WorldWideScience

Sample records for preventative services task

  1. U.S. Preventive Services Task Force

    Science.gov (United States)

    ... for Guideline Development About the USPSTF Our Members Conflict of Interest Disclosures Task Force Resources Our ... Announcements Final Research Plan: Screening for Hepatitis B Virus Infection in ...

  2. 77 FR 56845 - Meeting of the Community Preventive Services Task Force (Task Force)

    Science.gov (United States)

    2012-09-14

    ...: Matters to be discussed: Tobacco, oral health and cardiovascular disease. Meeting Accessibility: This... HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health...

  3. Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-04-25

    Preeclampsia affects approximately 4% of pregnancies in the United States. It is the second leading cause of maternal mortality worldwide and may lead to serious maternal complications, including stroke, eclampsia, and organ failure. Adverse perinatal outcomes for the fetus and newborn include intrauterine growth restriction, low birth weight, and stillbirth. Many of the complications associated with preeclampsia lead to early induction of labor or cesarean delivery and subsequent preterm birth. Preeclampsia is more prevalent among African American women than among white women. Differences in prevalence may be, in part, due to African American women being disproportionally affected by risk factors for preeclampsia. African American women also have case fatality rates related to preeclampsia 3 times higher than rates among white women. Inequalities in access to adequate prenatal care may contribute to poor outcomes associated with preeclampsia in African American women. To update the 1996 US Preventive Services Task Force (USPSTF) recommendation on screening for preeclampsia. The USPSTF reviewed the evidence on the accuracy of screening and diagnostic tests for preeclampsia, the potential benefits and harms of screening for preeclampsia, the effectiveness of risk prediction tools, and the benefits and harms of treatment of screen-detected preeclampsia. Given the evidence that treatment can reduce maternal and perinatal morbidity and mortality, and the well-established accuracy of blood pressure measurements, the USPSTF found adequate evidence that screening for preeclampsia results in a substantial benefit for the mother and infant. In addition, there is adequate evidence to bound the harms of screening for and treatment of preeclampsia as no greater than small. Therefore, the USPSTF concludes with moderate certainty that there is a substantial net benefit of screening for preeclampsia in pregnant women. The USPSTF recommends screening for preeclampsia in pregnant

  4. Screening for Syphilis Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2004 U. S. Preventive Services Task Force statement about screening for syphilis in pregnancy. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits of screening, the harms of screening, and the harms of treatment

  5. 78 FR 27969 - Meeting of the Community Preventive Services Task Force (Task Force)

    Science.gov (United States)

    2013-05-13

    ... control, diabetes prevention and control, motor vehicle-related injury prevention, improving oral health... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the... (CDC), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers...

  6. Screening for gestational diabetes mellitus : US preventive services task force recommendation statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Gordis, Leon; Gregory, Kimberly D.; Harris, Russell; Isham, George; LeFevre, Michael L.; Loveland-Cherry, Carol; Marion, Lucy N.; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Siu, Albert L.; Teutsch, Steven M.; Yawn, Barbara P.

    2008-01-01

    Description: Update of 2003 U. S. Preventive Services Task Force (USPSTF) recommendation about screening for gestational diabetes. Methods: The USPSTF weighed the evidence on maternal and neonatal benefits (reduction in preeclampsia, mortality, brachial plexus injury, clavicular fractures, admission

  7. 78 FR 57161 - Meeting of the Community Preventive Services Task Force

    Science.gov (United States)

    2013-09-17

    ... represent a broad range of research, practice, and policy expertise in prevention, wellness and health promotion, and public health, and are appointed by the CDC Director. The Task Force was convened in 1996 by... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...

  8. 78 FR 59939 - Meeting of the Community Preventive Services Task Force (Task Force)

    Science.gov (United States)

    2013-09-30

    ... be discussed: Cancer prevention and control, cardiovascular disease prevention and control, diabetes prevention and control, motor vehicle-related injury prevention, and promoting physical activity. Meeting...

  9. Screening for Hepatitis B Virus Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for hepatitis B virus hepatitis B virus infection in pregnancy. Methods: The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits

  10. 78 FR 2996 - Meeting of the Community Preventive Services Task Force (Task Force)

    Science.gov (United States)

    2013-01-15

    .... Matters to be discussed: Matters to be discussed: promoting health equity, improving oral health, cancer prevention and control-- preventing skin cancer, cardiovascular disease prevention and control, reducing tobacco use and secondhand smoke exposure, and diabetes prevention and control. Meeting Accessibility...

  11. U.S. Preventive Services Task Force Approach to Child Cognitive and Behavioral Health.

    Science.gov (United States)

    Kemper, Alex R; Mabry-Hernandez, Iris R; Grossman, David C

    2016-10-01

    An important component of routine preventive care for children is the monitoring of growth and development. Although cognitive, affective, and behavioral health problems are commonly encountered in pediatric primary care, there is debate around issues related to early detection of significant problems of this type, including the accuracy of screening and the benefits and harms of early diagnosis and treatment. The U.S. Preventive Services Task Force makes recommendations regarding clinical preventive services for primary care clinicians based on the best available scientific evidence. The Task Force has found important gaps related to the validity of commonly used screening tools and significant gaps related to the evidence regarding early treatment. This review describes the meaning of the grades used by the Task Force, how these grades are determined, and the grades assigned to childhood cognitive, affective, and behavioral health recommendations. The review summarizes common themes in the evidence gaps and the future research necessary to advance the field and improve child health outcomes. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  12. The Use of Rapid Review Methods for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Patnode, Carrie D; Eder, Michelle L; Walsh, Emily S; Viswanathan, Meera; Lin, Jennifer S

    2018-01-01

    Rapid review products are intended to synthesize available evidence in a timely fashion while still meeting the needs of healthcare decision makers. Various methods and products have been applied for rapid evidence syntheses, but no single approach has been uniformly adopted. Methods to gain efficiency and compress the review time period include focusing on a narrow clinical topic and key questions; limiting the literature search; performing single (versus dual) screening of abstracts and full-text articles for relevance; and limiting the analysis and synthesis. In order to maintain the scientific integrity, including transparency, of rapid evidence syntheses, it is imperative that procedures used to streamline standard systematic review methods are prespecified, based on sound review principles and empiric evidence when possible, and provide the end user with an accurate and comprehensive synthesis. The collection of clinical preventive service recommendations maintained by the U.S. Preventive Services Task Force, along with its commitment to rigorous methods development, provide a unique opportunity to refine, implement, and evaluate rapid evidence synthesis methods and add to an emerging evidence base on rapid review methods. This paper summarizes the U.S. Preventive Services Task Force's use of rapid review methodology, its criteria for selecting topics for rapid evidence syntheses, and proposed methods to streamline the review process. Copyright © 2018 American Journal of Preventive Medicine. All rights reserved.

  13. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2014-06-01

    Update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschool-aged children. The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. This recommendation applies to children age 5 years and younger. The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children from birth to age 5 years. (I Statement). Copyright © 2014 by the American Academy of Pediatrics.

  14. Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2016-12-20

    Genital herpes is a prevalent sexually transmitted infection in the United States, occurring in almost 1 in 6 persons aged 14 to 49 years. Infection is caused by 2 subtypes of the herpes simplex virus (HSV), HSV-1 and HSV-2. Antiviral medications may provide symptomatic relief from outbreaks but do not cure HSV infection. Neonatal herpes infection, while uncommon, can result in substantial morbidity and mortality. To update the 2005 US Preventive Services Task Force (USPSTF) recommendation on screening for genital herpes. The USPSTF reviewed the evidence on the accuracy, benefits, and harms of serologic screening for HSV-2 infection in asymptomatic persons, including those who are pregnant, as well as the effectiveness and harms of preventive medications and behavioral counseling interventions to reduce future symptomatic episodes and transmission to others. Based on the natural history of HSV infection, its epidemiology, and the available evidence on the accuracy of serologic screening tests, the USPSTF concluded that the harms outweigh the benefits of serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. The USPSTF recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. (D recommendation).

  15. Collaborative Modeling: Experience of the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Petitti, Diana B; Lin, Jennifer S; Owens, Douglas K; Croswell, Jennifer M; Feuer, Eric J

    2018-01-01

    Models can be valuable tools to address uncertainty, trade-offs, and preferences when trying to understand the effects of interventions. Availability of results from two or more independently developed models that examine the same question (comparative modeling) allows systematic exploration of differences between models and the effect of these differences on model findings. Guideline groups sometimes commission comparative modeling to support their recommendation process. In this commissioned collaborative modeling, modelers work with the people who are developing a recommendation or policy not only to define the questions to be addressed but ideally, work side-by-side with each other and with systematic reviewers to standardize selected inputs and incorporate selected common assumptions. This paper describes the use of commissioned collaborative modeling by the U.S. Preventive Services Task Force (USPSTF), highlighting the general challenges and opportunities encountered and specific challenges for some topics. It delineates other approaches to use modeling to support evidence-based recommendations and the many strengths of collaborative modeling compared with other approaches. Unlike systematic reviews prepared for the USPSTF, the commissioned collaborative modeling reports used by the USPSTF in making recommendations about screening have not been required to follow a common format, sometimes making it challenging to understand key model features. This paper presents a checklist developed to critically appraise commissioned collaborative modeling reports about cancer screening topics prepared for the USPSTF. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

  16. Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations.

    Science.gov (United States)

    Pace, Lydia E; He, Yulei; Keating, Nancy L

    2013-07-15

    In November 2009, the US Preventive Services Task Force (USPSTF) issued new recommendations regarding mammography screening. The Task Force recommended against routine screening for women ages 40 to 49 years and recommended biennial screening for women ages 50 to 74 years. The recommendations met great controversy in mass media and medical literature; whether they have had an impact on screening patterns is not known. The objective of this study was to determine whether the 2009 USPSTF recommendations led to changes in screening rates among women ages 40 to 49 years and ages 50 to 74 years. The authors performed cross-sectional assessments of mammography screening in 2005, 2008, and 2011 using data from the National Health Interview Survey, a nationally representative, in-person, household survey of the civilian, noninstitutionalized US population. In total, 27,829 women ages ≥ 40 years responded to the 2005, 2008, or 2011 surveys and reported about their mammography use. The primary outcome assessed was self-reported mammography screening in the past year. When adjusted for race, income, education level, insurance, and immigration status, mammography rates increased slightly from 2008 to 2011 (from 51.9% to 53.6%; P = .07) and did not decline within any age group. Among women ages 40 to 49 years, screening rates were 46.1% in 2008 and 47.5% in 2011 (P = 0.38). For women ages 50 to 74, screening rates were 57.2 in 2008 and 59.1 in 2011 (P = 0.09). Mammography rates did not decrease among women aged >40 years after publication of the USPSTF recommendations in 2009, suggesting that the vigorous policy debates and coverage in the media and medical literature have had an impact on the adoption of these recommendations. © 2013 American Cancer Society.

  17. Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-01-09

    Adolescent idiopathic scoliosis, a lateral curvature of the spine of unknown cause with a Cobb angle of at least 10°, occurs in children and adolescents aged 10 to 18 years. Idiopathic scoliosis is the most common form and usually worsens during adolescence before skeletal maturity. Severe spinal curvature may be associated with adverse long-term health outcomes (eg, pulmonary disorders, disability, back pain, psychological effects, cosmetic issues, and reduced quality of life). Early identification and effective treatment of mild scoliosis could slow or stop curvature progression before skeletal maturity, thereby improving long-term outcomes in adulthood. To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for idiopathic scoliosis in asymptomatic adolescents. The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of adolescent idiopathic scoliosis. The USPSTF found no direct evidence on screening for adolescent idiopathic scoliosis and health outcomes and no evidence on the harms of screening. The USPSTF found inadequate evidence on treatment with exercise and surgery. It found adequate evidence that treatment with bracing may slow curvature progression in adolescents with mild or moderate curvature severity (Cobb angle scoliosis cannot be determined. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents aged 10 to 18 years. (I statement).

  18. Screening for Gynecologic Conditions With Pelvic Examination: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; García, Francisco A R; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa; Siu, Albert L; Tseng, Chien-Wen

    2017-03-07

    Many conditions that can affect women's health are often evaluated through pelvic examination. Although the pelvic examination is a common part of the physical examination, it is unclear whether performing screening pelvic examinations in asymptomatic women has a significant effect on disease morbidity and mortality. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for gynecologic conditions with pelvic examination for conditions other than cervical cancer, gonorrhea, and chlamydia, for which the USPSTF has already made specific recommendations. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women 18 years and older who are not at increased risk for any specific gynecologic condition. Overall, the USPSTF found inadequate evidence on screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions in asymptomatic, nonpregnant adult women. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women. (I statement) This statement does not apply to specific disorders for which the USPSTF already recommends screening (ie, screening for cervical cancer with a Papanicolaou smear, screening for gonorrhea and chlamydia).

  19. Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Ebell, Mark; Epling, John W; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-03-28

    Celiac disease is caused by an immune response in persons who are genetically susceptible to dietary gluten, a protein complex found in wheat, rye, and barley. Ingestion of gluten by persons with celiac disease causes immune-mediated inflammatory damage to the small intestine. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for celiac disease. The USPSTF reviewed the evidence on the accuracy of screening in asymptomatic adults, adolescents, and children; the potential benefits and harms of screening vs not screening and targeted vs universal screening; and the benefits and harms of treatment of screen-detected celiac disease. The USPSTF also reviewed contextual information on the prevalence of celiac disease among patients without obvious symptoms and the natural history of subclinical celiac disease. The USPSTF found inadequate evidence on the accuracy of screening for celiac disease, the potential benefits and harms of screening vs not screening or targeted vs universal screening, and the potential benefits and harms of treatment of screen-detected celiac disease. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons. (I statement).

  20. Trends in Breast Cancer Screening: Impact of U.S. Preventive Services Task Force Recommendations.

    Science.gov (United States)

    Dehkordy, Soudabeh Fazeli; Hall, Kelli S; Roach, Allison L; Rothman, Edward D; Dalton, Vanessa K; Carlos, Ruth C

    2015-09-01

    Although there is general agreement among various guidelines on benefits of routine screening mammography, the age of screening initiation and the optimal frequency of the test remain controversial. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended against routine breast cancer screening in women aged younger than 50 years. In this study, screening mammography guideline adherence among U.S. women is explored by examining patterns in rates of mammography age of initiation and utilization in years prior to and following the 2009 USPSTF guideline implementation. U.S. population-based data from the 2007, 2008, 2010, and 2012 Behavioral Risk Factor Surveillance System surveys were used to measure the overall proportion and rate of change in the proportion of women who underwent screening mammography within the last year, by age and survey year. Data were accessed and analyzed in July 2014. Rates of mammography screening were lower in 2010 and 2012 compared with 2007 and 2008 (pscreening initiation at age 40 years increased over time and was the highest in the years following USPSTF guideline changes (p=0.012). These data support no perceptible change in U.S. women's patterns of screening mammography age at initiation within 3 years of the USPSTF guideline revision. Whether this finding reflects a delayed effect of guideline revision in population trends or rather health provider practice and patient preference for more frequent screening is unclear and requires further investigation. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-06-20

    Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF

  2. Periodic Screening Pelvic Examination: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Guirguis-Blake, Janelle M; Henderson, Jillian T; Perdue, Leslie A

    2017-03-07

    Recent changes in the periodicity of cervical cancer screening have led to questions about the role of screening pelvic examinations among asymptomatic women. To systematically review literature on health benefits, accuracy, and harms of the screening pelvic examination for gynecologic conditions for the US Preventive Services Task Force (USPSTF). MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials for relevant English-language studies published through January 13, 2016, with surveillance through August 3, 2016. Two reviewers independently screened abstracts and studies. The search yielded 8678 unique citations; 316 full-text articles were reviewed, and 9 studies including 27 630 patients met inclusion criteria. Two reviewers rated study quality using USPSTF criteria. Morbidity; mortality; diagnostic accuracy for any gynecologic cancer or condition except cervical cancer, gonorrhea, and chlamydia, which are covered by other USPSTF screening recommendations; harms (false-positive rates, false-negative rates, surgery rates). No trials examined the effectiveness of the pelvic examination in reducing all-cause mortality, reducing cancer- and disease-specific morbidity and mortality, or improving quality of life. Eight studies reported accuracy for the screening pelvic examination: ovarian cancer (4 studies; n = 26 432), bacterial vaginosis (2 studies; n = 930), trichomoniasis (1 study; n = 779), and genital herpes (1 study; n = 779). In the 4 ovarian cancer screening studies, low prevalence of ovarian cancer consistently resulted in low positive predictive values (PPVs) and false-positive rates, with a lack of precision in accuracy estimates (sensitivity range, 0%-100%; specificity range, 91%-99%; PPV range, 0%-3.6%; negative predictive value [NPV] range, ≥99%). Each diagnostic accuracy study for bacterial vaginosis, trichomoniasis, and genital herpes was performed in a high-prevalence population with substantial proportions of

  3. Screening for Celiac Disease: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Chou, Roger; Bougatsos, Christina; Blazina, Ian; Mackey, Katherine; Grusing, Sara; Selph, Shelley

    2017-03-28

    Silent or subclinical celiac disease may result in potentially avoidable adverse health consequences. To review the evidence on benefits and harms of screening for celiac disease in asymptomatic adults, adolescents, and children 3 years and older for the US Preventive Services Task Force. Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews, searched to June 14, 2016. Randomized clinical trials and cohort or case-control studies on clinical benefits and harms of screening vs no screening for celiac disease or treatment vs no treatment for screen-detected celiac disease; studies on diagnostic accuracy of serologic tests for celiac disease. One investigator abstracted data, a second checked data for accuracy, and 2 investigators independently assessed study quality using predefined criteria. Cancer incidence, gastrointestinal outcomes, psychological outcomes, child growth outcomes, health outcomes resulting from nutritional deficiencies, quality of life, mortality, and harms of screening. No meta-analytic pooling was done. One systematic review and 3 primary studies met inclusion criteria. No trials of screening for celiac disease were identified. One recent, good-quality systematic review of 56 original studies and 12 previous systematic reviews (sample sizes of primary studies ranging from 62 to more than 12 000 participants) found IgA tissue transglutaminase was associated with high accuracy (sensitivity and specificity both >90%) for diagnosing celiac disease. IgA endomysial antibodies tests were associated with high specificity. Only 2 studies of serologic tests for celiac disease involving 62 and 158 patients were conducted in asymptomatic populations and reported lower sensitivity (57% and 71%). One fair-quality, small (n = 40) Finnish treatment trial of asymptomatic adults with screen-detected celiac disease based on positive serologic findings found initiation of a gluten-free diet associated with

  4. 77 FR 4561 - Meeting of the Community Preventive Services Task Force

    Science.gov (United States)

    2012-01-30

    ... meeting is open to the public, limited only by space availability. Dated: January 17, 2012. Tanja Popovic... independent, nonfederal body of nationally known leaders in public health practice, policy, and research who... interventions in public health and health promotion. During this meeting, the Task Force will consider the...

  5. 76 FR 30722 - Meeting of the Task Force on Community Preventive Services

    Science.gov (United States)

    2011-05-26

    ... discussed. Meeting Accessibility: This meeting is open to the public, limited only by teleconference space...--an independent, nonfederal body of nationally known leaders in public health practice, policy, and... interventions in public health and health promotion. During this meeting the Task Force will consider the...

  6. 76 FR 55394 - Meeting of the Task Force on Community Preventive Services

    Science.gov (United States)

    2011-09-07

    ... Disease. Meeting Accessibility: This meeting is open to the public, limited only by space availability... independent, nonfederal body of nationally known leaders in public health practice, policy, and research who... interventions in public health and health promotion. During this meeting, the Task Force will consider the...

  7. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement.

    Science.gov (United States)

    LeFevre, Michael L

    2014-12-02

    Update of the 1996 U.S. Preventive Services Task Force (USPSTF) recommendation on aspirin prophylaxis in pregnancy. The USPSTF reviewed the evidence on the effectiveness of low-dose aspirin in preventing preeclampsia in women at increased risk and in decreasing adverse maternal and perinatal health outcomes, and assessed the maternal and fetal harms of low-dose aspirin during pregnancy. This recommendation applies to asymptomatic pregnant women who are at increased risk for preeclampsia and who have no prior adverse effects with or contraindications to low-dose aspirin. The USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia. (B recommendation).

  8. Cooperation Between Probation Officers and Other Services in Implementing Prevention and Social Rehabilitation Tasks

    Directory of Open Access Journals (Sweden)

    Danuta Jurczyk

    2015-12-01

    Full Text Available The article discusses the current legal regulations dealing with the tasks and duties of probation officers, as well as the misinterpretation of the role of probation officers in the mass media, among employees of other institutions and the charges of the officers. The authors have described a few of the most essential differences in working with an individual and his environment between career officers, social workers and police officers. They have stressed that understanding the differences in the scope of duties, as well as undertaking effective cooperation, are the key factors that affect the effectiveness of social rehabilitation interactions.

  9. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive services Task Force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2014-04-15

    Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation on vitamin supplementation to prevent cardiovascular disease and cancer. The USPSTF reviewed the evidence on the efficacy of multivitamin or mineral supplements in the general adult population for the prevention of cardiovascular disease and cancer. This recommendation applies to healthy adults without special nutritional needs (typically aged 50 years or older). It does not apply to children, women who are pregnant or may become pregnant, or persons who are chronically ill or hospitalized or have a known nutritional deficiency. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of multivitamins for the prevention of cardiovascular disease or cancer. (I statement). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of single- or paired-nutrient supplements (except β-carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement). The USPSTF recommends against β-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation).

  10. Conflicts of Interest in Clinical Guidelines: Update of U.S. Preventive Services Task Force Policies and Procedures.

    Science.gov (United States)

    Ngo-Metzger, Quyen; Moyer, Virginia; Grossman, David; Ebell, Mark; Woo, Meghan; Miller, Therese; Brummer, Tana; Chowdhury, Joya; Kato, Elisabeth; Siu, Albert; Phillips, William; Davidson, Karina; Phipps, Maureen; Bibbins-Domingo, Kirsten

    2018-01-01

    The U.S. Preventive Services Task Force (USPSTF) provides independent, objective, and scientifically rigorous recommendations for clinical preventive services. A primary concern is to avoid even the appearance of members having special interests that might influence their ability to judge evidence and formulate unbiased recommendations. The conflicts of interest policy for the USPSTF is described, as is the formal process by which best practices were incorporated to update the policy. The USPSTF performed a literature review, conducted key informant interviews, and reviewed conflicts of interest policies of ten similar organizations. Important findings included transparency and public accessibility; full disclosure of financial relationships; disclosure of non-financial relationships (that create the potential for bias and compromise a member's objective judgment); disclosure of family members' conflicts of interests; and establishment of appropriate reporting periods. Controversies in best practices include the threshold of financial disclosures, ease of access to conflicts of interest policies and declarations, vague definition of non-financial biases, and request for family members' conflicts of interests (particularly those that are non-financial in nature). The USPSTF conflicts of interest policy includes disclosures for immediate family members, a clear non-financial conflicts of interest definition, long look-back period and application of the policy to prospective members. Conflicts of interest is solicited from all members every 4 months, formally reviewed, adjudicated, and made publicly available. The USPSTF conflicts of interest policy is publicly available as part of the USPSTF Procedure Manual. A continuous improvement process can be applied to conflicts of interest policies to enhance public trust in members of panels, such as the USPSTF, that produce clinical guidelines and recommendations. Copyright © 2018 American Journal of Preventive Medicine

  11. Serologic Screening for Genital Herpes: An Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Feltner, Cynthia; Grodensky, Catherine; Ebel, Charles; Middleton, Jennifer C; Harris, Russell P; Ashok, Mahima; Jonas, Daniel E

    2016-12-20

    Genital herpes simplex virus (HSV) infection is a prevalent sexually transmitted infection. Vertical transmission of HSV can lead to fetal morbidity and mortality. To assess the evidence on serologic screening and preventive interventions for genital HSV infection in asymptomatic adults and adolescents to support the US Preventive Services Task Force for an updated recommendation statement. MEDLINE, Cochrane Library, EMBASE, and trial registries through March 31, 2016. Surveillance for new evidence in targeted publications was conducted through October 31, 2016. English-language randomized clinical trials (RCTs) comparing screening with no screening in persons without past or current symptoms of genital herpes; studies evaluating accuracy and harms of serologic screening tests for HSV-2; RCTs assessing preventive interventions in asymptomatic persons seropositive for HSV-2. Dual review of abstracts, full-text articles, and study quality; pooled sensitivities and specificities of screening tests using a hierarchical summary receiver operating characteristic curve analysis when at least 3 similar studies were available. Accuracy of screening tests, benefits of screening, harms of screening, reduction in genital herpes outbreaks. A total of 17 studies (n = 9736 participants; range, 24-3290) in 19 publications were included. No RCTs compared screening with no screening. Most studies of the accuracy of screening tests were from populations with high HSV-2 prevalence (greater than 40% based on Western blot). Pooled estimates of sensitivity and specificity of the most commonly used test at the manufacturer's cutpoint were 99% (95% CI, 97%-100%) and 81% (95% CI, 68%-90%), respectively (10 studies; n = 6537). At higher cutpoints, pooled estimates were 95% (95% CI, 91%-97%) and 89% (95% CI, 82%-93%), respectively (7 studies; n = 5516). Use of this test at the manufacturer's cutpoint in a population of 100 000 with a prevalence of HSV-2 of 16% (the

  12. Screening for Dyslipidemia in Younger Adults: A Systematic Review for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Chou, Roger; Dana, Tracy; Blazina, Ian; Daeges, Monica; Bougatsos, Christina; Jeanne, Thomas L

    2016-10-18

    Dyslipidemia may occur in younger adults (defined as persons aged 21 to 39 years) and is an important risk factor for cardiovascular disease. Screening might identify younger adults with asymptomatic dyslipidemia who may benefit from lipid-lowering therapies. To update the 2008 U.S. Preventive Services Task Force review on dyslipidemia screening in younger adults. The Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and MEDLINE through May 2016, and reference lists. Randomized, controlled trials; cohort studies; and case-control studies on screening for or treatment of asymptomatic dyslipidemia in adults aged 21 to 39 years. The plan was for 1 investigator to abstract data and a second to check their accuracy, and for 2 investigators to independently assess study quality; however, no studies met the inclusion criteria. No study evaluated the effects of lipid screening versus no screening, treatment versus no treatment, or delayed versus earlier treatment on clinical outcomes in younger adults. In addition, no study evaluated the diagnostic yield of alternative screening strategies (such as targeted screening of persons with a family history of hyperlipidemia vs. general screening) in younger adults. No direct relevant evidence. Direct evidence on the benefits and harms of screening for or treatment of dyslipidemia in younger adults remains unavailable. Estimating the potential effects of screening for dyslipidemia in this population requires extrapolation from studies performed in older adults. Agency for Healthcare Research and Quality.

  13. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-04-17

    Because of the aging population, osteoporotic fractures are an increasingly important cause of morbidity and mortality in the United States. Approximately 2 million osteoporotic fractures occurred in the United States in 2005, and annual incidence is projected to increase to more than 3 million fractures by 2025. Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, and 20% to 30% of patients will die. To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on vitamin D supplementation, with or without calcium, to prevent fractures. The USPSTF reviewed the evidence on vitamin D, calcium, and combined supplementation for the primary prevention of fractures in community-dwelling adults (defined as not living in a nursing home or other institutional care setting). The review excluded studies conducted in populations with a known disorder related to bone metabolism (eg, osteoporosis or vitamin D deficiency), taking medications known to be associated with osteoporosis (eg, long-term steroids), or with a previous fracture. The USPSTF found inadequate evidence to estimate the benefits of vitamin D, calcium, or combined supplementation to prevent fractures in community-dwelling men and premenopausal women. The USPSTF found adequate evidence that daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium has no benefit for the primary prevention of fractures in community-dwelling, postmenopausal women. The USPSTF found inadequate evidence to estimate the benefits of doses greater than 400 IU of vitamin D or greater than 1000 mg of calcium to prevent fractures in community-dwelling postmenopausal women. The USPSTF found adequate evidence that supplementation with vitamin D and calcium increases the incidence of kidney stones. The USPSTF concludes that the current evidence is insufficient to assess the balance of the

  14. Behavioral interventions and counseling to prevent child abuse and neglect: a systematic review to update the US Preventive services task force recommendation.

    Science.gov (United States)

    Selph, Shelley S; Bougatsos, Christina; Blazina, Ian; Nelson, Heidi D

    2013-02-05

    In 2004, the U.S. Preventive Services Task Force determined that evidence was insufficient to recommend behavioral interventions and counseling to prevent child abuse and neglect. To review new evidence on the effectiveness of behavioral interventions and counseling in health care settings for reducing child abuse and neglect and related health outcomes, as well as adverse effects of interventions. MEDLINE and PsycINFO (January 2002 to June 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the second quarter of 2012), Scopus, and reference lists. English-language trials of the effectiveness of behavioral interventions and counseling and studies of any design about adverse effects. Investigators extracted data about study populations, designs, and outcomes and rated study quality using established criteria. Eleven fair-quality randomized trials of interventions and no studies of adverse effects met inclusion criteria. A trial of risk assessment and interventions for abuse and neglect in pediatric clinics for families with children aged 5 years or younger indicated reduced physical assault, Child Protective Services (CPS) reports, nonadherence to medical care, and immunization delay among screened children. Ten trials of early childhood home visitation reported reduced CPS reports, emergency department visits, hospitalizations, and self-reports of abuse and improved adherence to immunizations and well-child care, although results were inconsistent. Trials were limited by heterogeneity, low adherence, high loss to follow-up, and lack of standardized measures. Risk assessment and behavioral interventions in pediatric clinics reduced abuse and neglect outcomes for young children. Early childhood home visitation also reduced abuse and neglect, but results were inconsistent. Additional research on interventions to prevent child abuse and neglect is needed. Agency for Healthcare Research and Quality.

  15. Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services.

    Science.gov (United States)

    Zaza, S; Wright-De Agüero, L K; Briss, P A; Truman, B I; Hopkins, D P; Hennessy, M H; Sosin, D M; Anderson, L; Carande-Kulis, V G; Teutsch, S M; Pappaioanou, M

    2000-01-01

    A standardized abstraction form and procedure was developed to provide consistency, reduce bias, and improve validity and reliability in the Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide). The content of the abstraction form was based on methodologies used in other systematic reviews; reporting standards established by major health and social science journals; the evaluation, statistical and meta-analytic literature; expert opinion and review; and pilot-testing. The form is used to classify and describe key characteristics of the intervention and evaluation (26 questions) and assess the quality of the study's execution (23 questions). Study procedures and results are collected and specific threats to the validity of the study are assessed across six categories (intervention and study descriptions, sampling, measurement, analysis, interpretation of results and other execution issues). Each study is abstracted by two independent reviewers and reconciled by the chapter development team. Reviewers are trained and provided with feedback. What to abstract and how to summarize the data are discretionary choices that influence conclusions drawn on the quality of execution of the study and its effectiveness. The form balances flexibility for the evaluation of papers with different study designs and intervention types with the need to ask specific questions to maximize validity and reliability. It provides a structured format that researchers and others can use to review the content and quality of papers, conduct systematic reviews, or develop manuscripts. A systematic approach to developing and evaluating manuscripts will help to promote overall improvement of the scientific literature.

  16. Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-09-05

    One of the most important causes of vision abnormalities in children is amblyopia (also known as "lazy eye"). Amblyopia is an alteration in the visual neural pathway in a child's developing brain that can lead to permanent vision loss in the affected eye. Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors (strabismus, anisometropia, or both). Early identification of vision abnormalities could prevent the development of amblyopia. Studies show that screening rates among children vary by race/ethnicity and family income. Data based on parent reports from 2009-2010 indicated identical screening rates among black non-Hispanic children and white non-Hispanic children (80.7%); however, Hispanic children were less likely than non-Hispanic children to report vision screening (69.8%). Children whose families earned 200% or more above the federal poverty level were more likely to report vision screening than families with lower incomes. To update the 2011 US Preventive Services Task Force (USPSTF) recommendation on screening for amblyopia and its risk factors in children. The USPSTF reviewed the evidence on the accuracy of vision screening tests and the benefits and harms of vision screening and treatment. Surgical interventions were considered to be out of scope for this review. Treatment of amblyopia is associated with moderate improvements in visual acuity in children aged 3 to 5 years, which are likely to result in permanent improvements in vision throughout life. The USPSTF concluded that the benefits are moderate because untreated amblyopia results in permanent, uncorrectable vision loss, and the benefits of screening and treatment potentially can be experienced over a child's lifetime. The USPSTF found adequate evidence to bound the potential harms of treatment (ie, higher false-positive rates in low-prevalence populations) as small. Therefore, the USPSTF concluded with moderate certainty that the overall net benefit is moderate for

  17. Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Jonas, Daniel E; Amick, Halle R; Feltner, Cynthia; Weber, Rachel Palmieri; Arvanitis, Marina; Stine, Alexander; Lux, Linda; Harris, Russell P

    2017-01-24

    Many adverse health outcomes are associated with obstructive sleep apnea (OSA). To review primary care-relevant evidence on screening adults for OSA, test accuracy, and treatment of OSA, to inform the US Preventive Services Task Force. MEDLINE, Cochrane Library, EMBASE, and trial registries through October 2015, references, and experts, with surveillance of the literature through October 5, 2016. English-language randomized clinical trials (RCTs); studies evaluating accuracy of screening questionnaires or prediction tools, diagnostic accuracy of portable monitors, or association between apnea-hypopnea index (AHI) and health outcomes among community-based participants. Two investigators independently reviewed abstracts and full-text articles. When multiple similar studies were available, random-effects meta-analyses were conducted. Sensitivity, specificity, area under the curve (AUC), AHI, Epworth Sleepiness Scale (ESS) scores, blood pressure, mortality, cardiovascular events, motor vehicle crashes, quality of life, and harms. A total of 110 studies were included (N = 46 188). No RCTs compared screening with no screening. In 2 studies (n = 702), the screening accuracy of the multivariable apnea prediction score followed by home portable monitor testing for detecting severe OSA syndrome (AHI ≥30 and ESS score >10) was AUC 0.80 (95% CI, 0.78 to 0.82) and 0.83 (95% CI, 0.77 to 0.90), respectively, but the studies oversampled high-risk participants and those with OSA and OSA syndrome. No studies prospectively evaluated screening tools to report calibration or clinical utility for improving health outcomes. Meta-analysis found that continuous positive airway pressure (CPAP) compared with sham was significantly associated with reduction of AHI (weighted mean difference [WMD], -33.8 [95% CI, -42.0 to -25.6]; 13 trials, 543 participants), excessive sleepiness assessed by ESS score (WMD, -2.0 [95% CI, -2.6 to -1.4]; 22 trials, 2721 participants), diurnal systolic

  18. Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Henderson, Jillian T; Webber, Elizabeth M; Sawaya, George F

    2018-02-13

    Ovarian cancer is relatively rare but the fifth-leading cause of cancer mortality among United States women. To systematically review evidence on benefits and harms of ovarian cancer screening among average-risk women to inform the United States Preventive Services Task Force. MEDLINE, PubMed, Cochrane Collaboration Registry of Controlled Trials; studies published in English from January 1, 2003, through January 31, 2017; ongoing surveillance in targeted publications through November 22, 2017. Randomized clinical trials of ovarian cancer screening in average-risk women that reported mortality or quality-of-life outcomes. Interventions included transvaginal ultrasound, cancer antigen 125 (CA-125) testing, or their combination. Comparators were usual care or no screening. Independent critical appraisal and data abstraction by 2 reviewers. Meta-analytic pooling of results was not conducted because of the small number of studies and heterogeneity of interventions. Ovarian cancer mortality, false-positive screening results and surgery, surgical complications, and psychological effects of screening. Four trials (N = 293 587) were included; of these, 3 (n = 293 038) assessed ovarian cancer mortality, and 1 (n = 549) reported only on psychological outcomes. Evaluated screening interventions included transvaginal ultrasound alone, transvaginal ultrasound plus CA-125 testing, and CA-125 testing alone. Test positivity for CA-125 was defined by a fixed serum level cutpoint or by a proprietary risk algorithm based on CA-125 level, change in CA-125 level over time, and age (risk of ovarian cancer algorithm [ROCA]). No trial found a significant difference in ovarian cancer mortality with screening. In the 2 large screening trials (PLCO and UKCTOCS, n = 271 103), there was not a statistically significant difference in complete intention-to-screen analyses of ovarian, fallopian, and peritoneal cancer cases associated with screening (PLCO: rate ratio, 1.18 [95

  19. [The vital tasks of preventive medicine].

    Science.gov (United States)

    Chizh, I M

    1996-05-01

    The article discusses the actual problems of prophylaxis in common system of troops medical supply and defines the subsequent reformative ways of preventive medicine. First of all, the necessity of organized principles revision of prophylactic direction is connected with the fact of main health indices negative dynamics of Armed Forces personal, indicative of weakening of all types of prophylactic work. These are prophylactic work among recruits during their adaptation to military service conditions, prophylactic medical examination, tempering, fiscal training and prophylaxis of infectious diseases. However, we shouldn't forget about positive experience accumulated in the past, as much as possible we should use the achievements of military medical science. For further development of preventive direction of troops and fleet medical supply the priority ways of essential tasks decision of military medicine have been planned. It is necessary to connect the decision of concrete tasks with general perspective of introduction in Armed Forces of region system of servicemen medical supply.

  20. 77 FR 18823 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

    Science.gov (United States)

    2012-03-28

    .... Additionally, the Task Force benefits from members with expertise in the following areas: Behavioral medicine... and expertise in the areas of behavioral medicine, family medicine, general internal medicine, and... during this cycle for future vacancies. ADDRESSES: Submit your responses either in writing or...

  1. 78 FR 23261 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

    Science.gov (United States)

    2013-04-18

    ... USPSTF, an independent body of experts in prevention and evidence-based medicine, works to improve the... individuals with demonstrated training and expertise in the areas of behavioral medicine, internal medicine... year and not selected during this cycle for future vacancies. To obtain a diversity of perspectives...

  2. An approach to addressing subpopulation considerations in systematic reviews: the experience of reviewers supporting the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Whitlock, Evelyn P; Eder, Michelle; Thompson, Jamie H; Jonas, Daniel E; Evans, Corinne V; Guirguis-Blake, Janelle M; Lin, Jennifer S

    2017-03-02

    Guideline developers and other users of systematic reviews need information about whether a medical or preventive intervention is likely to benefit or harm some patients more (or less) than the average in order to make clinical practice recommendations tailored to these populations. However, guidance is lacking on how to include patient subpopulation considerations into the systematic reviews upon which guidelines are often based. In this article, we describe methods developed to consistently consider the evidence for relevant subpopulations in systematic reviews conducted to support primary care clinical preventive service recommendations made by the U.S. Preventive Services Task Force (USPSTF). Our approach is grounded in our experience conducting systematic reviews for the USPSTF and informed by a review of existing guidance on subgroup analysis and subpopulation issues. We developed and refined our approach based on feedback from the Subpopulation Workgroup of the USPSTF and pilot testing on reviews being conducted for the USPSTF. This paper provides processes and tools for incorporating evidence-based identification of important sources of potential heterogeneity of intervention effects into all phases of systematic reviews. Key components of our proposed approach include targeted literature searches and key informant interviews to identify the most important subpopulations a priori during topic scoping, a framework for assessing the credibility of subgroup analyses reported in studies, and structured investigation of sources of heterogeneity of intervention effects. Further testing and evaluation are necessary to refine this proposed approach and demonstrate its utility to the producers and users of systematic reviews beyond the context of the USPSTF. Gaps in the evidence on important subpopulations identified by routinely applying this process in systematic reviews will also inform future research needs.

  3. State-by-state Variation in Prostate-specific Antigen Screening Trends Following the 2011 United States Preventive Services Task Force Panel Update.

    Science.gov (United States)

    Vetterlein, Malte W; Dalela, Deepansh; Sammon, Jesse D; Karabon, Patrick; Sood, Akshay; Jindal, Tarun; Meyer, Christian P; Löppenberg, Björn; Sun, Maxine; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

    2018-02-01

    To evaluate state-by-state trends in prostate-specific antigen (PSA) screening prevalence after the 2011 United States Preventive Services Task Force (USPSTF) recommendation against this practice. We included 222,475 men who responded to the Behavioral Risk Factor Surveillance System 2012 and 2014 surveys, corresponding to early and late post-USPSTF populations. Logistic regression was used to identify predictors of PSA screening and to calculate the adjusted and weighted state-by-state PSA screening prevalence and respective relative percent changes between 2012 and 2014. To account for unmeasured factors, the correlation between changes in PSA screening over time and changes in screening for colorectal and breast cancer were assessed. All analyses were conducted in 2016. Overall, 38.9% (95% confidence interval [CI] = 38.6%-39.2%) reported receiving PSA screening in 2012 vs 35.8% (95% CI = 35.1%-36.2%) in 2014. State of residence, age, race, education, income, insurance, access to care, marital status, and smoking status were independent predictors of PSA screening in both years (all P trends following the 2011 USPSTF recommendation. Further research is needed to elucidate the reasons for this heterogeneity in screening behavior among the states. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. National Trends in Prostate Biopsy and Radical Prostatectomy Volumes Following the US Preventive Services Task Force Guidelines Against Prostate-Specific Antigen Screening.

    Science.gov (United States)

    Halpern, Joshua A; Shoag, Jonathan E; Artis, Amanda S; Ballman, Karla V; Sedrakyan, Art; Hershman, Dawn L; Wright, Jason D; Shih, Ya Chen Tina; Hu, Jim C

    2017-02-01

    Studies demonstrate that use of prostate-specific antigen screening decreased significantly following the US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen screening in 2012. To determine downstream effects on practice patterns in prostate cancer diagnosis and treatment following the 2012 USPSTF recommendation. Procedural volumes of certifying and recertifying urologists from 2009 through 2016 were evaluated for variation in prostate biopsy and radical prostatectomy (RP) volume. Trends were confirmed using the New York Statewide Planning and Research Cooperative System and Nationwide Inpatient Sample. The study included a representative sample of urologists across practice settings and nationally representative sample of all RP discharges. We obtained operative case logs from the American Board of Urology and identified urologists performing at least 1 prostate biopsy (n = 5173) or RP (n = 3748), respectively. The 2012 USPSTF recommendation against routine population-wide prostate-specific antigen screening. Change in median biopsy and RP volume per urologist and national procedural volume. Following the USPSTF recommendation, median biopsy volume per urologist decreased from 29 to 21 (interquartile range [IQR}, 12-34; P following 2012 (parameter estimate, -0.25; SE, 0.03; P following the USPSTF recommendation, median RP volume per urologist decreased from 7 (IQR, 3-15) to 6 (IQR, 2-12) (P Following the 2012 USPSTF recommendation, prostate biopsy and RP volumes decreased significantly. A panoramic vantage point is needed to evaluate the long-term consequences of the 2012 USPSTF recommendation.

  5. Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten

    2016-06-21

    Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal anti-inflammatory drug use to prevent colorectal cancer (CRC). The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms. This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk. The USPSTF recommends initiating low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years. (B recommendation) The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I

  6. Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Whitlock, Evelyn P; Burda, Brittany U; Williams, Selvi B; Guirguis-Blake, Janelle M; Evans, Corinne V

    2016-06-21

    The balance between potential aspirin-related risks and benefits is critical in primary prevention. To evaluate the risk for serious bleeding with regular aspirin use in cardiovascular disease (CVD) primary prevention. PubMed, MEDLINE, Cochrane Central Register of Controlled Trials (2010 through 6 January 2015), and relevant references from other reviews. Randomized, controlled trials; cohort studies; and meta-analyses comparing aspirin with placebo or no treatment to prevent CVD or cancer in adults. One investigator abstracted data, another checked for accuracy, and 2 assessed study quality. In CVD primary prevention studies, very-low-dose aspirin use (≤100 mg daily or every other day) increased major gastrointestinal (GI) bleeding risk by 58% (odds ratio [OR], 1.58 [95% CI, 1.29 to 1.95]) and hemorrhagic stroke risk by 27% (OR, 1.27 [CI, 0.96 to 1.68]). Projected excess bleeding events with aspirin depend on baseline assumptions. Estimated excess major bleeding events were 1.39 (CI, 0.70 to 2.28) for GI bleeding and 0.32 (CI, -0.05 to 0.82) for hemorrhagic stroke per 1000 person-years of aspirin exposure using baseline bleeding rates from a community-based observational sample. Such events could be greater among older persons, men, and those with CVD risk factors that also increase bleeding risk. Power to detect effects on hemorrhagic stroke was limited. Harms other than serious bleeding were not examined. Consideration of the safety of primary prevention with aspirin requires an individualized assessment of aspirin's effects on bleeding risks and expected benefits because absolute bleeding risk may vary considerably by patient. Agency for Healthcare Research and Quality.

  7. C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Buckley, David I; Fu, Rongwei; Freeman, Michele; Rogers, Kevin; Helfand, Mark

    2009-10-06

    C-reactive protein (CRP) may help to refine global risk assessment for coronary heart disease (CHD), particularly among persons who are at intermediate risk on the basis of traditional risk factors alone. To assist the U.S. Preventive Services Task Force (USPSTF) in determining whether CRP should be incorporated into guidelines for CHD risk assessment. MEDLINE search of English-language articles (1966 to November 2007), supplemented by reference lists of reviews, pertinent studies, editorials, and Web sites and by expert suggestions. Prospective cohort, case-cohort, and nested case-control studies relevant to the independent predictive ability of CRP when used in intermediate-risk persons. Included studies were reviewed according to predefined criteria, and the quality of each study was rated. The validity of the body of evidence and the net benefit or harm of using CRP for CHD risk assessment were evaluated. The combined magnitude of effect was determined by meta-analysis. The body of evidence is of good quality, consistency, and applicability. For good studies that adjusted for all Framingham risk variables, the summary estimate of relative risk for incident CHD was 1.58 (95% CI, 1.37 to 1.83) for CRP levels greater than 3.0 mg/L compared with levels less than 1.0 mg/L. Analyses from 4 large cohorts were consistent in finding evidence that including CRP improves risk stratification among initially intermediate-risk persons. C-reactive protein has desirable test characteristics, and good data exist on the prevalence of elevated CRP levels in intermediate-risk persons. Limited evidence links changes in CRP level to primary prevention of CHD events. Study methods for measuring Framingham risk variables and other covariates varied. Ethnic and racial minority populations were poorly represented in most studies, limiting generalizability. Few studies directly assessed the effect of CRP on risk reclassification in intermediate-risk persons. Strong evidence indicates

  8. Aspirin for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: A Decision Analysis for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Dehmer, Steven P; Maciosek, Michael V; Flottemesch, Thomas J; LaFrance, Amy B; Whitlock, Evelyn P

    2016-06-21

    Evidence indicates that aspirin is effective for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) but also increases the risk for gastrointestinal (GI) and cerebral hemorrhages. To assess the net balance of benefits and harms from routine aspirin use across clinically relevant age, sex, and CVD risk groups. Decision analysis using a microsimulation model. 3 systematic evidence reviews. Men and women aged 40 to 79 years with a 10-year CVD risk of 20% or less, and no history of CVD and without elevated risk for GI or cerebral hemorrhages that would contraindicate aspirin use. Lifetime, 20 years, and 10 years. Clinical. Low-dose aspirin (≤100 mg/d). Primary outcomes are length and quality of life measured in net life-years and quality-adjusted life-years. Benefits include reduced nonfatal myocardial infarction, nonfatal ischemic stroke, fatal CVD, CRC incidence, and CRC mortality. Harms include increased fatal and nonfatal GI bleeding and hemorrhagic stroke. Lifetime net quality-adjusted life-years are positive for most adults initiating aspirin at ages 40 to 69 years, and life expectancy gains are expected for most men and women initiating aspirin at ages 40 to 59 years and 60 to 69 years with higher CVD risk. Harms may exceed benefits for persons starting aspirin in their 70s and for many during the first 10 to 20 years of use. Results are most sensitive to the relative risk for hemorrhagic stroke and CVD mortality but are affected by all relative risk estimates, baseline GI bleeding incidence and case-fatality rates, and disutilities associated with aspirin use. Aspirin effects by age are uncertain. Stroke benefits are conservatively estimated. Gastrointestinal bleeding incidence and case-fatality rates account only for age and sex. Lifetime aspirin use for primary prevention initiated at younger ages (40 to 69 years) and in persons with higher CVD risk shows the greatest potential for positive net benefit. Agency for Healthcare

  9. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Henderson, Jillian T; Whitlock, Evelyn P; O'Connor, Elizabeth; Senger, Caitlyn A; Thompson, Jamie H; Rowland, Maya G

    2014-05-20

    Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality. To systematically review benefits and harms of low-dose aspirin for preventing morbidity and mortality from preeclampsia. MEDLINE, Database of Abstracts of Reviews of Effects, PubMed, and Cochrane Central Register of Controlled Trials (January 2006 to June 2013); previous systematic reviews, clinical trial registries, and surveillance searches for large studies (June 2013 to February 2014). Randomized, controlled trials (RCTs) to assess benefits among women at high preeclampsia risk and RCTs or large cohort studies of harms among women at any risk level. English-language studies of fair or good quality were included. Dual quality assessment and abstraction of studies. Two large, multisite RCTs and 13 smaller RCTs of high-risk women (8 good-quality) were included, in addition to 6 RCTs and 2 observational studies of average-risk women to assess harms (7 good-quality). Depending on baseline risk, aspirin use was associated with absolute risk reductions of 2% to 5% for preeclampsia (relative risk [RR], 0.76 [95% CI, 0.62 to 0.95]), 1% to 5% for intrauterine growth restriction (RR, 0.80 [CI, 0.65 to 0.99]), and 2% to 4% for preterm birth (RR, 0.86 [CI, 0.76 to 0.98]). No significant perinatal or maternal harms were identified, but rare harms could not be ruled out. Evidence on long-term outcomes was sparse, but 18-month follow-up from the largest trial found no developmental harms. Benefits may have been overestimated due to small-study effects. Predictive intervals were not statistically significant. Future studies could shift findings toward the null. Daily low-dose aspirin beginning as early as the second trimester prevented clinically important health outcomes. No harms were identified, but long-term evidence was limited.

