provision. The author identifies deficiencies in educational preparation and proposes a range of actions to be taken. The article is focused on nursing, midwifery and health visiting education in England, but is deemed to be relevant to all health care professionals not only in Europe but other continents, as they become increasingly international and multi-ethnic.

  3. 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.

  4. Corporate moral responsibility in health care.

    Science.gov (United States)

    Wilmot, S

    2000-01-01

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

  5. 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.

  6. [Aspects of economic responsibility in health care].

    Science.gov (United States)

    Hauke, Eugen

    2007-01-01

    According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.

  7. Reducing pressure ulcer prevalence rates in the long-term acute care setting.

    Science.gov (United States)

    Milne, Catherine T; Trigilia, Donna; Houle, Tracy L; Delong, Sandra; Rosenblum, David

    2009-04-01

    Information about pressure ulcer prevalence, prevention, and optimal management strategies in the long-term acute care hospital (LTACH) setting is sparse. Although care processes in other patient care settings have been reported to affect pressure ulcer prevalence rates, the effect of such programs in the LTACH is unknown. To reduce perceived above-average pressure ulcer prevalence rates and improve care processes, a 108-bed LTACH used a failure mode and effects analysis to identify and address high-priority areas for improvement. Areas in need of improvement included a lack of 1) wound care professionals, 2) methods to consistently document prevention and wound data, and 3) an interdisciplinary wound care team approach, as well as a faulty electronic medical record. While prevalence data were collected, policies and procedures based on several published guidelines were developed and incorporated into the pressure ulcer plan of care by the newly established wound care team. Improved assessment and documentation methods, enhanced staff education, revised electronic records, wound care product reviews, and a facility-wide commitment to improved care resulted in a reduction of facility-acquired pressure ulcer prevalence from 41% at baseline to an average of 4.2% during the following 12 months as well as fewer missing electronic record data (improves care practices and reduces pressure ulcer prevalence in the LTACH. Studies to increase knowledge about the LTACH patient population and their unique needs and risk profiles are needed.

  8. Ethical thinking and discrimination in health care

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-02-01

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

  9. Dementia care and general physicians--a survey on prevalence, means, attitudes and recommendations.

    Science.gov (United States)

    Thyrian, Jochen René; Hoffmann, Wolfgang

    2012-12-01

    General physicians (GP) play a key role in providing appropriate care for people with dementia. It is important to understand their workload and opinions regarding areas for improvement. A group of 1,109 GPs working in Mecklenburg-Western Pomerania, Gemany (1.633 million inhabitants), were identified, contacted and asked to participate in a written survey. The survey addressed five main topics: (a) the GP, (b) the GP's practice, (c) the treatment of dementia, (d) personal views, attitudes and specific competences regarding dementia and (e) the GP's recommendations for improving dementia-related health care. The survey response rate was 31%. In total, the responding GPs estimated that they provided care to 12,587 patients with dementia every quarter year. The GPs also reported their opinions about screening instruments, treatment and recommendations for better care of dementia patients. Only 10% of them do not use screening instruments, one third felt competent in their care for patients with dementia and 54% opt for transfer of patients to a specialist for further neuropsychological testing. Four conclusions from this study are the following: (a) dementia care is a relevant and prevalent topic for GPs, (b) systematic screening instruments are widely used, but treatment is guided, mostly by clinical experience, (c) attitudes towards caring for people with dementia are positive, and (d) GPs recommend spending a lot more time with patients and caregivers and provision of better support in social participation. A majority of GPs recommend abolishing "Budgetierung", a healthcare budgeting system in the statutory health insurance programmes.

  10. How Health Care Complexity Leads to Cooperation and Affects the Autonomy of Health Care Professionals

    NARCIS (Netherlands)

    Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans

    2008-01-01

    Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    In Nigeria, cases of breast cancer cases have been prevalent for three decades and more than. 90% of cases can be ... The objective of this study therefore, was to assess rural women's level of awareness and knowledge of breast cancer and ..... Delayed first pregnancy is a risk factor for breast cancer. 56. 14.0. Taking of ...

  12. Ideology drives health care reforms in Chile.

    Science.gov (United States)

    Reichard, S

    1996-01-01

    The health care system of Chile evolved from rather unique historical circumstances to become one of the most progressive in Latin America, offering universal access to all citizens. Since the advent of the Pinochet regime in 1973, Chile has implemented Thatcherite/Reaganite reforms resulting in the privatization of much of the health care system. In the process, state support for health care has been sharply curtailed with deleterious effects on health services. As Chile emerges from the shadow of the Pinochet dictatorship, it faces numerous challenges as it struggles to rebuild its health care system. Other developing nations considering free-market reforms may wish to consider the high costs of the Chilean experiment.

  13. Prevalence, self-care behaviors, and self-care activities for peripheral neuropathy symptoms of HIV/AIDS.

    Science.gov (United States)

    Nicholas, Patrice K; Voss, Joachim; Wantland, Dean; Lindgren, Teri; Huang, Emily; Holzemer, William L; Cuca, Yvette; Moezzi, Shahnaz; Portillo, Carmen; Willard, Suzanne; Arudo, John; Kirksey, Kenn; Corless, Inge B; Rosa, María E; Robinson, Linda; Hamilton, Mary J; Sefcik, Elizabeth; Human, Sarie; Rivero-Mendez, Marta; Maryland, Mary; Nokes, Kathleen M; Eller, Lucille; Kemppainen, Jeanne; Dawson-Rose, Carol; Brion, John M; Bunch, Elli H; Shannon, Maureen; Nicholas, Thomas P; Viamonte-Ros, Ana; Bain, Catherine A

    2010-03-01

    As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors: (i) an interactive self-care factor; (ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy.