  10. Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Forman-Hoffman, Valerie; McClure, Emily; McKeeman, Joni; Wood, Charles T; Middleton, Jennifer Cook; Skinner, Asheley C; Perrin, Eliana M; Viswanathan, Meera

    2016-03-01

    Major depressive disorder (MDD) is common among children and adolescents and is associated with functional impairment and suicide. To update the 2009 U.S. Preventive Services Task Force (USPSTF) systematic review on screening for and treatment of MDD in children and adolescents in primary care settings. Several electronic searches (May 2007 to February 2015) and searches of reference lists of published literature. Trials and recent systematic reviews of treatment, test-retest studies of screening, and trials and large cohort studies for harms. Data were abstracted by 1 investigator and checked by another; 2 investigators independently assessed study quality. Limited evidence from 5 studies showed that such tools as the Beck Depression Inventory and Patient Health Questionnaire for Adolescents had reasonable accuracy for identifying MDD among adolescents in primary care settings. Six trials evaluated treatment. Several individual fair- and good-quality studies of fluoxetine, combined fluoxetine and cognitive behavioral therapy, escitalopram, and collaborative care demonstrated benefits of treatment among adolescents, with no associated harms. The review included only English-language studies, narrow inclusion criteria focused only on MDD, high thresholds for quality, potential publication bias, limited data on harms, and sparse evidence on long-term outcomes of screening and treatment among children younger than 12 years. No evidence was found of a direct link between screening children and adolescents for MDD in primary care or similar settings and depression or other health-related outcomes. Evidence showed that some screening tools are accurate and some treatments are beneficial among adolescents (but not younger children), with no evidence of associated harms. Agency for Healthcare Research and Quality.

  11. The impact of the United States Preventive Services Task Force (USPTSTF) recommendations against prostate-specific antigen (PSA) testing on PSA testing in Australia.

    Science.gov (United States)

    Zargar, Homayoun; van den Bergh, Roderick; Moon, Daniel; Lawrentschuk, Nathan; Costello, Anthony; Murphy, Declan

    2017-01-01

    To assess the impact of the United States Preventive Services Task Force (USPTSTF) recommendations on prostate-specific antigen (PSA) testing, prostate biopsy, and prostatectomy in Australian men based on the available Medicare data. Events were identified using Medicare item numbers for PSA testing (66655, 66659), prostate biopsy (37219), prostatectomy (37210), and prostatectomy with lymph node dissection (37211). The occurrences of each procedure was queried per 100 000 capita for consecutive financial years over the period 2000-2015. For each item number, reports were also generated for all Australian States. For PSA testing the data was stratified into three age groups of 45-54, 55-64, and 65-74 years. For assessing the rate of prostatectomy the capita rate values for two item numbers of prostatectomy (37210) and prostatectomy with lymph node dissection (37211) were combined. Steady declines in per capita incidences of all five item numbers assessed were seen for the three consecutive financial years (2013-2015) since the publication of the USPTSTF recommendation statement. These declines were seen across all Australian States. When examining the rate of PSA testing for the three age brackets 45-54, 55-64, and 65-74 years, similar trends were identified. Since the introduction of the USPTSTF recommendation statement there has been a steady nationwide decline in per capita incidences of PSA testing, prostate biopsy, and prostatectomy based on the Australian Medicare data. Whether these declines are in the right direction toward reduction in over-diagnosis and overtreatment of clinically insignificant prostate cancer or stage migration toward more locally advanced disease due to lost opportunity in diagnosing and treating early clinically significant prostate cancer will remain to be seen. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  12. The State of Prescreening Discussions About Prostate-specific Antigen Testing Following Implementation of the 2012 United States Preventive Services Task Force Statement.

    Science.gov (United States)

    Turini, George A; Gjelsvik, Annie; Renzulli, Joseph F

    2017-06-01

    To determine if the quality of prescreening discussions has changed following release of the United States Preventive Services Task Force statement against prostate cancer screening. This cross-sectional study used the 2012 and 2014 Behavioral Risk Factor Surveillance System surveys. Respondents were categorized based on the year in which they responded to the Behavioral Risk Factor Surveillance System Survey. Quality of prescreening discussion was operationalized as having discussed only advantages, only disadvantages, both advantages and disadvantages, or neither. Race/ethnicity, education level, income, insurance status, and having a prostate-specific antigen (PSA) level actually drawn after prescreening counseling served as confounders in our multivariate analysis. Among 217,053 men in the analytic sample, 37% were told about only advantages of PSA screening compared to 30% of men who were advised about both advantages and disadvantages. Men who were told about neither advantages nor disadvantages were more likely to be Hispanic, not graduate high school, have low income, and not have insurance. Controlling for covariates, men in 2014 were significantly more likely to have undergone PSA testing without having discussed either advantages or disadvantages than men in 2012. Comprehensive prescreening discussions about advantages and disadvantages of PSA testing are critical to informed decision making about prostate cancer screening. Disparities not only exist with regard to the quality of prescreening discussions that patients receive from their providers prior to PSA testing across categories of race/ethnicity, education, income, and insurance status, but these disparities became more substantial between 2012 and 2014. Further investigation is warranted to elicit more specific reasons behind these variations. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    O'Connor, Elizabeth A; Evans, Corinne V; Burda, Brittany U; Walsh, Emily S; Eder, Michelle; Lozano, Paula

    2017-06-20

    Obesity is common in children and adolescents in the United States, is associated with negative health effects, and increases the likelihood of obesity in adulthood. To systematically review the benefits and harms of screening and treatment for obesity and overweight in children and adolescents to inform the US Preventive Services Task Force. MEDLINE, PubMed, PsycINFO, Cochrane Collaboration Registry of Controlled Trials, and the Education Resources Information Center through January 22, 2016; references of relevant publications; government websites. Surveillance continued through December 5, 2016. English-language trials of benefits or harms of screening or treatment (behavior-based, orlistat, metformin) for overweight or obesity in children aged 2 through 18 years, conducted in or recruited from health care settings. Two investigators independently reviewed abstracts and full-text articles, then extracted data from fair- and good-quality trials. Random-effects meta-analysis was used to estimate the benefits of lifestyle-based programs and metformin. Weight or excess weight (eg, body mass index [BMI]; BMI z score, measuring the number of standard deviations from the median BMI for age and sex), cardiometabolic outcomes, quality of life, other health outcomes, harms. There was no direct evidence on the benefits or harms of screening children and adolescents for excess weight. Among 42 trials of lifestyle-based interventions to reduce excess weight (N = 6956), those with an estimated 26 hours or more of contact consistently demonstrated mean reductions in excess weight compared with usual care or other control groups after 6 to 12 months, with no evidence of causing harm. Generally, intervention groups showed absolute reductions in BMI z score of 0.20 or more and maintained their baseline weight within a mean of approximately 5 lb, while control groups showed small increases or no change in BMI z score, typically gaining a mean of 5 to 17 lb. Only 3 of 26

  14. Lipid Screening in Childhood and Adolescence for Detection of Multifactorial Dyslipidemia: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Lozano, Paula; Henrikson, Nora B; Morrison, Caitlin C; Dunn, John; Nguyen, Matt; Blasi, Paula R; Whitlock, Evelyn P

    2016-08-09

    Multifactorial dyslipidemia, characterized by elevated total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C), is associated with dyslipidemia and markers of atherosclerosis in young adulthood. Screening for dyslipidemia in childhood could delay or reduce cardiovascular events in adulthood. To systematically review the evidence on benefits and harms of screening adolescents and children for multifactorial dyslipidemia for the US Preventive Services Task Force (USPSTF). MEDLINE, Cochrane Central Register of Controlled Trials, and PubMed were searched for studies published between January 1, 2005, and June 2, 2015; studies included in a previous USPSTF evidence report and reference lists of relevant studies and ongoing trials were also searched. Surveillance was conducted through April 9, 2016. Fair- and good-quality studies in English with participants 0 to 20 years of age. Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Outcomes included dyslipidemia (TC≥200 mg/dL or LDL-C≥130 mg/dL) and atherosclerosis in childhood; myocardial infarction and ischemic stroke in adulthood; diagnostic yield (number of confirmed cases per children screened); and harms of screening or treatment. Simulated diagnostic yield was calculated as initial screening yield × positive predictive value from a study with confirmatory testing. Screening of children for multifactorial dyslipidemia has not been evaluated in randomized clinical trials. Based on 1 observational study (n = 6500) and nationally representative prevalence estimates, the simulated diagnostic yield of screening for elevated TC varies between 4.8% and 12.3% (higher in obese children [12.3%] and at the ages when TC naturally peaks-7.2% at age 9-11 years and 7.2% at age 16-19 years). One good-quality randomized clinical trial (n = 663) found a modest effect of intensive dietary counseling for

  15. Medical Services: Preventive Medicine

    Science.gov (United States)

    1990-10-15

    antimicrobial agents by analyzing and using significant sur- veillance data and antimicrobial susceptibility test data. (8) Recommend to the hospital...an MTF. Pest management in food service areas is addressed in paragraph 10–9. Cockroach infestations in portable food carts are difficult to control...items.Technical assistance in controlling cockroaches in food carts may be obtained from USAEHA. 10–11. Pest management of military subsistence and stored

  16. A framework for chiropractic training in clinical preventive services

    OpenAIRE

    Hawk, Cheryl; Evans, Marion Willard

    2013-01-01

    The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs? training prepare them to competently deliver them. The aim of this co...

  17. A framework for chiropractic training in clinical preventive services.

    Science.gov (United States)

    Hawk, Cheryl; Evans, Marion Willard

    2013-08-20

    The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs' training prepare them to competently deliver them. The aim of this commentary is to describe a framework for training in clinical preventive services, based largely on the USPSTF recommendations, which could be readily integrated into existing DC educational programs.

  18. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Jonas, Daniel E; Garbutt, James C; Amick, Halle R; Brown, Janice M; Brownley, Kimberly A; Council, Carol L; Viera, Anthony J; Wilkins, Tania M; Schwartz, Cody J; Richmond, Emily M; Yeatts, John; Evans, Tammeka Swinson; Wood, Sally D; Harris, Russell P

    2012-11-06

    Alcohol misuse, which includes the full spectrum from risky drinking to alcohol dependence, is a leading cause of preventable death in the United States. To evaluate the benefits and harms of behavioral counseling interventions for adolescents and adults who misuse alcohol. MEDLINE, EMBASE, the Cochrane Library, CINAHL, PsycINFO, International Pharmaceutical Abstracts, and reference lists of published literature (January 1985 through January 2012, limited to English-language articles). Controlled trials at least 6 months' duration that enrolled persons with alcohol misuse identified by screening in primary care settings and evaluated behavioral counseling interventions. One reviewer extracted data and a second checked accuracy. Two independent reviewers assigned quality ratings and graded the strength of the evidence. The 23 included trials generally excluded persons with alcohol dependence. The best evidence was for brief (10- to 15-minute) multicontact interventions. Among adults receiving behavioral interventions, consumption decreased by 3.6 drinks per week from baseline (weighted mean difference, 3.6 drinks/wk [95% CI, 2.4 to 4.8 drinks/wk]; 10 trials; 4332 participants), 12% fewer adults reported heavy drinking episodes (risk difference, 0.12 [CI, 0.07 to 0.16]; 7 trials; 2737 participants), and 11% more adults reported drinking less than the recommended limits (risk difference, 0.11 [CI, 0.08 to 0.13]; 9 trials; 5973 participants) over 12 months compared with control participants (moderate strength of evidence). Evidence was insufficient to draw conclusions about accidents, injuries, or alcohol-related liver problems. Trials enrolling young adults or college students showed reduced consumption and fewer heavy drinking episodes (moderate strength of evidence). Little or no evidence of harms was found. Results may be biased to the null because the behavior of control participants could have been affected by alcohol misuse assessments. In addition, evidence is

  19. If this then that: an introduction to automated task services.

    Science.gov (United States)

    Hoy, Matthew B

    2015-01-01

    This article explores automated task services, a type of website that allows users to create rules that are triggered by activity on one website and perform a task on another site. The most well-known automated task service is If This Then That (IFTTT), but recently a large number of these services have sprung up. These services can be used to connect websites, apps, business services, and even devices such as phones and home automation equipment. This allows for millions of possible combinations of rules, triggers, and actions. Librarians can put these services to use in many ways, from automating social media postings to remembering to bring their umbrella when rain is in the forecast. A list of popular automated task services is included, as well as a number of ideas for using these services in libraries.

  20. Medicare Preventive Services Quick Reference Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — This educational tool provides the following information on Medicare preventive services Healthcare Common Procedure Coding System (HCPCS)-Current Procedural...

  1. Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force

    Science.gov (United States)

    Li, Rui; Qu, Shuli; Zhang, Ping; Chattopadhyay, Sajal; Gregg, Edward W.; Albright, Ann; Hopkins, David; Pronk, Nicolaas P.

    2016-01-01

    Background Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk. Purpose To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs. Data Sources Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015. Study Selection English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes. Data Extraction Dual abstraction and assessment of relevant study details. Data Synthesis Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified. Limitation Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited. Conclusion Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community

  2. Distributed Services with Foreseen and Unforeseen Tasks: The Mobile Re-allocation Problem

    NARCIS (Netherlands)

    J.A. Larco Martinelli (Jose); R. Dekker (Rommert); U. Kaymak (Uzay)

    2007-01-01

    textabstractIn this paper we deal with a common problem found in the operations of security and preventive/corrective maintenance services: that of routing a number of mobile resources to serve foreseen and unforeseen tasks during a shift. We define the (Mobile Re-Allocation Problem) MRAP as the

  3. UAV and Service Robot Coordination for Indoor Object Search Tasks

    OpenAIRE

    Konam, Sandeep; Rosenthal, Stephanie; Veloso, Manuela

    2017-01-01

    Our CoBot robots have successfully performed a variety of service tasks in our multi-building environment including accompanying people to meetings and delivering objects to offices due to its navigation and localization capabilities. However, they lack the capability to visually search over desks and other confined locations for an object of interest. Conversely, an inexpensive GPS-denied quadcopter platform such as the Parrot ARDrone 2.0 could perform this object search task if it had acces...

  4. The increased effectiveness of HIV preventive intervention among men who have sex with men and of follow-up care for people living with HIV after 'task-shifting' to community-based organizations: a 'cash on service delivery' model in China.

    Science.gov (United States)

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on 'cash on service delivery' model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt 'cash on service delivery' model. Services provided by CBOs are cost-effective, as compared with that by government facilities.

  5. The increased effectiveness of HIV preventive intervention among men who have sex with men and of follow-up care for people living with HIV after 'task-shifting' to community-based organizations: a 'cash on service delivery' model in China.

    Directory of Open Access Journals (Sweden)

    Hongjing Yan

    Full Text Available A large number of men who have sex with men (MSM and people living with HIV/AIDS (PLHA are underserved despite increased service availability from government facilities while many community based organizations (CBOs are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China.HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on 'cash on service delivery' model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system.After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively.It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt 'cash on service delivery' model. Services provided by CBOs are cost-effective, as compared with that by government facilities.

  6. Interocular suppression prevents interference in a flanker task

    Directory of Open Access Journals (Sweden)

    Jin eFan

    2015-08-01

    Full Text Available Executive control of attention refers to processes that detect and resolve conflict among thoughts and actions. Despite the high-level nature of this faculty, the role of awareness in executive control is not well understood. In this study, we used interocular suppression to mask the flankers in an arrow flanker task, in which the flankers and the target arrow were presented simultaneously in order to elicit executive control of attention. Participants were unable to detect the flanker arrows or to reliably identify their direction when masked. There was a typical conflict effect (prolonged reaction time and increased error rate under flanker-target incongruent condition compared to congruent condition when the flanker arrows were unmasked, while the conflict effect was absent when the flanker arrows were masked with interocular suppression. These results suggest that blocking awareness of competing stimuli with interocular suppression prevents the involvement of executive control of attention.

  7. DoD Task Force on the Prevention of the Suicide by Members of the Armed Forces

    Science.gov (United States)

    2010-08-01

    with us. Their family, friends, fellow Service Members, and our Nation mourn their loss. We, the members of the Task Force, express our sincere...However, the Centers for Disease Control and Prevention (CDC) were already working on standardizing suicide nomenclature for the civilian sector, and...ideal of not one suicide in the Armed Forces. In the same way, while it is known that not all heart attacks will be prevented, work continues toward

  8. 42 CFR 405.2448 - Preventive primary services.

    Science.gov (United States)

    2010-10-01

    ... acuity screening. (15) Hearing screening. (16) Cholesterol screening. (17) Stool testing for occult blood... requirements. (e) Preventive primary services do not include eyeglasses, hearing aids, or preventive dental...

  9. The Increased Effectiveness of HIV Preventive Intervention among Men Who Have Sex with Men and of Follow-Up Care for People Living with HIV after ‘Task-Shifting’ to Community-Based Organizations: A ‘Cash on Service Delivery’ Model in China

    Science.gov (United States)

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    Background A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. Methods HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on ‘cash on service delivery’ model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. Findings After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. Conclusion It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt ‘cash on service delivery’ model. Services provided by CBOs are cost-effective, as compared with that by government facilities. PMID:25050797

  10. 49 CFR 40.343 - What tasks may a service agent perform for an employer?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What tasks may a service agent perform for an... What tasks may a service agent perform for an employer? As a service agent, you may perform for employers the tasks needed to comply with DOT agency drug and alcohol testing regulations, subject to the...

  11. Opportunities for Pharmacists and Student Pharmacists to Provide Clinical Preventive Services

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro Mager

    2017-01-01

    Full Text Available Pharmacists and student pharmacists can play an important role in providing clinical preventive services as specified by the United States Preventive Services Task Force (USPSTF. The USPSTF guidelines provide evidence-based recommendations about clinical preventive services for the general population. The purpose of this paper is to provide information to pharmacists and student pharmacists developing and implementing preventive health care services. Examples of successful pharmacy-based programs are also provided. Pharmacists and student pharmacists can provide preventive health care interventions by conducting screenings, providing education, and making referrals. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Paper

  12. Discussions about preventive services: a qualitative study.

    Science.gov (United States)

    Lasser, Karen E; Kelly, Bridget; Maier, Jan; Murillo, Jennifer; Hoover, Sonia; Isenberg, Karen; Osber, Deborah; Pilkauskas, Natasha; Willis, Bayo C; Hersey, James

    2008-09-03

    Elderly minority patients are less likely to receive influenza vaccination and colorectal cancer screening than are other patients. Communication between primary care providers (PCPs) and patients may affect service receipt. Encounters between 7 PCPs and 18 elderly patients were observed and audiotaped at 2 community health centers. Three investigators coded transcribed audiotapes and field notes. We used qualitative analysis to identify specific potential barriers to completion of preventive services and to highlight examples of how physicians used patient-centered communication and other facilitation strategies to overcome those barriers. Sharing of power and responsibility, the use of empathy, and treating the patient like a person were all important communication strategies which seemed to help address barriers to vaccination and colonoscopy. Other potential facilitators of receipt of influenza vaccine included (1) cultural competence, (2) PCP introduction of the discussion, (3) persistence of the PCP (revisiting the topic throughout the visit), (4) rapport and trust between the patient and PCP, and (5) PCP vaccination of the patient. PCP persistence as well as rapport and trust also appeared to facilitate receipt of colorectal cancer screening. Several communications strategies appeared to facilitate PCP communications with older patients to promote acceptance of flu vaccination and colorectal cancer screening. These strategies should be studied with larger samples to determine which are most predictive of compliance with prevention recommendations.

  13. Discussions about preventive services: a qualitative study

    Directory of Open Access Journals (Sweden)

    Osber Deborah

    2008-09-01

    Full Text Available Abstract Background Elderly minority patients are less likely to receive influenza vaccination and colorectal cancer screening than are other patients. Communication between primary care providers (PCPs and patients may affect service receipt. Methods Encounters between 7 PCPs and 18 elderly patients were observed and audiotaped at 2 community health centers. Three investigators coded transcribed audiotapes and field notes. We used qualitative analysis to identify specific potential barriers to completion of preventive services and to highlight examples of how physicians used patient-centered communication and other facilitation strategies to overcome those barriers. Results Sharing of power and responsibility, the use of empathy, and treating the patient like a person were all important communication strategies which seemed to help address barriers to vaccination and colonoscopy. Other potential facilitators of receipt of influenza vaccine included (1 cultural competence, (2 PCP introduction of the discussion, (3 persistence of the PCP (revisiting the topic throughout the visit, (4 rapport and trust between the patient and PCP, and (5 PCP vaccination of the patient. PCP persistence as well as rapport and trust also appeared to facilitate receipt of colorectal cancer screening. Conclusion Several communications strategies appeared to facilitate PCP communications with older patients to promote acceptance of flu vaccination and colorectal cancer screening. These strategies should be studied with larger samples to determine which are most predictive of compliance with prevention recommendations.

  14. Predictive modeling: potential application in prevention services.

    Science.gov (United States)

    Wilson, Moira L; Tumen, Sarah; Ota, Rissa; Simmers, Anthony G

    2015-05-01

    In 2012, the New Zealand Government announced a proposal to introduce predictive risk models (PRMs) to help professionals identify and assess children at risk of abuse or neglect as part of a preventive early intervention strategy, subject to further feasibility study and trialing. The purpose of this study is to examine technical feasibility and predictive validity of the proposal, focusing on a PRM that would draw on population-wide linked administrative data to identify newborn children who are at high priority for intensive preventive services. Data analysis was conducted in 2013 based on data collected in 2000-2012. A PRM was developed using data for children born in 2010 and externally validated for children born in 2007, examining outcomes to age 5 years. Performance of the PRM in predicting administratively recorded substantiations of maltreatment was good compared to the performance of other tools reviewed in the literature, both overall, and for indigenous Māori children. Some, but not all, of the children who go on to have recorded substantiations of maltreatment could be identified early using PRMs. PRMs should be considered as a potential complement to, rather than a replacement for, professional judgment. Trials are needed to establish whether risks can be mitigated and PRMs can make a positive contribution to frontline practice, engagement in preventive services, and outcomes for children. Deciding whether to proceed to trial requires balancing a range of considerations, including ethical and privacy risks and the risk of compounding surveillance bias. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  15. Preventing Suicide in Prisons, Part II International Comparisons of Suicide Prevention Services in Correctional Facilities

    NARCIS (Netherlands)

    Diagle, M.S.; Daniel, A.E.; Dear, G.E.; Frottier, P.; Hayes, H.M.; Kerkhof, A.J.F.M.; Konrad, N.; Liebling, A.; Sarchiapone, M.

    2007-01-01

    The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences

  16. Medical students, clinical preventive services, and shared decision-making.

    Science.gov (United States)

    Keefe, Carole W; Thompson, Margaret E; Noel, Mary Margaret

    2002-11-01

    Improving access to preventive care requires addressing patient, provider, and systems barriers. Patients often lack knowledge or are skeptical about the importance of prevention. Physicians feel that they have too little time, are not trained to deliver preventive services, and are concerned about the effectiveness of prevention. We have implemented an educational module in the required family practice clerkship (1) to enhance medical student learning about common clinical preventive services and (2) to teach students how to inform and involve patients in shared decision making about those services. Students are asked to examine available evidence-based information for preventive screening services. They are encouraged to look at the recommendations of various organizations and use such resources as reports from the U.S. Preventive Services Task Force to determine recommendations they want to be knowledgeable about in talking with their patients. For learning shared decision making, students are trained to use a model adapted from Braddock and colleagues(1) to discuss specific screening services and to engage patients in the process of making informed decisions about what is best for their own health. The shared decision making is presented and modeled by faculty, discussed in small groups, and students practice using Web-based cases and simulations. The students are evaluated using formative and summative performance-based assessments as they interact with simulated patients about (1) screening for high blood cholesterol and other lipid abnormalities, (2) screening for colorectal cancer, (3) screening for prostate cancer, and (4) screening for breast cancer. The final student evaluation is a ten-minute, videotaped discussion with a simulated patient about screening for colorectal cancer that is graded against a checklist that focuses primarily on the elements of shared decision making. Our medical students appear quite willing to accept shared decision making as

  17. National pathways for suicide prevention and health services research.

    Science.gov (United States)

    Ahmedani, Brian K; Vannoy, Steven

    2014-09-01

    In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

  18. Task Shifting in Eastern Africa : Eye Care Services | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    To cope with this shortage, African providers practice task shifting, that is, allocating healthcare roles and procedures to less specialized health workers. VISION 2020 is a global initiative that strives to eliminate avoidable blindness by the year 2020. Some proponents of VISION 2020 believe that task shifting is essential to ...

  19. Denial of Service Prevention for 5G

    DEFF Research Database (Denmark)

    Li, Yao; Kaur, Bipjeet; Andersen, Birger

    2011-01-01

    5G wireless mobile communication is expected to include a large number of advanced technologies in order to further increase bandwidth, Quality of Service (QoS), improve usability and security, decrease delays and cost of service. Software Defined Radio (SDR) will be the platform for advanced ter...

  20. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    Science.gov (United States)

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

  1. The Role of Subjective Task Value in Service-Learning Engagement among Chinese College Students.

    Science.gov (United States)

    Li, Yulan; Guo, Fangfang; Yao, Meilin; Wang, Cong; Yan, Wenfan

    2016-01-01

    Most service-learning studies in higher education focused on its effects on students' development. The dynamic processes and mechanisms of students' development during service-learning, however, have not been explored thoroughly. Student engagement in service-learning may affect service-learning outcomes and be affected by subjective task value at the same time. The present study aimed to explore the effect of subjective task value on Chinese college student engagement during service-learning. Fifty-four Chinese college students participated in a 9-weeks service-learning program of interacting with children with special needs. Students' engagement and subjective task value were assessed via self-report questionnaires and 433 weekly reflective journals. The results indicated that the cognitive, emotional and behavioral engagement of Chinese college students demonstrated different developmental trends during service-learning process. Subjective task value played an essential role in student engagement in service-learning activities. However, the role of subjective task value varied with different stages. Finally, the implications for implementing service-learning in Chinese education were discussed.

  2. Discussions about preventive services: a qualitative study

    OpenAIRE

    Lasser, Karen E; Kelly, Bridget; Maier, Jan; Murillo, Jennifer; Hoover, Sonia; Isenberg, Karen; Osber, Deborah; Pilkauskas, Natasha; Willis, Bayo C; Hersey, James

    2008-01-01

    Abstract Background Elderly minority patients are less likely to receive influenza vaccination and colorectal cancer screening than are other patients. Communication between primary care providers (PCPs) and patients may affect service receipt. Methods Encounters between 7 PCPs and 18 elderly patients were observed and audiotaped at 2 community health centers. Three investigators coded transcribed audiotapes and field notes. We used qualitative analysis to identify specific potential barriers...

  3. A national survey of services for the prevention and management of falls in the UK

    Directory of Open Access Journals (Sweden)

    Potter Rachel

    2008-11-01

    Full Text Available Abstract Background The National Health Service (NHS was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines. Methods Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE. Results We identified 303 clinics across the UK. 231 (76% were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health. Conclusion The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.

  4. Service Robots for Hospitals: A Case Study of Transportation Tasks in a Hospital

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen

    2009-01-01

    In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to ver...... for implementing mobile service robots for transportation tasks in hospitals....

  5. Change Best: Task 2.3. Analysis of policy mix and development of Energy Efficiency Services

    International Nuclear Information System (INIS)

    Boonekamp, P.; Vethman, P.

    2010-04-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses task 2.3: Analysis of policy mix and development of Energy Efficiency Services.

  6. Task Shifting in Eastern Africa : Eye Care Services | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Little is known, however, about the strengths and weaknesses of this strategy, the productivity and quality of service provided, or the retention and satisfaction of the personnel involved. This study will measure the effect of enhanced supervision of general health workers, and the impact of trichiasis and cataract surgeons, ...

  7. Expanding Provision of Essential Surgical Services through Task ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The World Health Organization (WHO) recognizes the challenges and benefits of a competency-based approach to surgical services in its publication, Global Initiative for Emergency and Essential Surgical Care, which provides critical guidance on how to strengthen health systems to take on the burden of surgical problems ...

  8. Perceptions Regarding Male Suicide and Preventative Services in Co. Kilkenny

    OpenAIRE

    Butler, Louise; Phelan, Jim

    2005-01-01

    This paper examines perceptions regarding rural male suicide and the preventative services available in Co. Kilkenny to combat the problem. For every four male suicides, there is one female suicide. The problem is becoming a rural rather than an urban one. The research set out to identify gaps in services and existing policies in addressing suicide among young rural men. Data were obtained from interview with the service providers and also from focus group discussions with young rural Kilkenn...

  9. The Challenge and the Promise: Strengthening the Force, Preventing Suicide and Saving Lives. Final Report of the Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces

    Science.gov (United States)

    2010-08-01

    with us. Their family, friends, fellow Service Members, and our Nation mourn their loss. We, the members of the Task Force, express our sincere...However, the Centers for Disease Control and Prevention (CDC) were already working on standardizing suicide nomenclature for the civilian sector...all heart attacks will be prevented, work continues toward that end state with education, training, and treatment Work must continue toward the same

  10. Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians.

    Directory of Open Access Journals (Sweden)

    Juan E Corral

    Full Text Available Guatemala is currently undergoing an epidemiologic transition. Preventive services are key to reducing the burden of non-communicable diseases, and smoking counseling and cessation are among the most cost-effective and wide-reaching strategies. Internal medicine physicians are fundamental to providing such services, and their knowledge is a cornerstone of non-communicable disease control.A national cross-sectional survey was conducted in 2011 to evaluate knowledge of clinical preventive services for non-communicable diseases. Interns, residents, and attending physicians of the internal medicine departments of all teaching hospitals in Guatemala completed a self-administered questionnaire. Participants' responses were contrasted with the Guatemalan Ministry of Health (MoH prevention guidelines and the US Preventive Services Task Force (USPSTF recommendations. Analysis compared knowledge of recommendations within and between hospitals.In response to simulated patient scenarios, all services were recommended by more than half of physicians regardless of MoH or USPSTF recommendations. Prioritization was adequate according to the MoH guidelines but not including other potentially effective services (e.g. colorectal cancer and lipid disorder screenings. With the exception of colorectal and prostate cancer screening, less frequently recommended by interns, there was no difference in recommendation rates by level.Guatemalan internal medicine physicians' knowledge on preventive services recommendations for non-communicable diseases is limited, and prioritization did not reflect cost-effectiveness. Based on these data we recommend that preventive medicine training be strengthened and development of evidence-based guidelines for low-middle income countries be a priority.

  11. The demand for preventive and restorative dental services.

    Science.gov (United States)

    Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard

    2014-01-01

    Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Task-specific fall prevention training is effective for warfighters with transtibial amputations.

    Science.gov (United States)

    Kaufman, Kenton R; Wyatt, Marilynn P; Sessoms, Pinata H; Grabiner, Mark D

    2014-10-01

    Key factors limiting patients with lower extremity amputations to achieve maximal functional capabilities are falls and fear of falling. A task-specific fall prevention training program has successfully reduced prospectively recorded trip-related falls that occur in the community by the elderly. However, this program has not been tested in amputees. In a cohort of unilateral transtibial amputees, we aimed to assess effectiveness of a falls prevention training program by (1) quantifying improvements in trunk control; (2) measuring responses to a standardized perturbation; and (3) demonstrating retention at 3 and 6 months after training. Second, we collected patient-reported outcomes for balance confidence and falls control. Fourteen male military service members (26 ± 3 years) with unilateral transtibial amputations and who had been walking without an assistive device for a median of 10 months (range, 2-106 months) were recruited to participate in this prospective cohort study. The training program used a microprocessor-controlled treadmill designed to deliver task-specific postural perturbations that simulated a trip. The training consisted of six 30-minute sessions delivered over a 2-week period, during which task difficulty, including perturbation magnitude, increased as the patient's ability progressed. Training effectiveness was assessed using a perturbation test in an immersive virtual environment. The key outcome variables were peak trunk flexion and velocity, because trunk kinematics at the recovery step have been shown to be a determinant of fall likelihood. The patient-reported outcomes were also collected using questionnaires. The effectiveness of the rehabilitation program was also assessed by collecting data before perturbation training and comparing the key outcome parameters with those measured immediately after perturbation training (0 months) as well as both 3 and 6 months posttraining. Mean trunk flexion angle and velocity significantly improved

  13. 75 FR 22140 - Office of Clinical and Preventive Services; Division of Oral Health; Dental Preventive and...

    Science.gov (United States)

    2010-04-27

    ... Services; Division of Oral Health; Dental Preventive and Clinical Support Centers Program Announcement Type...' oral health by directly addressing the perceived needs of dental personnel and Area or regional dental... clinic-based and community-based oral health promotion/disease prevention (HP/DP) initiatives. Centers...

  14. Family Violence Prevention and Services Programs. Final rule.

    Science.gov (United States)

    2016-11-02

    This rule will better prevent and protect survivors of family violence, domestic violence, and dating violence, by clarifying that all survivors must have access to services and programs funded under the Family Violence Prevention and Services Act. More specifically, the rule enhances accessibility and non-discrimination provisions, clarifies confidentiality rules, promotes coordination among community-based organizations, State Domestic Violence Coalitions, States, and Tribes, as well as incorporates new discretionary grant programs. Furthermore, the rule updates existing regulations to reflect statutory changes made to the Family Violence Prevention and Services Act, and updates procedures for soliciting and awarding grants. The rule also increases clarity and reduces potential confusion over statutory and regulatory standards. The rule codifies standards already used by the program in the Funding Opportunity Announcements and awards, in technical assistance, in reporting requirements, and in sub-regulatory guidance.

  15. Behavioral Counseling to Prevent Skin Cancer

    Science.gov (United States)

    Understanding Task Force Recommendations Behavioral Counseling to Prevent Skin Cancer The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Behavioral Counseling ...

  16. Partner Services in STD Prevention Programs: A Review

    Science.gov (United States)

    Hogben, Matthew; Collins, Dayne; Hoots, Brooke; O’Connor, Kevin

    2015-01-01

    Background Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this paper, we review current literature with the goal of informing STD prevention programs. Methods We searched the literature for systematic reviews. We found nine reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, infections). We abstracted major conclusions and recommendations from the reviews. Results Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well-supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. Conclusions Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. STD prevention needs program-level research and development to generate this portfolio. PMID:26779688

  17. 78 FR 63208 - UPDATE-Meeting of the Community Preventive Services Task Force (Task Force)

    Science.gov (United States)

    2013-10-23

    ... healthy longevity, save lives and dollars and improve Americans' quality of life. CDC is mandated to...-governmental organizations, and at all levels of government can choose what best meets the needs, preferences... making about policy, practice, and research in a wide range of U.S. settings. Matters to be discussed...

  18. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    Directory of Open Access Journals (Sweden)

    Simbaya Joseph

    2010-09-01

    Full Text Available Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural, to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART and prevention of mother to child transmission (PMTCT per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of

  19. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    LENUS (Irish Health Repository)

    Walsh, Aisling

    2010-09-17

    Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV\\/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses\\/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV\\/AIDS service delivery has been on the back of sustained non

  20. Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review.

    Science.gov (United States)

    Zijlstra, A; Ufkes, T; Skelton, D A; Lundin-Olsson, L; Zijlstra, W

    2008-01-01

    The Prevention of Falls Network Europe (ProFaNE) aims to bring together European researchers and clinicians to focus on the development of effective falls prevention programs for older people. One of the objectives is to identify suitable balance assessment tools. Assessment procedures that combine a balance task with a cognitive task may be relevant since part of all falls occurs during dual-task performance of walking or other balance activities. To evaluate whether dual-task balance assessments are more sensitive than single balance tasks in predicting falls and detecting changes in balance performance after fall interventions. A systematic literature search was performed in the databases PubMed, EMBASE, CINAHL, AMED, PsycINFO and Cochrane. Articles were selected according to the following inclusion criteria: (1) population: older adults (mean age > or =65 years), (2) assessment tool: dual task combining gait or other balance task with a cognitive task, (3) design: prospective or retrospective data collection of falls, or intervention study. Analysis of papers focused on measures of predictive ability or sensitivity-to-change for both tasks during dual-task performance as well as for the single balance and cognitive task. Out of 114 dual-task studies in older people, 19 articles matched the inclusion criteria. Fourteen studies had sample sizes of 60 subjects or less; the studied populations, task combinations as well as other methodological aspects varied. None of the articles reported the same statistical measures for both tasks during dual-task performance as well as single balance and cognitive task. In two studies with prospective data collection of falls, higher odds ratios were found for the dual compared to the single balance task. Upon the available literature, conclusions for an added value of dual balance tasks for fall prediction or assessing fall intervention effects cannot be made due to incomplete comparisons of single and dual balance tasks

  1. Service task partition and distribution in star topology computer grid subject to data security constraints

    International Nuclear Information System (INIS)

    Xiang Yanping; Levitin, Gregory

    2011-01-01

    The paper considers grid computing systems in which the resource management systems (RMS) can divide service tasks into execution blocks (EBs) and send these blocks to different resources. In order to provide a desired level of service reliability the RMS can assign the same blocks to several independent resources for parallel execution. The data security is a crucial issue in distributed computing that affects the execution policy. By the optimal service task partition into the EBs and their distribution among resources, one can achieve the greatest possible service reliability and/or expected performance subject to data security constraints. The paper suggests an algorithm for solving this optimization problem. The algorithm is based on the universal generating function technique and on the evolutionary optimization approach. Illustrative examples are presented. - Highlights: → Grid service with star topology is considered. → An algorithm for evaluating service reliability and data security is presented. → A tradeoff between the service reliability and data security is analyzed. → A procedure for optimal service task partition and distribution is suggested.

  2. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  3. Integrating cervical cancer screening and preventive treatment with family planning and HIV-related services.

    Science.gov (United States)

    White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia

    2017-07-01

    Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  4. Primary Prevention Programs for Children in the Social Service System.

    Science.gov (United States)

    Ruffolo, Mary C.; Evans, Mary E.; Lukens, Ellen P.

    2003-01-01

    This paper presents the prevalence and incidence of children in need of social services due to child maltreatment, child poverty, parental incarceration, parental substance abuse problems, and homelessness. Examines early childhood family education and family support approaches in primary prevention designed to meet the needs of these children.…

  5. Current practice of adolescent preventive services among paediatric ...

    African Journals Online (AJOL)

    The provision of adolescent preventive services (APS) is imperative globally among clinicians, especially paediatricians.[1] Adolescents are at a developmental stage that is characterised by experimentation and risk-taking owing to their emerging cognitive abilities and social experiences.[1,2] They are therefore vulnerable ...

  6. Migrant's access to preventive health services in five EU countries.

    Science.gov (United States)

    Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia

    2017-08-23

    Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing

  7. Disabled persons' knowledge of HIV prevention and access to health care prevention services in South Africa.

    Science.gov (United States)

    Eide, Arne Henning; Schür, Clare; Ranchod, Chitra; Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite

    2011-12-01

    The main research question in this article is how access to information about HIV/AIDS and level of HIV/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed that gender and level of education, together with geographical differences, are key predictors for access to information and knowledge about HIV/AIDS among disabled people. For male respondents number of information sources predicts access to voluntary counselling and testing services and HIV testing, while knowledge about prevention predicts access to Voluntary Counselling and Testing centres. Significant gender differences with regards to information, knowledge and access to services highlight the need for gender specific prevention strategies among disabled people.

  8. An Ounce of Prevention: A Survey of Preventive Service Programs Contracted by New York City Special Services for Children.

    Science.gov (United States)

    Amlung, Susan, Ed.

    A survey of 47 New York City programs designed to provide preventive services to high risk families and children was undertaken through mailback collection forms, onsite interviews, and case record readings. Among findings were that data in the applications and monthly reports were incomplete and inconsistent; operational definitions of prevention…

  9. Increasing Customer Service Behaviors Using Manager-Delivered Task Clarification and Social Praise

    Science.gov (United States)

    Rice, Anna; Austin, John; Gravina, Nicole

    2009-01-01

    This project assessed an intervention to improve employee customer service behaviors (correct greetings and closing behaviors). A combination of task clarification and manager-delivered social praise resulted in increased correct greeting from 11.5% to 66% and correct closing from 8% to 70%. The effect was maintained at a 48-week follow-up for…

  10. Skills Issues in Other Business Services: Professional Services. Skills Task Force Research Paper 16.

    Science.gov (United States)

    Penn, Roger; Holt, Richard

    "Creative business services" have grown rapidly in Great Britain and are important in terms of their impact on the economy, including their contribution to international trade. They have helped and been boosted by such business changes as privatization, spread of information technology (IT), and contracting out of services. The sectors…

  11. Efficient targeting of homelessness prevention services for families.

    Science.gov (United States)

    Shinn, Marybeth; Greer, Andrew L; Bainbridge, Jay; Kwon, Jonathan; Zuiderveen, Sara

    2013-12-01

    We developed and evaluated a model to target homelessness prevention services to families more efficiently. We followed 11,105 families who applied for community-based services to prevent homelessness in New York City from October 1, 2004, to June 30, 2008, through administrative records, using Cox regression to predict shelter entry. Over 3 years, 12.8% of applicants entered shelter. Both the complete Cox regression and a short screening model based on 15 risk factors derived from it were superior to worker judgments, with substantially higher hit rates at the same level of false alarms. We found no evidence that some families were too risky to be helped or that specific risk factors were particularly amenable to amelioration. Despite some limitations, an empirical risk model can increase the efficiency of homelessness prevention services. Serving the same proportion of applicants but selecting those at highest risk according to the model would have increased correct targeting of families entering shelter by 26% and reduced misses by almost two thirds. Parallel models could be developed elsewhere.

  12. Service Users Facing Household Challenges : Their Experiences with Task-Centered Coping Approach

    Directory of Open Access Journals (Sweden)

    Rita Elisabeth Eriksen

    2015-03-01

    Full Text Available This article is based on a study of an educational and developmental programme, in which the task-centred coping approach (TCCA was a central part. Twenty social worker practitioners from Norwegian municipal social services (MSS participated in the programme, and practiced TCCA with 74 of their service users. The aim of the study was to develop knowledge about how service users evolve their housing competence by utilizing TCCA.The study was based on a way of participatory action research, in which the researcher was positioned as a partly participating researcher. The researcher tried to attain knowledge from the individualized activities of the service users and the practitioners, and use this knowledge as a contribution to developing their practice and the programme. User participation was one of the cornerstones of the study, and individualization meant matching the approaches of the practitioners to the experienced needs of the individual service user.

  13. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

    Science.gov (United States)

    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

  14. Nurse task shifting for antiretroviral treatment services in Namibia: implementation research to move evidence into action.

    Directory of Open Access Journals (Sweden)

    Gabrielle O'Malley

    Full Text Available Evidence from several sub-Saharan countries support nurse-initiated antiretroviral treatment as a feasible alternative to doctor-led models characteristic of early responses to the HIV epidemic. However, service delivery models shown to be effective in one country may not be readily adopted in another. This study used an implementation research approach to assist policy makers and other stakeholders to assess the acceptability and feasibility of task shifting in the Namibian context.The Namibian Ministry of Health and Social Services implemented a Task Shifting Demonstration Project (TSDP at 9 sites at different levels of the health system. Six months after implementation, a mixed methods evaluation was conducted. Seventy semi-structured interviews were conducted with patients, managers, doctors and nurses directly involved with the TSDP. Physician-evaluators observed and compared health service provision between doctors and nurses for 40 patients (80 observations, documenting performance in agreement with the national guidelines on 13 clinical care indicators.Doctors, nurses, and patients interviewed believed task shifting would improve access to and quality of HIV services. Doctors and nurses both reported an increase in nurses' skills as a result of the project. Observation data showed doctors and nurses were in considerable agreement (>80% with each other on all dimensions of HIV care and ≥90% on eight dimensions. To ensure success of national scale-up of the task shifting model, challenges involving infrastructure, on-going mentoring, and nursing scope of practice should be anticipated and addressed.In combination with findings from other studies in the region, data from the TSDP provided critical and timely information to the Namibian Ministry of Health and Social Services, thus helping to move evidence into action. Small-scale implementation research projects enable stakeholders to learn by doing, and provide an opportunity to test and

  15. The baby or the bath water? Lessons learned from the National Action Alliance for Suicide Prevention Research Prioritization Task Force literature review.

    Science.gov (United States)

    Davis Molock, Sherry; Heekin, Janet M; Matlin, Samantha G; Barksdale, Crystal L; Gray, Ekwenzi; Booth, Chelsea L

    2014-09-01

    The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a comprehensive literature review of suicide prevention/intervention trials to assess the quality of the scientific evidence. A literature "review of reviews" was conducted by searching the most widely used databases for mental health and public health research. The quality of the reviews was evaluated using the Revised Assessment of Multiple Systematic Reviews system; the quality of the scientific evidence for the suicide preventions/interventions was assessed using U.S. Preventive Services Task Force criteria. The reviews were limited to peer-reviewed publications with human subjects published in English. Ninety-eight systematic reviews and 45 primary sources on suicide prevention/interventions published between January 2000 and September 2012 were evaluated. The results suggest that the quality of both the systematic reviews and the scientific evidence for suicide preventions/interventions were mixed. The majority of the systematic reviews and prevention/interventions were evaluated as fair to poor in quality. There are many promising suicide prevention/intervention trials, but research findings are often inconclusive because of methodologic problems. Methodologic problems across systematic reviews include not conducting hand searches, not surveying gray literature, and being unable to aggregate data across studies. Methodologic problems with the scientific quality of the prevention/intervention trials include paucity of information on sample demographic characteristics, poorly defined outcomes, and excluding actively suicidal participants. Suggestions for ways to improve the quality of the systematic reviews and suicide preventions/interventions are provided. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

  16. Current situation and future tasks for psychiatric services in Japanese prisons.

    Science.gov (United States)

    Nomura, Toshiaki

    2009-08-01

    I outline the current situation and future tasks for psychiatric services in Japanese prisons. I describe the provision of facilities specializing in psychiatric services, preparation of legal aspects related to involuntary treatment, provision of therapeutic educational programs regarding addictive crimes, and the measures required for continuation of treatment after release from prison. I also discuss how, in the current system, under the "Act on Mental Care and Treatment for Persons who have Caused Serious Cases under the Condition of Insanity," unfairness arises in the treatment of mentally disordered offenders, requiring a division between medical care and justice (correctional institutions).

  17. A Web Service Protocol Realizing Interoperable Internet of Things Tasking Capability

    Science.gov (United States)

    Huang, Chih-Yuan; Wu, Cheng-Hung

    2016-01-01

    The Internet of Things (IoT) is an infrastructure that interconnects uniquely-identifiable devices using the Internet. By interconnecting everyday appliances, various monitoring, and physical mashup applications can be constructed to improve human’s daily life. In general, IoT devices provide two main capabilities: sensing and tasking capabilities. While the sensing capability is similar to the World-Wide Sensor Web, this research focuses on the tasking capability. However, currently, IoT devices created by different manufacturers follow different proprietary protocols and are locked in many closed ecosystems. This heterogeneity issue impedes the interconnection between IoT devices and damages the potential of the IoT. To address this issue, this research aims at proposing an interoperable solution called tasking capability description that allows users to control different IoT devices using a uniform web service interface. This paper demonstrates the contribution of the proposed solution by interconnecting different IoT devices for different applications. In addition, the proposed solution is integrated with the OGC SensorThings API standard, which is a Web service standard defined for the IoT sensing capability. Consequently, the Extended SensorThings API can realize both IoT sensing and tasking capabilities in an integrated and interoperable manner. PMID:27589759

  18. A Web Service Protocol Realizing Interoperable Internet of Things Tasking Capability.

    Science.gov (United States)

    Huang, Chih-Yuan; Wu, Cheng-Hung

    2016-08-31

    The Internet of Things (IoT) is an infrastructure that interconnects uniquely-identifiable devices using the Internet. By interconnecting everyday appliances, various monitoring, and physical mashup applications can be constructed to improve human's daily life. In general, IoT devices provide two main capabilities: sensing and tasking capabilities. While the sensing capability is similar to the World-Wide Sensor Web, this research focuses on the tasking capability. However, currently, IoT devices created by different manufacturers follow different proprietary protocols and are locked in many closed ecosystems. This heterogeneity issue impedes the interconnection between IoT devices and damages the potential of the IoT. To address this issue, this research aims at proposing an interoperable solution called tasking capability description that allows users to control different IoT devices using a uniform web service interface. This paper demonstrates the contribution of the proposed solution by interconnecting different IoT devices for different applications. In addition, the proposed solution is integrated with the OGC SensorThings API standard, which is a Web service standard defined for the IoT sensing capability. Consequently, the Extended SensorThings API can realize both IoT sensing and tasking capabilities in an integrated and interoperable manner.

  19. Mobile task management tool that improves workflow of an acute general surgical service.

    Science.gov (United States)

    Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon

    2015-10-01

    Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.

  20. Use of Six Sigma for eliminating missed opportunities for prevention services.

    Science.gov (United States)

    Gittner, LisaAnn S; Husaini, Baqar A; Hull, Pamela C; Emerson, Janice S; Tropez-Sims, Suzanne; Reece, Michelle C; Zoorob, Roger; Levine, Robert S

    2015-01-01

    Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. Missed preventative service opportunities were compared in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3% in the community clinic. Preventative services can be enhanced to Six Sigma quality when the nurse executive and medical staff agree on a single standard of nursing care executed via standing orders.

  1. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    Science.gov (United States)

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Designing Insurance to Promote Use of Childhood Obesity Prevention Services

    Directory of Open Access Journals (Sweden)

    Kimberly J. Rask

    2013-01-01

    Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

  3. Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.

    Science.gov (United States)

    Passfield, Juanine; Nielsen, Ilsa; Brebner, Neil; Johnstone, Cara

    2017-07-24

    Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services. Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement. Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated. Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate. What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to

  4. Provision of diagnostic and preventive services in general dental practice.

    Science.gov (United States)

    Brennan, D S; Spencer, A J

    2003-03-01

    Diagnosis and prevention are among the most frequently provided services in Australian private general dental practice, and have increased over recent times. The aims of this study were to examine the provision of examinations, radiographs, prophylaxis and topical fluoride, and to assess whether these services varied by patient, visit and oral health characteristics. Data were collected by a mailed survey of a random sample of dentists from each State/Territory in Australia in 1998-99 with a response rate of 71%. Data were collected from a log of service items provided on a typical day. Multivariate analyses of services showed that emergency visits were associated with higher rates [RR = Rate ratio, 95%CI] of radiographs (RR = 1.32, 1.06-1.66) but lower rates of prophylaxis (RR = 0.37, 0.29-0.48) and topical fluoride (RR = 0.20, 0.08-0.47) compared to non-emergency visits. Capital city patients had a higher rate of topical fluoride (RR = 2.06, 1.17-3.64) services than non-capital city patients. Patients with decayed teeth had a lower rate of prophylaxis services (RR = 0.82, 0.68-0.99) than patients with no decay. Compared to the reference of caries, patients with aesthetic problems had lower rates of radiographs (RR = 0. 19, 0.08-0.47) and topical fluoride (RR = 0.24, 0.08-0.71), those with cuspal fracture/failed restoration also had lower rates of radiographs (RR = 0.54, 0.37-0.80) and topical fluoride (RR = 0.52, 0.28-0.95), those with denture problems had lower rates of examinations (RR = 0.53, 0.32-0.87), radiographs (RR = 0.05, 0.01-0.28), prophylaxis (RR = 0.13, 0.04-0.37) and topical fluoride (RR = 0.04, 0.01-0.32), those with periodontal disease had higher rates of examinations (RR = 1.45, 1.13-1.85) and prophylaxis (RR = 2.39, 1.79-3.19), those with pulpal/periapical infection had lower rates of examination (RR = 0.55, 0.42-0.74) and prophylaxis (RR = 0.36, 0.19-0.66), but higher rates of radiographs (RR = 1.92, 1.48-2.50), those with recall

  5. Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.

    Science.gov (United States)

    Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard

    2016-01-01

    This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.

  6. CHANGE@CERN:Task Force 3: adjusting services to future needs

    CERN Multimedia

    2002-01-01

    We continue our articles on the Task Force reports The number of craftsmen and technicians could be increased with a change in the staff composition. The mandate for Task Force 3 was to make proposals for savings and new cost control procedures in the area of Industrial Support and Contracts for the period until 2009. The aim, explains the convenor, Karl-Heinz Kissler, was to keep spending under control under difficult conditions when staff numbers are decreasing and the work for the LHC becomes more demanding. The measures proposed, if implemented, could lead to savings of around 170 MCHF. The proposals involve both Industrial Services contracts, which were discussed in the Bulletin of the 22nd of April (n°17/2002) and readjustments for staff at CERN, on which we concentrate here. As with other Task Forces the principle aim was to be able to refocus resources onto the LHC project. In this respect, Task Force 3 could work within the framework of the revised programme for the LHC and the reduced non-LHC pro...

  7. Towards Service Robots for Everyday Environments Recent Advances in Designing Service Robots for Complex Tasks in Everyday Environments

    CERN Document Server

    Zöllner, Marius; Bischoff, Rainer; Burgard, Wolfram; Haschke, Robert; Hägele, Martin; Lawitzky, Gisbert; Nebel, Bernhard; Plöger, Paul; Reiser, Ulrich

    2012-01-01

    People have dreamed of machines, which would free them from unpleasant, dull, dirty and dangerous tasks and work for them as servants, for centuries if not millennia. Service robots seem to finally let these dreams come true. But where are all these robots that eventually serve us all day long, day for day? A few service robots have entered the market: domestic and professional cleaning robots, lawnmowers, milking robots, or entertainment robots. Some of these robots look more like toys or gadgets rather than real robots. But where is the rest? This is a question, which is asked not only by customers, but also by service providers, care organizations, politicians, and funding agencies. The answer is not very satisfying. Today’s service robots have their problems operating in everyday environments. This is by far more challenging than operating an industrial robot behind a fence. There is a comprehensive list of technical and scientific problems, which still need to be solved. To advance the state of the art...

  8. Tools for in service monitoring and testing of riser to prevent failure and extend service life

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)

    2005-07-01

    Exploration and development of new oil and gas fields is heavily dependant on use of flexible pipes and many field developments would not have been possible without them. The number of flexible risers in service is constantly increasing since relatively few offshore projects have reached the estimated operational life and the operational lifetime of several fields in-service has been extended due to new and improved technology. Many risers have been in service over a large number of years. Some risers have been operated under demanding conditions such as severe dynamic loads, high pressure and temperatures. One may in some cases find that risers actually have shorter service life than estimated in the design phase due to the severe operational conditions. In order to extend the use of the riser, some risers may have to be modified and re-terminated and prepared for a new and less demanding application. In order to operate risers safely, it is important to re-assess the fatigue life in order to prevent potential riser failure. The operator should implement methods and tools for in-service monitoring and testing. This paper addresses efficient and reliable methods and tools for monitoring of critical operational parameters as well as in-service riser testing. A brief description of structural failure modes will also be given in order to understand how to interpret test results in view of potential failure modes. (author)

  9. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure

  10. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  11. Purpose in life and use of preventive health care services.

    Science.gov (United States)

    Kim, Eric S; Strecher, Victor J; Ryff, Carol D

    2014-11-18

    Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08-1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99-1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16-1.39) or pap smear (OR = 1.16, 95% CI = 1.06-1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18-1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77-0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society.

  12. Purpose in life and use of preventive health care services

    Science.gov (United States)

    Kim, Eric S.; Strecher, Victor J.; Ryff, Carol D.

    2014-01-01

    Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08–1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99–1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16–1.39) or pap smear (OR = 1.16, 95% CI = 1.06–1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18–1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77–0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society. PMID:25368165

  13. Service-provider and utility task-leadership integration. Paper D

    Energy Technology Data Exchange (ETDEWEB)

    Bagshaw, S.; Van Tassell, D. [AP Services, Inc., Freeport, PA (United States)

    2011-07-01

    As nuclear power utilities strive to stream-line their organizations, while improving outage and refurbishment project performance, the necessity for effective relationships and interaction between utility and service-providers becomes paramount. Successful integration of Service-Provider into the Utility's environment is achievable and has been demonstrated. Early and extensive engagement in front-end planning, single-point-of-continuity, and the use of integrated execution teams, are some of the critical elements for ensuring success. The paper discusses Task-Leadership Integration at the three levels of; utility executive level 'need-statement'; a 'why is this important' discussion; and as a 'thoughtful tutorial' on its features and practice. (author)

  14. Measuring quality of dental care: Caries prevention services for children.

    Science.gov (United States)

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  15. ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task

    OpenAIRE

    Pollard, Christine D.; Sigward, Susan M.; Powers, Christopher M.

    2017-01-01

    Background: Injury prevention training has been shown to be effective in reducing the incidence of noncontact anterior cruciate ligament (ACL) injury; however, the underlying reason for the success of these training programs is unclear. Purpose: To investigate whether an ACL injury prevention program that has been shown to reduce the incidence of ACL injury alters sagittal plane hip and knee biomechanics during a drop-landing task. Study Design: Descriptive laboratory study. Methods: Thirty f...

  16. A case of community-based fall prevention: Survey of organization and content of minor home help services in Swedish municipalities.

    Science.gov (United States)

    Bernfort, Lars; Eckard, Nathalie; Husberg, Magnus; Alwin, Jenny

    2014-11-01

    The aim of this study was to survey minor home help services provided by Swedish municipalities with the main purpose to prevent fall injuries. If minor home help services were presented on the homepage of a municipality, an initial telephone contact was taken. Thereafter a questionnaire was administered, including questions about target groups, aim with the services, tasks included, costs and restrictions for users, budget, and experienced gains with the services. Municipalities not providing minor home help services were asked about the reason therefore and if the municipality had previously provided the services Results: The questionnaire response rate was 92%. In 191 of Sweden's 290 municipalities services were provided by, or in cooperation with, the municipality. Reasons for not providing the services were mainly financial and lack of demand. Services were more often provided in larger cities and in municipalities located in populous regions. In some municipalities services were performed by persons with functional disabilities or unemployed persons. Both providers and users expressed satisfaction with the services aspects expressed were that services lead to greater sense of safety and social gains the effect of the services in terms of fall prevention is yet to be proved with only a small fall-preventive effect services are probably cost-effective improved quality of life, sense of safety, and being able to offer meaningful work to otherwise unemployed persons are important aspects that might in themselves motivate the provision of minor home help services. © 2014 the Nordic Societies of Public Health.

  17. Guide to DCP Study Close-Out: Milestones and Tasks | Division of Cancer Prevention

    Science.gov (United States)

    This guide assists Consortium Lead Organization (CLO) planning for DCP study close-out. Study close-out tasks are organized under milestones, which help mark progress toward completion of the close-out process. Once tasks associated with a milestone are underway, planning for the next milestone may begin. Click on a milestone to view the associated close-out tasks. |

  18. Urban–rural disparity in utilization of preventive care services in China

    Science.gov (United States)

    Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

    2016-01-01

    Abstract Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban–rural disparity in utilization of preventive care services in China, and determined how much of the urban–rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder–Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban–rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (−1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services

  19. Urban-rural disparity in utilization of preventive care services in China.

    Science.gov (United States)

    Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

    2016-09-01

    Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between

  20. Preventing Dental Caries in Children from Birth Through Age Five Years

    Science.gov (United States)

    Understanding Task Force Recommendations Preventing Dental Caries in Children from Birth Through Age Five Years The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement ...

  1. Prevention of Substance Abuse in the Workplace: Review of Research on the Delivery of Services.

    Science.gov (United States)

    Cook, Royer; Schlenger, William

    2002-01-01

    This paper discusses some of the chief reasons for engaging in substance abuse prevention in the workplace; outlines the foundations of workplace prevention services; and reviews recent research on workplace substance abuse prevention, including the major preventive interventions aimed at the workplace environment and the individual worker.…

  2. Socially-assigned race, healthcare discrimination and preventive healthcare services.

    Directory of Open Access Journals (Sweden)

    Tracy Macintosh

    Full Text Available Race and ethnicity, typically defined as how individuals self-identify, are complex social constructs. Self-identified racial/ethnic minorities are less likely to receive preventive care and more likely to report healthcare discrimination than self-identified non-Hispanic whites. However, beyond self-identification, these outcomes may vary depending on whether racial/ethnic minorities are perceived by others as being minority or white; this perception is referred to as socially-assigned race.To examine the associations between socially-assigned race and healthcare discrimination and receipt of selected preventive services.Cross-sectional analysis of the 2004 Behavioral Risk Factor Surveillance System "Reactions to Race" module. Respondents from seven states and the District of Columbia were categorized into 3 groups, defined by a composite of self-identified race/socially-assigned race: Minority/Minority (M/M, n = 6,837, Minority/White (M/W, n = 929, and White/White (W/W, n = 25,913. Respondents were 18 years or older, with 61.7% under age 60; 51.8% of respondents were female. Measures included reported healthcare discrimination and receipt of vaccinations and cancer screenings.Racial/ethnic minorities who reported being socially-assigned as minority (M/M were more likely to report healthcare discrimination compared with those who reported being socially-assigned as white (M/W (8.9% vs. 5.0%, p = 0.002. Those reporting being socially-assigned as white (M/W and W/W had similar rates for past-year influenza (73.1% vs. 74.3% and pneumococcal (69.3% vs. 58.6% vaccinations; however, rates were significantly lower among M/M respondents (56.2% and 47.6%, respectively, p-values<0.05. There were no significant differences between the M/M and M/W groups in the receipt of cancer screenings.Racial/ethnic minorities who reported being socially-assigned as white are more likely to receive preventive vaccinations and less likely to report

  3. Study on the methodology for predicting and preventing errors to improve reliability of maintenance task in nuclear power plant

    International Nuclear Information System (INIS)

    Hanafusa, Hidemitsu; Iwaki, Toshio; Embrey, D.

    2000-01-01

    The objective of this study was to develop and effective methodology for predicting and preventing errors in nuclear power plant maintenance tasks. A method was established by which chief maintenance personnel can predict and reduce errors when reviewing the maintenance procedures and while referring to maintenance supporting systems and methods in other industries including aviation and chemical plant industries. The method involves the following seven steps: 1. Identification of maintenance tasks. 2. Specification of important tasks affecting safety. 3. Assessment of human errors occurring during important tasks. 4. Identification of Performance Degrading Factors. 5. Dividing important tasks into sub-tasks. 6. Extraction of errors using Predictive Human Error Analysis (PHEA). 7. Development of strategies for reducing errors and for recovering from errors. By way of a trial, this method was applied to the pump maintenance procedure in nuclear power plants. This method is believed to be capable of identifying the expected errors in important tasks and supporting the development of error reduction measures. By applying this method, the number of accidents resulting form human errors during maintenance can be reduced. Moreover, the maintenance support base using computers was developed. (author)

  4. A robust certification service for highly dynamic MANET in emergency tasks

    DEFF Research Database (Denmark)

    Ge, M; Lam, K Y; Gollmann, Dieter

    2009-01-01

    mechanisms. In this paper, we tackle issues critical to asymmetric key management in MANET, which almost invariably serves as a basis of security services in a network environment. To address the deficiencies of existing key management schemes, we propose the concept of mission-specific certificate to manage......In emergency tasks, cross-agency operations being carried out in disaster-hit areas require some supporting communication system for command and control. Mobile Ad hoc Network (MANET) is a very suitable way to meet such communication requirements since it can function without any pre......-installed communication infrastructure. Owing to potential threats in the field environment and the unique features of MANET (e.g. the open nature of wireless links and the absence of security infrastructure), security of communications over MANET is a serious issue that is typically addressed by asymmetric cryptographic...

  5. Preventing Suicide in Prisons, Part I Recommendations fromthe International Association for Suicide Prevention Task Force on Suicide in Prisons

    NARCIS (Netherlands)

    Konrad, N.; Daigle, M.S.; Daniel, A.E.; Dear, G.E.; Frottier, P.; Hayes, L.M.; Kerkhof, A.J.F.M.; Liebling, A.; Sarchiapone, M.

    2007-01-01

    In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more

  6. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... Act Expands Prevention Coverage for Women’s Health and Well-Being The Affordable Care Act – the health insurance reform ... preventive services are necessary for women’s health and well-being and therefore should be considered in the development ...

  7. Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service.

    Science.gov (United States)

    Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

    2015-01-01

    Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists). It is incumbent upon clinical directors (CDs) and health service managers (HSMs) to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1) explore CDs' and HSMs' perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2) record the strategies they have utilized to help therapists provide preventive care to adolescents. In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists' ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric dental specialists and working with local health district clinical leaders would be a practical way to improve models of preventive oral health care for adolescents. The main issue raised in this study is that preventive dentistry per se lacks strong support from the central funding agency, and that increasing prevention activities is not a simple

  8. Evaluating Efficiencies in Preventive Medicine: Comparing Approaches Between the Services

    Science.gov (United States)

    2016-02-29

    assigned to Marine units; and support to Navy and Marine units from hospital , clinical, and preventive medicine units.41 Also similar to the Army...biohazards, safety, respiratory protection, hazard controls, and ergonomics .113 Moreover, they are responsible for the detection, assessment, and...Preventive Medicine Technicians Preventive Medicine Technicians are unique in how they become qualified. They begin their careers as Hospital

  9. The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy.

    Science.gov (United States)

    Thurman, David J; Begley, Charles E; Carpio, Arturo; Helmers, Sandra; Hesdorffer, Dale C; Mu, Jie; Touré, Kamadore; Parko, Karen L; Newton, Charles R

    2018-04-10

    Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke. Applying consistent criteria, we assessed the quality of each study and extracted data on measures of risk from those with adequate quality ratings, summarizing findings across studies as medians and interquartile ranges. Among higher-quality population-based studies, the median prevalence of active epilepsy across all ages was 11.1 per 1000 population in lower- and middle-income countries (LMIC) and 7.0 per 1000 in high-income countries (HIC). Perinatal brain insults were the largest attributable fraction of preventable etiologies in children, with median estimated fractions of 17% in LMIC and 15% in HIC. Stroke was the most common preventable etiology among older adults with epilepsy, both in LMIC and in HIC, accounting for half or more of all new onset cases. TBI was the attributed cause in nearly 5% of epilepsy cases in HIC and LMIC. CNS infections were a more common attributed cause in LMIC, accounting for about 5% of all epilepsy cases. Among some rural LMIC communities, the median proportion of epilepsy cases attributable to endemic neurocysticercosis was 34%. A large proportion of the overall public health burden of epilepsy is attributable to preventable causes. The attributable fraction for perinatal causes, infections, TBI, and stroke in sum reaches nearly 25% in both LMIC and HIC. Public health interventions addressing maternal and child health care, immunizations, public sanitation, brain injury prevention, and stroke prevention have the potential to significantly reduce the burden of epilepsy. Wiley Periodicals, Inc.

  10. 75 FR 4051 - Defense Health Board; DoD Task Force on the Prevention of Suicide by Members of the Armed Forces...

    Science.gov (United States)

    2010-01-26

    ... of the Secretary Defense Health Board; DoD Task Force on the Prevention of Suicide by Members of the Armed Forces; Meeting AGENCY: Department of Defense (DoD). ACTION: Notice of meeting. ] SUMMARY...)(2) of Public Law, the DoD Task Force on the Prevention of Suicide by Members of the Armed Forces...

  11. Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

    2014-06-12

    This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services.

  12. Introduction and Overview: Prevention Services--From Optimistic Promise to Widespread, Effective Practice.

    Science.gov (United States)

    Weissberg, Roger P.; Kuster, Carol Bartels; Gullotta, Thomas P.

    This opening chapter provides an overview of the book, "Healthy Children 2010: Establishing Preventive Services." The article describes the purpose of the work, which is to provide strategies to establish and successfully implement effective prevention services in key socializing settings that powerfully affect the growth an development…

  13. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    Science.gov (United States)

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  14. Preventive family service coordination for parents with a mental illness in the Netherlands

    NARCIS (Netherlands)

    Wansink, H.J.; Hosman, C.M.H.; Janssens, J.M.A.M.; Hoencamp, E.; Willems, W.J.H.

    2014-01-01

    TOPIC: The Preventive Basic Care Management (PBCM) program is a Dutch service coordination program for parents with mental illnesses, which focuses on organizing tailored support from various services for parents and their children from a preventive perspective. PURPOSE: The article discusses our

  15. Policy Framework for Covering Preventive Services Without Cost Sharing: Saving Lives and Saving Money?

    Science.gov (United States)

    Chen, Stephanie C; Pearson, Steven D

    2016-08-01

    The US Affordable Care Act mandates that private insurers cover a list of preventive services without cost sharing. The list is determined by 4 expert committees that evaluate the overall health effect of preventive services. We analyzed the process by which the expert committees develop their recommendations. Each committee uses different criteria to evaluate preventive services and none of the committees consider cost systematically. We propose that the existing committees adopt consistent evidence review methodologies and expand the scope of preventive services reviewed and that a separate advisory committee be established to integrate economic considerations into the final selection of free preventive services. The comprehensive framework and associated criteria are intended to help policy makers in the future develop a more evidence-based, consistent, and ethically sound approach.

  16. Change Best.Task 2.1. National Report on the Energy Efficiency Service Business in Italy

    International Nuclear Information System (INIS)

    Sabbatucci, N.; Labanca, N.

    2009-05-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses Task 2.1: National Report on the Energy Efficiency Service Business in Italy. More information can be found on the website of Change Best at www.changebest.eu.

  17. Change Best.Task 2.1. National Report on the Energy Efficiency Service Business in the Netherlands

    International Nuclear Information System (INIS)

    Boonekamp, P.; Vethman, P.

    2009-11-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses Task 2.1: National Report on the Energy Efficiency Service Business in the Netherlands. More information can be found on the website of Change Best at www.changebest.eu.

  18. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Substance abuse prevention and treatment services... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining... substance abuse prevention and treatment Block Grant, an Indian tribe or tribal organization is not required...

  19. ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task.

    Science.gov (United States)

    Pollard, Christine D; Sigward, Susan M; Powers, Christopher M

    2017-09-01

    Injury prevention training has been shown to be effective in reducing the incidence of noncontact anterior cruciate ligament (ACL) injury; however, the underlying reason for the success of these training programs is unclear. To investigate whether an ACL injury prevention program that has been shown to reduce the incidence of ACL injury alters sagittal plane hip and knee biomechanics during a drop-landing task. Descriptive laboratory study. Thirty female club soccer players (age range, 11-17 years) with no history of knee injury participated in this study. Kinematics and ground-reaction forces were collected while each participant performed a drop-landing task prior to and immediately after participation in a 12-week ACL injury prevention training program. After ACL injury prevention training, participants demonstrated decreased knee extensor moments ( P = .03), increased energy absorption at the hip ( P = .04), decreased knee-to-hip extensor moment ratios ( P = .05), and decreased knee-to-hip energy absorption ratios ( P = .03). Participation in an ACL injury prevention training program decreased reliance on the knee extensor muscles and improved use of the hip extensor muscles, which may explain the protective effect of this type of training program on ACL injury. Based on these findings, clinicians can better understand how ACL injury prevention training, such as the Prevent Injury and Enhance Performance (PEP) Program, may change movement behavior at both the hip and knee. Furthermore, the study findings may support the implementation of the PEP Program, or a similar program, for clinicians aiming to improve use of the hip in an effort to reduce knee loading and consequent injuries.

  20. A systematic review of qualitative evidence on barriers and facilitators to the implementation of task-shifting in midwifery services.

    Science.gov (United States)

    Colvin, Christopher J; de Heer, Jodie; Winterton, Laura; Mellenkamp, Milagros; Glenton, Claire; Noyes, Jane; Lewin, Simon; Rashidian, Arash

    2013-10-01

    to synthesise qualitative research on task-shifting to and from midwives to identify barriers and facilitators to successful implementation. systematic review of qualitative evidence using a 4-stage narrative synthesis approach. We searched the CINAHL, Medline and the Social Science Citation Index databases. Study quality was assessed and evidence was synthesised using a theory-informed comparative case-study approach. midwifery services in any setting in low-, middle-, and high-income countries. midwives, nurses, doctors, patients, community members, policymakers, programme managers, community health workers, doulas, traditional birth attendants and other stakeholders. task shifting to and from midwives. thirty-seven studies were included. Findings were organised under three broad themes: (1) challenges in defining and defending the midwifery model of care during task shifting, (2) training, supervision and support challenges in midwifery task shifting, and (3) teamwork and task shifting. this is the first review to report implementation factors associated with midwifery task shifting and optimisation. Though task shifting may serve as a powerful means to address the crisis in human resources for maternal and newborn health, it is also a complex intervention that generally requires careful planning, implementation and ongoing supervision and support to ensure optimal and safe impact. The unique character and history of the midwifery model of care often makes these challenges even greater. evidence from the review fed into the World Health Organisation's 'Recommendations for Optimizing Health Worker Roles to Improve Access to Key Maternal and Newborn Health Interventions through Task Shifting' guideline. It is appropriate to consider task shifting interventions to ensure wider access to safe midwifery care globally. Legal protections and liabilities and the regulatory framework for task shifting should be designed to accommodate new task shifted practices. © 2013

  1. Clients\\' Satisfaction With Services For Prevention Of Mother-To ...

    African Journals Online (AJOL)

    Objective: The study was conducted to assess clients' satisfaction with PMTCT services on privacy, waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. Methods: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services.

  2. Optimal utilization of outages. The tasks of the OEM and/or service provider

    International Nuclear Information System (INIS)

    Jakobs, Norbert; Grauf, Eberhard

    1998-01-01

    The deregulation of Europe's power market on January 1, 1999 will force many electric utilities and especially nuclear power plant operators to introduce extensive cost-cutting measures in order that they can hold their own in the new competitive environment. Existing plants basically have three potential ways of reducing their power generating costs: by increasing availability, reducing fuel costs and cutting back operating costs. Optimizing plant outages provides considerable potential for raising plant availability but can also lower operating costs by reducing expenditure on maintenance. In order to optimize an outage in terms of performance time and cost, there are a number of starting points based on certain key factors: organization, planning, logistics, performance monitoring, plant and equipment enhancements as well as personnel motivation. To reach this goal it is necessary for the original equipment manufacturer (OEM) and/or service provider to be involved in these activities to a much greater extent than before and for a closer form of partnership to be established with the consumer. For it is only within a team having a common set of goals that the successes of the past have been able to be achieved and new tasks can be efficiently handled in the future. (author)

  3. Astronaut James S. Voss Performs Task in the Russian Zvezda Service Module

    Science.gov (United States)

    2001-01-01

    Astronaut James S. Voss, Expedition Two flight engineer, performs an electronics task in the Russian Zvezda Service Module on the International Space Station (ISS). Zvezda is linked to the Russian-built Functional Cargo Block (FGB), or Zarya, the first component of the ISS. Zarya was launched on a Russian Proton rocket prior to the launch of Unity, the first U.S.-built component to the ISS. Zvezda (Russian word for star), the third component of the ISS and the primary Russian contribution to the ISS, was launched by a three-stage Proton rocket on July 12, 2000. Zvezda serves as the cornerstone for early human habitation of the station, providing living quarters, a life support system, electrical power distribution, a data processing system, a flight control system, and a propulsion system. It also provides a communications system that includes remote command capabilities from ground flight controllers. The 42,000-pound module measures 43 feet in length and has a wing span of 98 feet. Similar in layout to the core module of Russia's Mir space station, it contains 3 pressurized compartments and 13 windows that allow ultimate viewing of Earth and space.

  4. Developing Pre-Service Teacher Capacity to Make Appropriate Choices of Tasks and Resources through Diagnostic Assessment of Children's Work

    Science.gov (United States)

    Hurst, Chris

    2014-01-01

    This paper reports on one phase of a long-term project investigating mathematical content knowledge of pre-service teachers. A cohort of second year PSTs conducted a diagnostic assessment and a series of associated tutoring sessions with a primary aged child. The focus here is on the PSTs' ability to make appropriate task choices following the…

  5. The Effects of Task Clarification, Feedback, and Goal Setting on Student Advisors' Office Behaviors and Customer Service

    Science.gov (United States)

    Tittelbach, Danielle; DeAngelis, Maureen; Sturmey, Peter; Alvero, Alicia M.

    2007-01-01

    This study evaluated the effects of feedback, task clarification and goal-setting on office behaviors and customer service of ten undergraduate participants that served as university advisors. A multiple baseline design was implemented across three target behaviors: client greeting, front-desk behaviors, and punctuality. During intervention the…

  6. Rural, suburban, and urban differences in factors that impact physician adherence to clinical preventive service guidelines.

    Science.gov (United States)

    Khoong, Elaine C; Gibbert, Wesley S; Garbutt, Jane M; Sumner, Walton; Brownson, Ross C

    2014-01-01

    Rural-urban disparities in provision of preventive services exist, but there is sparse research on how rural, suburban, or urban differences impact physician adherence to clinical preventive service guidelines. We aimed to identify factors that may cause differences in adherence to preventive service guidelines among rural, suburban, and urban primary care physicians. This qualitative study involved in-depth semistructured interviews with 29 purposively sampled primary care physicians (10 rural, 10 suburban, 9 urban) in Missouri. Physicians were asked to describe barriers and facilitators to clinical preventive service guideline adherence. Using techniques from grounded theory analysis, 2 coders first independently conducted content analysis then reconciled differences in coding to ensure agreement on intended meaning of transcripts. Patient epidemiologic differences, distance to health care services, and care coordination were reported as prominent factors that produced differences in preventive service guideline adherence among rural, suburban, and urban physicians. Epidemiologic differences impacted all physicians, but rural physicians highlighted the importance of occupational risk factors in their patients. Greater distance to health care services reduced visit frequency and was a prominent barrier for rural physicians. Care coordination among health care providers was problematic for suburban and urban physicians. Patient resistance to medical care and inadequate access to resources and specialists were identified as barriers by some rural physicians. The rural, suburban, or urban context impacts whether a physician will adhere to clinical preventive service guidelines. Efforts to increase guideline adherence should consider the barriers and facilitators unique to rural, suburban, or urban areas. © 2013 National Rural Health Association.

  7. Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

    Science.gov (United States)

    Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

    2018-02-01

    Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services

  8. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services

    Science.gov (United States)

    ... received these screenings in the past 12 months. Definitions Blood pressure screening : Based on responses to the ... of service, such as accidents or dental care. Hypertension : To be classified with diagnosed hypertension, also called ...

  9. Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.

    Science.gov (United States)

    2015-07-14

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.

  10. Healthcare Professional Shortage and Task-Shifting to Prevent Cardiovascular Disease: Implications for Low- and Middle-Income Countries.

    Science.gov (United States)

    Tsolekile, Lungiswa Primrose; Abrahams-Gessel, Shafika; Puoane, Thandi

    2015-12-01

    Cardiovascular diseases (CVD) account for 18 million of annual global deaths with more than three quarters of these deaths occurring in low- and middle-income countries (LMIC). In LMIC, the distribution of risk factors is heterogeneous, with urban areas being the worst affected. Despite the availability of effective CVD interventions in developed countries, many poor countries still struggle to provide care due to lack of resources. In addition, many LMIC suffer from staff shortages which pose additional burden to the healthcare system. Regardless of these challenges, there are potentially effective strategies such as task-shifting which have been used for chronic conditions such as HIV to address the human resource crisis. We propose that through task-shifting, certain tasks related to prevention be shifted to non-physician health workers as well as non-nurse health workers such as community health workers. Such steps will allow better coverage of segments of the underserved population. We recognise that for task-shifting to be effective, issues such as clearly defined roles, evaluation, on-going training, and supervision must be addressed.

  11. Preventing Restricted Space Inference in Online Route Planning Services

    Directory of Open Access Journals (Sweden)

    Florian Dorfmeister

    2016-03-01

    Full Text Available Online route planning services compute routes from any given location to a desired destination address. Unlike offline implementations, they do so in a traffic-aware fashion by taking into consideration up-to-date map data and real-time traffic information. In return, users have to provide precise location information about a route’s endpoints to a not necessarily trusted service provider. As suchlike leakage of personal information threatens a user’s privacy and anonymity, this paper presents PrOSPR, a comprehensive approach for using current online route planning services in a privacy-preserving way, and introduces the concept of k-immune route requests to avert inference attacks based on restricted space information. Using a map-based approach for creating cloaked regions for the start and destination addresses, our solution queries the online service for routes between subsets of points from these regions. This, however, might result in the returned path deviating from the optimal route. By means of empirical evaluation on a real road network, we demonstrate the feasibility of our approach regarding quality of service and communication overhead.

  12. IDENTITY THEFT SERVICES: Services Offer Some Benefits but Are Limited in Preventing Fraud

    Science.gov (United States)

    2017-03-01

    17-254 Identity Theft Services standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to... audited financial statements. Page 34 GAO-17-254 Identity Theft Services Although the websites of many identity theft services ...reasonable assurance that significant decisions on the use of identity theft services are appropriately documented. We provided a draft of this

  13. Fall prevention services for older Aboriginal people: investigating availability and acceptability.

    Science.gov (United States)

    Lukaszyk, Caroline; Coombes, Julieann; Keay, Lisa; Sherrington, Catherine; Tiedemann, Anne; Broe, Tony; Lovitt, Lorraine; Ivers, Rebecca

    2016-12-14

    Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population. To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia. A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients. Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social

  14. Speak Up: Help Prevent Errors in Your Care: Laboratory Services

    Science.gov (United States)

    ... informed member of your health care team. The “Speak Up” program is sponsored by The Joint Commission. ... prevent health care mistakes, patients are urged to “Speak Up.” S peak up if you have questions or ...

  15. Health@Home - An e-Service Model for Disease Prevention and Healthcare in the Home

    Science.gov (United States)

    Gupta, Milon; Chotard, Laure; Ingþórsson, Ólafur; Bastos, João; Borges, Isabel

    The ageing of the population, the growth of chronic diseases, and the explosion of healthcare costs jeopardise the sustainability of healthcare systems in many European countries. This opens opportunities for innovative prevention and healthcare services supported by information and communication technologies (ICT). The natural focus for providing such services is the home. However, the e-health services provided in the home so far are limited in scope and fragmented. This paper suggests a comprehensive service model for home-based e-health services in Europe, which aims to overcome the current service fragmentation. The Health@Home model integrates disease prevention and healthcare for different groups of citizens at different stages on the health scale. The technical challenge of this model is the national and Europe-wide integration of heterogeneous systems and services in a way that makes them reliable and easy to use for all citizens, particularly those with low technical abilities and severe impairments.

  16. Strengthening effective preventive services for refugee populations: toward communities of solution

    OpenAIRE

    Griswold, Kim S.; Pottie, Kevin; Kim, Isok; Kim, Wooksoo; Lin, Li

    2018-01-01

    Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or ...

  17. Task-shifting of HIV/AIDS services down the professional ladder ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

    World Health Organization/UNAIDS/PEPAR. Study on Task Shifting Regulatory Framework Mapping. Study in Ethiopia. Report of a WHO Expert. Committee. WHO: Geneva. Technical Report Series. (number- draft report), December, 2007. 2. Philips M, Zachariah R, Venis S. Task shifting for antiretroviral treatment delivery in ...

  18. Task-shifting of HIV/AIDS services down the professional ladder ...

    African Journals Online (AJOL)

    This review tried to bring to light success stories and challenges of other African countries on the same topic as lesson for current endeavors in Ethiopia where the process of implementation of task shifting is in its early stage. It concluded that task shifting can help improve access, coverage and quality of HIV/AIDS related ...

  19. Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service

    Directory of Open Access Journals (Sweden)

    Masoe AV

    2015-03-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1Faculty of Health and Medicine, School of Health Sciences, Oral Health, University of Newcastle, Ourimbah, 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia Background: Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists. It is incumbent upon clinical directors (CDs and health service managers (HSMs to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1 explore CDs’ and HSMs’ perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2 record the strategies they have utilized to help therapists provide preventive care to adolescents. Subjects and methods: In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists’ ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric

  20. Role of African American Churches in Cancer Prevention Services

    Science.gov (United States)

    1999-08-01

    health is a bedrock value of the SDA. God tells man in Genesis what to eat and the bible emphasizes a vegetarian diet , an example of a biblical health...nurses within the church to educate people away from unhealthy eating behaviors. There are plans to present health fairs along with the homecoming...do things in order to prevent disease such as maintain a healthy diet . Life style, temperance, nutrition, exercise, good water, sunshine. No access of

  1. 77 FR 14378 - Family Violence Prevention and Services/Grants for Domestic Violence Shelters and Supportive...

    Science.gov (United States)

    2012-03-09

    ...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... Prevention and Services/Grants for Domestic Violence Shelters and Supportive Services/Grants to States AGENCY... Act (FVPSA) to States (including Territories and Insular Areas). The purpose of these grants is to: (1...

  2. 77 FR 14393 - Family Violence Prevention and Services/Grants to State Domestic Violence Coalitions

    Science.gov (United States)

    2012-03-09

    ... relatives, involvement in after-school activities) and characteristics (e.g., self-esteem, relationship... Prevention and Services/Grants to State Domestic Violence Coalitions AGENCY: Family and Youth Services Bureau... and coordinate with States, tribes, localities, cities, and the private sector to be involved in State...

  3. Service-Learning in Higher Education: Focus on Eating Disorder Prevention

    Science.gov (United States)

    Roofe, Nina; Brinegar, Jennifer; Seymour, Gayle

    2015-01-01

    Interdisciplinary service-learning projects are mutually beneficial for communities and students. This service-learning project focused on eating disorder prevention and involved students majoring in nutrition, art, and psychology at a public Southern university. The nutrition majors completed the Eating Attitudes Test before and after the…

  4. College Teaching and Community Outreaching: Service Learning in an Obesity Prevention Program

    Science.gov (United States)

    Himelein, Melissa; Passman, Liz; Phillips, Jessica M.

    2010-01-01

    Background: Service learning can enrich students' knowledge, skills and commitment to occupational goals while positively affecting communities. Undergraduate students in a course on obesity engaged in service learning by assisting with a family-based obesity prevention program, Getting Into Fitness Together (GIFT). Purpose: The impact of GIFT on…

  5. A Model Human Sexuality--HIV/AIDS Prevention and Intervention Service-Learning Program

    Science.gov (United States)

    Stewart, Clarence, M., Jr.

    2005-01-01

    This article deals with a service-learning program focused on human sexuality and HIV/AIDS prevention and intervention at the Howard University Department of Health, Human Performance and Leisure Studies. Topics discussed include how this program was created, an overview of peer education, HIV/AIDS peer education training, and services provided to…

  6. Autonomous underwater handling system for service, measurement and cutting tasks for the decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Hahn, M.; Haferkamp, H.; Bach, W.; Rose, N.

    1992-01-01

    For about 10 years the Institute for Material Science at the Hanover University has worked on projects of underwater cutting and welding. Increasing tasks to be done in nuclear facilities led to the development of special handling systems to support and handle the cutting tools. Also sensors and computers for extensive and complex tasks were integrated. A small sized freediving handling system, equipped with 2 video cameras, ultrasonic and radiation sensors and a plasma cutting torch for inspection and decommissioning tasks in nuclear facilities is described in this paper. (Author)

  7. Provision of relapse prevention interventions in UK NHS Stop Smoking Services: a survey

    Directory of Open Access Journals (Sweden)

    McEwen Andy

    2010-07-01

    Full Text Available Abstract Background UK NHS Stop Smoking Services provide cost effective smoking cessation interventions but, as yet, there has been no assessment of their provision of relapse prevention interventions. Methods Electronic questionnaire survey of 185 UK Stop Smoking Services Managers. Results Ninety six Stop Smoking Service managers returned completed questionnaires (52% response rate. Of these, 58.3% (n = 56 ran NHS Stop Smoking Services which provided relapse prevention interventions for clients with the most commonly provided interventions being behavioural support: telephone (77%, group (73%, and individual (54%. Just under half (48%, n = 27 offered nicotine replacement therapy (NRT, 21.4% (n = 12 bupropion; 19.6% (n = 11 varenicline. Over 80% of those providing relapse prevention interventions do so for over six months. Nearly two thirds of all respondents thought it was likely that they would either continue to provide or commence provision of relapse prevention interventions in their services. Of the remaining respondents, 66.7% (n = 22 believed that the government focus on four-week quit rates, and 42.9% (14 services believed that inadequate funding for provision of relapse prevention interventions, were major barriers to introducing these interventions into routine care. Conclusions Just over half of UK managers of NHS Stop Smoking Services who responded to the questionnaire reported that, in their services, relapse prevention interventions were currently provided for clients, despite, at that time, there being a weak evidence base for their effectiveness. The most commonly provided relapse prevention interventions were those for which there was least evidence. If these interventions are found to be effective, barriers would need to be removed before they would become part of routine care.

  8. A profile-aware microtasking approach for improving task assignment in crowdsourcing services

    CSIR Research Space (South Africa)

    Mtsweni, Jabu

    2016-05-01

    Full Text Available research methodology was adopted to build the proposed artefact, which was evaluated for relevance using comparative analysis and crowdsourcing metrics. The results suggest that exploiting micro workers' profiles could improve task design, assignment...

  9. Does time pressure create barriers for people to receive preventive health services?

    Science.gov (United States)

    Yao, Xiaoxi; Dembe, Allard E; Wickizer, Thomas; Lu, Bo

    2015-05-01

    Regular use of recommended preventive health services can promote good health and prevent disease. However, individuals may forgo obtaining preventive care when they are busy with competing activities and commitments. This study examined whether time pressure related to work obligations creates barriers to obtaining needed preventive health services. Data from the 2002-2010 Medical Expenditure Panel Survey (MEPS) were used to measure the work hours of 61,034 employees (including 27,910 females) and their use of five preventive health services (flu vaccinations, routine check-ups, dental check-ups, mammograms and Pap smear). Multivariable logistic regression analyses were performed to test the association between working hours and use of each of those five services. Individuals working long hours (>60 per week) were significantly less likely to obtain dental check-ups (OR=0.81, 95% CI: 0.72-0.91) and mammograms (OR=0.47, 95% CI: 0.31-0.73). Working 51-60 h weekly was associated with less likelihood of receiving Pap smear (OR=0.67, 95% CI: 0.46-0.96). No association was found for flu vaccination. Time pressure from work might create barriers for people to receive particular preventive health services, such as breast cancer screening, cervical cancer screening and dental check-ups. Health practitioners should be aware of this particular source of barriers to care. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. How a North Carolina program boosted preventive oral health services for low-income children.

    Science.gov (United States)

    Rozier, R Gary; Stearns, Sally C; Pahel, Bhavna T; Quinonez, Rocio B; Park, Jeongyoung

    2010-12-01

    Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than age three. Analysis of physician and dentist Medicaid claims from the period 2000-2006 shows that the program greatly increased preventive oral health services. By 2006 approximately 30 percent of well-child visits for children ages six months up to three years included these services. However, additional strategies are needed to ensure preventive oral health care for more low-income children.

  11. Factors affecting utilization of cervical cancer prevention services in low-resource settings

    Directory of Open Access Journals (Sweden)

    Bingham Allison

    2003-01-01

    Full Text Available Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided.

  12. Insights from a national survey into why substance abuse treatment units add prevention and outreach services

    Directory of Open Access Journals (Sweden)

    Lemak Christy

    2006-08-01

    Full Text Available Abstract Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1 environmental, (2 unit-level, and (3 unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care

  13. Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study.

    Science.gov (United States)

    Benjamins, S Janine; Damen, Maurice L W; van Stel, Henk F

    2015-01-01

    In the Netherlands a need is felt for more flexible Child Health Care services, both efficient and tailored to needs. We set up a study on impact and feasibility of task delegation to child health care nurses performing all regular checkups on children aged 2 months to 4 years. Abnormal findings were discussed with the attending child health care doctor. This article describes impact and feasibility of this task delegation from four viewpoints: competences of nurses; percentage of children assigned to the nurse; change in abnormal findings and referrals; experiences of professionals and parents. Two experiment teams and two control teams were compared before and after starting task delegation. Nurses in the experiment teams were trained to carry out regular checkups on healthy children. Assignment to the experiment schedule was a joint decision by doctor and nurse. Nursing competences were measured by means of questionnaires. Percentage of children assigned to the nurse and screening results of eyes, heart, hips, growth and development were extracted from the electronic health record. Difference in change was compared between experiment and control teams. Mann-Whitney tests and logistic generalized estimating equations were used to test for significance. Experiences of professionals and parents were evaluated through focus group interviews, which were subjected to a qualitative analysis. Nurses in the experiment regions showed improvement in medical screening skills. No difference in change was perceived in general nursing competences. In the experiment group, 69% of all children were assigned to the nurse. There were no significant differences in change in the percentages of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips. Interviews showed that both doctors and nurses thought positively of the new working method, yet made some recommendations for improvements. Parents felt well-informed and experienced an

  14. Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study.

    Directory of Open Access Journals (Sweden)

    S Janine Benjamins

    Full Text Available In the Netherlands a need is felt for more flexible Child Health Care services, both efficient and tailored to needs. We set up a study on impact and feasibility of task delegation to child health care nurses performing all regular checkups on children aged 2 months to 4 years. Abnormal findings were discussed with the attending child health care doctor. This article describes impact and feasibility of this task delegation from four viewpoints: competences of nurses; percentage of children assigned to the nurse; change in abnormal findings and referrals; experiences of professionals and parents.Two experiment teams and two control teams were compared before and after starting task delegation. Nurses in the experiment teams were trained to carry out regular checkups on healthy children. Assignment to the experiment schedule was a joint decision by doctor and nurse. Nursing competences were measured by means of questionnaires. Percentage of children assigned to the nurse and screening results of eyes, heart, hips, growth and development were extracted from the electronic health record. Difference in change was compared between experiment and control teams. Mann-Whitney tests and logistic generalized estimating equations were used to test for significance. Experiences of professionals and parents were evaluated through focus group interviews, which were subjected to a qualitative analysis.Nurses in the experiment regions showed improvement in medical screening skills. No difference in change was perceived in general nursing competences. In the experiment group, 69% of all children were assigned to the nurse. There were no significant differences in change in the percentages of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips. Interviews showed that both doctors and nurses thought positively of the new working method, yet made some recommendations for improvements. Parents felt well-informed and

  15. Pollution prevention assessment for a manufacturer of food service equipment

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, H.W.; Kostrzewa, M.F. [Colorado State Univ., Fort Collins, CO (United States). Dept. of Mechanical Engineering; Looby, G.P. [University City Science Center, Philadelphia, PA (United States)

    1995-09-01

    The US Environmental Protection Agency (EPA) has funded a pilot project to assist small and medium-size manufacturers who want to minimize their generation of waste but who lack the expertise to do so. In an effort to assist these manufacturers Waste Minimization Assessment Centers (WMACs) were established at selected universities and procedures were adapted from the EPA Waste Minimization Opportunity Assessment Manual. The WMAC team at Colorado State University performed an assessment at a plant that manufacturers commercial food service equipment. Raw materials used by the plant include stainless steel, mild steel, aluminum, and copper and brass. Operations performing in the plant include cutting, forming, bending, welding, polishing, painting, and assembly The team`s report, detailing findings and recommendations, indicated that paint-related wastes (organic solvents) are generated in large quantities and that significant cost savings could be achieved by retrofitting the water curtain paint spray booth to operate as a dry filter paint booth. Toluene could be replaced by a less toxic solvent. This Research Brief was developed by the principal investigators and EPA`s National Risk Management Research Laboratory, Cincinnati, OH, to announce key findings of an ongoing research project that is fully documented in a separate report of the same title available from University City Science Center.

  16. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    Science.gov (United States)

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, pwellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Drinking Patterns, Gender and Health II: Predictors of Preventive Service Use.

    Science.gov (United States)

    Green, Carla A; Polen, Michael R; Leo, Michael C; Perrin, Nancy A; Anderson, Bradley M; Weisner, Constance M

    2010-07-01

    Chronic diseases and injuries are elevated among people with substance use problems/dependence, yet heavier drinkers use fewer routine and preventive health services than non-drinkers and moderate drinkers, while former drinkers and abstainers use more than moderate drinkers. Researchers hypothesize that drinking clusters with attitudes and practices that produce better health among moderate drinkers and that heavy drinkers avoid doctors until becoming ill, subsequently quitting and using more services. Gender differences in alcohol consumption, health-related attitudes, practices, and prevention-services use may affect these relationships. A stratified random sample of health-plan members (7884; 2995 males, 4889 females) completed a mail survey that was linked to 24 months of health-plan records. Data were used to examine relationships between alcohol use, gender, health-related attitudes/practices, health, and prevention-service use. Controlling for attitudes, practices, and health, female lifelong abstainers and former drinkers were less likely to have mammograms; individuals with alcohol use disorders and positive AUDIT scores were less likely to obtain influenza vaccinations. AUDIT-positive women were less likely to undergo colorectal screening than AUDIT-positive men. Consistent predictors of prevention-services use were: self-report of having a primary care provider (positive); disliking visiting the doctor (negative); smoking cigarettes (negative), and higher BMI (negative). When factors associated with drinking are controlled, patterns of alcohol consumption have limited effects on preventive service use. Individuals with stigmatized behaviors (e.g., hazardous/harmful drinking, smoking, or high BMIs) are less likely to receive care. Making care experiences positive and carefully addressing stigmatized health practices could increase preventive service use.

  18. Provider perceptions on HIV risk and prevention services within permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony

    2017-10-01

    Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH. The purpose of this study was to investigate how PSH providers approach HIV prevention and the challenges they perceive surrounding HIV prevention in PSH. Results serve as a critical first step toward addressing the acceptability and feasibility of providing HIV/STI prevention services to PSH residents. As part of a longitudinal mixed methods study examining HIV risk and prevention behavior among homeless unaccompanied adults moving into PSH in Los Angeles, we conducted eleven focus groups with a total of 60 frontline staff across 10 PSH agencies. Thirty-three percent of focus group participants were African American, 32% were Hispanic, and 55% were women. Results suggest that provider awareness and knowledge of PrEP is very limited, and provision of formal HIV prevention programing for residents is perceived as challenging. Informal, ad hoc conversations with residents about sexual risk and HIV prevention do occur when providers have rapport with clients and perceive risk. There are significant gaps in HIV prevention services through PSH but also opportunities to enhance providers' efforts to promote the health of residents through prevention.

  19. Functional foods and cardiometabolic diseases* International Task Force for Prevention of Cardiometabolic Diseases.

    Science.gov (United States)

    Assmann, G; Buono, P; Daniele, A; Della Valle, E; Farinaro, E; Ferns, G; Krogh, V; Kromhout, D; Masana, L; Merino, J; Misciagna, G; Panico, S; Riccardi, G; Rivellese, A A; Rozza, F; Salvatore, F; Salvatore, V; Stranges, S; Trevisan, M; Trimarco, B; Vetrani, C

    2014-12-01

    Mounting evidence supports the hypothesis that functional foods containing physiologically-active components may be healthful. Longitudinal cohort studies have shown that some food classes and dietary patterns are beneficial in primary prevention, and this has led to the identification of putative functional foods. This field, however, is at its very beginning, and additional research is necessary to substantiate the potential health benefit of foods for which the diet-health relationships are not yet scientifically validated. It appears essential, however, that before health claims are made for particular foods, in vivo randomized, double-blind, placebo controlled trials of clinical end-points are necessary to establish clinical efficacy. Since there is need for research work aimed at devising personalized diet based on genetic make-up, it seems more than reasonable the latter be modeled, at present, on the Mediterranean diet, given the large body of evidence of its healthful effects. The Mediterranean diet is a nutritional model whose origins go back to the traditional dietadopted in European countries bordering the Mediterranean sea, namely central and southern Italy, Greece and Spain; these populations have a lower incidence of cardiovascular diseases than the North American ones, whose diet is characterized by high intake of animal fat. The meeting in Naples and this document both aim to focus on the changes in time in these two different models of dietary habits and their fall out on public health.

  20. 76 FR 22708 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

    Science.gov (United States)

    2011-04-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) Advisory Committee..., regarding activities related to prevention and control of HIV/AIDS and other STDs, the support of health...

  1. 75 FR 78997 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

    Science.gov (United States)

    2010-12-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) Advisory Committee... and other committee management activities, for both the Centers for Disease Control and Prevention and...