  14. A Message to Health Care Professionals

    Centers for Disease Control (CDC) Podcasts

    2011-10-11

    This podcast features teens who urge US health care professionals to talk to teen patients about pregnancy and contraception.  Created: 10/11/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Reproductive Health (DRH).   Date Released: 10/11/2011.

  15. Towards safe information technology in health care

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2011-01-01

    textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in

  16. Prevalence of low back pain among health sciences students.

    Science.gov (United States)

    AlShayhan, Fahad Abdullah; Saadeddin, Munir

    2018-02-01

    To determine the prevalence of low back pain (LBP) among health sciences students and to identify the associated factors. Cross-sectional study was conducted among 1163 students from five health sciences colleges during the academic year 2016-2017. Self-administered questionnaire was conducted and included 4 sections: demographic characteristics, risk factors, Nordic musculoskeletal questionnaire and Oswestry disability questionnaire. Data were analyzed using SPSS. Mean age was 20.74 ± (1.59 years). 70.9% of students were female. Lifetime prevalence of LBP was 56.6%, 12-month prevalence 48.8%, and point prevalence 21.2%. Dentistry students had highest lifetime prevalence of LBP (67.6%) with significant p value (Spending more than 10 h on computer or tablet was significantly associated with LBP (OR 2.19; 95% CI 1.30-3.70; p = 0.003). Feeling discomfort on bed was associated with LBP (OR 1.81; 95% CI 1.38-2.38; p ≤ 0.001). Uncomfortable college furniture was associated with LBP (OR 1.40; 95% CI 1.09-1.79; p = 0.008). Using heavy backpack was found to be associated with LBP (OR 1.49; 95% CI 1.01-2.03; p = 0.011). Most of students LBP (90.3%) found to cause minimal disability on Oswestry scale. This study has shown high prevalence of LBP among future healthcare provider. These risk factors should be well established to minimize the prevalence of LBP among future health sciences students. Dentistry students at higher risk of developing LBP compared to other students.

  17. The changing roles of health care personnel in health and health care management.

    Science.gov (United States)

    Hunter, D J

    1996-09-01

    Health care reform has become a global phenomenon. Countries are experiencing similar problems with their health care systems and are reaching for similar solutions. Management is seen as crucial in many countries as the principal means of securing supply-side reforms. Many of these centre on establishing a new relationship between professionals, notably the medical profession, and the state. The aim has been to exercise greater influence over how professionals practice and use resources. The application of new public management principles based on industrial sector practices and concepts of management has created tensions within professional groups who feel themselves, and their craft, to be under attack. But the new managerialism has to be seen within a context of rapid social and economic change. It is not possible to predict what the impact of such change is likely to be on health services in the future or on those who provide them. The paper offers an overview of health care reforms and assesses how it is shaping, or re-shaping, the roles and tasks of health care personnel. One conclusion is the mismatch between the management style favoured by policy-makers and reformers and the necessary flexibility required in skill mix and organization of work. High-trust relations lie at the heart of professional forms of organisation whereas the new managerialism appears to be based on the expectation of low-trust relations. The paper concludes with a brief look at the implications of all these developments for training and education and finds that there is still a long way to go before there is any real prospect of providing and equipping health care personnel with the requisite skills to enable them to meet the complex challenges that are a common characteristic of health care systems.

  18. 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.

  19. [Maternal depressive symptomatology in México: National prevalence, care, and population risk profiles].

    Science.gov (United States)

    de Castro, Filipa; Place, Jean Marie; Villalobos, Aremis; Allen-Leigh, Betania

    2015-01-01

    This study estimates the prevalence of depressive symptomatology (DS) in women with children younger than five years of age, examines detection and care rates and probabilities of developing DS based on specific risk profiles. The sample consists of 7 187 women with children younger than five drawn from the Ensanut 2012. DS prevalence is 19.91%, which means at least 4.6 million children live with mothers who experience depressive symptoms indicative of moderate to severe depression. Rates of detection (17.06%) and care (15.19%) for depression are low. DS is associated with violence (OR=2.34; IC95% 1.06-5.15), having ≥4 children, having a female baby, older age of the last child, low birth weight, food insecurity, and sexual debut <15 years old (p<0.01). Accumulated probability of DS, taking into consideration all risk factors measured, is 69.76%. It could be reduced to 13.21% through prevention efforts focused on eliminating violence, food insecurity, bias against having a female baby, and low birth weight. DS is a compelling public health problem in Mexico associated with a well-defined set of risk factors that warrant attention and timely detection at various levels of care.

  20. Maternal depressive symptomatology in México: National prevalence, care, and population risk profiles.

    Directory of Open Access Journals (Sweden)

    Filipa de Castro

    2015-03-01

    Full Text Available Objective. This study estimates the prevalence of depressive symptomatology (DS in women with children younger than five years of age, examines detection and care rates and probabilities of developing DS based on specific risk profiles. Materials and methods. The sample consists of 7 187 women with children younger than five drawn from the Ensanut 2012. Results. DS prevalence is 19.91%, which means at least 4.6 million children live with mothers who experience depressive symptoms indicative of moderate to severe depression. Rates of detection (17.06% and care (15.19% for depression are low. DS is associated with violence (OR=2.34; IC95% 1.06-5.15, having ≥4 children, having a female baby, older age of the last child, low birth weight, food insecurity, and sexual debut menor que 15 years old (p menor que 0.01. Accumulated probability of DS, taking into consideration all risk factors measured, is 69.76%. It could be reduced to 13.21% through prevention efforts focused on eliminating violence, food insecurity, bias against having a female baby, and low birth weight. Conclusions. DS is a compelling public health problem in Mexico associated with a well-defined set of risk factors that warrant attention and timely detection at various levels of care.