  2. Preventive care and recall intervals. Targeting of services in child dental care in Norway.

    Science.gov (United States)

    Wang, N J; Aspelund, G Ø

    2010-03-01

    Skewed caries distribution has made interesting the use of a high risk strategy in child dental services. The purpose of this study was to describe the preventive dental care given and the recall intervals used for children and adolescents in a low caries risk population, and to study how the time spent for preventive care and the length of intervals were associated with characteristics of the children and factors related to care delivery. Time spent for and type of preventive care, recall intervals, oral health and health behaviour of children and adolescents three to 18 years of age (n = 576) and the preventive services delivered were registered at routine dental examinations in the public dental services. The time used for preventive dental care was on average 22% of the total time used in a course of treatment (7.3 of 33.4 minutes). Less than 15% of the variation in time spent for prevention was explained by oral health, oral health behaviours and other characteristics of the children and the service delivery. The mean (SD) recall intervals were 15.4 (4.6) months and 55% of the children were given intervals equal to or longer than 18 months. Approximately 30% of the variation in the length of the recall intervals was explained by characteristics of the child and the service delivery. The time used for preventive dental care of children in a low risk population was standardized, while the recall intervals to a certain extent were individualized according to dental health and dental health behaviour.

  3. Strengthening effective preventive services for refugee populations: toward communities of solution.

    Science.gov (United States)

    Griswold, Kim S; Pottie, Kevin; Kim, Isok; Kim, Wooksoo; Lin, Li

    2018-01-01

    Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or may not be congruent with their beliefs on health care. Effective interventions in primary care include the appropriate use of culturally and linguistically trained interpreters for health care visits and use of evidence-based guidelines. Effective approaches for the delivery of preventive health and wellness services require community engagement and collaborations between public health and primary care. In order to provide optimal preventive and longitudinal screening services for refugees, policies and practice should be guided by unimpeded access to robust primary care systems. These systems should implement evidence-based guidelines, comprehensive health coverage, and evaluation of process and preventive care outcomes.

  4. Impact of the fast track prevention program on health services use by conduct-problem youth.

    Science.gov (United States)

    Jones, Damon; Godwin, Jennifer; Dodge, Kenneth A; Bierman, Karen L; Coie, John D; Greenberg, Mark T; Lochman, John E; McMahon, Robert J; Pinderhughes, Ellen E

    2010-01-01

    We tested the impact of the Fast Track conduct disorder prevention program on the use of pediatric, general health, and mental health services in adolescence. Participants were 891 public kindergarten boys and girls screened from a population of 9594 children and found to be at risk for conduct disorder. They were assigned randomly (by school) to intervention or control conditions and were followed for 12 years. Intervention lasted 10 years and included parent training, child social-cognitive skills training, reading tutoring, peer-relations enhancement, and classroom curricula and management. Service use was assessed through annual interviews of parents and youth. Youth assigned to preventive intervention had significantly reduced use of professional general health, pediatric, and emergency department services relative to control youth on the basis of parent-report data. For control-group youth, the odds of greater use of general health services for any reason and general health services use for mental health purposes were roughly 30% higher and 56% higher, respectively. On the basis of self-report data, the intervention reduced the likelihood of outpatient mental health services among older adolescents for whom odds of services use were more than 90% higher among control-group youth. No differences were found between intervention and control youth on the use of inpatient mental health services. Statistical models controlled for key study characteristics, and potential moderation of the intervention effect was assessed. Random assignment to the Fast Track prevention program is associated with reduced use of general health and outpatient mental health services in adolescents. Future studies should examine the mechanism of this impact and service use patterns as subjects reach young adulthood.

  5. Report of the Defense Task Force on Sexual Assault in the Military Services

    Science.gov (United States)

    2009-12-01

    Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment,” Journal of...Interpersonal Violence 15, 5 (2000): 489-502. 60 Terri L. Messman-Moore, and Amy L. Brown, “Risk Perception, Rape, and Sexual Revictimization : A...Sexual Revictimization in a Female Navy Recruit Sample,” Journal of Traumatic Stress 12, no. 2 (1999): 211-225. Defense Task Force on Sexual

  6. Adherence to Clinical Preventative Service Guidelines by Selected Military Healthcare Providers

    Science.gov (United States)

    1997-03-18

    for disease, such as malignancy, lupus. Type 1 diabetes, anorexia , HIV, and other endocrine disorders (American Cancer Society. 1992). Thus, height...Studies have shown that clinicians may fail to provide recommended clinical ^ preventative services, often because there is uncertainty among...clinicians as to what % ’\\ ’I services to provide and how often to provide them (Harris, et al, 1990; Hayward ,et al, { I 1991). Uncertainties about

  7. Performance deterioration modeling and optimal preventive maintenance strategy under scheduled servicing subject to mission time

    Directory of Open Access Journals (Sweden)

    Li Dawei

    2014-08-01

    Full Text Available Servicing is applied periodically in practice with the aim of restoring the system state and prolonging the lifetime. It is generally seen as an imperfect maintenance action which has a chief influence on the maintenance strategy. In order to model the maintenance effect of servicing, this study analyzes the deterioration characteristics of system under scheduled servicing. And then the deterioration model is established from the failure mechanism by compound Poisson process. On the basis of the system damage value and failure mechanism, the failure rate refresh factor is proposed to describe the maintenance effect of servicing. A maintenance strategy is developed which combines the benefits of scheduled servicing and preventive maintenance. Then the optimization model is given to determine the optimal servicing period and preventive maintenance time, with an objective to minimize the system expected life-cycle cost per unit time and a constraint on system survival probability for the duration of mission time. Subject to mission time, it can control the ability of accomplishing the mission at any time so as to ensure the high dependability. An example of water pump rotor relating to scheduled servicing is introduced to illustrate the failure rate refresh factor and the proposed maintenance strategy. Compared with traditional methods, the numerical results show that the failure rate refresh factor can describe the maintenance effect of servicing more intuitively and objectively. It also demonstrates that this maintenance strategy can prolong the lifetime, reduce the total lifetime maintenance cost and guarantee the dependability of system.

  8. Secondary prevention of fractures after hip fracture: a qualitative study of effective service delivery.

    Science.gov (United States)

    Drew, S; Judge, A; Cooper, C; Javaid, M K; Farmer, A; Gooberman-Hill, R

    2016-05-01

    There is variation in how services to prevent secondary fractures after hip fracture are delivered and no consensus on best models of care. This study identifies healthcare professionals' views on effective care for the prevention of these fractures. It is hoped this will provide information on how to develop services. Hip fracture patients are at high risk of subsequent osteoporotic fractures. Whilst fracture prevention services are recommended, there is variation in delivery and no consensus on best models of care. This study aims to identify healthcare professionals' views on effective care for prevention of secondary fracture after hip fracture. Forty-three semi-structured interviews were undertaken with healthcare professionals involved in delivering fracture prevention across 11 hospitals in one English region. Interviews explored views on four components of care: (1) case finding, (2) osteoporosis assessment, (3) treatment initiation, and (4) monitoring and coordination. Interviews were audio-recorded, transcribed, anonymised and coded using NVivo software. Case finding: a number of approaches were discussed. Multiple methods ensured there was a 'backstop' if patients were overlooked. Osteoporosis assessment: there was no consensus on who should conduct this. The location of the dual energy X-ray absorptiometry (DXA) scanner influenced the likelihood of patients receiving a scan. Treatment initiation: it was felt this was best done in inpatients rather request initiation in the post-discharge/outpatients period. Monitoring (adherence): adherence was a major concern, and participants felt more monitoring could be conducted by secondary care. Coordination of care: participants advocated using dedicated coordinators and formal and informal methods of communication. A gap between primary and secondary care was identified and strategies suggested for addressing this. A number of ways of organising effective fracture prevention services after hip fracture were

  9. Use of caries prevention services in the Northwest PRECEDENT dental network.

    Science.gov (United States)

    Ferracane, J; Hilton, T; Korpak, A; Gillette, J; McIntyre, P Speed; Berg, J

    2011-02-01

    This cross-sectional study assessed the use of caries preventive services by Northwest PRECEDENT dental network practitioners and compared the caries experience of patients who received such services in the past 12 months with those who had not. An oral health survey was conducted on approximately 20 patients seen by each of 97 private practice dental practitioners in the network. Eligible patients (total of 1877 aged 3-92) were randomly assessed for the occurrence of one or more new caries lesions as well as having received the following preventive services within the past 12 months: fluoride varnish or gel, sealant in molar or premolar, and prophylaxis. Patients were stratified by gender and age (1-17 years old, 18-64 years old, and 65+ years old). Logistic regression was used to investigate the association between the practitioner characteristics and the use of preventive services, as well as the preventive services and the presence of a new caries lesion in the past 12 months. The percent of patients in age category 1-17 years old/18-64 years old/65+ years old receiving each preventive treatment varied as follows: 95%/85%/81% for prophylaxis, 87%/24%/22% for fluoride, and 27%/2%/0% for sealant. There was a very limited association between the use of a specific preventive service and practitioner gender, and no significant association between use of services and practice location (rural, urban or suburban). There was a significant association between greater use of sealants for dentists with 0-15 years of practice experience as compared with those having more than 25 years of experience. For the 1-17-year-old age group, boys had about 1.7 times the odds of having a new lesion than girls in the past 12 months, and patients receiving a sealant had 1.9 times the odds of having a new caries lesion. In the 18-64-year-old group, receiving a prophylaxis in the past 12 months was significantly associated with lower odds for having a new lesion (odds ratio = 0.57). This

  10. Identification of genetic counseling service delivery models in practice: a report from the NSGC Service Delivery Model Task Force.

    Science.gov (United States)

    Cohen, Stephanie A; Marvin, Monica L; Riley, Bronson D; Vig, Hetal S; Rousseau, Julie A; Gustafson, Shanna L

    2013-08-01

    Increasing demand for genetic services has resulted in the need to evaluate current service delivery models (SDMs) and consider approaches that improve access to and efficiency of genetic counseling (GC). This study aimed to describe SDMs currently used by the GC community. The NSGC membership was surveyed regarding the use of four SDMs: in-person GC, telephone GC, group GC, and telegenetics GC. Variables related to access and components of use were also surveyed, including: appointment availability, time-per-patient, number of patients seen, billing, and geographic accessiblity. Seven hundred one usable responses were received. Of these, 54.7 % reported using an in-person SDM exclusively. The remainder (45.3 %) reported using multiple SDMs. Telephone, group and telegenetics GC were used often or always by 8.0 %, 3.2 % and 2.2 % of respondents, respectively. Those using an in-person SDM reported the ability to see the highest number of patients per week (p 4 h away. This study shows that genetic counselors are incorporating SDMs other than traditional in-person genetic counseling, and are utilizing more than one model. These adaptations show a trend toward shorter wait time and shorter length of appointments. Further study is indicated to analyze benefits and limitations of each individual model and factors influencing the choice to adopt particular models into practice.

  11. Task scheduler and service subsystem for the common node of a distributed function laboratory computer network

    International Nuclear Information System (INIS)

    Stubblefield, F.W.; Dimmler, D.G.

    1976-01-01

    In a functionally distributed computer system, the system function is partitioned into less complex functions which reside at decreasing functional hierarchy levels. At some point in the partitioning process, all software and hardware required to implement an identified function are confined to a node of the system. The type of hardware elements and the form of the software required at the node are determined by the node function. This principle is illustrated in the case of a task scheduler for the common node of a distributed function laboratory computer system having a star-like configuration

  12. Backcasting to identify food waste prevention and mitigation opportunities for infant feeding in maternity services.

    Science.gov (United States)

    Ryan-Fogarty, Yvonne; Becker, Genevieve; Moles, Richard; O'Regan, Bernadette

    2017-03-01

    Food waste in hospitals is of major concern for two reasons: one, healthcare needs to move toward preventative and demand led models for sustainability and two, food system sustainability needs to seek preventative measures such as diet adaptation and waste prevention. The impact of breast-milk substitute use on health services are well established in literature in terms of healthcare implications, cost and resourcing, however as a food demand and waste management issue little has been published to date. This paper presents the use of a desk based backcasting method to analyse food waste prevention, mitigation and management options within the Irish Maternity Service. Best practice in healthcare provision and waste management regulations are used to frame solutions. Strategic problem orientation revealed that 61% of the volume of ready to use breast-milk substitutes purchased by maternity services remains unconsumed and ends up as waste. Thirteen viable strategies to prevent and manage this waste were identified. Significant opportunities exist to prevent waste and also decrease food demand leading to both positive health and environmental outcomes. Backcasting methods display great promise in delivering food waste management strategies in healthcare settings, especially where evidenced best practice policies exist to inform solution forming processes. In terms of food waste prevention and management, difficulties arise in distinguishing between demand reduction, waste prevention and waste reduction measures under the current Waste Management Hierarchy definitions. Ultimately demand reduction at source requires prioritisation, a strategy which is complimentary to health policy on infant feeding. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. A High School Depression and Suicide Prevention Program: A Collaboration between Health Education and Psychological Services.

    Science.gov (United States)

    Moilanen, Donna L.; Bradbury, Susan

    2002-01-01

    Examined a collaboration between health education and psychological services in generating a high school depression and suicide prevention program. The five-component program raised awareness of teen depression and suicide, increased communication about these issues within the school and community, and provided information about available…

  14. 75 FR 59173 - TRICARE: Elimination of Copayments for Authorized Preventive Services for Certain TRICARE...

    Science.gov (United States)

    2010-09-27

    ... follows: SEC. 711. WAIVER OF CO-PAYMENTS FOR PREVENTIVE SERVICES FOR CERTAIN TRICARE BENEFICIARIES. (a) Waiver of Certain Co-payments--Subject to subsection (b) and under regulations prescribed by the Secretary of Defense, the Secretary shall-- (1) Waive all co-payments under sections 1079(b) and 1086(b) of...

  15. Scientific foundation of in-service training for prevention of peer violence

    Directory of Open Access Journals (Sweden)

    Pavlović Miroslav V.

    2016-01-01

    Full Text Available The paper analyzes the compatibility of the continuous in-service teacher training for prevention of peer violence and modern scientific knowledge in this area. The first part of the paper summarizes the results of 12 systematic reviews and meta-analyses of the effectiveness of the studies of antibullying programs published since 2000. which relate to the effects of uni-modal and multi-modal programs, and the efficacy of interventions used in anti-bullying programs. The second part of the paper analyses the approved programs of in-service teacher training, in which priority is given to the prevention of violence, abuse and negligence. We analyzed 39 programs of continuous in-service teacher training, and focused on the empirical bases of the programs (researches which confirm the effectiveness of a program and the contents of the training (the level of preventive activity, modality, field, and interventions. The results of the analysis of the programs of continuous in-service training for peer violence prevention are discussed in the context of modern scientific knowledge of effectiveness of anti-bullying programs and of professional development of teachers and counsellors.

  16. Youth Gambling Prevention: Can Public Service Announcements Featuring Celebrity Spokespersons Be Effective?

    Science.gov (United States)

    Shead, N. Will; Walsh, Kelly; Taylor, Amy; Derevensky, Jeffrey L.; Gupta, Rina

    2011-01-01

    Children and adolescents are at increased risk of developing gambling problems compared to adults. A review of successful prevention campaigns targeting drinking and driving, smoking, unprotected sex, and drug use suggests that public service announcements (PSAs) featuring celebrity spokespersons have strong potential for raising awareness of the…

  17. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    Science.gov (United States)

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Results Throughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. Conclusion The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units. PMID:23938145

  18. Women's responses to changes in U.S. Preventive Task Force's mammography screening guidelines: results of focus groups with ethnically diverse women.

    Science.gov (United States)

    Allen, Jennifer D; Bluethmann, Shirley Morrison; Sheets, Margaret; Opdyke, Kelly Morrison; Gates-Ferris, Kathryn; Hurlbert, Marc; Harden, Elizabeth

    2013-12-12

    The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women's awareness of, attitudes toward, and intention to comply with these new guidelines. Women ages 40-50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women's screening behaviors and on breast cancer outcomes.

  19. Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review

    NARCIS (Netherlands)

    Ufkes, T.; Skelton, D. A.; Lundin-Olsson, L.; Zijlstra, Wiebren; Zijlstra, Agnes

    2008-01-01

    Background: The Prevention of Falls Network Europe (ProFaNE) aims to bring together European researchers and clinicians to focus on the development of effective falls prevention programs for older people. One of the objectives is to identify suitable balance assessment tools. Assessment procedures

  20. Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia.

    Science.gov (United States)

    Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra

    2018-01-30

    Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations. CR and Aboriginal Community Controlled Health Services were identified through the Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Structured interviews with CR coordinators included questions specific to program delivery, content, referral and attendance. Of the 38 CR services identified, 23 (61%) were located in rural (n = 11, 29%) and remote (n = 12, 32%) regions. Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) found 77% of rural/remote services were hospital-based, with no service providing a comprehensive home-based or alternative method of program delivery. The majority of rural (60%) and remote (80%) services provided CR through chronic condition exercise programs compared with 17% of metropolitan services; only 27% of rural/remote programs provided education classes. Rural/remote coordinators were overwhelmingly physiotherapists, and only 50% of rural and 33% of remote programs had face-to-face access to multidisciplinary support. Patient referral and attendance rates differed greatly across WA and referrals to rural/remote services generally numbered less than 5 per month. Program evaluation was reported by 33% of rural/remote coordinators. Geography, population density and service availability limits patient access to CR services in rural/remote WA. Current

  1. Lifestyle risk factors and utilization of preventive services in disabled elderly adults in the community.

    Science.gov (United States)

    Kim, Dae Hyun; Sagar, Utpal N; Adams, Suzanne; Whellan, David J

    2009-10-01

    Lifestyle risk factor counseling and preventive health services are important to disabled elderly adults to prevent adverse health outcomes. We aimed to examine the prevalence of lifestyle risk factors and utilization of preventive health services in community-dwelling 2,982 adults, aged 60 years or older, with or without disability, in Southeastern Pennsylvania in 2004. The severity of disability was classified as no [independent activities of daily living (ADL) and instrumental activities of daily living (IADL)], some (independent ADL, dependent IADL), and severe limitation (dependent ADL). The prevalence of lifestyle risk factors (cigarette smoking, obesity, binge alcohol use, unhealthy diet, and physical inactivity) and utilization rate of a comprehensive list of preventive health services (risk factor counseling, disease management, vaccination, and cancer screening) were measured, across the disability categories. The prevalence of disability was 14.6% for some limitation and 10.3% for severe limitation. As disability increases, participants with unhealthy diet, physical inactivity, and obesity became more prevalent (8.8, 15.7, and 25.2% for no, some, and severe limitation, respectively) and fewer osteoporosis screenings were performed (51.5, 38.8, and 37.8%). Utilization of other services did not vary significantly across the disability categories, but participants with some or severe limitation were less likely than those without to receive needed health services overall (19.3% or 16.2 vs. 24.2%; P for trend = .047). In conclusion, disabled elderly adults have more undesirable lifestyle risk factors, but are less likely to receive needed health services than nondisabled counterparts. More attention is needed to this vulnerable population.

  2. Development of Support Service for Prevention and Recovery from Dementia and Science of Lethe

    Science.gov (United States)

    Otake, Mihoko

    Purpose of this study is to explore service design method through the development of support service for prevention and recovery from dementia towards science of lethe. We designed and implemented conversation support service via coimagination method based on multiscale service design method, both were proposed by the author. Multiscale service model consists of tool, event, human, network, style and rule. Service elements at different scales are developed according to the model. Interactive conversation supported by coimagination method activates cognitive functions so as to prevent progress of dementia. This paper proposes theoretical bases for science of lethe. Firstly, relationship among coimagination method and three cognitive functions including division of attention, planning, episodic memory which decline at mild cognitive imparement. Secondly, thought state transition model during conversation which describes cognitive enhancement via interactive communication. Thirdly, Set Theoretical Measure of Interaction is proposed for evaluating effectiveness of conversation to cognitive enhancement. Simulation result suggests that the ideas which cannot be explored by each speaker are explored during interactive conversation. Finally, coimagination method compared with reminiscence therapy and its possibility for collaboration is discussed.

  3. Estimating the Size and Cost of the STD Prevention Services Safety Net.

    Science.gov (United States)

    Gift, Thomas L; Haderxhanaj, Laura T; Torrone, Elizabeth A; Behl, Ajay S; Romaguera, Raul A; Leichliter, Jami S

    2015-01-01

    The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years.

  4. Reorienting a paediatric oral health service towards prevention: lessons from a qualitative study of dental professionals.

    Science.gov (United States)

    Cashmore, Aaron W; Noller, Jennifer; Ritchie, Jan; Johnson, Bronwyn; Blinkhorn, Anthony S

    2011-04-01

    Reorienting primary care dental services towards prevention is a priority for improving the oral health of Australian children with extensive dental caries. We explored the attitudes and beliefs of dental staff about the factors that helped or hindered the establishment and implementation of a hospital-based parent counselling program to manage existing, and prevent new, carious lesions in children. A further aim was to explore the influence of the program on the hospital's reorientation to prevention. Eight of nine program staff participated in two focus group interviews, and two co-ordinating staff participated in semi-structured interviews. Interviews were audio-recorded and transcribed. Interview recordings and transcripts were analysed by qualitative thematic analysis. The participants identified a number of factors that they felt influenced the establishment and implementation of the program, including the dental team's support of the initiative, the advantages of building on existing clinic infrastructure and procedures, the utility of harnessing dental assistants as a resource for oral health promotion, and the confidence of dental professionals to provide parent counselling. Efforts to establish a preventive program in a public paediatric dental service should ensure that all members of the dental team are engaged during all phases of the program, that dental assistants are trained and supported to deliver parent counselling, and that interprofessional partnerships with services such as dietetics are fostered.

  5. Preventive care delivered within Public Dental Service after caries risk assessment of young adults.

    Science.gov (United States)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-08-01

    To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Definition of technology development missions for early space stations orbit transfer vehicle serving. Phase 2, task 1: Space station support of operational OTV servicing

    Science.gov (United States)

    1983-01-01

    Representative space based orbital transfer vehicles (OTV), ground based vehicle turnaround assessment, functional operational requirements and facilities, mission turnaround operations, a comparison of ground based versus space based tasks, activation of servicing facilities prior to IOC, fleet operations requirements, maintenance facilities, OTV servicing facilities, space station support requirements, and packaging for delivery are discussed.

  7. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.

    2010-12-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21% of interruptions were caused by human error. We focus on Change Management, the process with the largest risk of human error, and identify the main instances of human errors as the 4 Wrongs: request, time, configuration item, and command. Analysis of change records revealed that the humanerror prevention by partial automation is highly relevant. We propose the HEP Framework, a framework for execution of IT Service Delivery operations that reduces human error by addressing the 4 Wrongs using content integration, contextualization of operation patterns, partial automation of command execution, and controlled access to resources.

  8. Pasa la Voz: using peer driven interventions to increase Latinas' access to and utilization of HIV prevention and testing services.

    Science.gov (United States)

    Ramos, Rebecca L; Green, Nancy Lorenza; Shulman, Lawrence C

    2009-02-01

    Promotoras along the U.S.-Mexico border in the role of animadoras (motivators) used a chain referral strategy called Pasa la Voz (Spread the Word). Latinas at high to moderate risk of HIV infection became better informed about prevention, accessed prevention services, and referred other at-risk Latinas for services.

  9. Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer

    Science.gov (United States)

    ... and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer The U.S. Preventive Services Task Force ( ... and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer. This final recommendation statement applies to ...

  10. The role of the health services in the prevention of alcohol-related facial injury.

    LENUS (Irish Health Repository)

    McHugh, E E

    2009-10-01

    This paper outlines the preventive health strategic measures that are currently in place and it endeavours to consider how improvements can be made to our national preventive strategy with the goal of reducing alcohol-related facial injuries. It is based on a review of the literature sourced through PubMed, Ovid Medline and the Cochrane database. The main findings are that increased funding, legislative amendment and media involvement are key to improving the work of the health services in their struggle to limit the ever increasing alcohol-related incidents that are experienced by society today.

  11. Home and community care services: a major opportunity for preventive health care

    Directory of Open Access Journals (Sweden)

    Lujic Sanja

    2010-05-01

    Full Text Available Abstract Background In Australia, the Home and Community Care (HACC program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8% participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis

  12. Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Moineddin Rahim

    2006-07-01

    Full Text Available Abstract Background To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. Methods A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms© were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. Results Randomly-selected charts were reviewed at baseline (n = 509 and post-intervention (n = 608. Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing to 93% (blood pressure measurement, similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p = 0.0001, and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p Conclusion This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates

  13. Feasibility and impact of doctor-nurse task delegation in preventive child health care in the netherlands, a controlled before-after study

    NARCIS (Netherlands)

    Benjamins, S. Janine; Damen, Maurice L W; Van Stel, Henk F.

    2015-01-01

    Background  In the Netherlands a need is felt for more flexible Child Health Care services, both efficient and tailored to needs.We set up a study on impact and feasibility of task delegation to child health care nurses performing all regular checkups on children aged 2 months to 4 years. Abnormal

  14. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar

    Directory of Open Access Journals (Sweden)

    Sharon Low

    2014-09-01

    Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in

  15. Evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothers.

    Science.gov (United States)

    Patchen, Loral; Letourneau, Kathryn; Berggren, Erica

    2013-01-01

    This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.

  16. Availability of Clean Tap Water and Medical Services Prevents the Incidence of Typhoid Fever

    OpenAIRE

    Lee, Deog-Yong; Lee, Esther; Park, HyeMin; Kim, SeongHan

    2013-01-01

    Objective: In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever. Methods: We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors. Results: To prevent typhoid fever in the communit...

  17. Preventing degradation and in-service inspection of NPP steam generator

    International Nuclear Information System (INIS)

    Ding Xunshen

    1999-01-01

    The author describes the degradation of steam generator tubes in initial operating stage of France NPP. The author emphatically presents the preventive measures to tackle degradation and In-service inspection of Daya Bay NPP 1 unit as a guarantee of safety operation, including secondary side water chemistry monitoring and controlling, leakage rate monitoring, eddy-current inspection, mechanical cleaning, cleanliness inspection, foreign objects removal and etc

  18. Review Of Prevention Techniques For Denial Of Service DOS Attacks In Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Poonam Rolla

    2015-08-01

    Full Text Available Wireless Sensor Networks comprised of several tiny sensor nodes which are densely deployed over the region to monitor the environmental conditions. These sensor nodes have certain design issues out of which security is the main predominant factor as it effects the whole lifetime of network. DDoS Distributed denial of service attack floods unnecessary packets in the sensor network. A review on DDoS attacks and their prevention techniques have been done in this paper.

  19. Task sharing to improve the prevention, diagnosis and management of rheumatic heart disease: a systematic review protocol.

    Science.gov (United States)

    Abdullahi, Leila Hussein; Smit, Inge; Engel, Mark E; Watkins, David A; Zühlke, Liesl Joanna

    2018-02-14

    Rheumatic heart disease (RHD) remains an important cause of cardiovascular morbidity and mortality globally due to weak health systems in many countries. RHD can be effectively prevented and managed; however, RHD-related interventions have not been widely adopted in countries with severe human resource constraints. Task sharing is a recognised approach to personnel shortages that could prove effective for RHD and has, anecdotally, been attempted in a few settings. We propose a systematic review and meta-analysis protocol to assess models that use non-physician workers to expand access to, and quality of, RHD-related healthcare. We will include randomised controlled trials (RCT), cluster RCTs, quasi-experimental and controlled before and after studies providing information on the effectiveness of non-physician workers in providing care for streptoccocal pharyngitis, rheumatic fever and RHD. We will search relevant electronic databases and grey literature using medical subject headings. Standardised data extraction forms will be used to collect effect sizes that will be pooled in random-effects models. We will also conduct subgroup analyses and note other important quantitative findings, such as cost reduction, and qualitative findings, such as patient satisfaction. We will also assess study quality and risk of bias and metabias. Ethics approval is not required for this systematic review of previously published literature. The results of the systematic review will be broadly disseminated via conference presentations, multidisciplinary workshops and peer-reviewed publications. CRD42017072989. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Spousal concordance for overall health risk status and preventive service compliance.

    Science.gov (United States)

    Pai, Chih-Wen; Godboldo-Brooks, Ambyr; Edington, Dee W

    2010-07-01

    In this study we examined spousal concordance for two aggregate measures of health risk status and compliance with preventive service recommendations among 9620 pairs of cohabitating, opposite-sex married couples. Health risk appraisals were the primary data source to measure two outcome variables. Health risk status was compiled from 12 health risks and categorized into three levels (low-, medium-, and high-risk status). Overall preventive service compliance status was estimated by seven age-sex specific preventive service recommendations and dichotomized into lower and higher compliance status. For each of the husband and wife populations, we conducted proportional odds models and logistic regression models to assess spousal concordance for the two aggregate measures respectively. All models were adjusted for household income, one's characteristics (age, race, education, disease burden), and the same set of characteristics and the corresponding outcome variable from the spouse. A positive correlation within spousal pairs was statistically significant for both health risk status and compliance status (p education. 2010 Elsevier Inc. All rights reserved.

  1. Iranian key informants' perspectives towards gender sensitive STIs/HIV/AIDS prevention service delivery

    Directory of Open Access Journals (Sweden)

    Fatemeh Rahmanian

    2016-07-01

    Full Text Available More than 340 million new cases of sexually transmitted infections occur throughout the world every year. The average annual STIs growth rate was 17%from 1998 to 2006 in Iran. As this epidemic has progressed, relevant literatures shown that, gender has a critical element in implementation and impact of these programs. Most reproductive health programs haven’t integrated gender mainstreaming to their service deliveries. In order to explore key informants perspectives towards gender sensitive STIs/HIV/AIDS prevention service delivery, this study was done. Participants including health managers, health policy makers and reproductive health providers were selected purposefully and continued by snow ball sampling. 43 semi-structured in depth interviews with 37 key informants analyzed according to content analysis. Main categories were generated after processing and organizing the codes. Key informants clearly explained the gender sensitive STIs/HIV/AIDS prevention structure in three domains: training gender sensitive providers, facilities and management. In our country, transforming gender neural to more complete gender sensitive STIs/HIV/AIDS prevention services needs structural reforms that make these interventions more effective.

  2. Improving access to preventive dental services through a school-based dental sealant program.

    Science.gov (United States)

    Devlin, Dee; Henshaw, Michelle

    2011-01-01

    The lack of access to preventive dental services, such as dental sealants, can be a major barrier to optimal dental health. School-based dental sealant programs can serve as programs to improve access to preventive dental services. This school-based dental sealant program managed by a Boston dental school with collaborating partners in the metro west area of Massachusetts provides free dental sealants to second grade children. The number of second grade children having dental sealants was tracked for 6 school years and compared with the Healthy People 2010 objective of 50% of all children aged 8 years to have at least 1 dental sealant. From school years 2003 to 2004 through 2008 to 2009, 1,609 dental screenings were provided for second grade children. Of those, 1,189 received dental sealants. To determine whether or not the Healthy People 2010 objective was met, the number of children who received dental sealants from the school-based program was added to the number of children who already had their permanent first molars sealed by their own dentist at the time of the dental screening, plus children with sealants per parent report. In total, the aggregate second grade enrollment having sealants during the designated school years was 54%. The specific Healthy People 2010 objective was achieved over the designated time period. School-based dental sealant programs can help to decrease or eliminate barriers for access to preventive dental services by increasing the number of children who receive dental sealants.

  3. Fraud Prevention A Study In Regional Public Service Agency BLUD For Hospital In Malang Regency Indonesia

    Directory of Open Access Journals (Sweden)

    Koenta Adji Koerniawan

    2017-04-01

    Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420

  4. A longitudinal study assessing childcare services' adoption of obesity prevention policies and practices.

    Science.gov (United States)

    Yoong, Sze Lin; Finch, Meghan; Nathan, Nicole; Wiggers, John; Lecathelinais, Christophe; Jones, Jannah; Dodds, Pennie; Wolfenden, Luke

    2016-07-01

    Despite ongoing investments to improve the obesogenic environments of childcare settings, little is known regarding how these services have changed their physical activity and nutrition-promoting practices. This study aims to describe changes in the proportion of Australian childcare services that have adopted best-practice healthy eating and physical activity practices between 2006 and 2013 and to assess whether adoption varied by socio-economic status and locality. A randomly selected sample of nominated supervisors (n = 358) from childcare services located in New South Wales, Australia, participated in a telephone survey in 2006, 2009, 2010 and 2013. Supervisors reported on their service's adoption of six practices: (i) having written nutrition and physical activity policies; (ii) staff trained in physical activity and nutrition in the past year; (iii) scheduled time for fundamental movement skills and (iv) outdoor play; (v) weekly or less screen time opportunities; and (vi) serving only non-sweetened beverages. A significant increase in the prevalence of services adopting all but one practice, between 2006 and 2013 was identified. Ninety one percent of services adopted four or more practices, a significant increase from 38% in 2006. There were no differences in the proportion of services adopting each practice by locality and socio-economic status. Government investment in obesity prevention programmes can equitably improve childcare service's adoption of healthy eating and physical activity promoting practices on a jurisdiction-wide basis. The establishment of a routine system to monitor adoption of a broader range of practices by childcare services is warranted. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  5. Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance.

    Science.gov (United States)

    Marcewicz, Lauren H; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

    2017-05-01

    Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

  6. Public Health Investment in Team Care: Increasing Access to Clinical Preventive Services in Los Angeles County

    Directory of Open Access Journals (Sweden)

    Tony Kuo

    2018-02-01

    Full Text Available As part of federal and local efforts to increase access to high quality, clinical preventive services (CPS in underserved populations, the Los Angeles County Department of Public Health (DPH partnered with six local health system and community organization partners to promote the use of team care for CPS delivery. Although these partners were at different stages of organizational capacity, post-program review suggests that each organization advanced team care in their clinical or community environments, potentially affecting >250,000 client visits per year. Despite existing infrastructure and DPH’s funding support of CPS integration, partner efforts faced several challenges. They included lack of sustainable funding for prevention services; limited access to community resources that support disease prevention; and difficulties in changing health-care provider behavior. Although team care can serve as a catalyst or vehicle for delivering CPS, downstream sustainability of this model of practice requires further state and national policy changes that prioritize prevention. Public health is well positioned to facilitate these policy discussions and to assist health system and community organizations in strengthening CPS integration.

  7. Development of Support Service for Prevention and Recovery from Dementia and Science of Lethe

    Science.gov (United States)

    Otake, Mihoko

    This paper proposes multiscale service design method through the development of support service for prevention and recovery from dementia towards science of lethe. Proposed multiscale service model consists of tool, event, human, network, style and rule. Service elements at different scales are developed according to the model. Firstly, the author proposes and practices coimagination method as an ``event'', which is expected to prevent the progress of cognitive impairment. Coimagination support system was developed as a ``tool''. Experimental results suggest the effective activation of episodic memory, division of attention, and planning function of participants by the measurement of cognitive activities during the coimagination. Then, Fonobono Research Institute was established as a ''network'' for ``human'' who studies coimagination, which is a multisector research organization including elderly people living around Kashiwa city, companies including instrument and welfare companies, Kashiwa city and Chiba prefecture, researchers of the University of Tokyo. The institute proposes and realizes lifelong research as a novel life ``style'' for elderly people, and discusses life with two rounds as an innovative ``rule'' for social system of aged society.

  8. Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

    Science.gov (United States)

    Kranz, Ashley M; Preisser, John S; Rozier, R Gary

    2015-07-01

    Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS. We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding. Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits. POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings. Copyright © 2015 by the American Academy of Pediatrics.

  9. Coverage of certain preventive services under the Affordable Care Act. Interim final rules.

    Science.gov (United States)

    2014-08-27

    This document contains interim final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA Guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. Additionally, under current regulations, accommodations are available with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), and student health insurance coverage arranged by eligible organizations that are institutions of higher education, that effectively exempt them from this requirement. The regulations establish a mechanism for separately furnishing payments for contraceptive services on behalf of participants and beneficiaries of the group health plans of eligible organizations that avail themselves of an accommodation, and enrollees and dependents of student health coverage arranged by eligible organizations that are institutions of higher education that avail themselves of an accommodation. These interim final regulations augment current regulations in light of the Supreme Court's interim order in connection with an

  10. Understanding preventive health screening services use in persons with serious mental illness: how does integrated behavioral health primary care compare?

    Science.gov (United States)

    Xiong, Glen L; Iosif, Ana-Maria; Suo, Shannon; Mccarron, Robert M; Koike, Alan; Onate, John; Carter, Cameron S

    2015-01-01

    People with serious mental illness have reduced life expectancy, in large part due to reduced access to medical services and underutilization of preventive health services. This is a cross-sectional study that compared preventive services use in an integrated behavioral health primary care clinic (IBHPC) with two existing community mental health programs. Participants completed questionnaires about preventive health services use that contained 33 questions about demographic clinical information, and use of preventive health services, from October 2010 to December 2012. Services examined included mammogram, Papanicolaou Test, prostate specific antigen, digital rectal exam, fecal occult blood test, and flexible sigmoidoscopy or colonoscopy; blood pressure, height and weight, cholesterol, and blood sugar for diabetes; and influenza immunization, Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) antibodies. A health service utilization score was developed and used as primary outcome for data analyses. In the multivariate analyses female gender (p compared to White), program type (p compared to one community mental health program (p compared another (p = 0.34). There was high variability in use of individual services among the clinical programs. More studies are needed to examine the effectiveness of integrated care in improving use of health screening services. Characteristics of the clinic in relation to use of preventive services deserve further study. © 2015, The Author(s).

  11. Investigating the Development of the Internal and External Service Tasks of Non-executive Directors: The Case of the Netherlands (1997-2005)

    OpenAIRE

    Bezemer, P.J.; Maassen, G.F.; van den Bosch, F.A.J.; Volberda, H.W.

    2007-01-01

    textabstractDuring the last decade, globalization and liberalization of financial markets, changing societal expectations and corporate governance scandals have increased the attention for the fiduciary duties of non-executive directors. In this context, recent corporate governance reform initiatives have emphasized the control task and independence of non-executive directors. However, little attention has been paid to their impact on the external and internal service tasks of non-executive d...

  12. The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

    Science.gov (United States)

    Signorelli, C; Riccò, M; Odone, A

    2016-01-01

    The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

  13. Beyond Culture and Language: Access to Diabetes Preventive Health Services among Somali Women in Norway

    Directory of Open Access Journals (Sweden)

    Abdi A. Gele

    2015-01-01

    Full Text Available Despite the high prevalence of type 2 diabetes in some immigrant and refugee communities in Norway, there is very little information available on their utilization of diabetes prevention interventions, particularly for women from Somali immigrant communities. A qualitative study of 30 Somali immigrant women aged 25 years and over was carried out in the Oslo area. Unstructured interviews were used to explore women’s knowledge of diabetes, their access to preventive health facilities, and factors impeding their reception of preventive health programs targeted for the prevention of type 2 diabetes. The study participants were found to have a good knowledge of diabetes. They knew that a sedentary lifestyle and unhealthy diet are among the risk factors for diabetes. Regardless of their knowledge, participants reported a sedentary lifestyle accompanied with the consumption of an unhealthy diet. This was attributed to a lack of access to tailored physical activity services and poor access to health information. Considering gender-exclusive training facilities for Somali immigrant women and others with similar needs, in addition to access to tailored health information on diet, may encourage Somali women to adopt a healthy lifestyle, and it will definitely contribute to a national strategy for the prevention of diabetes.

  14. Chair-side preventive interventions in the Public Dental Service in Norway.

    Science.gov (United States)

    Widström, E; Tillberg, A; Byrkjeflot, L I; Skudutyte-Rysstad, R

    2016-08-26

    Objective and setting In Norway, the Public Dental Service (PDS) caters for the young (chair-side preventive measures used in the public clinics and compared them with recommendations in evidence-based guidelines in the neighbouring countries.Materials and methods After ethical approval, the regional Chief Dental Officers (CDOs) emailed questionnaires to their local clinics (N = 421) where the most experienced dentist and dental hygienist were asked to respond on behalf of the clinic. Answers were received from 256 clinics (response rate 61%). Altogether, 215 dentists and 166 dental hygienists answered.Results Of the respondents, 26% reported that their clinic had agreed guidelines on preventive treatment to be used by all staff. Oral hygiene and fluoride toothpaste recommendations were considered appropriate. Almost 60% claimed that flossing instructions were given to all children and adolescents and 40% that fluoride varnish was used on all the young. Fissure sealants were used after individual assessment (80%). A third of the respondents claimed that fluoride tablets and fluoride rinse were recommended for all or most children and fluoride rinses for adults, even in addition to regular use of fluoride toothpaste. Dental hygienists used all methods more often than dentists. On adults, preventive measures were more often used on individual assessment. Half (48%) of the respondents were interested in new evidence-based national guidelines on preventive care.Conclusions Chair-side preventive treatment measures were numerous in the well-resourced Norwegian PDS, but partly outdated.

  15. Suburban Poverty: Barriers to Services and Injury Prevention among Marginalized Women Who Use Methamphetamine

    Directory of Open Access Journals (Sweden)

    Boeri, Miriam

    2011-07-01

    Full Text Available Objective: This paper aims to identify the needed healthcare and social services barriers for women living in suburban communities who are using or have used methamphetamine. Drug users are vulnerable to injury, violence and transmission of infectious diseases, and having access to healthcare has been shown to positively influence prevention and intervention among this population. Yet little is known regarding the social context of suburban drug users, their risks behaviors, and their access to healthcare.Methods: The data collection involved participant observation in the field, face-to-face interviews and focus groups. Audio-recorded in-depth life histories, drug use histories, and resource needs were collected from 31 suburban women who were former or current users of methamphetamine. The majority was drawn from marginalized communities and highly vulnerable to risk for injury and violence. We provided these women with healthcare and social service information and conducted follow-up interviews to identify barriers to these services.Results: Barriers included (1 restrictions imposed by the services and (2 limitations inherent in the women’s social, economic, or legal situations. We found that the barriers increased the women’s risk for further injury, violence and transmission of infectious diseases. Women who could not access needed healthcare and social resources typically used street drugs that were accessible and affordable to self-medicate their untreated emotional and physical pain.Conclusion: Our findings add to the literatureon how healthcare and social services are related to injury prevention. Social service providers in the suburbs were often indifferent to the needs of drug-using women. For these women, health services were accessed primarily at emergency departments (ED. To break the cycle of continued drug use, violence and injury, we suggest that ED staff be trained to perform substance abuse assessments and provide

  16. Availability of clean tap water and medical services prevents the incidence of typhoid Fever.

    Science.gov (United States)

    Lee, Deog-Yong; Lee, Esther; Park, Hyemin; Kim, Seonghan

    2013-04-01

    In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever. We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors. To prevent typhoid fever in the community, it is necessary to provide clean tap water service to 35.5% of the population, with an individual requiring 173 L of clean water daily. Appropriate access to clean water (51% service coverage, 307 L) helped the population to maintain individual hygiene and food safety practices, which brought about a decrease in the incidence of typhoid fever, and subsequently a decrease in fatality rate, which was achieved twice. During the 8-year study period, the fatality rate decreased to 1% when the population has access to proper medical service. The fatality rate was primarily affected by the availability of medical services as well as by the incidence of typhoid fever. However, an analysis of the study results showed that the incidence of typhoid fever was affected only by the availability of clean water through the tap water system.

  17. Effects of preventive family service coordination for parents with mental illnesses and their children, a RCT.

    Science.gov (United States)

    Wansink, Henny J; Janssens, Jan M A M; Hoencamp, Erik; Middelkoop, Barend J C; Hosman, Clemens M H

    2015-06-01

    Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as developed in the Preventive Basic Care Management (PBCM) program, improve parenting and prevent child behavioral problems? This randomized controlled clinical trial (RCT) compared the effectiveness of PBCM with a control condition. Ninety-nine outpatients of a community mental health center were randomized to intervention or control. Primary outcomes included parenting quality (assessed by the HOME instrument), parenting skills (parenting skills subscale of FFQ), and parenting stress (PDH). Secondary outcomes are child behavioral problems (SDQ). Outcomes were assessed at baseline and after 9 and 18 months. Effects were analyzed by Repeated Measures Analysis of Variance. Most families were single-parent families belonging to ethnic minorities. The results of the first RCT on effects of PBCM suggest that this intervention is feasible and has a positive effect on parenting skills. There was no evidence for effects on the quality of parenting and parenting stress, nor preventive effects on child behavioral problems. Replication studies in other sites, with more power, including monitoring of the implementation quality and studying a broader palette of child outcomes are needed to confirm the positive effects of PBCM. Long-term prospective studies are needed to investigate if improved parenting skills lead to positive effects in the children in the long run. (c) 2015 APA, all rights reserved).

  18. Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

    Science.gov (United States)

    Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M

    2017-03-01

    We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Suicide Prevention Public Service Announcements (PSAs): Examples from Around the World.

    Science.gov (United States)

    Ftanou, Maria; Cox, Georgina; Nicholas, Angela; Spittal, Matthew J; Machlin, Anna; Robinson, Jo; Pirkis, Jane

    2017-04-01

    Media campaigns have received increased attention as an intervention for combating suicide. Suicide prevention campaigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention campaigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.

  20. [Preventing addictive practices in the workplace thanks to occupational health services].

    Science.gov (United States)

    Dano, Corinne

    2017-06-01

    The workplace can be concerned by all types and all levels of addictive practices: consumption of alcohol or psychoactive substances, work addiction, internet addiction and technology addiction. Addictions can be related to multiple factors, both within and outside the workplace. With the employer, responsible for occupational health and safety, the multidisciplinary team of the inter-company occupational health service must today implement a collective and global prevention policy with regard to addictions, in addition to the traditional follow-up. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.

    Science.gov (United States)

    Lafata, Jennifer Elston; Shay, L Aubree; Brown, Richard; Street, Richard L

    2016-04-01

    The use of physician office-based tools such as electronic health records (EHRs), health risk appraisal (HRA) instruments, and written patient reminder lists is encouraged to support efficient, high-quality, patient-centered care. We evaluate the association of exam room use of EHRs, HRA instruments, and self-generated written patient reminder lists with patient-physician communication behaviors, recommended preventive health service delivery, and visit length. Observational study of 485 office visits with 64 primary care physicians practicing in a health system serving the Detroit metropolitan area. Study data were obtained from patient surveys, direct observation, office visit audio-recordings, and automated health system records. Outcome measures included visit length in minutes, patient use of active communication behaviors, physician use of supportive talk and partnership-building communication behaviors, and percentage of delivered guideline-recommended preventive health services for which patients are eligible and due. Simultaneous linear regression models were used to evaluate associations between tool use and outcomes. Adjusted models controlled for patient characteristics, physician characteristics, characteristics of the relationship between the patient and physician, and characteristics of the environment in which the visit took place. Prior to adjusting for other factors, visits in which the EHR was used on average were significantly (p communication behaviors facilitating patient involvement (2.1 vs. 2.6 occurrences), but more use of active patient communication behaviors (4.4 vs. 2.6). Likewise, HRA use was significantly associated with increased preventive services delivery (62.1 percent vs. 57.0 percent). All relationships remained significant (p > .05) in adjusted models with the exception of that between HRA use and preventive service delivery. Office-based tools intended to facilitate the implementation of desired primary care practice

  2. Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services

    OpenAIRE

    Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane

    2016-01-01

    Objective: This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions.

  3. Changes in dual-task performance after 5 months of karate and fitness training for older adults to enhance fall prevention.

    Science.gov (United States)

    Pliske, Gerald; Emmermacher, Peter; Weinbeer, Veronika; Witte, Kerstin

    2016-12-01

    Demographic changes resulting in an aging population are major factors for an increase of fall-related injuries. Especially in situations where dual tasks such as walking whilst talking have to be performed simultaneously the risk of a fall-related injury increases. It is well known that some types of martial art (e.g. Tai Chi) can reduce the risk of a fall. It is unknown if the same is true for karate. In this randomized, controlled study 68 people with a mean age of 69 years underwent 5-month karate training, 5-month fitness training or were part of a control group. Before and after the time of intervention a gait analysis with normal walk, a cognitive dual task and a motor dual task were performed. The gait parameter step frequency, walking speed, single-step time and single-step length were investigated. It could be seen that all groups improved their gait parameters after a 5-month period, even the control group. A sporty intervention seems to affect mainly the temporal gait parameters positively. This effect was especially demonstrated for normal walk and cognitive dual task. An improvement of the human walk seems to be possible through karate and fitness training, even under dual-task conditions. A prolonged intervention time with multiple repetitions of gait analysis could give better evidence if karate is a useful tool to increase fall prevention.

  4. [Hygiene and Infection Prevention in Medical Institutions, Kindergartens and Schools - Statutory Basis, Infection Control Practice and Experiences of the Public Health Services].

    Science.gov (United States)

    Heudorf, U

    2015-07-01

    Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community. Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Preventing crime by people with schizophrenic disorders: the role of psychiatric services.

    Science.gov (United States)

    Hodgins, S; Müller-Isberner, R

    2004-09-01

    Knowledge of when and how to implement treatments to prevent criminal offending among people with schizophrenia is urgently needed. To identify opportunities for interventions to prevent offending among men with schizophrenic disorders by tracking their histories of offending and admissions to hospital. We examined 232 men with schizophrenic disorders discharged from forensic and general psychiatric hospitals. Data were collected from participants, family members and official records. More than three-quarters (77.8%) of the forensic patients had previously been admitted to general psychiatric services; 24.3% of the general psychiatric patients had a criminal record. Offences had been committed by 39.8% of the forensic patients and 10.8% of the general psychiatric patients before their first admission to general psychiatry, and after their first admission these 59 patients committed 195 non-violent and 59 violent offences. Subsequently, 49 of them committed serious violent offences that led to forensic hospital admission. The offenders were distinguished by a pervasive and stable pattern of antisocial behaviour evident from at least mid-adolescence. General psychiatry requires resources in order to prevent criminal offending among a subgroup of patients with schizophrenic disorders.

  6. [Role of specialized care services of the national health service in the framework for the prevention of occupational risks (II)].

    Science.gov (United States)

    Gallo-Fernández, M

    Since 1986, the Government of Navarra has taken over the functions of security and health as part of the health 'area', with a broad conception of health, avoiding separating the citizen from the worker. In 1993, the Instituto Navarro de Salud Laboral created, under the direction of the departments of Health and Labor, combined diverse functions and resources, integrating preexisting structures into a technical department to be responsible for the overall health care of workers. The structure is based on two coordinated pillars, security and hygiene at work and occupational health. As more specifically to do with health, we describe the systems of epidemiological information and vigilance and programs for occupational disabilities, health activities in industry and investigation of diseases. The Unidades de Salud Laboral link the workplace with the public health service. The occupational health plan of Navarra will set out future strategies. It is necessary to involve neurologists in occupational health. Occupational risks and injury are everyone's problem. The neurologist's role in accidents is usually of health care; detection of illness is more difficult when an occupational relationship is not considered. Data from work should be included in the clinical history. The official figures for occupational neurological diseases are ridiculous and more cases should be detected. There should be a fluid relationship between neurologists, occupational doctors and experts in prevention.

  7. Potentially preventable use of emergency services: the role of low health literacy.

    Science.gov (United States)

    Schumacher, Jessica R; Hall, Allyson G; Davis, Terry C; Arnold, Connie L; Bennett, Robert D; Wolf, Michael S; Carden, Donna L

    2013-08-01

    Limited health literacy is a barrier for understanding health information and has been identified as a risk factor for overuse of the emergency department (ED). The association of health literacy with access to primary care services in patients presenting to the ED has not been fully explored. To examine the relationship between health literacy, access to primary care, and reasons for ED use among adults presenting for emergency care. Structured interviews that included health literacy assessment were performed involving 492 ED patients at one Southern academic medical center. Unadjusted and multivariable logistic regression models assessed the relationship between health literacy and (1) access to a personal physician; (2) doctor office visits; (3) ED visits; (4) hospitalizations; and (5) potentially preventable hospital admissions. After adjusting for sociodemographic and health status, those with limited health literacy reported fewer doctor office visits [odds ratio (OR)=0.6; 95% confidence interval (CI), 0.4-1.0], greater ED use, (OR=1.6; 95% CI, 1.0-2.4), and had more potentially preventable hospital admissions (OR=1.7; 95% CI, 1.0-2.7) than those with adequate health literacy. After further controlling for insurance and employment status, fewer doctor office visits remained significantly associated with patient health literacy (OR=0.5; 95% CI, 0.3-0.9). Patients with limited health literacy reported a preference for emergency care, as the services were perceived as better. Among ED patients, limited health literacy was independently associated with fewer doctor office visits and a preference for emergency care. Policies to reduce ED use should consider steps to limit barriers and improve attitudes toward primary care services.

  8. [Online Health Services for the Prevention of Stress-associated Psychological Impairments at the Workplace].

    Science.gov (United States)

    von Hofe, I; Latza, U; Lönnfors, S; Muckelbauer, R

    2017-03-01

    Objective: The aim of this systematic review is to provide an overview of the evidence from randomized controlled trials (RCTs) on the effect of online health services for the prevention of stress-associated psychological impairments at the workplace. Methods: The databases EMBASE, PubMed and PsycINFO were systematically searched for English, French and German references. Included were RCTs that examined the influence of online health services on stress-associated impairment in adult employees at the workplace. The Critical Appraisal Skills Programme (CASP) checklist was used for quality appraisal. Results: Out of 5 632 identified references, 13 RCTs were included in this study. The intervention approaches included movement and relaxation exercises, imparting of knowledge, cognitive-behavioral/social-behavioral interventions, risk communication, health coaching, mindfulness training, and career identity training. In 4 RCTs among mainly white collar employees, the interventions led to improvements in stress-associated outcomes (2 RCTs of high, one of medium and one of low quality level). 9 further RCTs (5 of them of a medium and 4 of a low quality level) did not show a beneficial intervention effect. Conclusion: There are effective health services for the prevention of stress-associated psychological impairments at the workplace. A final conclusion on the kind of intervention that is effective cannot be drawn due to the limited number of RCTs using various intervention approaches. Interventions of at least 12 weeks and a combination of multiple approaches were more often effective. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

    Directory of Open Access Journals (Sweden)

    Oldenburg Brian

    2009-12-01

    Full Text Available Abstract Background Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia. Methods Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA and internal reliability testing (Cronbach's alpha were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent. Results The PCA identified five scales with acceptable levels of internal consistency were: (1 social support (ten items, alpha 0.86; (2 perceived interpersonal care (five items, alpha 0.87, (3 concerns about availability of health care and accessibility to health care (eight items, alpha 0.80, (4 value of good health (five items, alpha 0.79, and (5 attitudes towards health care (three items, alpha 0.75. Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

  10. Implementation of secondary fracture prevention services after hip fracture: a qualitative study using extended Normalization Process Theory

    OpenAIRE

    Drew, Sarah; Judge, Andrew; May, Carl; Farmer, Andrew; Cooper, Cyrus; Javaid, M Kassim; Gooberman-Hill, Rachael

    2015-01-01

    Background National and international guidance emphasizes the need for hospitals to have effective secondary fracture prevention services, to reduce the risk of future fractures in hip fracture patients. Variation exists in how hospitals organize these services, and there remain significant gaps in care. No research has systematically explored reasons for this to understand how to successfully implement these services. The objective of this study was to use extended Normalization Process Theo...

  11. Evaluating the integration of chronic disease prevention and management services into primary health care.

    Science.gov (United States)

    Fortin, Martin; Chouinard, Maud-Christine; Bouhali, Tarek; Dubois, Marie-France; Gagnon, Cynthia; Bélanger, Martin

    2013-04-08

    The increasing number of patients with chronic diseases represents a challenge for health care systems. The Chronic Care Model suggests a multi-component remodelling of chronic disease services to improve patient outcomes. To meet the complex and ongoing needs of patients, chronic disease prevention and management (CDPM) has been advocated as a key feature of primary care producing better outcomes, greater effectiveness and improved access to services compared to other sectors. The objective of this study is to evaluate the adaptation and implementation of an intervention involving the integration of chronic disease prevention and management (CDPM) services into primary health care. The implementation of the intervention will be evaluated using descriptive qualitative methods to collect data from various stakeholders (decision-makers, primary care professionals, CDPM professionals and patients) before, during and after the implementation. The evaluation of the effects will be based on a combination of experimental designs: a randomized trial using a delayed intervention arm (n = 326), a before-and-after design with repeated measures (n = 163), and a quasi-experimental design using a comparative cohort (n = 326). This evaluation will utilize self-report questionnaires measuring self-efficacy, empowerment, comorbidity, health behaviour, functional health status, quality of life, psychological well-being, patient characteristics and co-interventions. The study will take place in eight primary care practices of the Saguenay region of Quebec (Canada). To be included, patients will have to be referred by their primary care provider and present at least one of the following conditions (or their risk factors): diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, asthma. Patients presenting serious cognitive problems will be excluded. In the short-term, improved patient self-efficacy and empowerment are expected. In the mid-term, we expect to observe an

  12. HIV risk behaviors, knowledge, and prevention service experiences among African American and other offenders.

    Science.gov (United States)

    Belenko, Steven R; Shedlin, Michele; Chaple, Michael

    2005-11-01

    African Americans are at the intersection of the AIDS epidemic and burgeoning prison and offender populations, yet little is known about offenders' HIV knowledge and risk behaviors or ability to access effective services. We present findings from an exploratory study based on 300 interviews with New York City offenders conducted in 2001-2002. The data indicate relatively high rates of HIV infection and HIV risk behaviors among African American and other offenders. There were no clear patterns of risk behaviors by race/ethnicity. Although overall HIV knowledge level is high, important gaps in HIV knowledge remain and there is widespread skepticism among offenders about government information about HIV/AIDS. In the corrections setting, there is inconsistent access to HIV prevention and education services, and an emphasis on more passive learning materials. To reduce HIV infection rates, there is a need to expand peer-led and culturally- and gender-specific interventions, and to improve access to correctional facilities for community-based HIV service providers. HIV interventions must also be expanded for offenders on probation and parole. Mandatory HIV education and harm reduction approaches should be considered.

  13. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  14. Integration of HIV prevention into Sexual and Reproductive Health Services in an urban setting in South Africa

    Directory of Open Access Journals (Sweden)

    Shireen Parker

    2013-01-01

    Full Text Available Background: The United Nations Political Declaration on HIV and AIDS of 2006 stressed the need to strengthen policy and programme linkages between HIV and Sexual and Reproductive Health (SRH. However, the effectiveness and best practices for strengthening SRH and HIV linkages are poorly researched in the context of family-planning services. In Cape Town, HIV-prevention services have been integrated into family-planning services. There are two models of service configuration: dedicated stand-alone reproductive health clinics and family planning services located in comprehensive primary-care facilities.Objective: To describe how reproductive health services are integrating HIV prevention and care strategies and to measure the coverage and quality of these integrated services.Methods: A cross-sectional study was conducted using structured interviews with facility managers; a facility-based checklist; and a patient record review to assess the availability of resources, training, access, quality and integration.Results: Facilities in Cape Town are equipped adequately to offer integrated HIV-prevention and SRH services. Overall there was poor coverage of integrated services with 54% of family planning clients having a known HIV status; 47% being screened for a sexually transmitted infection and 55% being offered HIV counselling and testing and receiving condoms. Quality and continuity of care seemed better at the dedicated clinics than at the comprehensive facilities,supported by better training coverage.Conclusion: Engaging middle-level management is crucial with regard to improving integration within a well-resourced setting.

  15. Short message service (SMS) applications for disease prevention in developing countries.

    Science.gov (United States)

    Déglise, Carole; Suggs, L Suzanne; Odermatt, Peter

    2012-01-12

    The last decade has witnessed unprecedented growth in the number of mobile phones in the developing world, thus linking millions of previously unconnected people. The ubiquity of mobile phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention efforts. The aim of this review was to describe the characteristics and outcomes of SMS interventions for disease prevention in developing countries and provide recommendations for future work. A systematic search of peer-reviewed and gray literature was performed for papers published in English, French, and German before May 2011 that describe SMS applications for disease prevention in developing countries. A total of 34 SMS applications were described, among which 5 had findings of an evaluation reported. The majority of SMS applications were pilot projects in various levels of sophistication; nearly all came from gray literature sources. Many applications were initiated by the project with modes of intervention varying between one-way or two-way communication, with or without incentives, and with educative games. Evaluated interventions were well accepted by the beneficiaries. The primary barriers identified were language, timing of messages, mobile network fluctuations, lack of financial incentives, data privacy, and mobile phone turnover. This review illustrates that while many SMS applications for disease prevention exist, few have been evaluated. The dearth of peer-reviewed studies and the limited evidence found in this systematic review highlight the need for high-quality efficacy studies examining behavioral, social, and economic outcomes of SMS applications and mobile phone interventions aimed to promote health in developing country contexts.

  16. [Task redistribution in Dutch dental care in relation to dental hygienists' job satisfaction].

    Science.gov (United States)

    Jerkovic, K; van Offenbeek, M A G; van der Schans, C P

    2010-05-01

    In research into a professional cross-section of dental hygienists, we studied the extent to which task redistribution has an influence on job satisfaction. The research among randomly chosen dental hygienists consisted of questions about organizational and personal characteristics, the set of assigned tasks, task characteristics and job satisfaction. The respondents were divided into 3 clusters which differed in the breadth of their sets of tasks. Although prevention and periodontology services remain the core tasks in dental hygienists' jobs, the degree of task redistribution differed strongly from cluster to cluster. Respondents with a considerable degree of task redistribution experienced the most task variation, but scored significantly lower on the task characteristics autonomy, feedback, task identity and task importance. This explains why redistribution does not directly correspond with a greater degree of job satisfaction. Moreover, it is precisely the dental hygienists with a broad set of tasks who are significantly less satisfied with their salary than those with a traditional set of tasks.

  17. Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

    Science.gov (United States)

    Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle

    2010-01-01

    BACKGROUND The contribution of masculinity to men’s healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). MEASUREMENTS Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60–0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45–0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34–5.20), blood pressure (OR: 3.03; 95% CI: 1.45–6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03–4.23). CONCLUSIONS Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men’s blood pressure and cholesterol screening. Routine

  18. Integration of prevention of mother-to-child HIV transmission into maternal health services in Senegal.

    Science.gov (United States)

    Cisse, C

    2017-06-01

    The objective of this study was to assess the level of integration of prevention of mother-to-child HIV transmission (PMTCT) in facilities providing services for maternal, newborn, and child health (MNCH) and reproductive health (RH) in Senegal. The survey, conducted from August through November, 2014, comprised five parts : a literature review to assess the place of this integration in the health policies, standards, and protocols in effect in Senegal; an analysis by direct observation of attitudes and practices of 25 healthcare providers at 5 randomly-selected obstetrics and gynecology departments representative of different levels of the health pyramid; a questionnaire evaluating knowledge and attitudes of 10 providers about the integration of PMTCT services into MNCH/RH facilities; interviews to collect the opinions of 70 clients, including 16 HIV-positive, about the quality of PMTCT services they received; and a questionnaire evaluating knowledge and opinions of 14 policy-makers/managers of health programs focusing on mothers and children about this integration. The literature review revealed several constraints impeding this integration : the policy documents, standards, and protocols of each of the programs involved do not clearly indicate the modalities of this integration; the programs are housed in two different divisions while the national Program against the Human Immunodeficiency Virus reports directly to the Prime Minister; program operations remains generally vertical; the resources for the different programs are not sufficiently shared; there is no integrated training module covering integrated management of pregnancy and delivery; and supervision for each of the different programs is organized separately.The observation of the providers supporting women during pregnancy, during childbirth, and in the postpartum period, showed an effort to integrate PMTCT into the MNCH/RH services delivered daily to clients. But this desire is hampered by many

  19. Expansion of Vaccination Services and Strengthening Vaccine-Preventable Diseases Surveillance in Haiti, 2010-2016.

    Science.gov (United States)

    Tohme, Rania A; Francois, Jeannot; Cavallaro, Kathleen F; Paluku, Gilson; Yalcouye, Idrissa; Jackson, Ernsley; Wright, Tracie; Adrien, Paul; Katz, Mark A; Hyde, Terri B; Faye, Pape; Kimanuka, Francine; Dietz, Vance; Vertefeuille, John; Lowrance, David; Dahl, Benjamin; Patel, Roopal

    2017-10-01

    Following the 2010 earthquake, Haiti was at heightened risk for vaccine-preventable diseases (VPDs) outbreaks due to the exacerbation of long-standing gaps in the vaccination program and subsequent risk of VPD importation from other countries. Therefore, partners supported the Haitian Ministry of Health and Population to improve vaccination services and VPD surveillance. During 2010-2016, three polio, measles, and rubella vaccination campaigns were implemented, achieving a coverage > 90% among children and maintaining Haiti free of those VPDs. Furthermore, Haiti is on course to eliminate maternal and neonatal tetanus, with 70% of communes achieving tetanus vaccine two-dose coverage > 80% among women of childbearing age. In addition, the vaccine cold chain storage capacity increased by 91% at the central level and 285% at the department level, enabling the introduction of three new vaccines (pentavalent, rotavirus, and pneumococcal conjugate vaccines) that could prevent an estimated 5,227 deaths annually. Haiti moved from the fourth worst performing country in the Americas in 2012 to the sixth best performing country in 2015 for adequate investigation of suspected measles/rubella cases. Sentinel surveillance sites for rotavirus diarrhea and meningococcal meningitis were established to estimate baseline rates of those diseases prior to vaccine introduction and to evaluate the impact of vaccination in the future. In conclusion, Haiti significantly improved vaccination services and VPD surveillance. However, high dependence on external funding and competing vaccination program priorities are potential threats to sustaining the improvements achieved thus far. Political commitment and favorable economic and legal environments are needed to maintain these gains.

  20. Factors that influence the preventive care offered to adolescents accessing Public Oral Health Services, NSW, Australia

    Directory of Open Access Journals (Sweden)

    Masoe AV

    2015-06-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia; 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia Background: Many adolescents are at risk of dental caries and periodontal disease, which may be controlled through health education and clinical preventive interventions provided by oral health and dental therapists (therapists. Senior clinicians (SCs can influence the focus of dental care in the New South Wales (NSW Public Oral Health Services as their role is to provide clinical support and advice to therapists, advocate for their communities, and inform Local Health District (LHD managers of areas for clinical quality improvement. The objective of this study was to record facilitating factors and strategies that are used by SCs to encourage therapists to provide preventive care and advice to adolescent patients. Methods: In-depth, semistructured interviews were undertaken with 16 SCs from all of the 15 NSW LHDs (nine rural and six metropolitan. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: All SCs from the 15 NSW Health LHDs participated in the study. Factors influencing SCs' ability to integrate preventive care into clinical practice were: 1 clinical leadership and administrative support, 2 professional support network, 3 clinical and educational resources, 4 the clinician's patient management aptitude, and 5 clinical governance processes. Clinical quality improvement and continuing professional development strategies equipped clinicians to manage and enhance adolescents' confidence toward self-care. Conclusion: This study shows that SCs have a clear understanding of strategies to enhance the therapist's offer of scientific-based preventive care to adolescents. The problem

  1. [Educational intervention for the prevention of osteoporosis in a rural primary healthcare service].

    Science.gov (United States)

    Pérez Fernández, María Reyes; Almazán Ortega, Raquel; Martínez Portela, José María; Alves Pérez, M Teresa; Segura Iglesias, M Carmen; Pérez Fernández, Román

    2013-12-21

    The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1=110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2=106): information by post. After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P<.001) and decreased the Ca (P ≤.048) and PTH (P<.001) levels. The control group increased its BMI (P<.001) and its BMD (P ≤.048), maintained its Ca levels and decreased the PTH values (P=.01). The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  2. Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes.

    Science.gov (United States)

    Gary, Tiffany L; Maiese, Eric M; Batts-Turner, Marian; Wang, Nae-Yuh; Brancati, Fredrick L

    2005-12-01

    The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of Consumer Assessment of Health Plans Survey (CAHPS) and use of diabetes-related preventive health care and ER were assessed by self-report. We then followed participants for 12 months to determine ER use prospectively. In general, participants gave favorable ratings of their care; over 70% reported that they had no problem getting care, over 60% reported the highest ratings on the communication and courtesy domains, and mean ratings (0-10 scale) for personal doctor and overall health care were high (8.8 and 8.4, respectively). Using poisson regression models adjusted for age, education, and self-reported rating of health, several aspects of patient satisfaction were associated with subsequent ER use. Participants who reported that medical staff were usually helpful or that doctors and nurses usually spent enough time were 0.49 and 0.37 times, respectively, less likely to use the ER (all p < 0.05). However, few aspects of patient satisfaction were associated with better preventive services. These data suggest that greater patient satisfaction was associated with lower ER use in urban African-Americans. Whether measures to improve patient satisfaction would reduce ER use requires further prospective study.

  3. Sustainable energy for all. Technical report of task force 1 in support of the objective to achieve universal access to modern energy services by 2030

    Energy Technology Data Exchange (ETDEWEB)

    Birol, Fatih [International Energy Agency, Paris (France); Brew-Hammond, Abeeku (University of Science and Technology (Ghana

    2012-04-15

    The UN Secretary General established the Sustainable Energy for All initiative in order to guide and support efforts to achieve universal access to modern energy, rapidly increase energy efficiency, and expand the use of renewable energies. Task forces were formed involving prominent energy leaders and experts from business, government, academia and civil society worldwide. The goal of the Task Forces is to inform the implementation of the initiative by identifying challenges and opportunities for achieving its objectives. This report contains the findings of Task Force One which is dedicated to the objective of achieving universal access to modern energy services by 2030. The report shows that universal energy access can be realized by 2030 with strong, focused actions set within a coordinated framework.

  4. [Self-assessment of tasks and roles of occupational medicine service (OMS) nurses in the Polish system of workers' health protection].

    Science.gov (United States)

    Sakowski, Piotr

    2010-01-01

    This paper presents the results of survey performed to find out how occupational medicine service (OMS) nurses assess their tasks and roles in the Polish system of workers' health protection. The survey was carried out in a random group of 200 OMS nurses. The survey showed that OMS nurses form-an experienced professional group. According to self-assessment they have an opportunity to use their competence in its full scope. Almost half of respondents agreed that in Poland the skills of OMS nurses are properly used. There are two reasons why certain tasks are not performed by OMS nurses, first, certain tasks are assigned to other persons in the unit; second, employers are sometimes not interested in those tasks or find them not necessary. The majority of nurses assess their knowledge and preparation to perform tasks relatively well, however they want to broaden their knowledge and improve their skills. OMS nurses play an important role in the Polish system of workers' health protection. They perform many tasks, which fall within the scope of OMS activities being currently implemented. Their competences are usually properly used. There is a need to convince employers that the scope of services provided by OMS units should be extended and adequately financed. This should result in the better use of OMS nurses' competences. Nurses are well educated and skilled to perform their jobs. Nevertheless, they feel the need to broaden their knowledge. Although the programs of specialization and qualification courses are rather comprehensive, nurses declare that some areas should be enriched with additional information.

  5. Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

    OpenAIRE

    Nyondo, Alinane Linda; Chimwaza, Angela Faith; Muula, Adamson Sinjani

    2014-01-01

    Background Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman’s risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this s...

  6. Preventive and clinical care provided to adolescents attending public oral health services New South Wales, Australia: a retrospective study.

    Science.gov (United States)

    Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

    2014-11-28

    Dental Therapists and Oral Health Therapists (Therapists) working in the New South Wales (NSW) Public Oral Health Service are charged with providing clinical dental treatment including preventive care for all children under 18 years of age. Adolescents in particular are at risk of dental caries and periodontal disease which may be controlled through health education and clinical preventive interventions. However, there is a dearth of evidence about the type or the proportion of clinical time allocated to preventive care.The aim of this study is to record the proportion and type of preventive care and clinical treatment activities provided by Therapists to adolescents accessing the NSW Public Oral Health Service. Clinical dental activity data for adolescents was obtained from the NSW Health electronic Information System for Oral Health (ISOH) for the year 2011. Clinical activities of Therapists were examined in relation to the provision of different types of preventive care for adolescents by interrogating state-wide public oral health data stored on ISOH. Therapists were responsible for 79.7 percent of the preventive care and 83.0 percent of the restorative treatment offered to adolescents accessing Public Oral Health Services over the one year period. Preventive care provided by Therapists for adolescents varied across Local Health Districts ranging from 32.0 percent to 55.8 percent of their clinical activity. Therapists provided the majority of clinical care to adolescents accessing NSW Public Oral Health Services. The proportion of time spent undertaking prevention varied widely between Local Health Districts. The reasons for this variation require further investigation.

  7. An Improved Model for Headway-Based Bus Service Unreliability Prevention with Vehicle Load Capacity Constraint at Bus Stops

    Directory of Open Access Journals (Sweden)

    Weiya Chen

    2012-01-01

    Full Text Available This paper presents an improved model for improving headway-based bus route service reliability at bus stops using real-time preventive operation control, taking into account dynamic interaction among random passenger demand, stochastic driving conditions of route segments, and vehicle load capacity constraint. In this model, the real-time information of passenger demand and vehicle operation is involved to predict the imminent unacceptable headway deviation, in the case of which some in-time preventive control strategies are deployed according to the given control rules. As a case study, a single fixed bus route with high-frequency services was simulated and different scenarios of real-time preventive operation control were performed. Headway adherence and average passenger wait time were used to measure bus service reliability. The results show that the improved model is closer to the real bus route service, and using real-time information to predict potential service unreliability and trigger in-time preventive control can reduce bus bunching and avoid big gap.

  8. The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.

    Science.gov (United States)

    Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather

    2017-03-08

    People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and

  9. Prioritizing industries for occupational injury prevention and research in the Services Sector in Washington State, 2002-2010.

    Science.gov (United States)

    Anderson, Naomi J; Bonauto, David K; Adams, Darrin

    2014-01-01

    The Services Sector, as defined by the National Occupational Research Agenda (NORA), is comprised of a diverse industry mix and its workers face a variety of occupational exposures and hazards. The objective of this study was to identify high-risk industry groups within the Services Sector for prevention targeting. Compensable Washington State workers' compensation claims from the Services Sector from 2002 through 2010 were analyzed. A "prevention index" (PI), the average of the rank orders of claim count and claim incidence rate, was used to rank 87 Services Sector industry groups by seven injury types: Work- Related Musculoskeletal Disorders (WMSDs), Fall to Lower Level, Fall on Same Level, Struck By/Against, Caught In/Under/Between, Motor Vehicle, and Overexertion. In the PI rankings, industry groups with high injury burdens appear higher ranked than industry groups with low counts or low rates of injury, indicating a need for prioritizing injury prevention efforts in these groups. In the Services Sector, these 7 injury types account for 84% of compensable claims in WA. The industry groups highest ranked by PI across the injury types included: Services to Buildings and Dwellings; Executive, Legislative, and Other General Government Support; and Waste Collection. WMSDs had the highest compensable claims rates. Services is a large sector of the economy, and the substantial number, rate, and cost of occupational injuries within this sector should be addressed. Several Services Sector industry groups are at high risk for a variety of occupational injuries. Using a PI to rank industry groups based on their injury risk provides information with which to guide prevention efforts.

  10. Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

    Science.gov (United States)

    Pazol, Karen; Robbins, Cheryl L; Black, Lindsey I; Ahrens, Katherine A; Daniels, Kimberly; Chandra, Anjani; Vahratian, Anjel; Gavin, Lorrie E

    2017-10-27

    Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services. QFP describes how to provide these services and recommends using family planning and other primary care visits to screen for and offer the full range of these services. This report presents baseline estimates of the use of these preventive services before the publication of QFP that can be used to monitor progress toward improving the quality of preventive care received by women and men of reproductive age. 2011-2013. Three surveillance systems were used to document receipt of preventive health services among women and men of reproductive age as recommended in QFP. The National Survey of Family Growth (NSFG) collects data on factors that influence reproductive health in the United States since 1973, with a focus on fertility, sexual activity, contraceptive use, reproductive health care, family formation, child care, and related topics. NSFG uses a stratified, multistage probability sample to produce nationally representative estimates for the U.S. household population of women and men aged 15-44 years. This report uses data from the 2011-2013 NSFG. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences

  11. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  12. Investigation for integration of the German Public Health Service in catastrophe and disaster prevention programs in Germany

    International Nuclear Information System (INIS)

    Pfenninger, E.; Koenig, S.; Himmelseher, S.

    2004-01-01

    This research project aimed at investigating the integration of the GPHS into the plans for civil defence and protection as well as catastrophe prevention of the Federal Republic of Germany. Following a comprehensive analysis of the current situation, potential proposals for an improved integrative approach will be presented. In view of the lack of topics relevant for medical care in disaster medicine in educational curricula and training programs for medical students and postgraduate board programs for public health physicians, a working group of the Civil Protection Board of the German Federal Ministry of the Interior already complained in their 'Report on execution of legal rules for protection and rescue of human life as well as restitution of public health after disaster' in 1999, that the integration of the GPHS into catastrophe and disaster prevention programs has insufficiently been solved. On a point-by-point approach, our project analysed the following issues: - Legislative acts for integration of the German Public Health Service into medical care in catastrophes and disasters to protect the civilian population of Germany and their implementation and execution. - Administrative rules and directives on state and district levels that show relationship to integration of the German Public Health Service into preparedness programs for catastrophe prevention and management and their implementation and execution. - Education and postgraduate training options for physicians and non-physician employees of the German Public health Service to prepare for medical care in catastrophes and disasters. - State of knowledge and experience of the German Public Health Service personnel in emergency and disaster medicine. - Evaluation of the German administrative catastrophe prevention authorities with regard to their integration of the German Public Health Service into preparedness programs for catastrophe prevention and management. - Development of a concept to remedy the

  13. Task 20 - Prevention of Chloride Corrosion in High-Temperature Waste Treatment Systems (Corrosives Removals from Vitrification Slurries)

    International Nuclear Information System (INIS)

    Timpe, R.C.; Aulich, T.R.

    1998-01-01

    GTS Duratek is working with BNFL Incorporated on a US Department of Energy (DOE) contract to develop a facility to treat and immobilize radioactive waste at the Hanford site in southeast Washington. Development of the 10-ton/day Hanford facility will be based on findings from work at Duratek's 3.3-ton/day pilot plant in Columbia, Maryland, which is in the final stage of construction and scheduled for shakedown testing in early 1999. In prior work with the Catholic University of America Vitreous State Laboratory, Duratek has found that slurrying is the most efficient way to introduce low-level radioactive, hazardous, and mixed wastes into vitrification melters. However, many of the Hanford tank wastes to be vitrified contain species (primarily chloride and sulfate) that are corrosive to the vitrifier or the downstream air pollution control equipment, especially under the elevated temperature conditions existent in these components. Removal of these corrosives presents a significant challenge because most tank wastes contain high (up to 10-molar) concentrations of sodium hydroxide (NaOH) along with significant levels of nitrate, nitrite, and other anions, which render standard ion-exchange, membrane filtration, and other separation technologies relatively ineffective. In Task 20, the Energy and Environmental Research Center (EERC) will work with Duratek to develop and optimize a vitrification pretreatment process for consistent, quantitative removal of chloride and sulfate prior to vitrifier injection

  14. 75 FR 52958 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

    Science.gov (United States)

    2010-08-30

    ... such as medical decisionmaking, clinical epidemiology, behavioral medicine, health equity, and health... family medicine, internal medicine, obstetrics/gynecology, pediatrics, nursing, behavioral medicine, health equity or methodology. AHRQ will retain and consider for future vacancies the nominations of those...

  15. 75 FR 69094 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

    Science.gov (United States)

    2010-11-10

    ..., behavioral medicine, health equity, and health economics. For individuals with clinical expertise in primary... field of expertise. Applicants must have no substantial conflicts of interest, whether financial... interest. Such information will concern matters such as financial holdings, consultancies, and research...

  16. [Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

    Science.gov (United States)

    Kubota, Satoshi; Kawai, Hiromi

    2015-01-01

    In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

  17. The American Psychological Association Task Force assessment of violent video games: Science in the service of public interest.

    Science.gov (United States)

    Calvert, Sandra L; Appelbaum, Mark; Dodge, Kenneth A; Graham, Sandra; Nagayama Hall, Gordon C; Hamby, Sherry; Fasig-Caldwell, Lauren G; Citkowicz, Martyna; Galloway, Daniel P; Hedges, Larry V

    2017-01-01

    A task force of experts was convened by the American Psychological Association (APA) to update the knowledge and policy about the impact of violent video game use on potential adverse outcomes. This APA Task Force on Media Violence examined the existing literature, including the meta-analyses in the field, since the last APA report on media violence in 2005. Because the most recent meta-analyses were published in 2010 and reflected work through 2009, the task force conducted a search of the published studies from 2009-2013. These recently published articles were scored and assessed by a systematic evidentiary review, followed by a meta-analysis of the high utility studies, as documented in the evidentiary review. Consistent with the literature that we reviewed, we found that violent video game exposure was associated with: an increased composite aggression score; increased aggressive behavior; increased aggressive cognitions; increased aggressive affect, increased desensitization, and decreased empathy; and increased physiological arousal. The size of the effects was similar to that in prior meta-analyses, suggesting a stable result. Our task force concluded that violent video game use is a risk factor for adverse outcomes, but found insufficient studies to examine any potential link between violent video game use and delinquency or criminal behavior. Our technical report is the basis of this article. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Patient profile in a bone health and osteoporosis prevention service in Ireland.

    Science.gov (United States)

    McGowan, B; Bennett, K; Marry, J; Walsh, J B; Casey, M C

    2012-12-01

    To (1) characterise a cohort of patients attending a major osteoporosis clinic in Ireland and (2) examine the prescribing of preventative therapies amongst these patients. Data were taken from 2006-2007 on patients attending the Osteoporosis Clinic at St. James's Hospital, Dublin. Information gathered included age, gender, fracture history, past medical and surgical history, co-morbidities, the results of the first DXA scans, anti-resorptive therapies along with other medications prescribed. Of all patients 87.6% were female and the mean age was 68 years (SD = 14.31). In total 166 (74%) patients had osteoporosis, 40 (17.8%) had osteopenia and 18 patients (8%) had normal T-score values, 163 (72.7%) had a history of a fracture. Only 13.7% of the patients did not have a documented history of other co-morbidities. Comprehensive services such as the Osteoporosis Clinic at St. James's Hospital can provide the necessary screening, monitoring and prescribing of appropriate osteoporosis medications with additional follow-up if required to this at risk group reducing the unnecessarily traumatic effects of the disease on patients.

  19. Motivations and experiences of women who accessed "see and treat" cervical cancer prevention services in Zambia.

    Science.gov (United States)

    White, Heather L; Mulambia, Chishimba; Sinkala, Moses; Mwanahamuntu, Mulindi H; Parham, Groesbeck P; Kapambwe, Sharon; Moneyham, Linda; Kempf, Mirjam C; Chamot, Eric

    2012-06-01

    In Zambia, a country with a generalized HIV epidemic, age-adjusted cervical cancer incidence is among the highest worldwide. In 2006, the University of Alabama at Birmingham-Center for Infectious Disease Research in Zambia and the Zambian Ministry of Health launched a visual inspection with acetic acid (VIA) -based "see and treat" cervical cancer prevention program in Lusaka. All services were integrated within existing government-operated primary health care facilities. Study aims were to (i) identify women's motivations for cervical screening, (ii) document women's experiences with screening and (iii) describe the potentially reciprocal influences between women undergoing cervical screening and their social networks. Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with women who accepted screening and with care providers. Low-level content analysis was performed to identify themes evoked by participants. Between September 2009 and July 2010, 60 women and 21 care providers participated in 8 FGD and 10 IDI. Women presented for screening with varying needs and expectations. A majority discussed their screening decisions and experiences with members of their social networks. Key reinforcing factors and obstacles to VIA screening were identified. Interventions are needed to gain support for the screening process from influential family members and peers.

  20. Does a TV Public Service Advertisement Campaign for Suicide Prevention Really Work?

    Science.gov (United States)

    Song, In Han; You, Jung-Won; Kim, Ji Eun; Kim, Jung-Soo; Kwon, Se Won; Park, Jong-Ik

    2017-05-01

    One of the critical measures in suicide prevention is promoting public awareness of crisis hotline numbers so that individuals can more readily seek help in a time of crisis. Although public service advertisements (PSA) may be effective in raising the rates of both awareness and use of a suicide hotline, few investigations have been performed regarding their effectiveness in South Korea, where the suicide rate is the highest among OECD countries. The goal of this study was to evaluate the effectiveness of a television PSA campaign. We analyzed a database of crisis phone calls compiled by the Korean Ministry of Health and Welfare to track changes in call volume to a crisis hotline that was promoted in a TV campaign. We compared daily call counts for three periods of equal length: before, during, and after the campaign. The number of crisis calls during the campaign was about 1.6 times greater than the number before or after the campaign. Relative to the number of suicide-related calls in the previous year, the number of calls during the campaign period surged, displaying a noticeable increase. The findings confirmed that this campaign had a positive impact on call volume to the suicide hotline.

  1. Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010-2015.

    Science.gov (United States)

    Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet

    2017-10-26

    Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the "ABCDs" of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public-private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems.

  2. Screening for Trauma Exposure, and Posttraumatic Stress Disorder and Depression Symptoms among Mothers Receiving Child Welfare Preventive Services

    Science.gov (United States)

    Chemtob, Claude M.; Griffing, Sascha; Tullberg, Erika; Roberts, Elizabeth; Ellis, Peggy

    2011-01-01

    The role of parental trauma exposure and related mental health symptoms as risk factors for child maltreatment for parents involved with the child welfare (CW) system has received limited attention. In particular, little is known about the extent to which mothers receiving CW services to prevent maltreatment have experienced trauma and suffered…

  3. Perspectives of rural health and human service practitioners following suicide prevention training programme in Australia: A thematic analysis.

    Science.gov (United States)

    Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas

    2018-01-08

    There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subsample of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery. © 2018 John Wiley & Sons Ltd.

  4. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  5. Experiences and wisdom behind the numbers: qualitative analysis of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force stakeholder survey.

    Science.gov (United States)

    Booth, Chelsea L

    2014-09-01

    The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a stakeholder survey including 716 respondents from 49 U.S. states and 18 foreign countries. To conduct a qualitative analysis on responses from individuals representing four main stakeholder groups: attempt and loss survivors, researchers, providers, and policy/administrators. This article focuses on a qualitative analysis of the early-round, open-ended responses collected in a modified online Delphi process, and, as an illustration of the research method, focuses on analysis of respondents' views of the role of life and emotional skills in suicide prevention. Content analysis was performed using both inductive and deductive code and category development and systematic qualitative methods. After the inductive coding was completed, the same data set was re-coded using the 12 Aspirational Goals (AGs) identified by the Delphi process. Codes and thematic categories produced from the inductive coding process were, in some cases, very similar or identical to the 12 AGs (i.e., those dealing with risk and protective factors, provider training, preventing reattempts, and stigma). Other codes highlighted areas that were not identified as important in the Delphi process (e.g., cultural/social factors of suicide, substance use). Qualitative and mixed-methods research are essential to the future of suicide prevention work. By design, qualitative research is explorative and appropriate for complex, culturally embedded social issues such as suicide. Such research can be used to generate hypotheses for testing and, as in this analysis, illuminate areas that would be missed in an approach that imposed predetermined categories on data. Published by Elsevier Inc.

  6. A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dzuba Ilana

    2005-12-01

    Full Text Available Abstract Background Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. Methods Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions to assess the perspectives of women, providers, policy makers and community members. Results There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services

  7. Service-learning in higher education relevant to the promotion of physical activity, healthful eating, and prevention of obesity

    Directory of Open Access Journals (Sweden)

    Richard R Rosenkranz

    2012-01-01

    Full Text Available Service-learning is a type of experiential teaching and learning strategy combining classroom instruction and meaningful community service and guided activities for reflection. This educational approach has been used frequently in higher education settings, including an array of disciplines such as medicine, theology, public health, physical education, nutrition, psychology, anthropology, and sociology. The purpose of the present review paper was to provide guidance on the use of service-learning within higher education, relevant to the preventive medicine and public health topics of healthful eating, physical activity, and obesity prevention. In service-learning, coursework is structured to address community needs, and to benefit students through the real-world application of knowledge. The benefits for students include positive impacts on social skills, empathy, awareness, understanding, and concern regarding community issues, plus greater confidence and skills to work with diverse populations, increased awareness of community resources, improved motivation, and enhanced knowledge. Educational institutions may also benefit through improved "town and gown" relations, as strong ties, partnerships, and mutually beneficial activities take place. The present literature review describes several service-learning applications such as nutrition education for kids, dietary improvement for seniors, foodservice recipe modification on a college campus, an intergenerational physical activity program for nursing home residents, motor skill development in kindergarteners, organized elementary school recess physical activities, health education, and obesity prevention in children. From this review, service-learning appears to have great potential as a flexible component of academic coursework in the areas of preventive medicine and public health.

  8. Contact with HIV prevention services highest in gay and bisexual men at greatest risk: cross-sectional survey in Scotland

    Directory of Open Access Journals (Sweden)

    Hart Graham J

    2010-12-01

    Full Text Available Abstract Background Men who have sex with men (MSM remain the group most at risk of acquiring HIV in the UK and new HIV prevention strategies are needed. In this paper, we examine what contact MSM currently have with HIV prevention activities and assess the extent to which these could be utilised further. Methods Anonymous, self-complete questionnaires and Orasure™ oral fluid collection kits were distributed to men visiting the commercial gay scenes in Glasgow and Edinburgh in April/May 2008. 1508 men completed questionnaires (70.5% response rate and 1277 provided oral fluid samples (59.7% response rate; 1318 men were eligible for inclusion in the analyses. Results 82.5% reported some contact with HIV prevention activities in the past 12 months, 73.1% obtained free condoms from a gay venue or the Internet, 51.1% reported accessing sexual health information (from either leaflets in gay venues or via the Internet, 13.5% reported talking to an outreach worker and 8.0% reported participating in counselling on sexual health or HIV prevention. Contact with HIV prevention activities was associated with frequency of gay scene use and either HIV or other STI testing in the past 12 months, but not with sexual risk behaviours. Utilising counselling was also more likely among men who reported having had an STI in the past 12 months and HIV-positive men. Conclusions Men at highest risk, and those likely to be in contact with sexual health services, are those who report most contact with a range of current HIV prevention activities. Offering combination prevention, including outreach by peer health workers, increased uptake of sexual health services delivering behavioural and biomedical interventions, and supported by social marketing to ensure continued community engagement and support, could be the way forward. Focused investment in the needs of those at highest risk, including those diagnosed HIV-positive, may generate a prevention dividend in the long

  9. Effectiveness of National Weather Service heat alerts in preventing mortality in 20 US cities.

    Science.gov (United States)

    Weinberger, Kate R; Zanobetti, Antonella; Schwartz, Joel; Wellenius, Gregory A

    2018-04-09

    Extreme heat is a well-documented public health threat. The US National Weather Service (NWS) issues heat advisories and warnings (collectively, "heat alerts") in advance of forecast extreme heat events. The effectiveness of these alerts in preventing deaths remains largely unknown. To quantify the change in mortality rates associated with heat alerts in 20 US cities between 2001 and 2006. Because NWS heat alerts are issued based on forecast weather and these forecasts are imperfect, in any given location there exists a set of days of similar observed heat index in which heat alerts have been issued for some days but not others. We used a case-crossover design and conditional logistic regression to compare mortality rates on days with versus without heat alerts among such eligible days, adjusting for maximum daily heat index and temporal factors. We combined city-specific estimates into a summary measure using standard random-effects meta-analytic techniques. Overall, NWS heat alerts were not associated with lower mortality rates (percent change in rate: -0.5% [95% CI: -2.8, 1.9]). In Philadelphia, heat alerts were associated with a 4.4% (95% CI: -8.3, -0.3) lower mortality rate or an estimated 45.1 (95% empirical CI: 3.1, 84.1) deaths averted per year if this association is assumed to be causal. No statistically significant beneficial association was observed in other individual cities. Our results suggest that between 2001 and 2006, NWS heat alerts were not associated with lower mortality in most cities studied, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths. These results highlight the need to better link alerts to effective communication and intervention strategies to reduce heat-related mortality. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. [Analysis of activities of the preventive dentistry service in the Health Area 8 of the Valencia Autonomous Region].

    Science.gov (United States)

    Llena Puy, M C; Ausina Márquez, V

    1996-02-29

    We describe and analize the activities we carried out in a surgery from a preventive dentistry unit. Longitudinal descriptive study from 1993 since 1994. Health Area 8 from the Valencian Autonomous Region. Children from 3 to 14 year-old attendant to the preventive dentistry unit's surgery (2.497). We visited 5.012 children. The highest percentage of population corresponded to the zona 4, where began at first the preventive service. The activities distribution was as follow: oral explorations and plaque control (100%), fluoride topic aplication (90.38%), diet control (36.81%), pit and fisure sealants (6.46%), profilaxis (8.71%), radiological diagnosis (6.46%), dental emergencies (2.17%). The users origin was: 38.88% school oral explorations made over 6- and 10-year-old children; 63.71% from self-request; and 16.45% sent by other health professionals. 41.42% were continuated visits. Demand of preventive dental services is very high in our health area, although incorporation of therapeutic techniques is wished by the population. This demand increase as well as the surgery is closer to the user. People from big cities are stubborn using these services from smallest villages, even having transport facilities. Children start coming to the consults between 5-6 year-old, keeping an acceptable control until 12 approximately.

  11. Religion and preventive service use: do congregational support and religious beliefs explain the relationship between attendance and utilization?

    Science.gov (United States)

    Benjamins, Maureen R; Ellison, Christopher G; Krause, Neal M; Marcum, John P

    2011-12-01

    Religious individuals are more likely to engage in healthy practices, including using preventive services; however, the underlying mechanisms have not been adequately explored. To begin addressing this, the current study examines the association between religious attendance, four aspects of congregational support, two health-related religious beliefs, and the use of preventive services (cholesterol screening, flu shot, and colonoscopy) among a national sample of Presbyterian adults (n = 1,076). The findings show that two aspects of congregational support are relevant to these types of behavioral health. First, church-based health activities are significantly related to the use of cholesterol screenings and flu shots (OR = 1.13, P God locus of health control scale or beliefs about the sanctity of the body, are related to preventive service use in this population. Although attendance is predictive of service use in unadjusted models, the association appears to be explained by age rather than by the congregational or belief variables. These findings contribute to a more nuanced understanding of the various ways in which religion might impact health behaviors and may also help to shape and refine interventions designed to improve individual well-being.

  12. Prevention, diagnosis, and treatment of tuberculosis in children and mothers: evidence for action for maternal, neonatal, and child health services.

    Science.gov (United States)

    Getahun, Haileyesus; Sculier, Delphine; Sismanidis, Charalambos; Grzemska, Malgorzata; Raviglione, Mario

    2012-05-15

    Tuberculosis affected an estimated 8.8 million people and caused 1.4 million deaths globally in 2010, including a half-million women and at least 64 000 children. It also results in nearly 10 million cumulative orphans due to parental deaths. Moreover, it causes 6%-15% of all maternal mortality, which increases to 15%-34% if only indirect causes are considered. Increasingly, more women with tuberculosis are notified than men in settings with a high prevalence of human immunodeficiency virus (HIV), and maternal tuberculosis increases the vertical transmission of HIV. Tuberculosis prevention, diagnosis, and treatment services should be included as key interventions in the integrated management of pregnancy and child health. Tuberculosis screening using a simple clinical algorithm that relies on the absence of current cough, fever, weight loss, and night sweats should be used to identify eligible pregnant women living with HIV for isoniazid preventive therapy or for further investigation for tuberculosis disease as part of services for prevention of vertical HIV transmission. While implementing these simple, low-cost, effective interventions as part of maternal, neonatal, and child health services, the unmet basic and operational tuberculosis research needs of children, pregnant, and breastfeeding women should be addressed. National policy makers, program managers, and international stakeholders (eg, United Nations bodies, donors, and implementers) working on maternal, neonatal, and child health, especially in HIV-prevalent settings, should give due attention and include tuberculosis prevention, diagnosis, and treatment services as part of their core functions and address the public health impacts of tuberculosis in their programs and services.

  13. Association Between Parental Barriers to Accessing a Usual Source of Care and Children's Receipt of Preventive Services.

    Science.gov (United States)

    Bellettiere, John; Chuang, Emmeline; Hughes, Suzanne C; Quintanilla, Isaac; Hofstetter, C Richard; Hovell, Melbourne F

    Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents' reasons for not having a usual source of care were associated with their children's receipt of preventive services. We used pooled data from the 2011-2014 National Health Interview Survey (n = 34 843 participants). Parents' reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (affordability), attitudes and beliefs about health care (acceptability), and all other nonfinancial barriers (accessibility, accommodation, and availability). We used multivariable logistic regression models to test associations between parental barriers and children's receipt of past-year well-child care visits and influenza vaccinations, controlling for other child, family, and contextual factors. In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they "don't need a doctor and/or haven't had any problems" or they "don't like, trust, or believe in doctors" had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children's receipt of preventive services. Results were independent of several factors relevant to children's access to preventive health care, including whether the child had a usual source of care. Parents' attitudes and beliefs about having a usual source of care were strongly associated with their children's receipt of recommended preventive health services. Rates of receipt of child preventive

  14. Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

    Directory of Open Access Journals (Sweden)

    Brownie S

    2014-11-01

    Full Text Available Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5MMHN and Nurse Practitioner Programs, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, AustraliaAbstract: Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.Keywords: primary health care planning, community health care, nurse-led clinics, allied health personnel

  15. 'We are doing our best': African and African-Caribbean fatherhood, health and preventive primary care services, in England.

    Science.gov (United States)

    Williams, Robert; Hewison, Alistair; Stewart, Mel; Liles, Clive; Wildman, Stuart

    2012-03-01

    Recent policy pronouncements emphasise the importance of engaging fathers with preventive primary care services. However, in England, there is a paucity of literature which examines African and African-Caribbean fathers' experiences of service provision. This paper reports a study that investigated African and African-Caribbean fathers' beliefs about fatherhood, health and preventive primary care services, with the aim of addressing the deficit in the literature. Nine focus groups involving 46 African and African-Caribbean fathers, recruited using purposive sampling, were undertaken between October 2008-January 2009. Fatherhood was seen as a core aspect of the participants' identities. The fathers enacted these identities in a number of ways, such as caring for and protecting children, which were influenced by spirituality, relationships with women, paid work and racism. The fathers had concerns about their bodies, medical conditions, physical activity and forms of consumption. However, their primary focus was on maintaining and improving the well-being of their children. This resulted in them neglecting their own health needs as they had to meet the obligations of family life and paid work. The fathers reported limited contact with preventive primary care services and were unaware of their purpose, function and availability. They identified ethnicity as a positive asset, and felt their families and communities had particular strengths. However they acknowledged that structural constraints, including racism, influenced their perceptions of and access to local health services. The engagement of African and African-Caribbean fathers needs to be addressed more specifically in policy as part of a broader programme of action to tackle health inequalities. In addition, child health services could build on fathers' commitment to children's well-being through practice that addresses fathers' as well as mothers' needs in families. © 2011 Blackwell Publishing Ltd.

  16. The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

    Science.gov (United States)

    Shane, Dan M; Wehby, George L

    2017-09-01

    Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

  17. Decomposing socioeconomic inequalities in the use of preventive eye screening services among individuals with diabetes in Korea.

    Science.gov (United States)

    Hwang, Jongnam

    2016-06-01

    The aim of this study was to assess the socioeconomic inequalities in the use of preventive eye screening services among individuals with diabetes in Korea. Using nationally representative survey data, the concentration index (CI) and decomposition of the CI were used to capture and quantify income-related inequalities. The results show income-related inequality in the use of eye screening services among individuals with diabetes, suggesting that services were concentrated among individuals with higher incomes. After adjusting for need factors, such as sex, age and self-rated health, the inequality still persisted as observed horizontal inequity in the services, indicating that unequal care was provided for equal need. The decomposition approach revealed that the largest contributions to the observed inequality were higher education and higher income levels. Having private insurance and residing in non-Seoul metro areas also contributed to the observed pro-rich inequality. These findings suggest that income- and education-related barriers to the use of preventive eye screening services for individuals with diabetes should be targeted for removal at the national level to achieve the goal of equal care for equal need in diabetes management.

  18. The Research Library's Role in Digital Repository Services: Final Report of the ARL Digital Repository Issues Task Force

    Science.gov (United States)

    Association of Research Libraries, 2009

    2009-01-01

    Libraries are making diverse contributions to the development of many types of digital repositories, particularly those housing locally created digital content, including new digital objects or digitized versions of locally held works. In some instances, libraries are managing a repository and its related services entirely on their own, but often…

  19. Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals.

    Science.gov (United States)

    Harker, Rachel; Pidgeon, Aileen M; Klaassen, Frances; King, Steven

    2016-06-08

    Human service professionals are concerned with the intervention and empowerment of vulnerable social populations. The human service industry is laden with employment-related stressors and emotionally demanding interactions, which can lead to deleterious effects, such as burnout and secondary traumatic stress. Little attention has been given to developing knowledge of what might enable human service workers to persist and thrive. Cultivating and sustaining resilience can buffer the impact of occupational stressors on human service professionals. One of the psychological factors associated with cultivating resilience is mindfulness. The aim of this current research is to improve our understanding of the relationship between resilience, mindfulness, burnout, secondary traumatic stress, and psychological distress among human service professionals. The current study surveyed 133 human service professionals working in the fields of psychology, social work, counseling, youth and foster care work to explore the predictive relationship between resilience, mindfulness, and psychological distress. The results showed that higher levels of resilience were a significant predictor of lower levels of psychological distress, burnout and secondary traumatic stress. In addition, higher levels of mindfulness were a significant predictor of lower levels of psychological distress and burnout. The findings suggest that cultivating resilience and mindfulness in human service professionals may assist in preventing psychological distress burnout and secondary traumatic stress. Limitations of this study are discussed together with implications for future research.

  20. [Evaluation of the organization of health services as a strategy for the prevention and control of visceral leishmaniasis].

    Science.gov (United States)

    Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da

    2016-01-01

    to evaluate the organization of health services as a strategy for the prevention and control of visceral leishmaniasis (VL) in Ribeirão das Neves, Minas Gerais, Brazil, from 2010 to 2012. this was a case study evaluation of the degree of implementation of a strategy for the integration of health care services, control of zoonosis and epidemiological surveillance; it consisted of observing the work process, interviewing health professionals and analysing secondary data from information systems. implementation was partially adequate (84%); in terms of structure, the human resources component had the worst evaluation (64%) whilst in terms of work process, evaluation was 80% for reorganization of care and 77% for surveillance; in the period 2010-2012 there was a 20% increase in reported cases of VL and a 20% reduction in the time interval between reporting a case and starting treatment. the strategy contributed to the improvement of the organization of VL prevention and control actions.

  1. Strategies for recruiting injection drug users for HIV prevention services in Delhi, India.

    Science.gov (United States)

    Tun, Waimar; Sebastian, Mary Philip; Sharma, Vartika; Madan, Ira; Souidi, Samir; Lewis, Dean; Thior, Ibou; Sarna, Avina

    2013-09-25

    We utilized multiple recruitment approaches to recruit IDUs in a longitudinal cohort study to examine HIV incidence and behavior change pre- and post-introduction of comprehensive HIV prevention services. IDUs were recruited through peer referral, targeted outreach by outreach workers (ORWs) and as walk-in clients at drop-in centers. Participants received monetary compensation for participation (USD 0.80). Participants were given recruitment coupons to recruit peers (regardless of recruitment method). For peer referral, participants received a food coupon, as secondary compensation, for each peer he/she successfully recruited. We report the profile of IDUs by recruitment method, based on the baseline behavioral survey and HIV test results. Cost per IDU recruited by recruitment method was also calculated. A total of 3,818 IDUs were recruited between May 2011 and October 2011. More than half of the study participants were recruited through targeted outreach (ORW: 53.6%; peer-referral: 26.3%; walk-ins: 20.1%). Of the participants who were given recruitment coupons, 92.7% recruited no peers. Those who successfully recruited at least one peer were significantly more likely to be in a stable living accommodation compared to those who did not recruit any peers (51.1% versus 42.7%; p < 0.05). Only 45.9% of the food coupons were claimed for successful recruitment of peers. Peer-referred IDUs were more likely to be living with family or relatives (50.7% versus ORW: 40.1% and walk-in: 39.8%; p < 0.001) rather than on the street or shared housings compared to the other two recruitment modes. Walk-ins were more likely than peer-referred and ORW-referred IDUs to be HIV-positive (walk-ins: 26.1%; peer-referred: 19.1%; ORW: 19.9%; p < 0.01) and have risky injection practices (walk-ins: 62.2%; ORW: 57.0%; peer-referred: 58.6%; p < 0.05). The cost per IDU recruited through ORW referral method was the most costly at USD 16.30, followed by peer-referral at USD 8.40 and

  2. Performance-based incentives may be appropriate to address challenges to delivery of prevention of vertical transmission of HIV services in rural Mozambique: a qualitative investigation.

    Science.gov (United States)

    Schuster, Roseanne C; de Sousa, Octávio; Rivera, Jacqueline; Olson, Rebecca; Pinault, Delphine; Young, Sera L

    2016-10-07

    Performance-based incentives (PBIs) have garnered global attention as a promising strategy to improve healthcare delivery to vulnerable populations. However, literature gaps in the context in which an intervention is implemented and how the PBIs were developed exist. Therefore, we (1) characterized the barriers and promoters to prevention of vertical transmission of HIV (PVT) service delivery in rural Mozambique, where the vertical transmission rate is 12 %, and (2) assessed the appropriateness for a PBI's intervention and application to PVT. We conducted 24 semi-structured interviews with nurses, volunteers, community health workers, and traditional birth attendants about the barriers and promoters they experienced delivering PVT services. We then explored emergent themes in subsequent focus group discussions (n = 7, total participants N = 92) and elicited participant perspectives on PBIs. The ecological motivation-opportunity-ability framework guided our iterative data collection and thematic analysis processes. The interviews revealed that while all health worker cadres were motivated intrinsically and by social recognition, they were dissatisfied with low and late remuneration. Facility-based staff were challenged by factors across the rest of the ecological levels, primarily in the opportunity domain, including the following: poor referral and record systems (work mandate), high workload, stock-outs, poor infrastructure (facility environment), and delays in obtaining patient results and donor payment discrepancies (administrative). Community-based cadres' opportunity challenges included lack of supplies, distance (work environment), lack of incorporation into the health system (administration), and ability challenges of incorrect knowledge (health worker). PBIs based on social recognition and that enable action on intrinsic motivation through training, supervision, and collaboration were thought to have the most potential for targeting improvements

  3. Service contract with periodic preventive maintenance for a dump truck sold with a two-dimensional warranty

    Science.gov (United States)

    Nasrum, A.; Pasaribu, U. S.; Husniah, H.

    2016-02-01

    This paper deals with maintenance service contract for a dump truck sold with a two-dimensional warranties. We consider a situation where an agent offers two maintenance contract options and the owner of the equipment has to select the optimal option either the OEM carried out all repairs and preventive maintenance activities (option one) or the OEM only carries out failure while the costumer undertakes preventive maintenance action in-house (option two). As the number of preventive maintenance and corrective maintenance that occurs in the area of servicing contracts is very influential in determining the value of the contract, we have to determine the optimal time between preventive maintenance that can minimize the cost of repair in the contract area. Moreover, we also study the maintenance service contract considering reduction of the intensity function after preventive maintenance from both the owner and OEM point of views. In this paper, we use a Weibull intensity function to consider a product with increasing failure intensity. We use a non-cooperative game formulation to determine the optimal price structure (i.e., the contract price and repair cost) for the OEM and the owner. A numerical example derived from the model has shown that if the owner choose option one then the owner obtain a higher profit compared with the profit resulted from option two. The result agree with earlier work which uses the accelerated failure time (AFT) for the failure modeling, while here we model the failure of the dump truck without the use of the AFT.

  4. Comparison of preventive care in Medicaid managed care and Medicaid fee for service in institutions and private practices.

    Science.gov (United States)

    Fairbrother, G; Hanson, K L; Butts, G C; Friedman, S

    2001-01-01

    To compare preventive screening for children in Medicaid managed care (MMC) with children in Medicaid fee for service (M-FFS) in private and institutional settings. The sample included randomly selected institutions and private practice physicians in New York City. Within setting, children in MMC and M-FFS were sampled randomly and charts reviewed for immunizations and lead and anemia screening. In both institutions and private practices, children enrolled in MMC appeared more likely to be up-to-date than their M-FFS counterparts for immunizations (institution, P private practice, P institution, P private practice, P institution, P private practice, P private physicians. When considering 10 different attributes of managed care plans, no clear pattern of association with better preventive care services was observed. The positive effect of managed care on preventive care services was largely explained by more visits and longer follow-up time; however, there were differences between institutions and private practices, with enrollment in MMC associated with some positive effect on screenings in private practices.

  5. Cancer screening and health system resilience: keys to protecting and bolstering preventive services during a financial crisis.

    Science.gov (United States)

    Martin-Moreno, Jose M; Anttila, Ahti; von Karsa, Lawrence; Alfonso-Sanchez, Jose L; Gorgojo, Lydia

    2012-09-01

    The aim of this paper is to elucidate the rationale for sustaining and expanding cost-effective, population-based screening services for breast, cervical and colorectal cancers in the context of the current financial crisis. Our objective is not only to promote optimal delivery of high-quality secondary cancer prevention services, but also to underline the importance of strengthening comprehensive cancer control, and with it, health system response to the complex care challenges posed by all chronic diseases. We focus primarily on issues surrounding planning, organisation, implementation and resources, arguing that given the growing cancer burden, policymakers have ample justification for establishing and expanding population-based programmes that are well-organised, well-resourced and well-executed. In a broader economic context of rescue packages, deficits and cutbacks to government entitlements, health professionals must intensify their advocacy for the protection of vital preventive health services by fighting for quality services with clear benefits for population health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training.

    Science.gov (United States)

    Tsai, Liang-Ching; Ko, Yi-An; Hammond, Kyle E; Xerogeanes, John W; Warren, Gordon L; Powers, Christopher M

    2017-12-01

    Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10-15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI). Participants demonstrated a decrease in peak anterior tibial shear forces (11.1 ± 3.3 vs. 9.6 ± 2.7 N · kg -1 ; P = 0.008) and peak tibiofemoral compressive forces (68.4 ± 7.6 vs. 62.0 ± 5.5 N · kg -1 ; P = 0.015) post-training. The decreased peak anterior tibial shear was accompanied by a decrease in the quadriceps anterior shear force, while the decreased peak compressive force was accompanied by decreased ground reaction force and hamstring forces. Our data provide justification for injury prevention programmes that encourage greater hip and knee flexion during landing to reduce tibiofemoral joint loading.

  7. Work activity in food service: The significance of customer relations, tipping practices and gender for preventing musculoskeletal disorders.

    Science.gov (United States)

    Laperrière, Ève; Messing, Karen; Bourbonnais, Renée

    2017-01-01

    Some evidence shows that food servers are exposed to an elevated risk of musculoskeletal disorders and injuries, and that their work activity varies by gender. Interviews of servers and observations of food service in Québec, Canada, were carried out in three restaurants and a questionnaire was administered to 64 workers from 44 other restaurants. The relationship with the customer has specific effects on work activity and transforms the physical, emotional and cognitive work. Strategies intended to speed service or otherwise related to the customer relationship can involve health risks. Women reported more direct food service (p customer relationship could be important in preventing musculoskeletal disorders in this population and that women are at particular risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. 78 FR 23263 - Standing Funding Opportunity Announcement for Family Violence Prevention and Services Grants to...

    Science.gov (United States)

    2013-04-18

    ...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... to States for Domestic Violence Shelters and Support Services AGENCY: Family and Youth Services... Act (FVPSA) to States (including territories and insular areas). The purpose of these grants is to: (1...

  9. Effects of Preventive Family Service Coordination for Parents With Mental Illnesses and Their Children, a RCT

    NARCIS (Netherlands)

    Wansink, H.J.; Janssens, J.M.A.M.; Hoencamp, E.; Middelkoop, B.J.C.; Hosman, C.M.H.

    2015-01-01

    Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as

  10. Preventing future fractures: effectiveness of an orthogeriatric fracture liaison service compared to an outpatient fracture liaison service and the standard management in patients with hip fracture.

    Science.gov (United States)

    Naranjo, Antonio; Fernández-Conde, Sonia; Ojeda, Soledad; Torres-Hernández, Laura; Hernández-Carballo, Carolina; Bernardos, Idoia; Rodríguez, Sinforiano; Laynez, Pedro

    2017-12-11

    An observational study was carried out in two hospitals in patients > 65 years admitted for hip fracture. At 6 months, 15% of patients in the hospital with orthogeriatric standard care and 75% in the hospital with fracture liaison service were receiving bisphosphonates. Many patients with fractures are discharged without preventive therapy against further fractures. We sought to compare the effectiveness of an orthogeriatric fracture liaison service (FLS), outpatient FLS, and the standard care after hip fractures in prevention of future fractures. An observational study was carried out in two hospitals in patients > 65 years of age, admitted between March and July 2016 for fractures. The Candelaria hospital (HUNSC) has no specific protocol for secondary prevention, while at the Negrin Hospital (HUGCDN), an FLS nurse visits the inpatients, gathers metabolic history, instructs regarding the diet, exercises, and fall prevention, and completes a discharge report regarding osteoporosis treatment. The prescription rate of osteoporosis treatment was analyzed at admission, discharge, and 6 months after discharge. We also analyzed the data of patients with hip fractures who attended the outpatient FLS before March 2016. We included a total of 185 inpatients with a mean age of 82 years and 73% were women. At admission, 8% of the patients in HUNSC and 10% in HUGCDN were receiving bisphosphonates. At discharge, the percentages were 8 and 96%, while at 6 months they were 15 and 75%, respectively (p < 0.001). The outpatient FLS recorded 206 hip fractures (27% of discharges for fractures), with 77% adherence to treatment at 6 months. Compared with the conventional management, the FLS model for inpatients with hip fractures achieved a fivefold increase in the adherence to treatment at 6 months, similar to the rates of outpatient FLS.

  11. Preventative services offered by veterinarians on sheep farms in England and Wales: Opinions and drivers for proactive flock health planning.

    Science.gov (United States)

    Bellet, Camille; Woodnutt, Joanna; Green, Laura E; Kaler, Jasmeet

    2015-12-01

    Recent independent UK government reports and studies have highlighted the importance, but lack, of flock health services provided by veterinarians. Qualitative interviews were analysed by thematic analysis to construct belief statements to understand veterinarians' opinions on preventative advice and drivers for current services to sheep farmers. A postal questionnaire was sent to 515 sheep practices registered with the Royal College of Veterinary Surgeon (RCVS) in England and Wales in 2012 to gather quantitative data on these belief statements and to gather demographic information and current services provided by the veterinarian. Exploratory factor analysis with heuristic approaches was conducted on the respondents' belief statements to identify common factors of veterinarian beliefs. Three main factors were identified: motivation for proactiveness, perceived capability to offer preventative services and perceived opportunity to deliver these services. A beta regression model was built to identify the factors significantly associated with the time veterinarians spent in an advisory role. The relative proportion of time increased by 10% (1.01-1.19), 16% (1.03-1.30) and 29% (CI: 1.09-1.53) for each unit increase in score for factor 1 motivation, factor 2 capability and factor 3 opportunity respectively, indicating that these latent factors explained time veterinarians spent in an advisory role with sheep clients. There was a significant correlation between these factors suggesting influence of the associated beliefs between factors. This study provides insight into the nature and drivers of veterinarians' current behaviour and beliefs. These results could be further tested in behaviour intervention studies and help in designing efficient strategies aiming at promoting proactive health services offered by veterinarians on sheep farms in England and Wales. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Using heuristic algorithms for capacity leasing and task allocation issues in telecommunication networks under fuzzy quality of service constraints

    Science.gov (United States)

    Huseyin Turan, Hasan; Kasap, Nihat; Savran, Huseyin

    2014-03-01

    Nowadays, every firm uses telecommunication networks in different amounts and ways in order to complete their daily operations. In this article, we investigate an optimisation problem that a firm faces when acquiring network capacity from a market in which there exist several network providers offering different pricing and quality of service (QoS) schemes. The QoS level guaranteed by network providers and the minimum quality level of service, which is needed for accomplishing the operations are denoted as fuzzy numbers in order to handle the non-deterministic nature of the telecommunication network environment. Interestingly, the mathematical formulation of the aforementioned problem leads to the special case of a well-known two-dimensional bin packing problem, which is famous for its computational complexity. We propose two different heuristic solution procedures that have the capability of solving the resulting nonlinear mixed integer programming model with fuzzy constraints. In conclusion, the efficiency of each algorithm is tested in several test instances to demonstrate the applicability of the methodology.

  13. Leverage of an Existing Cervical Cancer Prevention Service Platform to Initiate Breast Cancer Control Services in Zambia: Experiences and Early Outcomes

    Directory of Open Access Journals (Sweden)

    Leeya F. Pinder

    2017-09-01

    Full Text Available Purpose: In 2005, the Cervical Cancer Prevention Program in Zambia (CCPPZ was implemented and has since provided cervical cancer screen-and-treat services to more than 500,000 women. By leveraging the successes and experiences of the CCPPZ, we intended to build capacity for the early detection and surgical treatment of breast cancer. Methods: Our initiative sought to build capacity for breast cancer care through the (1 formation of a breast cancer advocacy alliance to raise awareness, (2 creation of resource-appropriate breast cancer care training curricula for mid- and high-level providers, and (3 implementation of early detection and treatment capacity within two major health care facilities. Results: Six months after the completion of the initiative, the following outcomes were documented: Breast health education and clinical breast examination (CBE services were successfully integrated into the service platforms of four CCPPZ clinics. Two new breast diagnostic centers were opened, which provided access to breast ultrasound, ultrasound-guided core needle biopsy, and needle aspiration. Breast health education and CBE were provided to 1,955 clients, 167 of whom were evaluated at the two diagnostic centers; 55 of those evaluated underwent core-needle biopsy, of which 17 were diagnosed with invasive cancer. Newly trained surgeons performed six sentinel lymph node mappings, eight sentinel lymph node dissections, and 10 breast conservation surgeries (lumpectomies. Conclusion: This initiative successfully established clinical services in Zambia that are critical for the early detection and surgical management of breast cancer.

  14. Diagnostic comparison of Centers for Disease Control and Prevention and International Obesity Task Force criteria for obesity classification in South African children.

    Science.gov (United States)

    Moselakgomo, Kankane V; Van Staden, Marlise

    2017-08-31

    This study was designed to estimate overweight and obesity in school children by using contrasting definitions recommended by the Centers for Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF). The sample size consisted of 1361 learners (n = 678 boys; n = 683 girls) aged 9-13 years who were randomly selected from Mpumalanga and Limpopo provinces of South Africa. A cross-sectional and descriptive design was used to measure the children's anthropometric characteristics. Based on height and weight measurements, the children's body mass index (BMI) was calculated and used to classify them as underweight, overweight and obese. Percentage body fat was calculated from the sum of two skinfolds (i.e. triceps and subscapular). Age-specific BMI, percentage body fat and sum of skinfolds were examined for the boys and girls. A higher prevalence of overweight and obesity was found in boys and girls when the CDC BMI categories were used. In contrast, the IOTF BMI classifications indicated a strong prevalence of underweight among the children. In contrast to the IOTF index that yielded a greater occurrence of underweight among South African children, the CDC criteria indicated a higher prevalence of obesity and overweight among the same children. Future large-scale surveillance studies are needed to determine the appropriateness of different definitions in order to establish a more reliable indicator for estimating overweight and obesity in South African children.

  15. 76 FR 81368 - TRICARE; Elimination of Co-payments for Authorized Preventive Services for Certain TRICARE...

    Science.gov (United States)

    2011-12-28

    ... run will save the government money. We agree, and are pleased to promulgate this rule. One respondent...). The TRICARE program has evolved over time as has the practice of medicine. Certain preventive health...

  16. A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.

    Science.gov (United States)

    Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I

    2016-06-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service

  17. Analysis of the method quality function deployment "qfd" in preventive services police

    Directory of Open Access Journals (Sweden)

    Lauro Soares de Freitas

    2015-02-01

    Full Text Available Despite of the significant contribution of QFD for the construction of the theoretical framework for managing the development of new products and services, there is an embryonic implementation in the public sector. The purpose of this article is to analyze the application of the method in the context of public safety, and the study was delimited to the School Patrol in the Military Police of Minas Gerais. Action research was the research strategy chosen and qualitative and quantitative methods were used to collect and analyze data. The QFD method proved to be effective for: systematize a large set of internal and external corporate information, facilitating the subsequent planning of policing; promote a dynamic oriented and structured in encounters between police and the community; identify the needs of public school and prioritize activities policing which better fulfill these desires; and to understand the ability of service of a School Patrol Unit. Moreover, the police service has a unique set of characteristics that partially hindered planning service by QFD. This service does not have a specific market niche, being a service of law and not by purchase. Also relies on legal aspects and regulates behaviors, generating rejection. Although this particular nature, two factors favored the application of the method: the institutionalization of the philosophy of community policing in the organization and to familiarizing officers with management concepts and quality. The final conclusion is that the QFD method was presented as a promising tool for improving the quality of Brazilian public services.

  18. Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes.

    Science.gov (United States)

    Garrow, Donald; Egede, Leonard E

    2006-01-01

    To assess the association between complementary and alternative medicine (CAM) use, preventive care practices, and use of conventional medical services among adults with diabetes. We analyzed data on 2,474 adults with diabetes. We created an overall CAM-use category based on use of any of the following: diets, herbs, chiropractic care, yoga, relaxation, acupuncture, ayuverda, biofeedback, chelation, energy healing, Reiki therapy, hypnosis, massage, naturopathy, and homeopathy. We used multiple logistic regression to assess the effect of CAM use on preventive care practices (receipt of influenza and pneumonia vaccines) and use of conventional medical services (number of primary care and emergency department visits). STATA was used for statistical analysis to account for the complex survey design. A total of 48% of adults with diabetes used some form of CAM. CAM use was independently associated with receipt of pneumonia vaccination (odds ratio 1.56 [95% CI 1.26-1.94]) but not significantly associated with receipt of influenza vaccination (1.17 [0.92-1.48]). CAM use was independently associated with visiting the emergency department (1.34 [1.06-1.70]), having six or more primary care visits (1.44 [1.14-1.83]), and having eight or more primary care visits (1.66 [1.22-2.25]). In contrast to the findings of previous studies, CAM use appears to be associated with increased likelihood of receipt of preventive care services and increased emergency department and primary care visits. CAM use may not be a barrier to use of conventional medical services in adults with diabetes.

  19. [The preventive and health promotion services for infants, children and youth. What is problematic for clients of the CLSCs].

    Science.gov (United States)

    Richard, Lucie; D'Amour, Danielle; Labadie, Jean-François; Brodeur, Jean-Marc; Pineault, Raynald; Séguin, Louise; Latour, Robert

    2003-01-01

    This article presents the results of a survey on preventive and health promotion (PHP) services provided by Quebec CLSCs for infants, children and youth. Two dimensions of services are examined: the diversity of PHP issues addressed and the type of clientele targeted by the CLSC team. Questionnaire survey. Although identified a priori as public health priorities, many PHP issues remain less often addressed by CLSCs. This is particularly the case for activities aimed at children and youth as compared to infants. In addition, the data show that CLSC teams are less inclined to target specific clienteles; when they do so, it is more often in the context of services for infants. This study is important in that it constitutes one of the first efforts to systematically document PHP services for infants, children, and youth. In shedding new light on intervention sectors that need to be reinforced, these results should help managers and policymakers as they reflect on the role of PHP services in CLSCs within the context of health reform.

  20. Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service

    Directory of Open Access Journals (Sweden)

    O'Dea Kerin

    2011-01-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the single greatest contributor to the gap in life expectancy between Indigenous and non-Indigenous Australians. Our objective is to determine if holistic CVD risk assessment, introduced as part of the new Aboriginal and Torres Strait Islander Adult Health Check (AHC, results in better identification of elevated CVD risk, improved delivery of preventive care for CVD and improvements in the CVD risk profile for Aboriginal adults in a remote community. Methods Interrupted time series study over six years in a remote primary health care (PHC service involving Aboriginal adults identified with elevated CVD risk (N = 64. Several process and outcome measures were audited at 6 monthly intervals for three years prior to the AHC (the intervention and three years following: (i the proportion of guideline scheduled CVD preventive care services delivered, (ii mean CVD medications prescribed and dispensed, (iii mean PHC consultations, (iv changes in participants' CVD risk factors and estimated absolute CVD risk and (v mean number of CVD events and iatrogenic events. Results Twenty-five percent of AHC participants were identified as having elevated CVD risk. Of these, 84% had not been previously identified during routine care. Following the intervention, there were significant improvements in the recorded delivery of preventive care services for CVD (30% to 53%, and prescription of CVD related medications (28% to 89% (P P = 0.004 following the intervention. However, there were no significant changes in the mean number of PHC consultations or mean number of CVD events or iatrogenic events. Conclusions Holistic CVD risk assessment during an AHC can lead to better and earlier identification of elevated CVD risk, improvement in the recorded delivery of preventive care services for CVD, intensification of treatment for CVD, and improvements in participants' CVD risk profile. Further research is required on

  1. Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services.

    Science.gov (United States)

    Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane

    2016-10-01

    This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions. Interns completed a survey before (n = 37) and after (n = 22) the interventions. The survey included 12 Likert scale questions about attitudes and intentions toward wellness and health promotion models. The interventions consisted of classroom lectures, clinical training, and online information pertaining to health promotion and wellness. The interns initially favored wellness models, perceived a need for them, and felt partially prepared to administer them, with mean Likert scores 4 or greater on a 1 to 5 scale. Afterward, the average scores were higher and the interns reported some benefit from this short course of training. The initial survey demonstrated that interns had some understanding of wellness, health promotion, and preventive services, and favored utilization of these services. The follow-up survey suggested that a short educational intervention could have a positive impact on these attitudes and future utilization of wellness procedures in their practices.

  2. Adding physical therapy services in the emergency department to prevent immobilization syndrome - a feasibility study in a university hospital.

    Science.gov (United States)

    Tousignant-Laflamme, Yannick; Beaudoin, Ann-Marie; Renaud, Anne-Marie; Lauzon, Stephanie; Charest-Bossé, Marie-Catherine; Leblanc, Louise; Grégoire, Maryse

    2015-12-03

    The association between the functional decline occurring with bedrest and hospitalization in older persons is well-known. A long wait in the emergency department (ED), where patients can be bedridden, is a risk factor for the development of an immobilization syndrome (IS). IS is one of the unwanted consequences of inactivity, which causes pathological changes in most organs and systems. Early mobility interventions, such as physical therapy (PT) delivered in the ED, may prevent its development. To our knowledge, no prior studies have reported on this topic. The goal of this study was to (i) assess the feasibility and (ii) explore the potential clinical value of adding PT services to the ED, in collaboration with nursing staff, to prevent IS. For 12 weeks, PT services were delivered in the ED to older persons (>65 years old) presenting with ≥1 clinical signs associated with the development of IS. Patients were screened by ED nurses and then seen by the physiotherapist. In order to assess feasibility, access to patients, percentage of patients who met eligibility criteria, acceptability of the intervention, and barriers/facilitators to the implementation were measured. To describe the clinical benefits of early PT services, we counted the number of new IS cases among patients after their admission to the ward. After 12 weeks, the ED nurses screened 187 potential patients and 20 received PT services in the ED (before their admission to the ward). Accessibility was not an issue and we observed good acceptability from the milieu. We did not find majors problems or insurmountable obstacles to implementation of the intervention. Clinical outcomes showed that nine patients received PT treatments in the ED and on the ward (after their admission). For the 11 other patients, no PT interventions were done in the ED following the assessment. Follow-up of these 11 patients showed that two of them developed IS during their hospital stay. As for the nine patients who began

  3. PREVENTION OF ONCOLOGICAL DISEASES AS THE BASIS OF INTERACTION OF ONCOLOGICAL SERVICE WITH PRIMARY LINK OF HEALTH CARE

    Directory of Open Access Journals (Sweden)

    L. M. Aleksandrova

    2017-01-01

    Full Text Available Malignant neoplasms (MN are the second cause of death for the population of Russia, resulted in 15.5% of all deaths in 2015. Their share in the structure of the male population mortality rate was 16.4%, female — 14.4%. Among both sexes, deaths of working age, the proportion of deaths from MN was 16.0%, among women of reproductive age — 16.3%. More than half of the working age population of deaths in Russia falls on the disease from the group of preventable death, and a third — to preventable causes, depending on the primary and secondary prevention, quality of care, along with a high prevalence of behavioral risk factors (RF, demographic characteristics, marked medical and social reasons for the high mortality rate of the MN: late uptake of the population for health care, lack of alertness in oncology healthcare professionals, patients defects in routing.The leading factor in increasing life expectancy is prevention. Today, prevention is regarded as active method of strengthening and preservation of health, and the currently existing approaches in promoting healthy life mostly only directed at the prevention of behavioral risk factors: tobacco use, poor diet, physical inactivity and harmful use of alcohol. Experts estimate the impact on them will prevent, at least 40% of the cases of MN.In Russia we have a 3-step system of health care. In general preventive health orientation is implemented on the 1st level: in the provision of primary health care. In this regard, particular attention should be paid to the implementation of measures for specific clinical examination of the adult population, which plays an important role in the early detection of both the disease and the risk factors for their development. Properly organized conduct of the clinical examination can provide a substantial, up to 30%, the contribution to the reduction of total mortality, including mortality from MN. The necessity of increasing the role of the oncology service

  4. Prevention and Punishment: Barriers to Accessing Health Services for Undocumented Immigrants in the United States

    Directory of Open Access Journals (Sweden)

    Parul Monga

    2014-01-01

    Full Text Available Undocumented immigrants face significant challenges in accessing health care. Throughout the United States, these challenges may relate to the structure of the public health system in which the undocumented find themselves. In addition, local, regional, and national practices aimed at targeting immigrants for deportation or other non-health reasons may serve to punish them for seeking health services or care. Spain and the United Kingdom serve as useful case studies in comparing the ability of the undocumented to seek health services in Europe and the United States. Overall, promoting access to comprehensive health services for the undocumented should be a national priority, along with analysis of any immigration-related laws or policies for potential harmful impact on health care access.

  5. Hitachi advanced operating nuclear power plant total preventive maintenance management and service system

    International Nuclear Information System (INIS)

    Araki, Masamitsu; Jibu, Noboru; Abe, Kazuhiro

    1990-01-01

    The recent rate of operation of Japanese nuclear power stations attained the result exceeding 70 %, but in order to improve it further and maintain the high reliability, the preventive maintenance program of more elaborate and systematic must be planned and executed. However, in order to establish the plan for maintaining efficiently and with high accuracy the enormous machinery and equipment exceeding 60000 in a nuclear power station, the high advance by mechanization is indispensable. Therefore, Hitachi Ltd. has developed the total preventive maintenance system, and it has partially begun operation. This system has the function of the life diagnosis of machinery and equipment, in addition, it constructs the data base with the specifications of machinery and equipment, the history of checkup, the information on reliability in Japan and foreign countries and so on, and based on these information, the recommendation of checkup, the proposal of improving facilities and other items are to be summarized and offered to electric power companies. The preventive maintenance activities in Hitachi Ltd., the concept and the outline of the total preventive maintenance system are reported. (K.I.)

  6. Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis.

    Science.gov (United States)

    Witt, Katrina; Milner, Allison; Allisey, Amanda; Davenport, Lauren; LaMontagne, Anthony D

    2017-04-01

    This brief report summarizes the international literature on the effectiveness of suicide prevention programs for protective and emergency services employees. A systematic search of 11 electronic databases was undertaken until June 30, 2015. Quantitative meta-analysis was undertaken to investigate the effectiveness of these programs on suicide rates at post-intervention. Qualitative analyses were also used to identify program components that may be associated with reductions in suicide rates. A total of 13 studies were included. Only six reported sufficient information on suicide rates to enable inclusion in quantitative analyses, however. On average, these programs were associated with an approximate halving in suicide rates over an average follow-up period of 5.25 years (SD = 4.2; range: 1-11) (Incidence Rate Ratio 0.45, 95%CI 0.31-0.65; five studies; I 2 14.8%). Few programs integrated activities at the primary prevention level. A greater focus on the relatively neglected area of workplace primary prevention could further improve suicide prevention effectiveness. Am. J. Ind. Med. 60:394-407, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. A Trial of Telephone Support Services to Prevent Further Intimate Partner Violence.

    Science.gov (United States)

    Stevens, Jack; Scribano, Philip V; Marshall, Jessica; Nadkarni, Radha; Hayes, John; Kelleher, Kelly J

    2015-12-01

    We conducted a randomized-controlled trial of telephone support services (TSS) versus enhanced usual care (EUC) for women who had reported intimate partner violence (IPV) within the past year during a visit to a pediatric emergency department. TSS nurse interventionists identified appropriate referrals to community programs, helped participants by problem-solving barriers to obtaining these local services, and provided social support. Three hundred women, ages 18 years and above were recruited. The TSS and EUC groups did not differ on any outcome variable, including IPV victimization, feelings of chronic vulnerability to a perpetrator, depressive symptoms, and posttraumatic stress disorder symptoms. © The Author(s) 2015.

  8. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  9. Analysis of the Prevention of Mother-to-Child Transmission (PMTCT Service utilization in Ethiopia: 2006-2010

    Directory of Open Access Journals (Sweden)

    Woldegebriel Yoseph

    2011-04-01

    Full Text Available Abstract Introduction Although progressive improvements have been made in the coverage and quality of prevention of HIV/AIDS mother-to-child transmission (PMTCT services in Ethiopia, the national coverage remained persistently low. Analysis of the cascaded PMTCT services can reveal the advancements made and the biggest hurdles faced during implementation. Objective To examine the progresses and unaddressed needs in access and utilization of PMTCT services in Ethiopia from 2006 to 2010 thereby developing best-fit regression models to predict the values of key PMTCT indicators at critical future points. Methods Five-year national level PMTCT data were analyzed in a cascaded manner. Five levels of analysis were used for ten major PMTCT indicators. These included description of progress made, assessment of unaddressed needs, developing best-fit models, prediction for future points and estimation using constant prevalence. Findings were presented using numerical and graphic summaries. Results Based on the current trend, Ethiopia could achieve universal ANC coverage by 2015. The prevalence of HIV at PMTCT sites has shown a four-fold decrease during the five-year period. This study has found that only 53% of known HIV-positive mothers and 48% of known HIV-exposed infants have received ARV prophylaxis. Based on assumption of constant HIV prevalence, the estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies. Conclusion There has been a remarkable improvement in the potential coverage of PMTCT services due to rapid increase in the number of PMTCT service outlets. However, the actual coverage remained low. Integration of PMTCT services with grassroots level health systems could unravel the problem.

  10. The accessibility of HIV-infected Poor Women to the Prevention of Mother to Child Transmission Service in Surakarta Indonesia

    Directory of Open Access Journals (Sweden)

    Argyo Demartoto

    2016-12-01

    Full Text Available Background: HIV transmission from HIV-infected mother to child can occur through pregnancy, birth and lactation process; therefore, there should be Prevention of Mother to Child Transmission or PMTCT. Aims & Objectives: This research aimed to study the HIV-infected poor women’s accessibility to the Prevention of Mother to Child Transmission Service in Surakarta Indonesia. Material & Methods: This study was a qualitative research with explorative approach conducted in October-December 2015 and HIV-infected poor women as the unit of analysis. The sampling technique used was maximum variation sampling. Techniques of collecting data used were observation, in-depth interview and documentation, while data analysis was conducted using an Interactive Model of analysis with materialist theory. Results: Structural, financial and personal or cultural constraints were found: less target-appropriate health insurance policy, expensive cost of delivery with section caesarian surgery and breastfeed-substituting formula milk, and limited knowledge, experience and negotiation with the service provider leading to the HIV-infected Poor Women’s limited accessibility to comprehensive and sustainable PMTCT. PMTCT socialization, the giving-birth insurance and Food Supplementation program activation by Empowerment Work Group in AIDS Coping Commission in Surakarta City was the opportunity to access PMTCT service. Conclusion: Although PMTCT resulted in some problems, particularly formula milk administration and delivery process with section caesarian surgery, this attempt should be taken to make the baby born healthy. For that reasons, PMTCT service and health insurance should be improved from beneficiary data to accessible and sustainable procedure.

  11. Sexual Abuse Prevention: A Training Program for Developmental Disabilities Service Providers

    Science.gov (United States)

    Bowman, Rachel A.; Scotti, Joseph R.; Morris, Tracy L.

    2010-01-01

    Persons with developmental disabilities are at an increased risk for becoming victims of sexual abuse. Research has revealed that the largest group of identified perpetrators of sexual abuse is developmental disability service providers. The purpose of the present study was to develop, implement, and evaluate the effectiveness of a sexual abuse…

  12. 78 FR 20648 - Standing Funding Opportunity Announcement for Family Violence Prevention and Services/Grants to...

    Science.gov (United States)

    2013-04-05

    ...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... to State Domestic Violence Coalitions AGENCY: Family and Youth Services Bureau (FYSB), Administration..., domestic violence, and dating violence; to provide for Coalitions to collaborate and coordinate with States...

  13. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Science.gov (United States)

    2012-03-21

    ... organizations such as hospitals, universities, and charities that are exempt from taxation under section 501 of... plan sponsors such as drug rebates, service fees, disease management program fees, or other sources... receive funding to pay benefits, other flows of funds, the extent to which funding from other sources may...

  14. Aspirin for Primary Prevention.

    Science.gov (United States)

    Richman, Ilana B; Owens, Douglas K

    2017-07-01

    Aspirin reduces the risk of nonfatal myocardial infarction and stroke, and the risk of colorectal cancer. Aspirin increases the risk of gastrointestinal and intracranial bleeding. The best available evidence supports initiating aspirin in select populations. In 2016, the US Preventive Services Task Force recommended initiating aspirin for the primary prevention of both cardiovascular disease and colorectal cancer among adults ages 50 to 59 who are at increased risk for cardiovascular disease. Adults 60 to 69 who are at increased cardiovascular disease risk may also benefit. There remains considerable uncertainty about whether younger and older patients may benefit. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Facilitators of and barriers to accessing clinical prevention services for the South Asian population in Surrey, British Columbia: a qualitative study.

    Science.gov (United States)

    Majid, Sanaa; Douglas, Rachel; Lee, Victoria; Stacy, Elizabeth; Garg, Arun K; Ho, Kendall

    2016-01-01

    British Columbia falls short in uptake of recommended clinical prevention services, with even lower rates among immigrant populations. This study explored facilitators of and barriers to uptake of clinical prevention services among people from South Asia, who represent 31% of the population in Surrey, British Columbia. We used a qualitative descriptive approach and employed vignettes in a focus group setting to elicit perspectives of South Asian people on accessing clinical prevention services. Participants aged 40 years or more were recruited between October 2014 and February 2015 from health care and community settings such as older-adult housing, day programs and health education events. Letters of introduction to the study were provided in English or Punjabi or both to all potential participants. We conducted qualitative content analysis of the results. Sixty-two South Asian adults (36 women and 26 men) aged 40-87 years participated in 1 of 8 focus groups in health care or community settings. Facilitators of and barriers to accessing clinical prevention services were noted at the patient, primary care provider and health care system levels. Facilitators at the patient level included taking ownership over one's health, health literacy and respecting the provider's advice; barriers included fear of the diagnosis, death and/or procedures, perceived low risk of disease or utility of the intervention, and side effects of procedures. Provider factors centred on a trust-based patient-provider relationship, strong communication and adequate time during visits. Health care system factors included such facilitators as processes to routinely offer prevention services as part of other health care or social services, systems that encourage prevention-oriented family practice and services at low or no cost to the patient. Our findings validate previously identified facilitators of and barriers to accessing preventive care for immigrant populations. However, the results

  16. A cost function for HIV prevention services: is there a 'u' – shape?

    Directory of Open Access Journals (Sweden)

    Hanson Kara

    2007-11-01

    Full Text Available Abstract Background Global resource needs estimation is a critical part of addressing the HIV/AIDS epidemic. To generate these estimates knowledge of costs and cost structures is required. The evidence base for costs of HIV prevention programmes is limited. Even less is known about the existence of economies scale and whether, as economic theory suggests, average costs form a 'u'-shaped curve as scale increases. Using an econometric analysis, this paper addresses this question by estimating marginal costs and economies of scale for HIV prevention programmes for vulnerable groups in Southern India with different levels of coverage. Methods Two hybrid translog-cost functions were estimated. First, expenditure data from 78 state-funded HIV prevention projects in Andhra Pradesh were used to explore the impact of scale, institutional history and price on costs; second, economic cost data from 16 commercial sex worker projects across Tamil Nadu and Andhra Pradesh were analysed to additionally assess the impact of the value of inputs not reported in expenditure data and location. Coefficient estimates were used to calculate marginal costs and economies of scale. Results The econometric model yielded a good fit (R2 = 0.46, p 2 = 0.79, p Conclusion Econometric analysis of these standardized datasets provides insights into how costs change with coverage, the impact of project location and nature of the project target group. The results demonstrate the importance of understanding the nature of the cost function when designing, budgeting and estimating resource requirements for scaling up coverage of HIV prevention projects.

  17. Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members

    Science.gov (United States)

    2017-01-04

    opposed to living in, for example, transitional housing, jails, prisons , or dormitories). 74 Preventing, Identifying, and Treating Prescription...practices” OR SBIRT NOT MM “smoking cessation” NOT AB china OR chinese OR nigeria OR sweden OR Norway OR france OR french OR canada OR wales OR england OR...monkeys OR mouse OR mice OR rat OR rats OR taiwan OR german OR germany OR france OR italy OR nigeria OR scotland OR ireland OR norway OR belgium OR

  18. Prevention Services for Externalizing and Anxiety Symptoms in Low-Income Children: the Role of Parent Preferences in Early Childhood.

    Science.gov (United States)

    Mian, Nicholas D; Godoy, Leandra; Eisenhower, Abbey S; Heberle, Amy E; Carter, Alice S

    2016-01-01

    Dissemination of prevention programs targeting young children is impeded by challenges with parent engagement. Matching program characteristics to parent preferences is associated with increased retention in clinical/intervention settings, but little is known about the types of prevention programs that interest parents. The objectives of this study were to better understand parents' preferences for services designed to prevent externalizing and anxiety disorders and to identify factors associated with preferences. Ethnically diverse, low-income caregivers (n = 485) of young children (11-60 months) completed surveys on child anxiety and externalizing symptoms, parental worry about their children, parent anxiety symptoms, and preferences for prevention group topics. Parents were more likely to prefer a group targeting externalizing behaviors compared to anxiety. Cluster analysis revealed four groups of children: low symptoms, moderate anxiety-low externalizing, moderate externalizing-low anxiety, and high anxiety and externalizing. Parents' preferences varied according to co-occurrence of child anxiety and externalizing symptoms; interest in a program targeting externalizing problems was associated with elevated externalizing problems (regardless of anxiety symptom level), parent anxiety symptoms, and parent worry about their child. Only parent anxiety symptoms predicted parents' interest in an anxiety-focused program, and preference for an anxiety-focused program was actually reduced if children had co-occurring anxiety and externalizing symptoms versus only anxiety symptoms. Results suggest that parents' interest in a program to prevent externalizing problems was well-aligned with the presenting problem, whereas preferences for anxiety programming suggest a more complex interplay among factors. Parent preferences for targeted programming are discussed within a broader framework of parent engagement.

  19. More attention to preventive health services needed for older persons in the United States of America

    Directory of Open Access Journals (Sweden)

    2003-06-01

    Full Text Available Medicare, el programa público estadounidense de seguro de salud que cubre a adultos mayores, debe concentrarse más en mantener a estos saludables y en ofrecer una gama más amplia de servicios sanitarios preventivos, en lugar de limitarse a atender a personas enfermas, de acuerdo con un informe publicado recientemente por Partnership for Prevention, una organización sin fines de lucro radicada en Washington, D.C. El informe, titulado A better Medicare for healthier seniors: recommendations to modernize Medicare's prevention policies, llama a que el programa de Medicare cubra más servicios capaces de prolongar la vida de personas de edad avanzada y de mejorar su calidad de vida. Hasta el momento, Medicare cubre solo 10 servicios preventivos. Tres de ellos son de inmunización (contra neumonía neumocócica, influenza y hepatitis B, y los siete restantes consisten en pruebas de tamizaje para diversos cánceres, osteoporosis y glaucoma. Medicare debe ampliar sus servicios preventivos habituales, según el informe, y abarcar la vacunación de refuerzo contra la difteria y el tétanos; el tamizaje de la agudeza visual, problemas auditivos, depresión y perfil de lípidos en suero; y el asesoramiento para abandonar el hábito de fumar, prevenir lesiones por accidentes automovilísticos y observar una dieta saludable. Algunos de los servicios preventivos propuestos por Partnership for Prevention podrían generar ahorros para Medicare. Otros no implicarían reducciones, pero ofrecerían a los beneficiarios más años de vida productivos a un costo razonable. Si Medicare hiciera mayor hincapié en los servicios preventivos, esto pudiera estimular a los servicios privados de salud a hacer lo mismo con las personas de cualquier edad en los Estados Unidos.

  20. Nighttime assaults: using a national emergency department monitoring system to predict occurrence, target prevention and plan services

    Directory of Open Access Journals (Sweden)

    Bellis Mark A

    2012-09-01

    Full Text Available Abstract Background Emergency department (ED data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults. Methods A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172 over a three-year period (31st March 2008 to 30th March 2011 to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting. Results Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P 2 = 0.918; P  Conclusions To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.

  1. Estimating the Cost Savings of Preventive Dental Services Delivered to Medicaid-Enrolled Children in Six Southeastern States.

    Science.gov (United States)

    Lee, Ilbin; Monahan, Sean; Serban, Nicoleta; Griffin, Paul M; Tomar, Scott L

    2017-11-30

    To quantify the impact of multiyear utilization of preventive dental services on downstream dental care utilization and expenditures for children. We followed 0.93 million Medicaid-enrolled children who were 3-6 years old in 2005 from 2005 to 2011. We used Medicaid claims data of Alabama, Georgia, Mississippi, North Carolina, South Carolina, and Texas. We clustered each state's study population into four groups based on utilization of topical fluoride and dental sealants before caries-related treatment using machine learning algorithms. We evaluated utilization rates and expenditures across the four groups and quantified cost savings of preventive care for different levels of penetration. We extracted all dental-related claims using CDT codes. In all states, Medicaid expenditures were much lower for children who received topical fluoride and dental sealants before caries development than for all other children, with a per-member per-year difference ranging from $88 for Alabama to $156 for Mississippi. The cost savings from topical fluoride and sealants across the six states ranged from $1.1M/year in Mississippi to $12.9M/year in Texas at a 10 percent penetration level. Preventive dental care for children not only improves oral health outcomes but is also cost saving. © Health Research and Educational Trust.

  2. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.

    Science.gov (United States)

    Mueller, Stephanie K; Schnipper, Jeffrey L; Giannelli, Kyla; Roy, Christopher L; Boxer, Robert

    2016-09-01

    Dispersion of inpatient care teams across different medical units impedes effective team communication, potentially leading to adverse events (AEs). To regionalize 3 inpatient general medical teams to nursing units and examine the association with communication and preventable AEs. Pre-post cohort analysis. A 700-bed academic medical center. General medicine patients on any of the participating nursing units before and after implementation of regionalized care. Regionalizing 3 general medical physician teams to 3 corresponding nursing units. Concordance of patient care plan between nurse and intern, and adjusted odds of preventable AEs. Of the 414 included nurse and intern paired surveys, there were no significant differences pre- versus postregionalization in total mean concordance scores (0.65 vs 0.67, P = 0.26), but there was significant improvement in agreement on expected discharge date (0.56 vs 0.68, P = 0.003), knowledge of the other provider's name (0.56 vs 0.86,P communication and lead to patient safety improvements. Journal of Hospital Medicine 2016;11:620-627. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  3. Stakeholders' perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi.

    Science.gov (United States)

    Nyondo, Alinane Linda; Chimwaza, Angela Faith; Muula, Adamson Sinjani

    2014-07-07

    Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman's risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this study was to identify factors that promote and hinder MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Understanding of the factors that influence MI will assist in developing strategies that will involve men more in the programme thereby improving the uptake of PMTCT and HIV testing and counselling services by women and men respectively. An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face to face Key Informant Interviews (KIIs) with health care workers and four Focus Group discussions (FGDs) with 18 men and 17 pregnant women attending antenatal care at the clinic. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analysed using thematic content analysis. Participants in both FGDs and KIIs identified the following barriers: lack of knowledge of MI in PMTCT, socioeconomic factors, relationship issues, timidity to be seen in a woman's domain, unplanned and or extramarital pregnancies, fear of knowing one's HIV status, unwillingness to be associated with the service, health facility based factors, peer influence and cultural factors. The factors that would potentially promote male involvement were categorized into community, health facility and personal or family level factors. The factors that may hinder or promote MI arise from different

  4. Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

    Science.gov (United States)

    2014-01-01

    Background Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman’s risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this study was to identify factors that promote and hinder MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Understanding of the factors that influence MI will assist in developing strategies that will involve men more in the programme thereby improving the uptake of PMTCT and HIV testing and counselling services by women and men respectively. Methods An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face to face Key Informant Interviews (KIIs) with health care workers and four Focus Group discussions (FGDs) with 18 men and 17 pregnant women attending antenatal care at the clinic. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analysed using thematic content analysis. Results Participants in both FGDs and KIIs identified the following barriers: lack of knowledge of MI in PMTCT, socioeconomic factors, relationship issues, timidity to be seen in a woman’s domain, unplanned and or extramarital pregnancies, fear of knowing one's HIV status, unwillingness to be associated with the service, health facility based factors, peer influence and cultural factors. The factors that would potentially promote male involvement were categorized into community, health facility and personal or family level factors. Conclusions The factors that may

  5. Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.

    Science.gov (United States)

    Byrne, Jo; Xu, Gang; Carr, Sue

    2015-03-01

    In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell. The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs. A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease. The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines. Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent. The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  6. Assessment of Prevention of Mother-to-Child Transmission HIV Services in the Bantey Meanchey Province in Cambodia.

    Science.gov (United States)

    Sau, Mealiny Sokun; Balamane, Maya; Lurie, Mark; Harwell, Joseph; Welle, Emily; Mean, Chhivun; Cu-Uvin, Susan

    2016-07-01

    Elimination of pediatric HIV requires a robust program for the prevention of mother-to-child transmission (PMTCT). The goal of this study was to assess the implementation of these services in Cambodia. This prospective study was conducted in Bantey Meanchey at 2 sites. Staff reviewed daily clinic and laboratory registration logs to gather data on PMTCT service access among antenatal women. A total of 12 140 pregnant women received antenatal care. Only 4034 (33.2%) received pre-HIV test counseling. Of which 3407 (84.5%) received an HIV test. Eighteen (94.7%) of 19 women testing HIV-seropositive received triple-combination antiretroviral (ARV) medication. Fifteen HIV-exposed infants were delivered during the study. One infant tested HIV positive and is on ARV medication. Acceptance for HIV testing was high among women who received pretest counseling. An increase in the number of counselors may improve the rates of HIV testing. Follow-up mechanisms targeting mother-baby pairs should focus on increasing timely service uptake in the public sector. © The Author(s) 2015.

  7. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services.

    Science.gov (United States)

    Wolfenden, Luke; Jones, Jannah; Williams, Christopher M; Finch, Meghan; Wyse, Rebecca J; Kingsland, Melanie; Tzelepis, Flora; Wiggers, John; Williams, Amanda J; Seward, Kirsty; Small, Tameka; Welch, Vivian; Booth, Debbie; Yoong, Sze Lin

    2016-10-04

    Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to:1. describe the impact of such strategies on childcare service staff knowledge, skills or attitudes;2. describe the cost or cost-effectiveness of such strategies;3. describe any adverse effects of such strategies on childcare services, service staff or children;4. examine the effect of such strategies on child diet, physical activity or weight status. We searched the following electronic databases on 3 August 2015: the Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, ERIC, CINAHL and SCOPUS. We also searched reference lists of included trials, handsearched two international implementation science journals and searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). We included any study (randomised or non-randomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. The review authors independently screened abstracts and titles, extracted trial data and assessed risk of bias in pairs; we resolved discrepancies via consensus. Heterogeneity across studies precluded pooling of data and undertaking quantitative

  8. Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes, Helper Behaviors and Comparison to Telephone Hotlines.

    Science.gov (United States)

    Mokkenstorm, Jan K; Eikelenboom, Merijn; Huisman, Annemiek; Wiebenga, Jasper; Gilissen, Renske; Kerkhof, Ad J F M; Smit, Johannes H

    2017-06-01

    Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention. © 2016 The American Association of Suicidology.

  9. GramHealth: a bottom-up approach to provide preventive healthcare services for unreached community.

    Science.gov (United States)

    Ahmed, Ashir; Kabir, Lutfe; Kai, Eiko; Inoue, Sozo

    2013-01-01

    Insufficient healthcare facilities and unavailability of medical experts in rural areas are the two major reasons that kept the people unreached to healthcare services. Recent penetration of mobile phone and the demand to basic healthcare services, remote health consultancy over mobile phone became popular in developing countries. In this paper, we introduce two such representative initiatives from Bangladesh and discuss the technical challenges they face to serve a remote patient. To solve these issues, we have prototyped a box with necessary diagnostic tools, we call it a "portable clinic" and a software tool, "GramHealth" for managing the patient information. We carried out experiments in three villages in Bangladesh to observe the usability of the portable clinic and verify the functionality of "GramHealth". We display the qualitative analysis of the results obtained from the experiment. GramHealth DB has a unique combination of structured, semi-structured and un-structured data. We are currently looking at these data to see whether these can be treated as BigData and if yes, how to analyze the data and what to expect from these data to make a better clinical decision support.

  10. [Recognition and communication of early preventive services in obstetrics : A qualitative interview study with parents].

    Science.gov (United States)

    Prüßmann, Christiane; Stindt, Daniela; Brunke, Jana; Klinkhammer, Ursula; Thyen, Ute

    2016-10-01

    The perception of patients' needs of support and sensitive communication about psychosocial stress all represent new, exacting tasks for nursing staff, midwives, social workers and physicians in obstetrics. As part of Good Start into the Family (GuStaF), a learning and teaching project in a university hospital, we were able to interview parents about their experiences with the intervention. Evaluation of the process of establishing contacts, the communication with professionals in obstetrics and the support offered from the perspective of parents. Qualitative guided interviews with seven families one year after the delivery. Problem areas reported by parents were predominately related to increased parental care and the feeling of being overwhelmed in addition to social stress. Core themes in communication addressed the entry into conversations, which was remembered negatively when advice was perceived as improper, patronizing or stigmatizing, and positively when professionals had listened sensitively and had provided tangible support. Some conversations increased stress. Relating to assistance and support, parents reported both positive and negative experiences. Justness and reliability emerged as particularly important topics. The attendance of families around the time of the delivery poses varying demands upon the hospital staff, not necessarily in keeping with traditional professional attitudes and competencies. Careful attention to the personal physical and emotional well-being of mothers and newborns, non-stigmatizing entry into the conversations, justness of the support and avoiding inconsistencies within the institution and the network all appear to be of great importance.

  11. Genetic and Preventive Services for Hereditary Breast and Ovarian Cancer in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Foretova Lenka

    2006-11-01

    Full Text Available Abstract The majority of hereditary breast and ovarian cancers can be accounted for by germline mutations in the BRCA1 and BRCA2 genes. Genetic counselling and testing in high-risk patients in the Czech Republic began in 1997 in two centres (Masaryk Memorial Cancer Institute in Brno, MMCI, and the General University Hospital plus the First Faculty of Medicine, Charles University in Prague, 1FMUK. Health insurance covers testing in MMCI, whereas testing at 1FMUK is covered by research grants. The spectrum of mutations in the BRCA1 gene is similar in the Bohemian (western and Moravian (eastern regions of the country but the mutation spectrum observed in the BRCA2 gene is completely different. There are three BRCA1 gene mutations that are responsible for 69% and 70.4% of all BRCA1 mutations identified in women reporting to the Brno and Prague centres, respectively. The two most frequent mutations in the BRCA2 gene, which comprises 41.5% of all detected BRCA2 mutations in Brno, were not found in women tested in the Prague centre. The testing of BRCA1/BRCA2 or other possible predisposition genes for hereditary breast/ovarian cancer is determined by medical geneticists after genetic counselling. Predictive testing is offered to persons older than 18 years of age. Genetic counselling centres are easily accessible to all inhabitants in the country. Specialized preventive care is mostly organized by MMCI and the General University Hospital in Prague; however, some patients and their family members are under the care of other oncology departments and clinics. The quality of preventive care in different hospitals is currently being investigated.

  12. Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben

    2017-05-01

    Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the

  13. Prevention and management of conflicts in the field of municipal services

    Directory of Open Access Journals (Sweden)

    V. A. Lobyzenkova

    2016-01-01

    Full Text Available Currently, it is difficult to imagine the existence of people, organizations, societies without conflicts. By themselves, these differences and contradictions can be a positive factor in the development of relations between people and those groups and organizations to which they are united. However, becoming sharp, they can interfere with the successful collaboration and lead to conflict. As many volume categories, the concept of conflict has many definitions and interpretations. One of them defines conflict as a lack of agreement between two or more parties that may be specific individuals or groups. Others invest in the conflict procedure, activity be suitable, considering the conflict active actions of each party sharing of their goals. A colored strong emotional feelings. Summarizing the different points of view, the authors referred to have conflict as a way to interact in the presence of contradictions and incompatible views, positions and interests, as a confrontation between interconnected, but following their purpose two or more parties. Exploring the theoretical side of the conflict, the article notes that it is a meaningful way to determine the object and subject of the conflict. In this regard reveals the content of the object, the subject of the conflict, the issues concerning the process of conflict management in the sphere of municipal service. Based on the analysis of law enforcement practice considers ways to manage and resolve conflicts, noted their negative influence in the power structures, which reduces credibility and confidence in the institution of public service as a whole by society. To improve the efficiency of state and municipal employees, the authors covered technology and ways of conflict management, methods of their overcoming and solutions.

  14. The Relationship Between Maternal Domestic Violence and Infant and Toddlers' Emotional Regulation: Highlighting the Need for Preventive Services.

    Science.gov (United States)

    Geyer, Chelsea; Ogbonnaya, Ijeoma Nwabuzor

    2017-11-01

    In an effort to further understand the impact of domestic violence (DV) on infant and toddlers' development, this research utilized data from the second cohort of National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the relationship between maternal DV and infant and toddlers' emotional regulation, and determine whether mothers' receipt of DV services mediated this relationship. The sample was limited to children aged 0 to 3 years and included (a) infants less than 1 year old ( n = 603), (b) infants 1 to less than 2 years old ( n = 310), and (c) toddlers 2 to 3 years old ( n = 268). Infant/toddlers' emotional regulation was measured using mothers' response on the How My Infant/Toddler/Child Usually Acts questionnaire. In addition, data were collected to assess whether (a) active DV was present during the time of the Child Protective Services (CPS) investigation and (b) mothers received DV services during the past year. Study research questions were examined using a series of multiple regression analyses. Mediation was tested based on Baron and Kenny's recommended model for establishing mediation. The mediational model was not found to be significant; however, a positive relationship existed between maternal DV and emotional regulation among infants aged less than 1 year old (β = 1.61, p = .039). There were no statistically significant relationships between DV and emotional regulation in the other age groups. These findings highlight the need to provide CPS-involved families victimized by DV with services that focus on preventing poor infant emotional regulation.

  15. Exploring the relevance of male involvement in the prevention of mother to child transmission of HIV services in Blantyre, Malawi.

    Science.gov (United States)

    Nyondo, Alinane Linda; Chimwaza, Angela Faith; Muula, Adamson Sinjani

    2014-10-30

    Male involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program. Male involvement in PMTCT is a fairly new concept in Malawi that has not been fully implemented within PMTCT service provision despite its inclusion in the PMTCT guidelines. One of the reasons for the limited MI is the lack of knowledge on both its relevance and the role of men in the program. Currently, men have been encouraged to participate in PMTCT services without prior research on their understanding of the relevance and their role in PMTCT. This information is vital to the development of programs that will require MI in PMTCT. The objective of this study was to explore the views of men, pregnant women and health care providers on the importance and roles of MI in PMTCT services in Blantyre Malawi. An exploratory descriptive qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) and its catchment area in Blantyre, Malawi. We conducted 6 key informant interviews (KIIs) with health care workers and 4 focus group discussions (FGDs) with 18 men and 17 pregnant women. Interviews and discussions were digitally recorded and simultaneously transcribed and translated into English. Data were analyzed using framework analysis approach. The major themes that emerged on the relevance of MI in PMTCT were a) uptake of interventions along the PMTCT cascade b) support mechanism and c) education strategy. Lack of MI in PMTCT was reported to result into non-disclosure of HIV test results and non-compliance with PMTCT interventions. Male involvement is paramount for the uptake of interventions at the different cascades of PMTCT. The absence of male involvement may compromise compliance with PMTCT interventions.

  16. Workers' exposure to electric fields during the task 'maintenance of an operating device of circuit breaker from a service platform' at 110-kV substations.

    Science.gov (United States)

    Korpinen, Leena; Pääkkönen, Rauno

    2018-02-26

    The objective of the study was to investigate occupational exposure to electric fields during the task 'maintenance of an operating device of circuit breaker from a service platform' at 110-kV substations. The aim was also to compare the results to Directive 2013/35/EU. At 16 substations, 255 electric field measurements were performed. The highest mean value of the electric fields was 9.6 kV⋅m -1 . At 63% of substations the maximum values were over 10.0 kV⋅m -1 , and at 31% of the substations the 75th percentiles were over 10.0 kV⋅m -1 , which is the low action level (AL) according to Directive 2013/35/EU. All measured values were below the high AL (20.0 kV⋅m -1 ). In the future, it is important to take into account that the measurements were only taken at Finnish 110-kV substations; therefore, it is not possible to generalize these results to other countries and different types of substations.

  17. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    Science.gov (United States)

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

  18. School health services and community nutrition: a historical perspective.

    Science.gov (United States)

    Rezola, J G; Santolaya, J; Orduna, J; Dehesa, F

    2001-12-01

    The Bilbao School Health Service was created at the beginning of the century with the aim of preventing transmittable diseases among children as well as improving nutrition. At that time such services were established in many other countries. Since then, according to evolving societal changes and emerging needs, the Service has reoriented its scope and structure towards the Health Promotion scheme. Current tasks include health screening examinations and hygiene surveillance as well as preventive and health education programmes.

  19. Patient-physician language concordance and use of preventive care services among limited English proficient Latinos and Asians.

    Science.gov (United States)

    Jih, Jane; Vittinghoff, Eric; Fernandez, Alicia

    2015-01-01

    Patient-physician language concordance among limited English proficient (LEP) patients is associated with better outcomes for specific clinical conditions. Whether or not language concordance contributes to use of specific preventive care services is unclear. We pooled data from the 2007 and 2009 California Health Interview Surveys to examine mammography, colorectal cancer (CRC) screening, and influenza vaccination use among self-identified LEP Latino and Asian (i.e., Chinese, Korean, and Vietnamese) immigrants. We defined language concordance by respondents reporting that their physician spoke their non-English language. Analyses were completed in 2013-2014. Language concordance did not appear to facilitate mammography use among Latinas (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] 0.72, 1.45). Among Asian women, we could not definitively exclude a negative association of language concordance with mammography (AOR=0.55, 95% CI 0.27, 1.09). Patient-physician language concordance was associated with lower odds of CRC screening among Asians but not Latinos (Asian AOR=0.50, 95% CI 0.29, 0.86; Latino AOR=0.85, 95% CI 0.56, 1.28). Influenza vaccination did not differ by physician language use among either Latinos or Asians. Patient-physician language concordance was not associated with higher use of mammography, CRC screening, or influenza vaccination. Language concordance was negatively associated with CRC screening among Asians for reasons that require further research. Future research should isolate the impact of language concordance on the use of preventive care services from health system factors.

  20. Characterization and typification of small ruminant farms providing fuelbreak grazing services for wildfire prevention in Andalusia (Spain).

    Science.gov (United States)

    Mena, Y; Ruiz-Mirazo, J; Ruiz, F A; Castel, J M

    2016-02-15

    Several wildfire prevention programs in Spain are using grazing livestock to maintain fuelbreaks with low levels of biomass. Even though shepherds are remunerated for these services, many of their farms are hardly viable in the current socio-economic context. By analyzing 54 small ruminant farms participating in the Grazed Fuelbreak Network in Andalusia (southern Spain), this research aimed to identify the main types and characteristics of such farms and, considering the challenges they are facing, propose strategies to improve both their economic viability and their effectiveness in fuelbreak grazing. Based on data collected through a survey on key farm management aspects, a multivariate analysis was performed and four main types of farm were identified: two clusters of dairy goat farms and two composed mostly of meat-purpose sheep farms. Farms in all clusters could benefit from improvements in the feeding and reproductive management of livestock, either to enhance their productivity or to make better use of the pasture resources available. Dairy goat farms remain more dependent on external animal feed to ensure a better lactation, therefore they should either diminish their workforce costs per animal or sell transformed products directly to consumers to improve their economic viability. Best fuelbreak grazing results were related to larger flocks combining sheep and goats, lower ratios of fuelbreak surface area per animal, and longer (year-long) grazing periods on fuelbreaks. Therefore, such farm features and adjusted fuelbreak assignments should be favored in wildfire prevention programs using grazing services. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

    Science.gov (United States)

    Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

    2017-05-01

    Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services.

    Science.gov (United States)

    Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha

    2018-02-08

    Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

  3. Disparities in health care access and receipt of preventive services by disability type: analysis of the medical expenditure panel survey.

    Science.gov (United States)

    Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M

    2014-12-01

    To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities. Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008. We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening. We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18-64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest. Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs. There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups. © Health Research and Educational Trust.

  4. Identification the intangibles arising from investments in prevention of occupational risks and their perception in SMEs. Implications in the service sector and the servitization

    Directory of Open Access Journals (Sweden)

    Máximo Cortés

    2014-04-01

    Full Text Available Purpose: Based on the concept of Intellectual Capital and the analysis of component elements, the study aims to identify potential intangibles arising from investments in prevention of occupational risks, analyzing if adequate preventive management helps to increase the value of the company, and establishing a comparative analysis of the industrial and service companies in order to observe specifications for each case. Besides the impact and implications arising thereon due to increased outsourcing and servitization processes in business are determined. Design/methodology: Analysis of the concept and components of Intellectual Capital, intangible generated on preventive action and indicators. Study of the relevant factors servitización and outsourcing, and implications with prevention. Empirical study: Initial study and further study. A comparative analysis considers their impact on the industrial sector relative to the service sector. Analysis of results and conclusions. Findings: This article determines if adequate preventive management helps to improve the image and increase the value of the company. The possible application of the components of Intellectual Capital with respect to intangibles generated in the prevention of occupational hazards is established, outlining the indicators to measure the generation of intangibles in preventive activities.Using both the initial and then further studies, the opinions and evaluation of entrepreneurs in Madrid can be assessed. A comparative analysis considers their impact on the industrial sector relative to the service sector, their particular characteristics, and the observed trend in the awareness of the benefits of prevention, in addition to establishing implications for the progressive increase servitization and outsourcing activities. Originality / Value: The paper provides information and interpretations which confirmed the importance of risk prevention as an intangible asset and a profitable

  5. Women's decision-making and uptake of services to prevent mother-to-child HIV transmission in Zambia.

    Science.gov (United States)

    Ford, Catherine; Chibwesha, Carla J; Winston, Jennifer; Jacobs, Choolwe; Lubeya, Mwansa Ketty; Musonda, Patrick; Stringer, Jeffrey S A; Chi, Benjamin H

    2018-04-01

    Women's empowerment is associated with engagement in some areas of healthcare, but its role in prevention of mother-to-child HIV transmission (PMTCT) services has not been previously considered. In this secondary analysis, we investigated the association of women's decision-making and uptake of health services for PMTCT. Using data from population-based household surveys, we included women who reported delivery in the 2-year period prior to the survey and were HIV-infected. We measured a woman's self-reported role in decision-making in her own healthcare, making of large purchases, schooling of children, and healthcare for children. For each domain, respondents were categorized as having an "active" or "no active" role. We investigated associations between decision-making and specific steps along the PMTCT cascade: uptake of maternal antiretroviral drugs, uptake of infant HIV prophylaxis, and infant HIV testing. We calculated unadjusted and adjusted odds ratios via logistic regression. From March to December 2011, 344 HIV-infected mothers were surveyed and 276 completed the relevant survey questions. Of these, 190 (69%) took antiretroviral drugs during pregnancy; 175 (64%) of their HIV-exposed infants received antiretroviral prophylaxis; and 160 (58%) had their infant tested for HIV. There was no association between decision-making and maternal or infant antiretroviral drug use. We observed a significant association between decision-making and infant HIV testing in univariate analyses (OR 1.56-1.85; p decision-making indicators were no longer statistically significant predictors of infant HIV testing in multivariate analyses. In conclusion, women who reported an active role in decision-making trended toward a higher likelihood of uptake of infant testing in the PMTCT cascade. Larger studies are needed to evaluate the impact of empowerment initiatives on the PMTCT service utilization overall and infant testing in particular.

  6. Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men.

    Science.gov (United States)

    Scheim, Ayden I; Santos, Glenn-Milo; Arreola, Sonya; Makofane, Keletso; Do, Tri D; Hebert, Patrick; Thomann, Matthew; Ayala, George

    2016-01-01

    Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n=3857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98) and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98). This first look at access to HIV prevention services for trans MSM

  7. Service utilization and cost of implementing a comprehensive HIV prevention and care program among people who inject drugs in Delhi, India.

    Science.gov (United States)

    Sebastian, Mary Philip; Dasgupta, Aparajita; Saraswati, Lopamudra Ray; Singh, Asha; Sharma, Vartika; Madan, Ira; Tun, Waimar; Pulerwitz, Julie; Thior, Ibou; Sarna, Avina

    2017-06-14

    WHO, UNODC, and UNAIDS recommend a comprehensive package for prevention, treatment, and care of HIV among people who inject drugs (PWID). We describe the uptake of services and the cost of implementing a comprehensive package for HIV prevention, treatment, and care services in Delhi, India. A cohort of 3774 PWID were enrolled for a prospective HIV incidence study and provided the comprehensive package: HIV and hepatitis testing and counseling, hepatitis B (HB) vaccination, syndromic management of sexually transmitted infections, clean needles-syringes, condoms, abscess care, and education. Supplementary services comprising tea and snacks, bathing facilities, and medical consultations were also provided. PWID were referred to government services for antiretroviral therapy (ART), TB care, opioid substitution therapy, and drug dependence treatment/rehabilitation. The project spent USD 1,067,629.88 over 36 months of project implementation: 1.7% on capital costs, 3.9% on participant recruitment, 26.7% for project management, 49.9% on provision of services, and 17.8% on supplementary services. Provision of HIV prevention and care services cost the project USD 140.41/PWID/year. 95.3% PWID were tested for HIV. Of the HIV-positive clients, only 17.8% registered for ART services after repeated follow-up. Reasons for not seeking ART services included not feeling sick, need for multiple visits to the clinic, and long waiting times. 61.8% of the PWID underwent HB testing. Of the 2106 PWID eligible for HB vaccination, 81% initiated the vaccination schedule, but only 29% completed all three doses, despite intensive follow-up by outreach workers. PWID took an average of 8 clean needles-syringes/PWID/year over the project duration, with a mid-project high of 16 needles-syringes/PWID/year. PWID continued to also procure needles from other sources, such as chemists. One hundred five PWID were referred to OST services and 267 for rehabilitation services. A comprehensive HIV

  8. Facilitators of and barriers to accessing clinical prevention services for the South Asian population in Surrey, British Columbia: a qualitative study

    Science.gov (United States)

    Majid, Sanaa; Douglas, Rachel; Lee, Victoria; Stacy, Elizabeth; Garg, Arun K.; Ho, Kendall

    2016-01-01

    Background: British Columbia falls short in uptake of recommended clinical prevention services, with even lower rates among immigrant populations. This study explored facilitators of and barriers to uptake of clinical prevention services among people from South Asia, who represent 31% of the population in Surrey, British Columbia. Methods: We used a qualitative descriptive approach and employed vignettes in a focus group setting to elicit perspectives of South Asian people on accessing clinical prevention services. Participants aged 40 years or more were recruited between October 2014 and February 2015 from health care and community settings such as older-adult housing, day programs and health education events. Letters of introduction to the study were provided in English or Punjabi or both to all potential participants. We conducted qualitative content analysis of the results. Results: Sixty-two South Asian adults (36 women and 26 men) aged 40-87 years participated in 1 of 8 focus groups in health care or community settings. Facilitators of and barriers to accessing clinical prevention services were noted at the patient, primary care provider and health care system levels. Facilitators at the patient level included taking ownership over one's health, health literacy and respecting the provider's advice; barriers included fear of the diagnosis, death and/or procedures, perceived low risk of disease or utility of the intervention, and side effects of procedures. Provider factors centred on a trust-based patient-provider relationship, strong communication and adequate time during visits. Health care system factors included such facilitators as processes to routinely offer prevention services as part of other health care or social services, systems that encourage prevention-oriented family practice and services at low or no cost to the patient. Interpretation: Our findings validate previously identified facilitators of and barriers to accessing preventive care for

  9. Accessibility to, Acceptability of, and Adherence to HIV/AIDS Prevention Services by Men Who Have Sex with Men: Challenges Encountered at Facility Level

    Directory of Open Access Journals (Sweden)

    P. C. N. Otambo

    2016-01-01

    Full Text Available The prevalence of HIV/AIDS among men who have sex with men (MSM in Nairobi has been reported to be 16.4% which is a public health concern. The aim of this study was to determine factors that affected accessibility to, acceptability of, and adherence to HIV/AIDS prevention services by men who have sex with men in Nairobi County, Kenya. Methods. The study used a mixed methods design, applying both quantitative and qualitative methods. Results. Over 70% of MSM reported that TB drugs, antiretroviral drugs, lubricants, condoms, and other STI treatment services were accessible. However, 31.6% of MSM reported that discrimination at the health facility level was a hindrance to accessing HIV/AIDS prevention services while 26.3% reported encountering stigma. 48.4% of MSM consumed alcohol while taking of drugs was reported, at 36.1%. Conclusion. Discrimination and stigma adversely affected MSM seeking HIV/AIDS prevention services in health facilities. MSM engaged in alcohol and substance abuse that likely affected their health seeking behavior. Although most prevention services are reported as accessible, uptake of the same needs to be considered.

  10. Analysis of international and European policy instruments: pollution swapping . Task 2 Service contract "Integrated measures in agriculture to reduce ammonia emissions"

    NARCIS (Netherlands)

    Oenema, O.; Velthof, G.L.

    2007-01-01

    This Report describes the results of Task 2 ‘Analysis of International and European policy instruments’. The aim of this task is to analyze the existing International and European policy instruments aiming at reducing emissions of ammonia, nitrous oxide and methane to the atmosphere and nitrate to

  11. Do Children with Autism Use Inner Speech and Visuospatial Resources for the Service of Executive Control? Evidence From Suppression in Dual Tasks

    Science.gov (United States)

    Holland, Lucy; Low, Jason

    2010-01-01

    Three experiments used dual-task suppression methodology to study the use of inner speech and visuospatial resources for mediating central executive performance by children with autism (CWA) and group-matched typically developing (TD) controls. Expt 1 revealed that CWA did not recruit inner speech to facilitate arithmetic task-switching…

  12. Computerized management of plant intervention tasks

    International Nuclear Information System (INIS)

    Quoidbach, G.

    2004-01-01

    The main objective of the 'Computerized Management of Plant Intervention Tasks' is to help the staff of a nuclear or a conventional power plant or of any other complex industrial facility (chemical industries, refineries, and so on) in planning, organizing, and carrying out any (preventive or corrective) maintenance task. This 'Computerized Management of Plant Intervention Tasks' is organized around a data base of all plant components in the facility that might be subjected to maintenance or tagout. It allows to manage, by means of intelligent and configurable 'mail service', the course of the intervention requests as well as various treatments of those requests, in a safe and efficient way, adapted to each particular organization. The concept of 'Computerized Management' of plant intervention tasks was developed by BELGATOM in 1983 for the Belgian nuclear power plants of ELECTRABEL. A first implementation of this concept was made at that time for the Doel NPP under the name POPIT (Programming Of Plant Intervention Tasks). In 1988, it was decided to proceed to a functional upgrade of the application, using advanced software and hardware techniques and products, and to realize a second implementation in the Tihange NPP under the name ACM (Application Consignation Maintenance). (author)

  13. Consumer Adoption of Future MyData-Based Preventive eHealth Services: An Acceptance Model and Survey Study.

    Science.gov (United States)

    Koivumäki, Timo; Pekkarinen, Saara; Lappi, Minna; Väisänen, Jere; Juntunen, Jouni; Pikkarainen, Minna

    2017-12-22

    Constantly increasing health care costs have led countries and health care providers to the point where health care systems must be reinvented. Consequently, electronic health (eHealth) has recently received a great deal of attention in social sciences in the domain of Internet studies. However, only a fraction of these studies focuses on the acceptability of eHealth, making consumers' subjective evaluation an understudied field. This study will address this gap by focusing on the acceptance of MyData-based preventive eHealth services from the consumer point of view. We are adopting the term "MyData", which according to a White Paper of the Finnish Ministry of Transport and Communication refers to "1) a new approach, a paradigm shift in personal data management and processing that seeks to transform the current organization centric system to a human centric system, 2) to personal data as a resource that the individual can access and control." The aim of this study was to investigate what factors influence consumers' intentions to use a MyData-based preventive eHealth service before use. We applied a new adoption model combining Venkatesh's unified theory of acceptance and use of technology 2 (UTAUT2) in a consumer context and three constructs from health behavior theories, namely threat appraisals, self-efficacy, and perceived barriers. To test the research model, we applied structural equation modeling (SEM) with Mplus software, version 7.4. A Web-based survey was administered. We collected 855 responses. We first applied traditional SEM for the research model, which was not statistically significant. We then tested for possible heterogeneity in the data by running a mixture analysis. We found that heterogeneity was not the cause for the poor performance of the research model. Thus, we moved on to model-generating SEM and ended up with a statistically significant empirical model (root mean square error of approximation [RMSEA] 0.051, Tucker-Lewis index [TLI] 0

  14. Consumer Adoption of Future MyData-Based Preventive eHealth Services: An Acceptance Model and Survey Study

    Science.gov (United States)

    Pekkarinen, Saara; Lappi, Minna; Väisänen, Jere; Juntunen, Jouni; Pikkarainen, Minna

    2017-01-01

    Background Constantly increasing health care costs have led countries and health care providers to the point where health care systems must be reinvented. Consequently, electronic health (eHealth) has recently received a great deal of attention in social sciences in the domain of Internet studies. However, only a fraction of these studies focuses on the acceptability of eHealth, making consumers’ subjective evaluation an understudied field. This study will address this gap by focusing on the acceptance of MyData-based preventive eHealth services from the consumer point of view. We are adopting the term "MyData", which according to a White Paper of the Finnish Ministry of Transport and Communication refers to "1) a new approach, a paradigm shift in personal data management and processing that seeks to transform the current organization centric system to a human centric system, 2) to personal data as a resource that the individual can access and control." Objective The aim of this study was to investigate what factors influence consumers’ intentions to use a MyData-based preventive eHealth service before use. Methods We applied a new adoption model combining Venkatesh’s unified theory of acceptance and use of technology 2 (UTAUT2) in a consumer context and three constructs from health behavior theories, namely threat appraisals, self-efficacy, and perceived barriers. To test the research model, we applied structural equation modeling (SEM) with Mplus software, version 7.4. A Web-based survey was administered. We collected 855 responses. Results We first applied traditional SEM for the research model, which was not statistically significant. We then tested for possible heterogeneity in the data by running a mixture analysis. We found that heterogeneity was not the cause for the poor performance of the research model. Thus, we moved on to model-generating SEM and ended up with a statistically significant empirical model (root mean square error of approximation

  15. Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi

    OpenAIRE

    Nyondo, Aliane Linda; Sinjani Muula, Adamson; Faith Chimwaza, Angela

    2013-01-01

    Background: Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT.Objective: The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi.Study design: An...

  16. Meeting the needs of women who use drugs and alcohol in North-east India – a challenge for HIV prevention services

    Science.gov (United States)

    2012-01-01

    Background The North-east Indian states of Manipur and Nagaland consistently report relatively high HIV prevalence. The targeted HIV prevention interventions in these two states are mostly delivered by non-government organizations (NGOs), and prevention of HIV transmission by injecting drug use is their main focus. Most injecting drug users (IDUs) are male, and the services are primarily tailored to meet their needs, which are not necessarily the same as those for women. This qualitative study describes the health service needs of women who use drugs and alcohol in Manipur and Nagaland, with the goal of identifying strategies and activities that can be implemented by NGOs wanting to improve their reach among vulnerable women. Methods In 2009-10, semi-structured in-depth interviews were conducted with 27 key informants and nine focus group discussions (FGDs) with women who use drugs and alcohol, and two FGDs with male IDUs. The thematic areas covered included: the context of female drug and alcohol use; drug and alcohol use patterns; HIV risk behaviours; barriers and facilitators of service use; perceived health needs; and expressed health service needs. The data were recorded, transcribed, translated and thematically analysed. Results The most problematic substance for women from Nagaland was alcohol, and for women from Manipur it was heroin. The most commonly identified health problems were primarily related to the women’s drug and alcohol use, reproductive health and mental health. Other problems of major concern included social exclusion, violence, children’s welfare, and financial difficulties. The expressed service needs of these women were women-only integrated health services, women-only detoxification and rehabilitation services, mental health services, desensitization of mainstream health workers, free access to medicines, assistance to meet basic needs, and a safe place for engaging in sex work. Conclusion The expressed health and other service needs

  17. Meeting the needs of women who use drugs and alcohol in North-east India – a challenge for HIV prevention services

    Directory of Open Access Journals (Sweden)

    Kermode Michelle

    2012-09-01

    Full Text Available Abstract Background The North-east Indian states of Manipur and Nagaland consistently report relatively high HIV prevalence. The targeted HIV prevention interventions in these two states are mostly delivered by non-government organizations (NGOs, and prevention of HIV transmission by injecting drug use is their main focus. Most injecting drug users (IDUs are male, and the services are primarily tailored to meet their needs, which are not necessarily the same as those for women. This qualitative study describes the health service needs of women who use drugs and alcohol in Manipur and Nagaland, with the goal of identifying strategies and activities that can be implemented by NGOs wanting to improve their reach among vulnerable women. Methods In 2009-10, semi-structured in-depth interviews were conducted with 27 key informants and nine focus group discussions (FGDs with women who use drugs and alcohol, and two FGDs with male IDUs. The thematic areas covered included: the context of female drug and alcohol use; drug and alcohol use patterns; HIV risk behaviours; barriers and facilitators of service use; perceived health needs; and expressed health service needs. The data were recorded, transcribed, translated and thematically analysed. Results The most problematic substance for women from Nagaland was alcohol, and for women from Manipur it was heroin. The most commonly identified health problems were primarily related to the women’s drug and alcohol use, reproductive health and mental health. Other problems of major concern included social exclusion, violence, children’s welfare, and financial difficulties. The expressed service needs of these women were women-only integrated health services, women-only detoxification and rehabilitation services, mental health services, desensitization of mainstream health workers, free access to medicines, assistance to meet basic needs, and a safe place for engaging in sex work. Conclusion The expressed

  18. Motivations and experiences of women who accessed ‘see and treat’ cervical cancer prevention services in Zambia

    Science.gov (United States)

    White, Heather L.; Mulambia, Chishimba; Sinkala, Moses; Mwanahamuntu, Mulindi H.; Parham, Groesbeck P.; Kapambwe, Sharon; Moneyham, Linda; Kempf, Mirjam C.; Chamot, Eric

    2014-01-01

    Background In Zambia, a country with a generalized HIV epidemic, age-adjusted cervical cancer incidence is among the highest worldwide. In 2006, the UAB-Center for Infectious Disease Research in Zambia and the Zambian Ministry of Health launched a visual inspection with acetic acid (VIA)-based “see and treat” cervical cancer prevention program in Lusaka. All services were integrated within existing government-operated primary health care facilities. Objective Study aims were to: 1) identify women's motivations for cervical screening; 2) document women's experiences with screening; and 3) describe the potentially reciprocal influences between women undergoing cervical screening and their social networks. Design & Methods Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with women who accepted screening and with care providers. Low-level content analysis was performed to identify themes evoked by participants. Between September, 2009 and July, 2010, 60 women and 21 care providers participated in 8 FGD and 10 IDI. Results Women presented for screening with varying needs and expectations. A majority discussed their screening decisions and experiences with members of their social networks. Key reinforcing factors and obstacles to VIA screening were identified. Conclusions Interventions are needed to gain support for the screening process from influential family members and peers. PMID:22369192

  19. The Relationship of Health Literacy with Health status, Preventive Behaviors and Health services Utilization in Baluchistan, Iran

    Directory of Open Access Journals (Sweden)

    Hossien Izadirad

    2015-12-01

    Full Text Available Background and Objectives: Health Literacy has been defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. People with inadequate health literacy have poorer health status. Thus, the aim of this study was to determine the status of health literacy and its relationship with general health status, use of health services and preventive behaviors. Materials and Methods: This descriptive-analytical study was conducted on 400 individuals aged 18to 65 years in Balochestan, Iran. Multi-stage cluster sampling was used. Data were collected using Health Literacy for Iranian Adults (HELIA questionnaires. Data analyses were conducted using Kruskal-Wallis and Mann-Whitney, using SPSS (version 18. Results: The mean age of the studied population was 9.29± 28.7years. Only %32 of adults were found to have adequate health literacy. Inadequate health literacy was more common in older people, ones with fewer years of schooling or lower household income, and females. The health literacy level was associated with outpatient visits, screening, and health status. Individuals with higher levels of health literacy had performed screening more than others. conclusions: Due to the low health literacy level in the target population, educational interventions are needed to develop health literacy skills in the community.

  20. The Family Check-Up and Service Use in High-Risk Families of Young Children: A Prevention Strategy with a Bridge to Community-Based Treatment

    NARCIS (Netherlands)

    Leijten, Patty; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Matthys, Walter; Dishion, Thomas J.

    2015-01-01

    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  1. The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment

    NARCIS (Netherlands)

    Leijten, P.; Shaw, D.S.; Gardner, F.; Wilson, M.N.; Matthys, W.; Dishion, T.J.

    2015-01-01

    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  2. College Students' Knowledge, Attitudes and Adherence to Public Service Announcements on Ebola in Nigeria: Suggestions for Improving Future Ebola Prevention Education Programmes

    Science.gov (United States)

    Ajilore, Kolade; Atakiti, Ifeoluwa; Onyenankeya, Kevin

    2017-01-01

    Introduction: Apprehension over a possible recurrence of Ebola remains pervasive among college students in Nigeria. Prevention education continues to be carried out through public service announcements (PSAs) on radio, television and in the social media. However, little is known about college students' knowledge, attitudes and adherence to PSAs on…

  3. Data-as-a-Service Platform for Delivering Healthy Lifestyle and Preventive Medicine: Concept and Structure of the DAPHNE Project.

    Science.gov (United States)

    Gibbons, Catherine; Bailador Del Pozo, Gonzalo; Andrés, Javier; Lobstein, Tim; Manco, Melania; Lewy, Hadas; Bergman, Einat; O'Callaghan, David; Doherty, Gavin; Kudrautseva, Olga; Palomares, Angel; Ram, Roni; Olmo, Alberto

    2016-12-09

    Overweight and obesity is related to many health problems and diseases. The current obesity epidemic, which is a major health problem, is closely related to a lack of physical activity, high levels of sedentary behavior, and increased energy intake; with evidence to show increasing incidence of these issues in the younger population. Tackling obesity and its comorbid conditions requires a holistic approach encompassing attention on physical activity, healthy diet, and behavioral activation in order to enable and maintain meaningful and long-term weight loss and weight maintenance. The objective of the Data-as-a-Service Platform for Healthy Lifestyle and Preventive Medicine (DAPHNE) project is to develop a breakthrough information communications technology (ICT) platform for tracking health, weight, physical activity, diet, lifestyle, and psychological components within health care systems, whereby the platform and clinical support is linked. The DAPHNE platform aims to deliver personalized guidance services for lifestyle management to the citizen/patient by means of (1) advanced sensors and mobile phone apps to acquire and store continuous/real-time data on lifestyle aspects, behavior, and surrounding environment; (2) individual models to monitor their health and fitness status; (3) intelligent data processing for the recognition of behavioral trends; and (4) specific services for personalized guidance on healthy lifestyle and disease prevention. It is well known that weight loss and maintenance of weight loss are particularly difficult. This tool will address some of the issues found with conventional treatment/advice in that it will collect data in real time, thereby reducing reliability issues known with recalling events once they have passed and will also allow adjustment of behavior through timely support and recommendations sent through the platform without the necessity of formal one-to-one visits between patient and clinician. Patient motivation

  4. Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004-2010.

    Science.gov (United States)

    Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

    2013-01-01

    This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004-2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources.

  5. Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

    Science.gov (United States)

    Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

    2013-01-01

    Background This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. Methods The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald’s business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). Results The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources. PMID:23439724

  6. HIV Prevention Services and Testing Utilization Behaviors among Men Who Have Sex with Men at Elevated Risk for HIV in Chongqing, China

    Science.gov (United States)

    Hu, Yifei; Wu, Guohui; Jia, Yujiang; Lu, Rongrong; Xiao, Yan; Raymond, H. F.; Ruan, Yuhua; Sun, Jiangping

    2014-01-01

    Objective. To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing. Methods. Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data. Results. Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2–15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization. Conclusion. It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services. PMID:24783195

  7. Cosmetology: Task Analyses. Competency-Based Education.

    Science.gov (United States)

    Henrico County Public Schools, Glen Allen, VA. Virginia Vocational Curriculum Center.

    These task analyses are designed to be used in combination with the "Trade and Industrial Education Service Area Resource" in order to implement competency-based education in the cosmetology program in Virginia. The task analysis document contains the task inventory, suggested task sequence lists, and content outlines for the secondary…

  8. Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members.

    Science.gov (United States)

    Edwards, Samuel T; Rubenstein, Lisa V; Meredith, Lisa S; Schmidt Hackbarth, Nicole; Stockdale, Susan E; Cordasco, Kristina M; Lanto, Andrew B; Roos, Philip J; Yano, Elizabeth M

    2015-09-01

    Unclear roles in interdisciplinary primary care teams can impede optimal team-based care. We assessed perceived task allocation among primary care providers (PCPs) and staff during implementation of a new patient-centered care model in Veterans Affairs (VA) primary care practices. We performed a cross-sectional survey of PCPs and primary care staff (registered nurses (RNs), licensed practical/vocational nurses (LPNs), and medical assistants/clerks (MAs)) in 23 primary care practices within one VA region. We asked subjects whether PCPs performed each of 14 common primary care tasks alone, or relied upon staff for help. Tasks included gathering preventive service history, disease screening, evaluating patients and making treatment decisions, intervening on lifestyle factors, educating patients about self-care activities and medications, refilling prescriptions, receiving and resolving patient messages, completing forms, tracking diagnostic data, referral tracking, and arranging home health care. We then performed multivariable regression to determine predictors of perceived PCP reliance on staff for each task. 162 PCPs and 257 staff members responded, a 60% response rate. For 12/14 tasks, fewer than 50% of PCPs reported relying on staff for help. For all 14 tasks, over 85% of RNs reported they were relied upon. For 12/14 tasks, over 50% of LPNs reported they were relied on, while for 5/14 tasks a majority of MAs reported being relied upon. Nurse practitioners and physician assistants (NP/PAs) reported relying on staff less than physicians. Early in the implementation of a team-based primary care model, most PCPs perceived they were solely responsible for most clinical tasks. RNs, and LPNs felt they were relied upon for most of the same tasks, while medical assistants/clerks reported being relied on for fewer tasks. Better understanding of optimal inter-professional team task allocation in primary care is needed. Published by Elsevier Inc.

  9. The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government’s interagency task force on family planning and HIV service integration

    Science.gov (United States)

    Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R.; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D. Heather

    2017-01-01

    Abstract Introduction: People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President’s Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Discussion: Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Conclusion: Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other

  10. Primary prevention of neural-tube defects and some other congenital abnormalities by folic acid and multivitamins: history, missed opportunity and tasks

    Science.gov (United States)

    Bártfai, Zoltán; Bánhidy, Ferenc

    2011-01-01

    The history of intervention trials of periconception folic acid with multivitamin and folic acid supplementation in women has shown a recent breakthrough in the primary prevention of structural birth defects, namely neural-tube defects and some other congenital abnormalities. Recently, some studies have demonstrated the efficacy of this new method in reducing congenital abnormalities with specific origin; for example, in the offspring of diabetic and epileptic mothers, and in pregnancy with high fever. The benefits and drawbacks of four possible uses of periconception folate/folic acid and multivitamin supplementation are discussed: we believe there has been a missed opportunity to implement this preventive approach in medical practice. The four methods are as follows: (i) dietary intake of folate and other vitamins, (ii) periconception folic acid/multivitamin supplementation, (iii) food fortification with folic acid, and (iv) the combination of oral contraceptives with 6S-5-methytetrahydrofolate (‘folate’). PMID:25083211

  11. Preventing slips and falls through leisure-time physical activity: findings from a study of limited-service restaurants.

    Directory of Open Access Journals (Sweden)

    Alberto J Caban-Martinez

    Full Text Available Physical activity has been shown to be beneficial at improving health in some medical conditions and in preventing injury. Epidemiologic studies suggest that physical activity is one factor associated with a decreased risk for slips and falls in the older (≥ 65 years adult population. While the risk of slips and falls is generally lower in younger than in older adults; little is known of the relative contribution of physical activity in preventing slips and falls in younger adults. We examined whether engagement in leisure-time physical activity (LTPA was protective of slips and falls among a younger/middle-aged (≤ 50 years old working population.475 workers from 36 limited-service restaurants in six states in the U.S. were recruited to participate in a prospective cohort study of workplace slipping. Information on LTPA was collected at the time of enrollment. Participants reported their slip experience and work hours weekly for up to 12 weeks. We investigated the association between the rate of slipping and the rate of major slipping (i.e., slips that resulted in a fall and/or injury and LTPA for workers 50 years of age and younger (n = 433, range 18-50 years old using a multivariable negative binomial generalized estimating equation model.The rate of major slips among workers who engaged in moderate (Adjusted Rate Ratio (RR  = 0.65; 95% Confidence Interval (CI  =  [0.18-2.44] and vigorous (RR = 0.64; 95%CI  =  [0.18-2.26] LTPA, while non-significant, were approximately one-third lower than the rate of major slips among less active workers.While not statistically significant, the results suggest a potential association between engagement in moderate and vigorous LTPA and the rate of major slips in younger adults. Additional studies that examine the role of occupational and non-occupational physical activity on the risk of slips, trips and falls among younger and middle aged adults appear warranted.

  12. A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention.

    Science.gov (United States)

    Ambia, Julie; Mandala, Justin

    2016-01-01

    The success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps. Selected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis. Interventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I(2)=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I(2)=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I(2)=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I(2)=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings. Our findings indicate that mobile phone-based reminders may increase the uptake

  13. Frequent inaccuracies in ABCD(2) scoring in non-stroke specialists' referrals to a daily Rapid Access Stroke Prevention service.

    LENUS (Irish Health Repository)

    Bradley, David

    2013-09-15

    The \\'accuracy\\' of age, blood pressure, clinical features, duration and diabetes (ABCD(2)) scoring by non-stroke specialists referring patients to a daily Rapid Access Stroke Prevention (RASP) service is unclear, as is the accuracy of ABCD(2) scoring by trainee residents. In this prospective study, referrals were classified as \\'confirmed TIAs\\' if the stroke specialist confirmed a clinical diagnosis of possible, probable or definite TIA, and \\'non-TIAs\\' if patients had a TIA mimic or completed stroke. ABCD(2) scores from referring physicians were compared with scores by experienced stroke specialists and neurology\\/geriatric medicine residents at a daily RASP clinic; inter-observer agreement was examined. Data from 101 referrals were analysed (mean age=60.0years, 58% male). The median interval between referral and clinic assessment was 1day. Of 101 referrals, 52 (52%) were \\'non-TIAs\\': 45 (86%) of 52 were \\'TIA mimics\\' and 7 (14%) of 52 were completed strokes. There was only \\'fair\\' agreement in total ABCD(2) scoring between referring physicians and stroke specialists (κ=0.37). Agreement was \\'excellent\\' between residents and stroke specialists (κ=0.91). Twenty of 29 patients scored as \\'moderate to high risk\\' (score 4-6) by stroke specialists were scored \\'low risk\\' (score 0-3) by referring physicians. ABCD(2) scoring by referring doctors is frequently inaccurate, with a tendency to underestimate stroke risk. These findings emphasise the importance of urgent specialist assessment of suspected TIA patients, and that ABCD(2) scores by non-stroke specialists cannot be relied upon in isolation to risk-stratify patients. Inter-observer agreement in ABCD(2) scoring was \\'excellent\\' between residents and stroke specialists, indicating short-term training may improve accuracy.

  14. Evaluation of the use of health care services for non-communicable disease and prevention by children and adolescents in south Italy.

    Science.gov (United States)

    Ascione, Flora; Cascone, Diana; Napolitano, Francesco; Di Giuseppe, Gabriella

    2017-08-04

    The objectives of this investigation are to evaluate the use of health care services for non-communicable disease and prevention by children and adolescents and to identify the factors linked to the use of health care services. This cross-sectional survey was conducted between December 2014 and January 2015 among 1198 parents of students aged between 5 and 18 years attending 12 selected schools in the geographic area of Salerno and Naples, Italy, using a self-administered questionnarie. 68.2% of parents stated that had visited their general practitioner (GP) or family pediatrician (FP) with their child in the last year. 66.2% of children had had at least one visit to a specialist and more than half (54.8%) had had preventive care visits in the last year. The use of preventive care visits within last year was significantly higher amongst female, among those who had visited their GP or FP and among those who had a parent with a college degree or higher. The proportion of emergency department visits and hospital admissions reported were 12.8% and 4.7% respectively. This results highlights the need of educational interventions for parents and adolescents in order to increase the utilization of preventive health services.

  15. Gap Task Force

    CERN Multimedia

    Lissuaer, D

    One of the more congested areas in the ATLAS detector is the GAP region (the area between the Barrel Calorimeter and the End Cap calorimeter) where Inner Detector services, LAr Services and some Tile services all must co-habitat in a very limited area. It has been clear for some time that the space in the GAP region is not sufficient to accommodate all that is needed. In the last few month additional problems of routing all the services to Z=0 have been encountered due to the very limited space between the Tile Calorimeter and the first layer of Muon chambers. The Technical Management Board (TMB) and the Executive Board (EB) decided in the middle of March to establish a Task Force to look at this problem and come up with a solution within well-specified guidelines. The task force consisted of experts from the ID, Muon, Liquid Argon and Tile systems in addition to experts from the Technical Coordination team and the Physics coordinator. The task force held many meetings and in general there were some very l...

  16. The impact of programs for prevention of mother-to-child transmission of HIV on health care services and systems in sub-Saharan Africa - A review.

    Science.gov (United States)

    Mutabazi, Jean Claude; Zarowsky, Christina; Trottier, Helen

    2017-01-01

    The global scale-up of Prevention of mother-to-child transmission (PMTCT) services is credited for a 52% worldwide decline in new HIV infections among children between 2001 and 2012. However, the epidemic continues to challenge maternal and paediatric HIV control efforts in Sub Saharan Africa (SSA), with repercussions on other health services beyond those directly addressing HIV and AIDS. This systematised narrative review describes the effects of PMTCT programs on other health care services and the implications for improving health systems in SSA as reported in the existing articles and scientific literature. The following objectives framed our review:To describe the effects of PMTCT on health care services and systems in SSA and assess whether the PMTCT has strengthened or weakened health systems in SSATo describe the integration of PMTCT and its extent within broader programs and health systems. Articles published in English and French over the period 1st January 2007 (the year of publication of WHO/UNICEF guidelines on global scale-up of the PMTCT) to 31 November 2016 on PMTCT programs in SSA were sought through searches of electronic databases (Medline and Google Scholar). Articles describing the impact (positive and negative effects) of PMTCT on other health care services and those describing its integration in health systems in SSA were eligible for inclusion. We assessed 6223 potential papers, reviewed 225, and included 57. The majority of selected articles offered arguments for increased health services utilisation, notably of ante-natal care, and some evidence of beneficial synergies between PMTCT programs and other health services especially maternal health care, STI prevention and early childhood immunisation. Positive and negative impact of PMTCT on other health care services and health systems are suggested in thirty-two studies while twenty-five papers recommend more integration and synergies. However, the empirical evidence of impact of PMTCT

  17. Economic and social factors are some of the most common barriers preventing women from accessing maternal and newborn child health (MNCH) and prevention of mother-to-child transmission (PMTCT) services: a literature review.

    Science.gov (United States)

    hIarlaithe, Micheal O; Grede, Nils; de Pee, Saskia; Bloem, Martin

    2014-10-01

    Support to health programming has increasingly placed an emphasis on health systems strengthening. Integration of prevention of mother-to-child transmission (PMTCT) and maternal and newborn child health (MNCH) services has been one of the areas where there has been a shift from a siloed to a more integrated approach. The scale-up of anti-retroviral therapy has made services increasingly available while also bringing them closer to those in need. However, addressing supply side issues around the availability and quality of care at the health centre level alone cannot guarantee better results without a more explicit focus on access issues. Access to PMTCT care and treatment services is affected by a number of barriers which influence decisions of women to seek care. This paper reviews published qualitative and quantitative studies that look at demand side barriers to PMTCT services and proposes a categorisation of these barriers. It notes that access to PMTCT services as well as eventual uptake and retention in PMTCT care starts with access to MNCH in general. While poverty often prevents women, regardless of HIV status, from accessing MNCH services, women living with HIV who are in need of PMTCT services face an additional set of PMTCT barriers. This review proposes four categories of barriers to accessing PMTCT: social norms and knowledge, socioeconomic status, physiological status and psychological conditions. Social norms and knowledge and socioeconomic status stand out. Transport is the most frequently mentioned socioeconomic barrier. With regard to social norms and knowledge, non-disclosure, stigma and partner relations are the most commonly cited barriers. Some studies also cite physiological barriers. Barriers related to social norms and knowledge, socioeconomic status and physiology can all be affected by the mental and psychological state of the individual to create a psychological barrier to access. Increased coverage and uptake of PMTCT services can be

  18. Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation.

    Science.gov (United States)

    Garcia-Borreguero, Diego; Silber, Michael H; Winkelman, John W; Högl, Birgit; Bainbridge, Jacquelyn; Buchfuhrer, Mark; Hadjigeorgiou, Georgios; Inoue, Yuichi; Manconi, Mauro; Oertel, Wolfgang; Ondo, William; Winkelmann, Juliane; Allen, Richard P

    2016-05-01

    A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) in conjunction with the European Restless Legs Syndrome Study Group (EURLSSG) and the RLS Foundation (RLS-F) to develop evidence-based and consensus-based recommendations for the prevention and treatment of long-term pharmacologic treatment of dopaminergic-induced augmentation in restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force made the following prevention and treatment recommendations: As a means to prevent augmentation, medications such as α2δ ligands may be considered for initial RLS/WED treatment; these drugs are effective and have little risk of augmentation. Alternatively, if dopaminergic drugs are elected as initial treatment, then the daily dose should be as low as possible and not exceed that recommended for RLS/WED treatment. However, the physician should be aware that even low dose dopaminergics can cause augmentation. Patients with low iron stores should be given appropriate iron supplementation. Daily treatment by either medication should start only when symptoms have a significant impact on quality of life in terms of frequency and severity; intermittent treatment might be considered in intermediate cases. Treatment of existing augmentation should be initiated, where possible, with the elimination/correction of extrinsic exacerbating factors (iron levels, antidepressants, antihistamines, etc.). In cases of mild augmentation, dopamine agonist therapy can be continued by dividing or advancing the dose, or increasing the dose if there are breakthrough night-time symptoms. Alternatively, the patient can be switched to an α2δ ligand or rotigotine. For severe augmentation the patient can be switched either to an α2δ ligand or rotigotine, noting that rotigotine may also produce augmentation at higher doses with long-term use. In more severe cases of augmentation an opioid may be considered, bypassing α2δ ligands and rotigotine

  19. HIV Risk Behaviors and Utilization of Prevention Services, Urban and Rural Men Who Have Sex with Men in the United States: Results from a National Online Survey.

    Science.gov (United States)

    McKenney, Jennie; Sullivan, Patrick S; Bowles, Kristina E; Oraka, Emeka; Sanchez, Travis H; DiNenno, Elizabeth

    2017-10-06

    Rural men who have sex with men (MSM) are heavily affected by HIV, and many lack culturally competent HIV prevention resources. Rural MSM may find sexual partners on the internet, which may also be a way to deliver prevention services to them. To understand the differences between rural and urban MSM with respect to HIV risk factors and behaviors and the utilization of online HIV prevention services, we used data from the 2012 Web-Based HIV Behavioral Survey (WHBS). Using WHBS data collected between June and August 2012, we compared the characteristics of MSM with positive or unknown HIV infection status who had sex with a male in the past 12 months, from rural vs urban areas using Chi square tests and median tests. We used logistic regression and calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to compare self-reported HIV risk behaviors, HIV/STI testing behaviors, use of prevention services, and perceived discrimination. Of the 8166 MSM included in our analysis, 3583 (44%) were from rural areas, and 4583 (56%) were from urban areas. Compared to urban MSM, rural MSM were less likely to ever test for HIV (aPR = 0.94, CI 0.92-0.95), to be tested for HIV in the last year (aPR = 0.83, CI 0.79-0.87), or to receive free condoms (aPR = 0.83, CI 0.79-0.86) or individual prevention counseling in the past year (aPR = 0.86, CI 0.78-0.95). Rural MSM were less likely to have been tested in the last year for syphilis, gonorrhea, or chlamydia (aPR = 0.70, CI 0.62-0.78; aPR = 0.72, CI 0.64-0.81; aPR = 0.75, CI 0.67-0.85, respectively). Rural MSM also reported perceiving less tolerance of gays and bisexuals within their community (aPR = 0.80, CI 0.77-0.84). HIV prevalence is lower among MSM in rural areas compared to MSM in urban areas, but rural MSM report that they are more likely to face intolerance and are less likely to use basic HIV prevention services compared to urban MSM. Therefore, this hard-to-reach population could benefit

  20. A Review of Research Literature on Obstacles That Prevent Use of ICT in Pre-Service Teachers' Educational Courses

    Science.gov (United States)

    Mirzajani, Hassan; Mahmud, Rosnaini; Ayub, Ahmad Fauzi Mohd; Luan, Wong Su

    2015-01-01

    In spite of growing amount of technologies, tools and information communication and technology (ICT) by providing pre-service teacher education courses, pre-service teachers' ICT utilization is not still as predicted. Research shows many barriers influencing pre-service teachers' utilization of ICT. Many researchers have identified a number of…

  1. [Mental health and work: integrated technical actions between services for preventive hygiene and worksite safety and mental health centers].

    Science.gov (United States)

    Bosco, M G; Salerno, S; Valcella, F

    1999-01-01

    We analyzed occupational and mental health activities in an occupational health service and in a mental health service using the Method of Organizational Congruences (MOC). No technical actions in either services were dedicated to mental health at work although this is prescribed by the Italian law (833/76) and has a demand among the local shared users identified in this study. We propose integrated technical action for mental health in public health services to address the risk of stress, burnout and mobbing in the workplace. Attention is drawn to the need for further research on health services in the field of organization and mental well-being.

  2. Prevalence of vaccine preventable diseases and utilization of routine immunizations services by parents of under‐one children in a semi‐urban community of Sokoto State, Nigeria

    Directory of Open Access Journals (Sweden)

    Kaoje AU

    2017-01-01

    Full Text Available Introduction Vaccine preventable diseases are categories of diseases that could be prevented by immunization. They affect children of less than five years of age. This study was conducted to determine the prevalence of vaccine preventable diseases and utilization of routine immunization services among parents/caregivers of under‐one children in Bodinga town of Sokoto State, Nigeria. Methods The study was community based and a descriptive cross sectional epidemiological study design was used. Four hundred households participated in the survey and were selected using a two stage sampling technique. A structured interviewer administered questionnaire with closed and some open‐ ended questions was used to collect the survey data through face‐to‐face interview. Data collected were entered into computer and analyzed using the SPSS version 23. Results were presented in simple tables for clarity. Results Measles was found to be the most prevalent vaccine preventable diseases in the community, while Hepatitis B has the least prevalence and mortality from these diseases was found to be 3%. Majority of the respondent were aware of Poliomyelitis as vaccine preventable disease and only few were aware of Hepatitis B vaccination. The percentage of fully vaccinated children was very low (4.75% while about one‐third of the children were not immunized at all. The socio‐cultural factors found to affect the utilization of routine immunization services includes: place of delivery (more for the hospital delivery, educational level and occupation of child’s parent affect positively more especially the mother. The major reason for not taking the children for immunization was Father’s refusal. Conclusion The study revealed that measles is the most prevalent vaccine preventable disease in the study area. The awareness of vaccine preventable diseases was found to be low except for poliomyelitis. Strengthening routine immunization including demand creation

  3. Navigating the risks of prevention of mother to child transmission (PMTCT) of HIV services in Kibera, Kenya: Barriers to engaging and remaining in care.

    Science.gov (United States)

    Thomson, Kerry A; Telfer, Barbara; Opondo Awiti, Patricia; Munge, Jane; Ngunga, Mathew; Reid, Anthony

    2018-01-01

    Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed. Using an inductive exploratory approach, four researchers coded the data and identified key themes. Five themes emerged from the data that may influence attrition from PMTCT service in this setting: 1) HIV in the context of Kibera, 2) knowledge of HIV status, 3) knowledge of PMTCT, 4) disclosure of HIV status, and 5) male partner support for PMTCT services. A new HIV diagnosis during pregnancy immediately triggered an ongoing risk assessment of perceived hazards in the home, community, and clinic environments that could occur as a result of female participation in PMTCT services. Male partners were a major influence in this risk assessment, but were generally unaware of PMTCT services. To preserve relationships with male partners, meet community expectations of womanhood, and maintain confidentiality while following recommendations of healthcare providers, women had to continuously weigh the risks and benefits of PMTCT services and interventions. Community-based HIV testing and PMTCT education, male involvement in antenatal care, and counseling customized to assist each woman in her own unique risk assessment, may improve uptake of and retention in care and optimize the HIV prevention benefit of PMTCT interventions.

  4. The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico

    OpenAIRE

    Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; B?rnighausen, Till; Velasco-Mondrag?n, H?ctor Eduardo; Darney, Blair Grant

    2017-01-01

    Background The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. Methods We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the avai...

  5. The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

    Science.gov (United States)

    Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

    2017-08-03

    The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P primary health care facilities. There is a shortage of health promoters in urban primary health facilities (P health promoters is lower than the ideal supply to deliver the guaranteed package of prevention and health promotion services. Policies must address the level and distribution of human resources in primary health facilities.

  6. Service-learning in higher education relevant to the promotion of physical activity, healthful eating, and prevention of obesity

    OpenAIRE

    Richard R Rosenkranz

    2012-01-01

    Service-learning is a type of experiential teaching and learning strategy combining classroom instruction and meaningful community service and guided activities for reflection. This educational approach has been used frequently in higher education settings, including an array of disciplines such as medicine, theology, public health, physical education, nutrition, psychology, anthropology, and sociology. The purpose of the present review paper was to provide guidance on the use of service-lear...

  7. Supplemental Screening for Breast Cancer in Women With Dense Breasts: A Systematic Review for the U.S. Preventive Services Task Force.

    Science.gov (United States)

    Melnikow, Joy; Fenton, Joshua J; Whitlock, Evelyn P; Miglioretti, Diana L; Weyrich, Meghan S; Thompson, Jamie H; Shah, Kunal

    2016-02-16

    Screening mammography has lower sensitivity and specificity in women with dense breasts, who experience higher breast cancer risk. To perform a systematic review of reproducibility of Breast Imaging Reporting and Data System (BI-RADS) density categorization and test performance and clinical outcomes of supplemental screening with breast ultrasonography, magnetic resonance imaging (MRI), and digital breast tomosynthesis (DBT) in women with dense breasts and negative mammography results. MEDLINE, PubMed, EMBASE, and Cochrane database from January 2000 to July 2015. Studies reporting BI-RADS density reproducibility or supplemental screening results for women with dense breasts. Quality assessment and abstraction of 24 studies from 7 countries; 6 studies were good-quality. Three good-quality studies reported reproducibility of BI-RADS density; 13% to 19% of women were recategorized between "dense" and "nondense" at subsequent screening. Two good-quality studies reported that sensitivity of ultrasonography for women with negative mammography results ranged from 80% to 83%; specificity, from 86% to 94%; and positive predictive value (PPV), from 3% to 8%. The sensitivity of MRI ranged from 75% to 100%; specificity, from 78% to 94%; and PPV, from 3% to 33% (3 studies). Rates of additional cancer detection with ultrasonography were 4.4 per 1000 examinations (89% to 93% invasive); recall rates were 14%. Use of MRI detected 3.5 to 28.6 additional cancer cases per 1000 examinations (34% to 86% invasive); recall rates were 12% to 24%. Rates of cancer detection with DBT increased by 1.4 to 2.5 per 1000 examinations compared with mammography alone (3 studies). Recall rates ranged from 7% to 11%, compared with 7% to 17% with mammography alone. No studies examined breast cancer outcomes. Good-quality evidence was sparse. Studies were small and CIs were wide. Definitions of recall were absent or inconsistent. Density ratings may be recategorized on serial screening mammography. Supplemental screening of women with dense breasts finds additional breast cancer but increases false-positive results. Use of DBT may reduce recall rates. Effects of supplemental screening on breast cancer outcomes remain unclear. Agency for Healthcare Research and Quality.

  8. Access to Basic HIV-Related Services and PrEP Acceptability among Men Who Have sex with Men Worldwide: Barriers, Facilitators, and Implications for Combination Prevention

    Directory of Open Access Journals (Sweden)

    George Ayala

    2013-01-01

    Full Text Available Introduction. Men who have sex with men (MSM are disproportionately impacted by HIV globally. Easily accessible combination HIV prevention strategies, tailored to the needs of MSM, are needed to effectively address the AIDS pandemic. Methods and Materials. We conducted a cross-sectional study among MSM (n=3748 from 145 countries from April to August 2012. Using multivariable random effects models, we examined factors associated with acceptability of preexposure prophylaxis (PrEP and access to condoms, lubricants, HIV testing, and HIV treatment. Results. Condoms and lubricants were accessible to 35% and 22% of all respondents, respectively. HIV testing was accessible to 35% of HIV-negative respondents. Forty-three percent of all HIV-positive respondents reported that antiretroviral therapy was easily accessible. Homophobia, outness, and service provider stigma were significantly associated with reduced access to services. Conversely, community engagement, connection to gay community, and comfort with service providers were associated with increased access. PrEP acceptability was associated with lower PrEP-related stigma, less knowledge about PrEP, less outness, higher service provider stigma, and having experienced violence for being MSM. Conclusions. Ensuring HIV service access among MSM will be critical in maximizing the potential effectiveness of combination approaches, especially given the interdependence of both basic and newer interventions like PrEP. Barriers and facilitators of HIV service access for MSM should be better understood and addressed.

  9. Inhibition of the prostaglandin E2 receptor EP2 prevents status epilepticus-induced deficits in the novel object recognition task in rats

    Science.gov (United States)

    Rojas, Asheebo; Ganesh, Thota; Manji, Zahra; O’neill, Theon; Dingledine, Raymond

    2016-01-01

    Survivors of exposure to an organophosphorus nerve agent may develop a number of complications including long-term cognitive deficits (Miyaki et al., 2005; Nishiwaki et al., 2001). We recently demonstrated that inhibition of the prostaglandin E2 receptor, EP2, attenuates neuroinflammation and neurodegeneration caused by status epilepticus (SE) induced by the soman analog, diisopropylfluorophosphate (DFP), which manifest within hours to days of the initial insult. Here, we tested the hypothesis that DFP exposure leads to a loss of cognitive function in rats that is blocked by early, transient EP2 inhibition. Adult male Sprague-Dawley rats were administered vehicle or the competitive EP2 antagonist, TG6-10-1, (ip) at various times relative to DFP-induced SE. DFP administration resulted in prolonged seizure activity as demonstrated by cortical electroencephalography (EEG). A single intraperitoneal injection of TG6-10-1 or vehicle 1 h prior to DFP did not alter the development of seizures, the latency to SE or the duration of SE. Rats administered six injections of TG6-10-1 starting 90 min after the onset of DFP-induced SE could discriminate between a novel and familiar object 6–12 weeks after SE, unlike vehicle treated rats which showed no preference for the novel object. By contrast, behavioral changes in the light-dark box and open field assays were not affected by TG6-10-1. Delayed mortality after DFP was also unaffected by TG6-10-1. Thus, selective inhibition of the EP2 receptor may prevent SE-induced memory impairment in rats caused by exposure to a high dose of DFP. PMID:27477533

  10. 75 FR 21301 - Office of Clinical and Preventive Services; Elder Care Initiative Long-Term Care Grant Program

    Science.gov (United States)

    2010-04-23

    ... incorporation of the above elements into a report or other document that guides LTC services/system implementation, including a plan for sustainability. Category 2--Implementation awards will support the following... currently have to guide development of LTC services or programs? a. What do we know about our elder and...

  11. Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.

    Science.gov (United States)

    Garrido-Cumbrera, Marco; Borrell, Carme; Palència, Laia; Espelt, Albert; Rodríguez-Sanz, Maica; Pasarín, M Isabel; Kunst, Anton

    2010-01-01

    In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening.

  12. [Objective: To present the process and challenges of developing an online competency-based course on public health policy using a collaborative international approach.Methods: Five public health experts, supported by an expert in educational technology, adopted a rigorous approach to the development of the course: a needs analysis, identification of objectives and competencies, development of a pedagogical scenario for each module and target, choice of teaching methods and learning activities, material to be identified or developed, and the responsibilities and tasks involved.Results: The 2-credit (90-hour) graduate course consists of six modules including an integration module. The modules start with a variety of case studies: tobacco law (neutral packaging), supervised injection sites, housing, integrated services for the frail elderly, a prevention programme for mothers from disadvantaged backgrounds, and the obligatory use of bicycle helmets. In modules 1, 3, 4 and 5, students learn about different stages of the public policy development process: emergence, formulation and adoption, implementation and evaluation. Module 2 focuses on the importance of values and ideologies in public policy. The integration module allows the students to apply the knowledge learned and addresses the role of experts in public policy and ethical considerations.Conclusion].

    Science.gov (United States)

    Hébert, Réjean; Coppieters, Yves; Pradier, Christian; Williams-Jones, Bryn; Brahimi, Cora; Farley, Céline

    2018-01-30

    To present the process and challenges of developing an online competency-based course on public health policy using a collaborative international approach. Five public health experts, supported by an expert in educational technology, adopted a rigorous approach to the development of the course: a needs analysis, identification of objectives and competencies, development of a pedagogical scenario for each module and target, choice of teaching methods and learning activities, material to be identified or developed, and the responsibilities and tasks involved. The 2-credit (90-hour) graduate course consists of six modules including an integration module. The modules start with a variety of case studies: tobacco law (neutral packaging), supervised injection sites, housing, integrated services for the frail elderly, a prevention programme for mothers from disadvantaged backgrounds, and the obligatory use of bicycle helmets. In modules 1, 3, 4 and 5, students learn about different stages of the public policy development process: emergence, formulation and adoption, implementation and evaluation. Module 2 focuses on the importance of values and ideologies in public policy. The integration module allows the students to apply the knowledge learned and addresses the role of experts in public policy and ethical considerations. The course has been integrated into the graduate programmes of the participating universities and allows students to follow, at a distance, an innovative training programme.

  13. "AN OUNCE OF PREVENTION..."

    Science.gov (United States)

    HASELKORN, FLORENCE

    PREVENTION AS FUNCTION, VALUE ISSUE, CONCEPTUAL SHORTCOMING, AND PRACTICE IS DISCUSSED AND RELATED TO EDUCATIONAL TASK. PREVENTION AS FUNCTION IS GENERATED BY OUR VALUE PREMISES. IN SEEKING TO PREVENT SOME FORMS OF SOCIAL DYSFUNCTION, WE MAY BE PERPETUATING OTHERS. THE CONCEPT OF PREVENTION IS AMBIGUOUS. CRUCIAL CONCEPTUAL ISSUES INCLUDE THE…

  14. The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

    Directory of Open Access Journals (Sweden)

    M. L.S. Mataboge

    2016-10-01

    Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

  15. The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

    Directory of Open Access Journals (Sweden)

    M.L.S. Mataboge

    2016-12-01

    Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

  16. The Relationship between Pre-Service Mathematics Teachers' Focus on Student Thinking in Lesson Analysis and Lesson Planning Tasks

    Science.gov (United States)

    Taylan, Rukiye Didem

    2018-01-01

    This study explored whether pre-service teachers' (PSTs') lesson analysis skills during a teacher education course in the country of Turkey were related to their skills of lesson planning. PSTs' lesson analysis skills during fieldwork were assessed by their attention to and interpretation of student thinking and learning, and how it is influenced…

  17. The Effects of a Combined Task Clarification, Goal Setting, Feedback, and Performance Contingent Consequence Intervention Package on Telephone Customer Service in a Medical Clinic Environment

    Science.gov (United States)

    Slowiak, Julie M.; Madden, Gregory J.; Mathews, Ramona

    2006-01-01

    Appointment coordinators at a mid-western medical clinic were to provide exceptional telephone customer service. This included using a standard greeting, speaking in an appropriate tone of voice during the conversation, and using a standard closing to end the call. An analysis suggested performance deficiencies resulted from weak antecedents, poor…

  18. Constrained Optimization Methods in Health Services Research—An Introduction: Report 1 of the ISPOR Optimization Methods Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Crown, William; Buyukkaramikli, Nasuh; Thokala, Praveen; Morton, Alec; Sir, Mustafa Y.; Marshall, Deborah A.; Tosh, Jon; Padula, William V.; IJzerman, Maarten Joost; Wong, Peter K.; Pasupathy, Kalyan S.

    2017-01-01

    Providing health services with the greatest possible value to patients and society given the constraints imposed by patient characteristics, health care system characteristics, budgets, and so forth relies heavily on the design of structures and processes. Such problems are complex and require a

  19. Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

    Directory of Open Access Journals (Sweden)

    Tirumalasetti Rao V

    2013-02-01

    Full Text Available Vasudha Tirumalasetti Rao,1 Bidhubhusan Mahapatra,2 Sachin Juneja,1 Indra R Singh11Transport Corporation of India Foundation, Gurgaon, Haryana, India 2Population Council, New Delhi, IndiaBackground: This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV prevention intervention for long-distance truck drivers operating on the national highways of India.Methods: The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010 and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402 and July 2009 (n = 1407.Results: The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001. A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001, and participated in health exhibitions (6% to 35%, P < 0.001. Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001, and attended one-one counseling (15% to 21%, P < 0.01. Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001.Conclusion: Adoption of a business model for HIV prevention helped to

  20. Allowing for MSD prevention during facilities planning for a public service: an a posteriori analysis of 10 library design projects.

    Science.gov (United States)

    Bellemare, Marie; Trudel, Louis; Ledoux, Elise; Montreuil, Sylvie; Marier, Micheline; Laberge, Marie; Vincent, Patrick

    2006-01-01

    Research was conducted to identify an ergonomics-based intervention model designed to factor in musculoskeletal disorder (MSD) prevention when library projects are being designed. The first stage of the research involved an a posteriori analysis of 10 recent redesign projects. The purpose of the analysis was to document perceptions about the attention given to MSD prevention measures over the course of a project on the part of 2 categories of employees: librarians responsible for such projects and personnel working in the libraries before and after changes. Subjects were interviewed in focus groups. Outcomes of the analysis can guide our ergonomic assessment of current situations and contribute to a better understanding of the way inclusion or improvement of prevention measures can support the workplace design process.

  1. Analyzing opportunities for energy conservation in municipal fleet management: service delivery patterns, equipment, supply, operations, and maintenance. Information bulletin of the energy task force of the urban consortium

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-01-01

    Vehicle fleet management as a five-step process is portrayed and the multiple energy conservation opportunities within each step are examined. The five steps described are, configuration of service area and service delivery patterns, equipping the fleet, operating the fleet, maintaining the fleet, and supplying the fleet with fuel. A systems approach to decision making about municipal fleets is outlined. Management options, control techniques, and devices are suggested for each of the five steps. Reference is made to analytic tools which will assist in deliberating options at each of these steps. These tools are presented in a list. Four concise case studies of jurisdictions which are taking deliberate steps to reduce fuel use are presented. Key opportunities for fuel conservation are then summarized, followed by a selected bibliography, and listing of reference materials and additional resources.

  2. What are the minimum requirements for ketogenic diet services in resource-limited regions? Recommendations from the International League Against Epilepsy Task Force for Dietary Therapy.

    Science.gov (United States)

    Kossoff, Eric H; Al-Macki, Nabil; Cervenka, Mackenzie C; Kim, Heung D; Liao, Jianxiang; Megaw, Katherine; Nathan, Janak K; Raimann, Ximena; Rivera, Rocio; Wiemer-Kruel, Adelheid; Williams, Emma; Zupec-Kania, Beth A

    2015-09-01

    Despite the increasing use of dietary therapies for children and adults with refractory epilepsy, the availability of these treatments in developing countries with limited resources remains suboptimal. One possible contributory factor may be the costs. There is often reported a significant perceived need for a large ketogenic diet team, supplements, laboratory studies, and follow-up visits to provide this treatment. The 2009 Epilepsia Consensus Statement described ideal requirements for a ketogenic diet center, but in some situations this is not feasible. As a result, the International League Against Epilepsy (ILAE) Task Force on Dietary Therapy was asked to convene and provide practical, cost-effective recommendations for new ketogenic diet centers in resource-limited regions of the world. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  3. The Potential Effects of the Defense Business Board Military Compensation Task Group’s 2011 Recommendations on Active-Duty Service Member Retirement

    Science.gov (United States)

    2012-12-01

    heavily upon Charles A. Henning’s (2011) Congressional Research Service report entitled Military Retirement Reform: A Review of Proposals and Options...active dUJt ar1er !he traoSilioo <!.ate woulo eam retitenw:n.t befits ur • .aer tM ·~~e·-’’ plan. ’All currel’!tly serving membe<$ woukl remain unde1

  4. Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project.

    Science.gov (United States)

    Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

    2017-01-01

    There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Three categories emerged from the analysis: "Balancing complex situations" clarified the complexity regarding senior employees; "Working with a proactive approach" indicated the need for working with a new proactive approach supporting sustainable health; and "Collaborate internally and externally" showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close

  5. What high-risk women are telling us about access to primary and reproductive health care and HIV prevention services.

    Science.gov (United States)

    Oliva, G; Rienks, J; McDermid, M

    1999-12-01

    Focus group discussions on barriers to health care and attitudes toward family planning, reproductive health services, and condom use were conducted with 63 women at high risk for HIV due to their own injection drug use, sex with injection drug users, sex industry work, or a history of multiple sexually transmitted diseases. Barriers identified include the high cost of health care, perceived poor quality of care and experiences of discrimination and stigmatization, geographic accessibility, fear of legal/social services punitive actions, misperceptions about the efficacy of birth control methods and condom usage, lack of sterilization services, and lack of male involvement. Where possible, findings from the focus groups are supported with quantitative survey data from a sample of high-risk women (n = 723). Recommendations are made for improving care for high-risk women.

  6. HIV Prevention Service Utilization in the Los Angeles House and Ball Communities: Past Experiences and Recommendations for the Future

    Science.gov (United States)

    Holloway, Ian W.; Traube, Dorian E.; Kubicek, Katrina; Supan, Jocelyn; Weiss, George; Kipke, Michele D.

    2012-01-01

    African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however,…

  7. Missed Opportunities along the Prevention of Mother-to-Child Transmission Services Cascade in South Africa: Uptake, Determinants, and Attributable Risk (the SAPMTCTE.

    Directory of Open Access Journals (Sweden)

    Selamawit Woldesenbet

    Full Text Available We examined uptake of prevention of mother-to-child HIV transmission (PMTCT services, predictors of missed opportunities, and infant HIV transmission attributable to missed opportunities along the PMTCT cascade across South Africa.A cross-sectional survey was conducted among 4-8 week old infants receiving first immunisations in 580 nationally representative public health facilities in 2010. This included maternal interviews and testing infants' dried blood spots for HIV. A weighted analysis was performed to assess uptake of antenatal and perinatal PMTCT services along the PMTCT cascade (namely: maternal HIV testing, CD4 count test/result, and receiving maternal and infant antiretroviral treatment and predictors of dropout. The population attributable fraction associated with dropouts at each service point are estimated.Of 9,803 mothers included, 31.7% were HIV-positive as identified by reactive infant antibody tests. Of these 80.4% received some form of maternal and infant antiretroviral treatment. More than a third (34.9% of mothers dropped out from one or more steps in the PMTCT service cascade. In a multivariable analysis, the following characteristics were associated with increased dropout from the PMTCT cascade: adolescent (<20 years mothers, low socioeconomic score, low education level, primiparous mothers, delayed first antenatal visit, homebirth, and non-disclosure of HIV status. Adolescent mothers were twice (adjusted odds ratio: 2.2, 95% confidence interval: 1.5-3.3 as likely to be unaware of their HIV-positive status and had a significantly higher rate (85.2% of unplanned pregnancies compared to adults aged ≥20 years (55.5%, p = 0.0001. A third (33.8% of infant HIV infections were attributable to dropout in one or more steps in the cascade.A third of transmissions attributable to missed opportunities of PMTCT services can be prevented by optimizing the uptake of PMTCT services. Identified risk factors for low PMTCT service uptake

  8. Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

    Directory of Open Access Journals (Sweden)

    Lydell M

    2017-05-01

    Full Text Available Marie Lydell,1 Cathrine Hildingh,1 Arne Söderbom,2 Kristina Ziegert1 1Center of Research on Welfare, Health and Sport (CVHI, School of Social and Health Sciences, 2Center for Innovation, Entrepreneurship and Learning Research (CIEL, School of Economics, Technology and Science, Halmstad University, Halmstad, Sweden Background: There is clearly a need for research in the field of occupational health service (OHS for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective: The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology: An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12. A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116. In phase III, a scoping review was undertaken. Results: Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion: The results outlined that it is necessary to

  9. Effectively Responding to the Commercial Sexual Exploitation of Children: A Comprehensive Approach to Prevention, Protection, and Reintegration Services.

    Science.gov (United States)

    Barnitz, Laura

    2001-01-01

    Discusses the international problem of commercial sexual exploitation of children (CSEC) and efforts to stop the practice and assist the victims. Considers initiatives to formulate a worldwide policy against CSEC, and anti-CSEC efforts in the United States, including law enforcement and education, and advocacy efforts and services for youth.…

  10. Effects of a National Public Service Information Campaign on Crime Prevention: Perspectives from Social Learning and Social Control Theory.

    Science.gov (United States)

    Lordan, Edward J.; Kwon, Joongrok

    This study examined the effects of public service advertising from two theoretical backgrounds: social learning theory and social control theory. Traditional social learning theory assumes that learning occurs by subjects performing responses and experiencing their effects, with reinforcement as the main determinant. Social control theory, as…

  11. Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

    Directory of Open Access Journals (Sweden)

    Elias Asfaw Zegeye

    2016-08-01

    Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

  12. Durch Kooperation und Vernetzung zu neuen Aufgabenfeldern – Serviceentwicklung in der Bibliothek der Medizinischen Fakultät Mannheim [Opening up new tasks through cooperation and networking – service development in the Library for the Medical Faculty of Mannheim

    Directory of Open Access Journals (Sweden)

    Semmler-Schmetz, Martina

    2013-09-01

    Full Text Available [english] The Library for the Medical Faculty of Mannheim of the University of Heidelberg supplies literature and information for research, teaching and further education purposes at the “Universitätsmedizin Mannheim”. Cooperation and networking with the central facilities, departments, working groups, and information multipliers result in new, future-oriented areas of work that go beyond traditional library tasks. New services for students focus primarily on academic research and writing skills, while information and consulting services which are flexible in terms of time and location are being developed for staff members of the clinical departments and institutes. The recent cooperation with actors in the field of evidence-based medicine has yielded the innovative service “systematic literature search” which is designed to support doctors and scientists in the preparation of grant proposals for clinical trials, systematic reviews, and guidelines. Currently, the library is widening access to its new services to include doctors, scientists, and other health practitioners in the region, and evaluating chargeable services for these user groups.[german] Die Bibliothek der Medizinischen Fakultät Mannheim der Universität Heidelberg dient der Literatur- und Informationsversorgung für Forschung, Lehre, Fort- und Weiterbildung an der Universitätsmedizin Mannheim. Neue, zukunftsorientierte Aufgabenfelder, die über die klassischen bibliothekarischen Arbeitsschwerpunkte hinausgehen, erschließt sich die Bibliothek durch enge Kooperation und Vernetzung mit den zentralen Einrichtungen und Abteilungen, Arbeitskreisen und Multiplikatoren innerhalb der Universitätsmedizin Mannheim. Neue Services für die Zielgruppe der Studierenden richten sich vor allem auf den Bereich des wissenschaftlichen Arbeitens, während für Mitarbeiter in den Einrichtungen, Kliniken und Instituten der Universitätsmedizin zeitlich und räumlich flexible Informations

  13. Constrained Optimization Methods in Health Services Research-An Introduction: Report 1 of the ISPOR Optimization Methods Emerging Good Practices Task Force.

    Science.gov (United States)

    Crown, William; Buyukkaramikli, Nasuh; Thokala, Praveen; Morton, Alec; Sir, Mustafa Y; Marshall, Deborah A; Tosh, Jon; Padula, William V; Ijzerman, Maarten J; Wong, Peter K; Pasupathy, Kalyan S

    2017-03-01

    Providing health services with the greatest possible value to patients and society given the constraints imposed by patient characteristics, health care system characteristics, budgets, and so forth relies heavily on the design of structures and processes. Such problems are complex and require a rigorous and systematic approach to identify the best solution. Constrained optimization is a set of methods designed to identify efficiently and systematically the best solution (the optimal solution) to a problem characterized by a number of potential solutions in the presence of identified constraints. This report identifies 1) key concepts and the main steps in building an optimization model; 2) the types of problems for which optimal solutions can be determined in real-world health applications; and 3) the appropriate optimization methods for these problems. We first present a simple graphical model based on the treatment of "regular" and "severe" patients, which maximizes the overall health benefit subject to time and budget constraints. We then relate it back to how optimization is relevant in health services research for addressing present day challenges. We also explain how these mathematical optimization methods relate to simulation methods, to standard health economic analysis techniques, and to the emergent fields of analytics and machine learning. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Tasks and possibilities of the Central Radiation Protection Service (SCPRI) of the French Ministry of Health and Labour in the field of radioactivity monitoring

    International Nuclear Information System (INIS)

    Pellerin, P.

    1986-01-01

    In France it is the SCPRI that is responsible for protecting the population against radioactivity hazards and for monitoring the radioactivity in the environment for detection of hazards that might emanate from the nuclear industry. This central service is subordinated to the French Ministry of Health and Labour and therefore acts independent of the nuclear industry. The SCPRI is responsible for preparing the legal framework of radiation protection. For this purpose, the service has most modernly equipped laboratories covering a surface of more than 5000 m 2 and a specific sampling and measuring network distributed over the whole French territory. Nuclear power plant monitoring is prescribed by law. It is done by the operators and is based on a variety of sampling and measuring activities, the frequency of which is set by the SCPRI. They mainly consist of continuous recording of the gamma radiation dose and systematic analyses of dust and rainwater, and of river and seawater sampled downstream a nuclear facility. The SCPRI carries out additional monitoring independent of the operators' activities. (orig./PW) [de

  15. This Much Water: a qualitative study using behavioural theory to develop a community service video to prevent child drowning in Western Australia.

    Science.gov (United States)

    Denehy, Mel; Leavy, Justine E; Jancey, Jonine; Nimmo, Lauren; Crawford, Gemma

    2017-07-31

    Drowning in children under the age of 5 is a frequently occurring, yet preventable event. This research used behavioural theory to test the suitability and appropriateness of a drowning prevention message in a community service video. This qualitative study used content analysis of focus groups. Constructs from the Health Belief Model guided the data analysis. Community organisations and playgrounds in Perth, Western Australia. Participants were parents or carers of at least one child under 5 years residing in Western Australia. Seven focus groups (n=57) were conducted with eight participants in each group. Most participants were parents (96%), female (95%), aged between 25 and 34 years (63%) and were born in Australia (68%). Participants indicated the community service video was credible in communicating the message that young children were susceptible to drowning in shallow water and that various water hazards existed in and around the home. However, a range of external factors, such as the child's age, type of water hazard, presence of siblings and other environmental factors, influenced risk perceptions. Child drowning was seen as a serious issue. Controlling access to water and the role of supervision were understood to be important factors in preventing drowning. The lack of published drowning prevention interventions shaped by behavioural theory limits the understanding of best practice. Using constructs from the Health Belief Model, this research confirmed the perceived seriousness, devastating and unforgettable consequence of drowning; however, findings were mixed regarding cues to action. Future development of drowning prevention media messages should test strategies to increase susceptibility and self-efficacy among the target group and explore the impact of different message senders. The findings provide a valuable understanding of possible messages and their execution for use in media campaigns, as one component of an effective public health

  16. Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services.

    Science.gov (United States)

    Bertram, Melanie Y; Sweeny, Kim; Lauer, Jeremy A; Chisholm, Daniel; Sheehan, Peter; Rasmussen, Bruce; Upreti, Senendra Raj; Dixit, Lonim Prasai; George, Kenneth; Deane, Samuel

    2018-04-05

    The global burden of non-communicable diseases (NCDs) is growing, and there is an urgent need to estimate the costs and benefits of an investment strategy to prevent and control NCDs. Results from an investment-case analysis can provide important new evidence to inform decision making by governments and donors. We propose a methodology for calculating the economic benefits of investing in NCDs during the Sustainable Development Goals (SDGs) era, and we applied this methodology to cardiovascular disease prevention in 20 countries with the highest NCD burden. For a limited set of prevention interventions, we estimated that US$120 billion must be invested in these countries between 2015 and 2030. This investment represents an additional $1·50 per capita per year and would avert 15 million deaths, 8 million incidents of ischaemic heart disease, and 13 million incidents of stroke in the 20 countries. Benefit-cost ratios varied between interventions and country-income levels, with an average ratio of 5·6 for economic returns but a ratio of 10·9 if social returns are included. Investing in cardiovascular disease prevention is integral to achieving SDG target 3.4 (reducing premature mortality from NCDs by a third) and to progress towards SDG target 3.8 (the realisation of universal health coverage). Many countries have implemented cost-effective interventions at low levels, so the potential to achieve these targets and strengthen national income by scaling up these interventions is enormous. Copyright © 2018 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

  17. Task-shifting Using a Pain Management Protocol in an Emergency Care Service: Nurses' Perception through the Eye of the Rogers's Diffusion of Innovation Theory.

    Science.gov (United States)

    Hadorn, Fabienne; Comte, Pascal; Foucault, Eliane; Morin, Diane; Hugli, Olivier

    2016-02-01

    It has been shown that over 70% of patients waiting in emergency departments (EDs) do not receive analgesics, despite the fact that more than 78% complain of pain. A clinical innovation in the form of a pain management protocol that includes task-shifting has been implemented in the ED of a university hospital in Switzerland in order to improve pain-related outcomes in patients. This innovation involves a change in clinical practice for physicians and nurses. The aim of this study is to explore nurses' perceptions on how well this innovation is adopted. This descriptive correlational study took place in the ED of a Swiss university hospital; the hospital provides healthcare for the city, the canton, and adjoining cantons. A convenience sample of 37 ED nurses participated. They were asked to complete a questionnaire comprising 56 statements based on Rogers's "Diffusion of Innovation" theory. Nurses' opinions (on a 1-10 Likert scale) indicate that the new protocol benefits the ED (mean [M] = 7.4, standard deviation [SD] = 1.21), is compatible with nursing roles (M = 8.0, SD = 1.9), is not too complicated to apply (M = 2.7, SD = 1.7), provides observable positive effects in patients (M = 7.0, SD = 1.28), and is relatively easy to introduce into daily practice (M = 6.5, SD = 1.0). Further studies are now needed to examine patients' experiences of this innovation. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. Drug and Alcohol Abuse Prevention Programs. Hearing before the Subcommittee on Manpower and Personnel and the Subcommittee on Preparedness of the Committee on Armed Services. United States Senate, Ninety-Eighth Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Armed Services.

    This document presents prepared statements and witness testimony from the Congressional hearing on drug and alcohol abuse prevention programs in the armed services. An opening statement by Senator Gordon J. Humphrey (chairman) highlights the importance of drug abuse prevention in the military. Witness testimony is given by the Assistant Secretary…

  19. How to Prevent Corruption Without Affecting Efficiency? An Overview of Safeguard Measures for Contracting Out Public Services

    Directory of Open Access Journals (Sweden)

    Roger E. HAMLIN

    2006-02-01

    Full Text Available The paper addresses the issue of finding the right balance between regulatory oversight, decision-making flexibility and reliance on market forces to safeguard the contracting-out process from corruption. The paper analyses the corrupt practices associated with contracting out local public services and the causes and consequences of this behavior. Taking into consideration new anticorruption strategies, we make recommendations for attaining equilibrium between flexible safeguard measures and accountable and transparent practices aimed at verifying whether regulations and standards are met. The strategy also emphasizes the training of public officials, to provide them with appropriate skills and professional capacity to identify and manage corruption risks. The last part of the paper recommends future research to identify best practices among different communities and states attempting to control corruption practices when contracting out public services.

  20. Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

    OpenAIRE

    Brownie, Sharon; Hills, Andrew P; Rossiter, Rachel

    2014-01-01

    Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5...

  1. How to Prevent Corruption Without Affecting Efficiency? An Overview of Safeguard Measures for Contracting Out Public Services

    OpenAIRE

    Roger E. HAMLIN; Bianca COBÂRZAN

    2006-01-01

    The paper addresses the issue of finding the right balance between regulatory oversight, decision-making flexibility and reliance on market forces to safeguard the contracting-out process from corruption. The paper analyses the corrupt practices associated with contracting out local public services and the causes and consequences of this behavior. Taking into consideration new anticorruption strategies, we make recommendations for attaining equilibrium between flexible safeguard measures and ...

  2. Use of Transnational Services to Prevent Treatment Interruption in Tuberculosis-Infected Persons Who Leave the United States.

    Science.gov (United States)

    Tschampl, Cynthia A; Garnick, Deborah W; Zuroweste, Edward; Razavi, Moaven; Shepard, Donald S

    2016-03-01

    A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries.

  3. The unmet provision of allergy services in Hong Kong impairs capability for allergy prevention-implications for the Asia Pacific region.

    Science.gov (United States)

    Lee, Tak-Hong; Leung, Ting-Fan; Wong, Gary; Ho, Marco; Duque, Jaime Rosa; Li, Philip Hei; Lau, Chak-Sing; Lam, Wai-Fan; Wu, Adrian; Chan, Eric; Lai, Christopher; Lau, Yu-Lung

    2017-12-10

    There is a high and rising prevalence of many allergic diseases in the Asia Pacific, including Hong Kong, which is unmatched by a commensurate provision of clinical allergy services. In the last 3 years, the allergy profile in Hong Kong has increased due to greater public engagement and more frequent educational activities, scientific outputs and publication of local guidelines on allergy prevention, diagnosis and treatment. Two new drug allergy clinics have been established in public hospitals, and for the first time in 20 years, Hong Kong has its first trainee in adult allergy. The current ratio of allergists per head of population has improved slightly from 1:1.46 (in 2014) to 1:1.17 million, but it is still low compared to many countries. The Hong Kong community is well supported by allergy-related professional societies and patient organisations. While the recent developments indicated some progress, Hong Kong remains inadequately equipped to take advantage of the new discoveries that may prevent allergic diseases and improve public health. There are also 5-fold more paediatric allergists than adult allergists per head of population. If this unbalance remains uncorrected, continuing care for allergic children as they grow into adulthood will be an increasing problem. This review provides recommendations to improve allergy service provision and training, including the creation of Centres of Excellence in allergy to drive the growth of this specialty.

  4. Preventative tele-health supported services for early stage chronic obstructive pulmonary disease: a protocol for a pragmatic randomized controlled trial pilot

    Directory of Open Access Journals (Sweden)

    Mountain Gail A

    2011-01-01

    Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a prevalent debilitating long term condition. It is the second most common cause of emergency admission to hospital in the UK and remains one of the most costly conditions to treat through acute care. Tele-health monitoring offers potential to reduce the rates of re-hospitalisation and emergency department visits and improve quality of life for people with COPD. However, the current evidence base to support technology adoption and implementation is limited and the resource implications for implementing tele-health in practice can be very high. This trial will employ tele-health monitoring in a preventative capacity for patients diagnosed with early stage COPD following discharge from hospital to determine whether it reduces their need for additional health service support or hospital admission and improves their quality of life. Methods/Design We describe a pilot study for a two arm, one site randomized controlled trial (RCT to determine the effect of tele-health monitoring on self-management, quality of life and patient satisfaction. Sixty patients who have been discharged from one acute trust with a primary diagnosis of COPD and who have agreed to receive community clinical support following discharge from acute care will be randomly assigned to one of two groups: (a Tele-health supported Community COPD Service; or (b Usual Care. The tele-health supported service involves the patient receiving two home visits with a specialist COPD clinician (nurse or physiotherapist then participating in daily tele-monitoring over an eight week period. Usual care consists of six home visits to the patient by specialist COPD clinicians again over eight successive weeks. Health status and quality of life data for all participants will be measured at baseline, on discharge from the service and at six months post discharge from the service. Discussion The tele-health service under study is a

  5. Profile, knowledge, and work patterns of a cadre of maternal, newborn, and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania.

    Science.gov (United States)

    LeFevre, Amnesty E; Mpembeni, Rose; Chitama, Dereck; George, Asha S; Mohan, Diwakar; Urassa, David P; Gupta, Shivam; Feldhaus, Isabelle; Pereira, Audrey; Kilewo, Charles; Chebet, Joy J; Cooper, Chelsea M; Besana, Giulia; Lutale, Harriet; Bishanga, Dunstan; Mtete, Emmanuel; Semu, Helen; Baqui, Abdullah H; Killewo, Japhet; Winch, Peter J

    2015-12-24

    Despite impressive decreases in under-five mortality, progress in reducing maternal and neonatal mortality in Tanzania has been slow. We present an evaluation of a cadre of maternal, newborn, and child health community health worker (MNCH CHW) focused on preventive and promotive services during the antenatal and postpartum periods in Morogoro Region, Tanzania. Study findings review the effect of several critical design elements on knowledge, time allocation, service delivery, satisfaction, and motivation. A quantitative survey on service delivery and knowledge was administered to 228 (of 238 trained) MNCH CHWs. Results are compared against surveys administered to (1) providers in nine health centers (n = 88) and (2) CHWs (n = 53) identified in the same districts prior to the program's start. Service delivery outputs were measured by register data and through a time motion study conducted among a sub-sample of 33 randomly selected MNCH CHWs. Ninety-seven percent of MNCH CHWs (n = 228) were interviewed: 55% male, 58% married, and 52% with secondary school education or higher. MNCH CHWs when compared to earlier CHWs were more likely to be unmarried, younger, and more educated. Mean MNCH CHW knowledge scores were <50% for 8 of 10 MNCH domains assessed and comparable to those observed for health center providers but lower than those for earlier CHWs. MNCH CHWs reported covering a mean of 186 households and were observed to provide MNCH services for 5 h weekly. Attendance of monthly facility-based supervision meetings was nearly universal and focused largely on registers, yet data quality assessments highlighted inconsistencies. Despite program plans to provide financial incentives and bicycles for transport, only 56% of CHWs had received financial incentives and none received bicycles. Initial rollout of MNCH CHWs yields important insights into addressing program challenges. The social profile of CHWs was not significantly associated with knowledge or

  6. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    LENUS (Irish Health Repository)

    Tickle, Martin

    2011-10-10

    Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods\\/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will

  7. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services.

    Science.gov (United States)

    Tickle, Martin; Milsom, Keith M; Donaldson, Michael; Killough, Seamus; O'Neill, Ciaran; Crealey, Grainne; Sutton, Matthew; Noble, Solveig; Greer, Margaret; Worthington, Helen V

    2011-10-10

    Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental

  8. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    Directory of Open Access Journals (Sweden)

    Noble Solveig

    2011-10-01

    Full Text Available Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years, fluoride toothpaste (1,450 ppm F (supplied twice per year, a toothbrush (supplied twice a year or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit. 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs

  9. AIDS Prevention: Views on the Administration's Budget Proposals. Briefing Report to the Chairman, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations, United States Senate.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    The General Accounting Office (GAO) conducted a study in response to Senator Lawton Chiles' request that the GAO explore the adequacy of the funding levels proposed for the Department of Health and Human Services' Public Health Service and the appropriateness of priorities reflected in the administration's proposed budget for prevention of…

  10. Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study

    Directory of Open Access Journals (Sweden)

    Suni Jaana

    2011-04-01

    Full Text Available Abstract Background The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. Methods The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. Results In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR = 0.34, 95% confidence interval (95% CI = 0.15 to 0.78, P = 0.011. This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI