Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia
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
Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia
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.
... 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...
Kim, Eric S; Strecher, Victor J; Ryff, Carol D
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.
Kim, Eric S.; Strecher, Victor J.; Ryff, Carol D.
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
Ahmedani, Brian K; Vannoy, Steven
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
Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard
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.
Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin
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…
Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen
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.
... 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 ...
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.
Xiong, Glen L; Iosif, Ana-Maria; Suo, Shannon; Mccarron, Robert M; Koike, Alan; Onate, John; Carter, Cameron S
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).
Yao, Xiaoxi; Dembe, Allard E; Wickizer, Thomas; Lu, Bo
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.
Eide, Arne Henning; Schür, Clare; Ranchod, Chitra; Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite
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.
Green, Carla A; Polen, Michael R; Leo, Michael C; Perrin, Nancy A; Anderson, Bradley M; Weisner, Constance M
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.
Rozier, R Gary; Stearns, Sally C; Pahel, Bhavna T; Quinonez, Rocio B; Park, Jeongyoung
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.
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
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.
... 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 ...
... 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...
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
... 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...
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.
Signorelli, C; Riccò, M; Odone, A
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.
Moilanen, Donna L.; Bradbury, Susan
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…
McHugh, E E
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.
Pai, Chih-Wen; Godboldo-Brooks, Ambyr; Edington, Dee W
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.
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.
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
Schumacher, Jessica R; Hall, Allyson G; Davis, Terry C; Arnold, Connie L; Bennett, Robert D; Wolf, Michael S; Carden, Donna L
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.
Kranz, Ashley M; Preisser, John S; Rozier, R Gary
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.
Cashmore, Aaron W; Noller, Jennifer; Ritchie, Jan; Johnson, Bronwyn; Blinkhorn, Anthony S
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.
Abdi A. Gele
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.
Kemper, Alex R; Mabry-Hernandez, Iris R; Grossman, David C
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.
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.
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.
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
Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane
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.
Fortin, Martin; Chouinard, Maud-Christine; Bouhali, Tarek; Dubois, Marie-France; Gagnon, Cynthia; Bélanger, Martin
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
von Hofe, I; Latza, U; Lönnfors, S; Muckelbauer, R
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.
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
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
Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle
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
Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A
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.
Bosco, M G; Salerno, S; Valcella, F
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.
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.
Pazol, Karen; Robbins, Cheryl L; Black, Lindsey I; Ahrens, Katherine A; Daniels, Kimberly; Chandra, Anjani; Vahratian, Anjel; Gavin, Lorrie E
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
Pfenninger, E.; Koenig, S.; Himmelseher, S.
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
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.
Richard R Rosenkranz
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.
Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas
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.
Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da
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.
Williams, Robert; Hewison, Alistair; Stewart, Mel; Liles, Clive; Wildman, Stuart
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.
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...
Llena Puy, M C; Ausina Márquez, V
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.
Getahun, Haileyesus; Sculier, Delphine; Sismanidis, Charalambos; Grzemska, Malgorzata; Raviglione, Mario
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.
Martin-Moreno, Jose M; Anttila, Ahti; von Karsa, Lawrence; Alfonso-Sanchez, Jose L; Gorgojo, Lydia
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.
Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M
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.
Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane
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.
Ahmed, Ashir; Kabir, Lutfe; Kai, Eiko; Inoue, Sozo
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.
Richard, Lucie; D'Amour, Danielle; Labadie, Jean-François; Brodeur, Jean-Marc; Pineault, Raynald; Séguin, Louise; Latour, Robert
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.
L. M. Aleksandrova
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
School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, youâll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement. Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/13/2017.
Bellet, Camille; Woodnutt, Joanna; Green, Laura E; Kaler, Jasmeet
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.
Garrido-Cumbrera, Marco; Borrell, Carme; Palència, Laia; Espelt, Albert; Rodríguez-Sanz, Maica; Pasarín, M Isabel; Kunst, Anton
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.
McGowan, B; Bennett, K; Marry, J; Walsh, J B; Casey, M C
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.
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
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.
Koivumäki, Timo; Pekkarinen, Saara; Lappi, Minna; Väisänen, Jere; Juntunen, Jouni; Pikkarainen, Minna
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
Pekkarinen, Saara; Lappi, Minna; Väisänen, Jere; Juntunen, Jouni; Pikkarainen, Minna
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
... Journal of Public Health. (95)3L471-477. Other sexual and behavioral health implications are equally... likely to participate in injurious health behaviors including smoking, alcohol and other drug abuse... smoking in certain facilities (or in some cases, any portion of the facility) in which regular or routine...
Mytton, Oliver T; Jackson, Christopher; Steinacher, Arno; Goodman, Anna; Langenberg, Claudia; Griffin, Simon; Wareham, Nick; Woodcock, James
The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation. We developed a microsimulation model to estimate the health benefits (incident ischaemic heart disease, stroke, dementia, and lung cancer) of the NHS Health Check programme in England. We simulated a population of adults in England aged 40-45 years and followed until age 100 years, using data from the Health Survey of England (2009-2012) and the English Longitudinal Study of Aging (1998-2012), to simulate changes in risk factors for simulated individuals over time. We used recent programme data to describe uptake of NHS Health Checks and of 4 associated interventions (statin medication, antihypertensive medication, smoking cessation, and weight management). Estimates of treatment efficacy and adherence were based on trial data. We estimated the benefits of the current NHS Health Check programme compared to a healthcare system without systematic health checks. This counterfactual scenario models the detection and treatment of risk factors that occur within 'routine' primary care. We also explored the impact of making feasible changes to implementation of the programme concerning eligibility, uptake of NHS Health Checks, and uptake of treatments offered through the programme. We estimate that the NHS Health Check programme prevents 390 (95% credible interval 290 to 500) premature deaths before 80 years of age and results in an additional 1,370 (95% credible interval 1,100 to 1,690) people
... Child Health Program evaluates and improves the quality and access to care for AI/AN women and children...-wide public policies apply to IHS grants with exception of the Discrimination policy. Requirements for... provide a [[Page 6119
Mutabazi, Jean Claude; Zarowsky, Christina; Trottier, Helen
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
Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant
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.
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.
Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A
To investigate factors that influence Dental Therapists and Oral Health Therapists (Therapists) plan preventive oral health care for adolescents attending New South Wales (NSW) Public Oral Health Services. A cross-sectional postal survey using two clinical vignettes were used to record the preventive care treatment plans offered by Therapists working across sixteen NSW Local Health Districts (LHDs). Data were tabulated and Chi square statistics were used in the analysis. One hundred and seventeen Therapists returned questionnaires giving a 64.6% response rate. The participants highlighted the importance of offering oral hygiene instruction (97.0%); dietary advice (95.0%) and topical fluoride applications (74.0%). Recommended home use products included fluoride toothpaste 5000ppmF (59.0%) and casein phosphopeptide amorphous phosphates plus fluoride (CPP-ACPF) paste (57.7%). Over 50% used fissure sealants. More respondents (88%) would utilise Motivational Interviewing strategies for a patient with dental caries concerns, however, only 63% would use this technique for a patient in pain (pdental disease, suggesting a need for Clinical Directors to consider providing more advice to Therapists on the scientific basis of preventing dental caries. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Johnson, Karen E; McRee, Annie-Laurie
Preparticipation examinations (PPEs), or sports physicals, present opportunities for health care providers to identify and discuss common adolescent health-risk behaviors. We sought to examine the prevalence of health-risk behaviors among high school athletes and the proportion of providers who address these behaviors during PPEs. For this descriptive study we used data from two statewide surveys: a survey of adolescents (n = 46,492) and a survey of nurse practitioners and physicians (n = 561). The most prevalent risk behaviors reported by student athletes were low levels of physical activity (70%), bullying perpetration (41%), and alcohol use (41%). Most providers (≥75%) addressed many common risk behaviors during PPEs but fewer addressed bullying, violence, and prescription drug use. Topics discussed differed by provider type and patient population. Many providers addressed critical threats to adolescent health during PPEs, but findings suggest potential disconnects between topics addressed during PPEs and behaviors of athletes. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Full Text Available BACKGROUND: The purpose of this study was to identify the incidence of frailty and to investigate the relationship between frailty status and health-related quality of life (HRQoL in the community-dwelling elderly population who utilize preventive health services. METHODS: People aged 65 years and older who visited a medical center in Taipei City from March to August in 2011 for an annual routine check-up provided by the National Health Insurance were eligible. A total of 374 eligible elderly adults without cognitive impairment had a mean age of 74.6±6.3 years. Frailty status was determined according to the Fried frailty criteria. HRQoL was measured with Short Form-36 (SF-36. Multiple regression analyses examined the relationship between frailty status and the two summary scales of SF-36. Models were adjusted for the participants' sociodemographic and health status. RESULTS: After adjusting for sociodemographic and health-related covariables, frailty was found to be more significantly associated (p<0.001 with lower scores on both physical and mental health-related quality of life summary scales compared with robustness. For the frailty phenotypes, slowness represented the major contributing factor in the physical component scale of SF-36, and exhaustion was the primary contributing factor in the mental component scale. CONCLUSION: The status of frailty is closely associated with HRQoL in elderly Taiwanese preventive health service users. The impacts of frailty phenotypes on physical and mental aspects of HRQoL differ.
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
Brownie, Sharon; Hills, Andrew P; Rossiter, Rachel
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...
Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; B?rnighausen, Till; Velasco-Mondrag?n, H?ctor Eduardo; Darney, Blair Grant
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...
Richard R Rosenkranz
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...
Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays) and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community's efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.
All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.
Oliva, G; Rienks, J; McDermid, M
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.
[The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care].
Brusaferro, Silvio; Marcolongo, Adriano; Schiava, Flavio; Bggio, Luca; Betta, Alberto; Buzzo, Armando; Cinquetti, Sandro; Coin, Paulo; Dal Fior, Tina; De Battisti, Fabio; De Marchi, Chiara; De Noni, Lucia; Donatoni, Luigi; Ferraresso, Anna; Gallo, Giovanni; Gallo, Lorenza; Gallo, Tolinda; Gottardello, Lorena; Menegon, Tiziana; Minuzzo, Michele; Paussi, Gianna; Pinna, Clara; Poli, Albino; Rossato, Luigi; Sbrogliò, Luca; Simeoni, Josef; Speccini, Manuela; Stoppato, Ugo; Superbi, Piero; Tardivo, Stefano; Urdich, Alessandro; Valsecchi, Massimo; Zamparo, Manuela
A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.
Ascione, Flora; Cascone, Diana; Napolitano, Francesco; Di Giuseppe, Gabriella
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.
In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795
Schuster, Roseanne C; McMahon, Devon E; Young, Sera L
Despite significant biomedical and policy advances, 199,000 infants and young children in sub-Saharan Africa (SSA) became infected with HIV in 2013, indicating challenges to implementation of these advances. To understand the nature of these challenges, we sought to (1) characterize the barriers and facilitators that health workers encountered delivering prevention of vertical transmission of HIV (PVT) services in SSA and (2) evaluate the use of theory to guide PVT service delivery. The PubMed and CINAHL databases were searched using keywords barriers, facilitators, HIV, prevention of vertical transmission of HIV, health workers, and their synonyms to identify relevant studies. Barriers and facilitators were coded at ecological levels according to the Determinants of Performance framework. Factors in this framework were then classified as affecting motivation, opportunity, or ability, per the Motivation-Opportunity-Ability (MOA) framework in order to evaluate domains of health worker performance within each ecological level. We found that the most frequently reported challenges occurred within the health facility level and spanned all three MOA domains. Barriers reported in 30% or more of studies from most proximal to distal included those affecting health worker motivation (stress, burnout, depression), patient opportunity (stigma), work opportunity (poor referral systems), health facility opportunity (overburdened workload, lack of supplies), and health facility ability (inadequate PVT training, inconsistent breastfeeding messages). Facilitators were reported in lower frequencies than barriers and tended to be resolutions to challenges (e.g., quality supervision, consistent supplies) or responses to an intervention (e.g., record systems and infrastructure improvements). The majority of studies did not use theory to guide study design or implementation. Interventions addressing health workers' multiple ecological levels of interactions, particularly the health
Mountain Gail A
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
Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina
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
M. L.S. Mataboge
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.
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.
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
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.
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
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.
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…
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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.
hIarlaithe, Micheal O; Grede, Nils; de Pee, Saskia; Bloem, Martin
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
von Dadelszen, Peter; Firoz, Tabassum; Donnay, France; Gordon, Rebecca; Justus Hofmeyr, G; Lalani, Shifana; Payne, Beth A; Roberts, James M; Teela, Katherine C; Vidler, Marianne; Sawchuck, Diane; Magee, Laura A
The hypertensive disorders of pregnancy, in particular preeclampsia, matter because adverse events occur in women with preeclampsia and, to a lesser extent, in women with the other hypertensive disorders. These adverse events are maternal, perinatal, and neonatal and can alter the life trajectory of each individual, should that life not be ended by complications. In this review we discuss a number of priorities and dilemmas that we perceive to be facing health services in low and middle income countries as they try to prioritize interventions to reduce the health burden related to preeclampsia. These priorities and dilemmas relate to calcium for preeclampsia prevention, risk stratification, antihypertensive and magnesium sulphate therapy, and mobile health. Significant progress has been and is being made to reduce the impact of preeclampsia in low and middle income countries, but it remains a priority focus as we attempt to achieve Millennium Development Goal 5.
Hawk, Cheryl; Evans, Marion Willard
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...
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
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
Hawk, Cheryl; Evans, Marion Willard
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.
Full Text Available Abstract Background Australians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB in high risk populations could significantly reduce disease progression and death related to end-stage liver disease and HCC. Consequently we are implementing the B Positive pilot project, aiming to optimise the management of CHB in at-risk populations in south-west Sydney. Program participants receive routine care, enhanced disease surveillance or specialist referral, according to their stage of CHB infection, level of viral load and extent of liver injury. In this paper we examine the program's potential impact on health services utilisation in the study area. Methods Estimated numbers of CHB infections were derived from Australian Bureau of Statistics data and applying estimates of HBV prevalence rates from migrants' countries of birth. These figures were entered into a Markov model of disease progression, constructing a hypothetical cohort of Asian-born adults with CHB infection. We calculated the number of participants in different CHB disease states and estimated the numbers of GP and specialist consultations and liver ultrasound examinations the cohort would require annually over the life of the program. Results Assuming a 25% participation rate among the 5,800 local residents estimated to have chronic hepatitis B infection, approximately 750 people would require routine follow up, 260 enhanced disease surveillance and 210 specialist care during the first year after recruitment is completed. This translates into 5 additional appointments per year for each local GP, 25 for each specialist and 420 additional liver ultrasound examinations. Conclusions While the program will not greatly affect the volume of local GP consultations, it will lead to a significant increase in
Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale
Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context.
Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2012.
Chowdhury, Pranesh P; Mawokomatanda, Tebitha; Xu, Fang; Gamble, Sonya; Flegel, David; Pierannunzi, Carol; Garvin, William; Town, Machell
Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level. January-December 2012. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012. In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of
Haro, A. S.
Discusses the need to apply modern scientific management to health administration in order to effectively manage programs utilizing increased preventive and curative capabilities. The value of having maximum information in order to make decisions, and problems of determining information content are reviewed. For journal availability, see SO 506…
Department of Veterans Affairs — This service provides web services used to obtain MyHealtheVet related data. The service does not support multiple Vista sites data access. Users of this service are...
Lasser, Karen E; Kelly, Bridget; Maier, Jan; Murillo, Jennifer; Hoover, Sonia; Isenberg, Karen; Osber, Deborah; Pilkauskas, Natasha; Willis, Bayo C; Hersey, James
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.
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.
Loeppke, Ronald; Edington, Dee W.; Bég, Sami
This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...
Zasa, R J
Indisputably, marketing plays an important role in today's competitive health service industry. It is essential for every medical group manager to learn about the marketing process and his role in pursuing marketing in his medical group. Conducting internal and external assessments, developing promotional techniques and strategies, organizing and implementing a plan, and evaluating results are all critical areas in the marketing effort. When each critical area is carefully examined and steps are properly taken, a marketing approach will be totally consistent with delivery of high-quality patient care services.
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...
... 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...
Gimbel, Sarah; Voss, Joachim; Mercer, Mary Anne; Zierler, Brenda; Gloyd, Stephen; Coutinho, Maria de Joana; Floriano, Florencia; Cuembelo, Maria de Fatima; Einberg, Jennifer; Sherr, Kenneth
The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement interventions. Over a period of six months, five experienced maternal-child health managers and researchers iteratively adapted and tested this systems analysis tool for pMTCT services. They prioritized components of the pMTCT cascade for inclusion, disseminated multiple versions to 27 health managers and piloted it in five facilities. Process mapping techniques were used to chart PMTCT cascade steps in these five facilities, to document antenatal care attendance, HIV testing and counseling, provision of prophylactic anti-retrovirals, safe delivery, safe infant feeding, infant follow-up including HIV testing, and family planning, in order to obtain site-specific knowledge of service delivery. Seven pMTCT cascade steps were included in the Excel-based final tool. Prevalence calculations were incorporated as sub-headings under relevant steps. Cells not requiring data inputs were locked, wording was simplified and stepwise drop-offs and maximization functions were included at key steps along the cascade. While the drop off function allows health workers to rapidly assess how many patients were lost at each step, the maximization function details the additional people served if only one step improves to 100% capacity while others stay constant. Our experience suggests that adaptation of a cascade analysis tool for facility-level pMTCT services is feasible and appropriate as a starting point for discussions of where to implement improvement strategies. The resulting tool facilitates the engagement of frontline health workers and managers who fill out, interpret, apply the tool, and then follow up with quality improvement activities. Research on
Opiate dependency is a medical disorder that requires treatment intervention. Primary health care not only entails treatment of illness but also involves disease prevention and health promotion. Based on Pender's revised Health Promotion Model, a descriptive study comparing the health promoting behaviors/practices in abusing and recovering opiate-dependent drug users is analyzed. Using the Health Promoting Lifestyle Profile II, a comparative descriptive, exploratory, nonexperimental design study was conducted to identify key health-promoting behaviors in recovering opiate-dependent drug users. Prevention strategy recommendations are discussed, along with future research recommendations. Copyright © 2013 Elsevier Inc. All rights reserved.
... 13544 of June 10, 2010 Establishing the National Prevention, Health Promotion, and Public Health Council... of Health and Human Services, the National Prevention, Health Promotion, and Public Health Council..., the public health system, and integrative health care in the United States; (b) develop, after...
Lystbæk, Christian Tang
Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... the two dimensions we identify four basic conceptions of health service robots, conceptualizing health service robots as critical, practical, desirable or affectionate, respectively. The article concludes with an outline of managerial concerns and points of departure for future research. Keywords: Service...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...
On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the
Health interventions addressed to the population as a whole from health care services are scarce and only exceptionally involve coordination among public health services (vaccinations and, in some autonomous communities, secondary breast cancer prevention). Health education programs addressed to schools are one of the most frequent interventions but their outcomes are not systematically evaluated. However, primary health care services carry out many clinical preventive activities. While the aims of these activities are laudable, the interventions themselves have substantial limitations, because they are an important source of dependency, a powerful incentive to consume drugs, and are also inefficient and inequitable ways of spending health resources. These limitations justify the testing of combined approaches between public health services and citizens' collectives to improve and protect community health. Developing community health programs based on cooperation between primary health care services and public health services requires strategies that produce appreciable results in the short term to both health sectors, as well as to the population, so that these programs stimulate the process and encourage further development. The settings in which collaboration is most promising are population health surveillance and monitoring in basic health areas, control of communicable diseases and epidemic outbreaks, health promotion and health protection programs through simultaneous clinical and community-based interventions, and improved management of all health services in local communities through joint evaluation. The resources needed to carry out these activities should be drawn from a reduction of clinical preventive activities that reduce workload and from an increase in the number and quality of the public health workforce.
Marcinkiewicz, Andrzej; Walusiak-Skorupa, Jolanta
The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache, speech disturbances). During her hospitalisation at the neurological unit ischemic stroke with transient mixed type aphasia was diagnosed. Magnetic resonance imaging (MRI) scan of the head revealed subacute ischemia. After an analysis of the accident circumstances, the employer's post accidental team decided that ischemic stroke had been an accident at work, because it was a sudden incident due to an external cause inducing work-related traumatic stroke. As a primary cause tough stress and emotional strain due to the situation developed while attending the customer were acknowledged. During control medical check up after 5 months the patient was found to be fit for work, so she could return to work. However, it should be noted that such a check up examination of subjects returning to work after stroke must be holistic, including the evaluation of job predispositions and health education aimed at secondary prevention of heart and vascular diseases with special reference to their risk factors. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Full Text Available The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache, speech disturbances. During her hospitalisation at the neurological unit ischemic stroke with transient mixed type aphasia was diagnosed. Magnetic resonance imaging (MRI scan of the head revealed subacute ischemia. After an analysis of the accident circumstances, the employer’s post accidental team decided that ischemic stroke had been an accident at work, because it was a sudden incident due to an external cause inducing work-related traumatic stroke. As a primary cause tough stress and emotional strain due to the situation developed while attending the customer were acknowledged. During control medical check up after 5 months the patient was found to be fit for work, so she could return to work. However, it should be noted that such a check up examination of subjects returning to work after stroke must be holistic, including the evaluation of job predispositions and health education aimed at secondary prevention of heart and vascular diseases with special reference to their risk factors. Med Pr 2015;66(4:595–599
involving the lateral ankle . • Ankle sprains represent 21 to 53% and 17 to 29% of all basketball and soccer injuries respectively. • Ankle sprains...Musculoskeletal Health and Injury Prevention Francis G. O’Connor, MD, MPH Patricia A. Deuster, PhD, MPH Department of Military and Emergency...DATES COVERED - 4. TITLE AND SUBTITLE Musculoskeletal Health and Injury Prevention 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT
Kosen, S; Gunawan, S
In Indonesia, rapid economic development has led to a reduction in poverty among the 195 million inhabitants. While population increased more than 50% from 1971 to 1990, the annual growth rate, crude birth rate, and total fertility rates have declined rapidly. Life expectancy has increased from 45.7 years in 1971 to 62.7 in 1994 as crude death rates and infant and child mortality rates have declined. Causes of death have shifted from infectious to chronic diseases, but in 1992 major causes of death in children under 5 years old were preventable, and the maternal mortality rate was 425/100,000. Policies which guide the development of health care call for improvements in quality of life, adherence to humanitarian principles, use of scientifically approved traditional medicine, and provision of public health through a three-tiered system. Health care is financed by the government and the community, and managed care has been encouraged. Foreign aid has bolstered development in the health sector. Adequate sanitation has been achieved for 35% of the population, and 65% of urban and 35% of rural residents have reasonable access to clean water. Improvements in health indicators include 55% contraceptive prevalence, reduction in prevalence of anemia during pregnancy, 55.8% of pregnant women receiving prenatal care, a decrease in protein-energy malnutrition among children under five, and high vaccination coverage. Remaining public health problems include malaria, tuberculosis, dengue hemorrhagic fever, an increase in HIV/AIDS, iodine-deficiency, an increasing number of traffic fatalities, and an increasing number of smokers. New health policies have been instituted to meet these challenges as Indonesia's need for a productive and competitive labor force increases.
Schnell-Inderst, Petra; Hunger, Theresa; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin Regina; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe
The German statutory health insurance (GKV) reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK), individual health services (IGeL) are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL?What ethical, social, and legal aspects are related to IGeL? FOR TWO OF THE MOST COMMON IGEL, THE SCREENING FOR GLAUCOMA AND THE SCREENING FOR OVARIAN AND ENDOMETRIAL CANCER BY VAGINAL ULTRASOUND (VUS), THE FOLLOWING QUESTIONS ARE ADDRESSED: What is the evidence for the clinical effectiveness?Are there sub-populations for whom screening might be beneficial? The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by ultrasound assessments with up to 25% of the offers. Cancer screening
Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...
Madan, Ira; Parsons, Vaughan; Cookson, Barry; English, John; Lavender, Tina; McCrone, Paul; Murphy, Caroline; Ntani, Georgia; Rushton, Lesley; Smedley, Julia; Williams, Hywel; Wright, Alison; Coggon, David
Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin care strategies and policy directives have been developed in recent years to minimise the risk, their effectiveness and cost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour change with respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural change intervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions, coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) who are particularly at risk. Secondary aims will be to assess impacts on participants' beliefs and behaviour regarding hand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care. We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nurses in intensive care units. Nurses at 'intervention-light' sites will be managed according to what would currently be regarded as best practice, with provision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact their occupational health (OH) department early if hand dermatitis occurs. Nurses at 'intervention-plus' sites will additionally receive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhanced provision of moisturising cream. The impact of the interventions will be compared using information collected by questionnaires and through standardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition, we will assemble relevant economic data
...: 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...
David A. Sleet
Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering . Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts .
Rezola, J G; Santolaya, J; Orduna, J; Dehesa, F
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.
Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly
Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…
Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N
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
Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.
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
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
Naburi, Helga; Mujinja, Phares; Kilewo, Charles; Orsini, Nicola; Bärnighausen, Till; Manji, Karim; Biberfeld, Gunnel; Sando, David; Geldsetzer, Pascal; Chalamila, Guerino; Ekström, Anna Mia
Option B+ for the prevention of mother-to-child transmission (PMTCT) of HIV (i.e., lifelong antiretroviral treatment for all pregnant and breastfeeding mothers living with HIV) was initiated in Tanzania in 2013. While there is evidence that this policy has benefits for the health of the mother and the child, Option B+ may also increase the workload for health care providers in resource-constrained settings, possibly leading to job dissatisfaction and unwanted workforce turnover. From March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and PMTCT services in Dar es Salaam, Tanzania. Multivariable logistic regression models were used to identify factors associated with job dissatisfaction and intention to quit one's job. Slightly over half (54%, 114/213) of the providers were dissatisfied with their current job, and 35% (74/213) intended to leave their job. Most of the providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The odds of reporting to be globally dissatisfied with one's job were high if the provider was dissatisfied with salary (adjusted odds ratio (aOR) 5.6, 95% CI 1.2-26.8), availability of protective gear (aOR 4.0, 95% CI 1.5-10.6), job description (aOR 4.3, 95% CI 1.2-14.7), and working hours (aOR 3.2, 95% CI 1.3-7.6). Perceiving clients to prefer PMTCT Option B+ reduced job dissatisfaction (aOR 0.2, 95% CI 0.1-0.8). The following factors were associated with providers' intention to leave their current job: job stability dissatisfaction (aOR 3.7, 95% CI 1.3-10.5), not being recognized by one's superior (aOR 3.6, 95% CI 1.7-7.6), and poor feedback on the overall unit performance (aOR 2.7, 95% CI 1.3-5.8). Job dissatisfaction and turnover intentions are comparatively high among nurses in Dar es Salaam's public-sector maternal care
Westerholm, Peter; Hasle, Peter; Fortuin, Rick
A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard
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.
The WHO´s aims regarding healthcare for the European region are mainly based on health promotion and preventive as well as supporting health education. The Ottawa Charta declares health promotion as a process to provide all people with a higher degree of self-determination regarding their health and thereby enabling them to increase it. General practitioners are of major importance regarding the medical area of behaviour oriented prevention by promoting health and acting preventive. ...
A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.
Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M
While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy
Hollederer, A; Wildner, M
There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.
McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort
Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.
Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge
Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.
Hogben, Matthew; Collins, Dayne; Hoots, Brooke; O’Connor, Kevin
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
Integrating reproductive and child health and HIV services in Tanzania: Implication to policy, systems and services. ... Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to ...
Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan
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
Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan
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
Kim, Nam-Hee; Lee, Ga-Yeong; Park, Su-Kyung; Kim, Yeun-Ju; Lee, Min-Young; Kim, Chun-Bae
This study aimed to evaluate the effects of a community-based oral hygiene service on general and periodontal health indicators of patients with hypertension and type 2 diabetes mellitus visiting a community health centre in Korea. The study used a one-group pretest-posttest and interrupted time-series design. A total of 151 participants (45% male), with a mean age of 63 ± 8.4 years, were included in the study; these included patients with hypertension (62%), diabetes (12%) and both hypertension and diabetes (26%). Two dental hygienists dedicated 2 days per week to this project, providing oral hygiene services to 10-13 participants per day. Four oral hygiene service sessions were provided per patient. The objective oral hygiene status and subjective self-reported periodontal status were compared before and after the service. The changes in blood pressure and glycosylated haemoglobin levels were also assessed. A lower frequency of subjective swelling was reported at the fourth session (37.9%) compared to the first (55.6%) session. Further, significantly fewer cases of calculus and bleeding were observed (p oral hygiene services provided by dental hygienists can promote objective oral hygiene and subjective periodontal status in the local community, and may help in the control of hypertension and diabetes. © 2017 John Wiley & Sons Ltd.
... 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...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health Preparedness and Response (OPHPR), with authority to redelegate, the authority to...
Andrzej Marcinkiewicz; Jolanta Walusiak-Skorupa
The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache,...
Kimberly J. Rask
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.
... 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...
Lasser, Karen E; Kelly, Bridget; Maier, Jan; Murillo, Jennifer; Hoover, Sonia; Isenberg, Karen; Osber, Deborah; Pilkauskas, Natasha; Willis, Bayo C; Hersey, James
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...
Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape. Kiran Sukeri, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, Helmut Erlacher ...
Wilson, Moira L; Tumen, Sarah; Ota, Rissa; Simmers, Anthony G
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.
The Preventive Health Care Application was a tool designed to enable clinicians to deliver and track appropriate and timely preventive services provided to all enrolled military health system members...
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito
According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.
Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia
The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Griswold, Kim S.; Pottie, Kevin; Kim, Isok; Kim, Wooksoo; Lin, Li
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 ...
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.
Jocelyne Kane Berman
Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.
Zwick, D I
Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear.
Carl Andrew Castro
Full Text Available This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD, mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research.
Natalie A. DiPietro Mager
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
Hardeman, F.; Hurtgen, C.; Vanhavere, F.; Vanmarcke, H.
SCK-CEN's programme on health-physics (1) offers complete services in health-physics measurements according to international quality standards; (2) contributes to improve continuously these measurement techniques and follows up international recommendations and legislation concerning the surveillance of workers; (3) provides support and advise to nuclear and non-nuclear industry on issues of radioactive contamination. Progress and achievements in 1997 are summarised
Vodopivec-Jamsek, Vlasta; de Jongh, Thyra; Gurol-Urganci, Ipek; Atun, Rifat; Car, Josip
Preventive health care promotes health and prevents disease or injuries by addressing factors that lead to the onset of a disease, and by detecting latent conditions to reduce or halt their progression. Many risk factors for costly and disabling conditions (such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases) can be prevented, yet healthcare systems do not make the best use of their available resources to support this process. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), could offer a convenient and cost-effective way to support desirable health behaviours for preventive health care. To assess the effects of mobile phone messaging interventions as a mode of delivery for preventive health care, on health status and health behaviour outcomes. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009).We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies with at least three time points before and after the intervention. We included studies using SMS or MMS as a mode of delivery for any type of preventive health care. We only included studies in which it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions. Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features
Ana Mª Rivas Hidalgo
Full Text Available Taking into account that climacteric constitutes a physiological state in woman’s life, which covers a large stage of her life cycle, it is important that nursery professionals will develop an Action Plan, whose main objective will be health. Covering, then, this stage from a multidisciplinary and holistic field is going to contribute to both: the adoption of healthy life habits and the repercussions that symptoms and physiological processes associated with menopause have on women. Another objective for nurses there must be to provide all our knowledge in a detailed and focused on the individual needs that may come up way. That way, we lay the foundations for facing climacteric with the minimum deterioration of the quality of life and well being.This article is an analysis of the etiology of every one of the most prevalent menopause problems, the predisposing factors to suffer them or to make them get worse, and the habits that are going to prevent larger spill-over effects of those problems. Furthermore, a revision about how nutrition, exercise, toxic substances consumption, etc. have repercussions on musculoskeletal problems, vascular symptoms, urogenital problems, psychological alterations, and gynaecological and breast cancer is made.
Khoong, Elaine C; Gibbert, Wesley S; Garbutt, Jane M; Sumner, Walton; Brownson, Ross C
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.
Since the early 1980-ties it has been tried to utilise smart cards in health care. All industrialised countries participated in those efforts. The most sustainable analyses took place in Europe--specifically in the United Kingdom, France, and Germany. The first systems installed (the service access cards in F and G, the Health Professional Card in F) are already conceptionally outdated today. The senior understanding of the great importance of smart cards for security of electronic communication in health care does contrast to a hesitating behaviour of the key players in health care and health politics in Germany. There are clear hints that this may relate to the low informatics knowledge of current senior management.
Watabe, Akihito; Wongwatanakul, Weranuch; Thamarangsi, Thaksaphon; Prakongsai, Phusit; Yuasa, Motoyuki
In the transition to the post-2015 agenda, many countries are striving towards universal health coverage (UHC). Achieving this, governments need to shift from curative care to promotion and prevention services. This research analyses Thailand's financing system for health promotion and prevention, and assesses policy options for health financing reforms. The study employed a mixed-methods approach and integrates multiple sources of evidence, including scientific and grey literature, expenditure data, and semi-structured interviews with key stakeholders in Thailand. The analysis was underpinned by the use of a well-known health financing framework. In Thailand, three agencies plus local governments share major funding roles for health promotion and prevention services: the Ministry of Public Health (MOPH), the National Health Security Office, the Thai Health Promotion Foundation and Tambon Health Insurance Funds. The total expenditure on prevention and public health in 2010 was 10.8% of the total health expenditure, greater than many middle-income countries that average 7.0-9.2%. MOPH was the largest contributor at 32.9%, the Universal Coverage scheme was the second at 23.1%, followed by the local governments and ThaiHealth at 22.8 and 7.3%, respectively. Thailand's health financing system for promotion and prevention is strategic and innovative due to the three complementary mechanisms in operation. There are several methodological limitations to determine the adequate level of spending. The health financing reforms in Thailand could usefully inform policymakers on ways to increase spending on promotion and prevention. Further comparative policy research is needed to generate evidence to support efforts towards UHC. © The Author 2016. Published by Oxford University Press.
... and management, integrative health care practices, and health promotion. Membership and Designation... HUMAN SERVICES Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and... March 23, 2010. The Advisory Group on Prevention, Health Promotion, and Integrative and Public Health...
... lifestyle-based chronic disease prevention and management, integrative health care practices, and health... HUMAN SERVICES Re-Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative... Services announces re- establishment of the Advisory Group on Prevention, Health Promotion, and Integrative...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health... Public Health Service Act (PHS), I have delegated to the Director, Centers for Disease Control and Prevention (CDC), and the Director, National Institute for Occupational Safety and Health (NIOSH), with...
Lang, Y C
1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.
Chen, Stephanie C; Pearson, Steven D
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.
Moon, O R
Early in the 1970s the Korean government recognized the necessity of Health Services Research (HSR). The law of the Korea Health Development Institute was promulgated in 1975, and a contribution from the Republic was combined with an Agency for International Development loan to field test low-cost health service strategies. A program to deploy Community Health Practitioners (CHPs), similar to family nurse practitioners or Medex has been demonstrated to be effective. The CHP training program grew from 9 in 1980 to 1343 in 1984. CHP's main functions are curative, preventive, educative, and administrative. They are selected registered nurses and/or midwives, where possible from serviced communities. They are trained in 24 weeks, including 12 weeks of clinical practice, in an anticipated recruiting post. CHPs help train village health volunteers (VHVs), who are literate women chosen by their communities. They work closely with the CHPs as a liaison with the village and in information gathering. An HSR orientation workshop held in Chuncheon in 1980, discussed role, policy, status, finance components, information systems, behavioral and manpower components, staff training, protocols for project development, HSR in the future and evaluation of the conference. In 1980, a National Workshop on Biomedical Research Methodology was also held, with World Health Organization and Korean consultants. Training of junior scientists would include introduction to scientific method, statement of problems, quantitative study technics, research proposals, and interpretation of results. The Korean Institute of Public Health sponsored a 1982 experts forum on the health care system, medical facilities, organizational management, financing and medical security, and health behavioral aspects. Training of trainers and lower level field workers, orientation of program managers, researchers, and communities themselves should all be training priorities. In future, CHPs should be refresher
Keefe, Carole W; Thompson, Margaret E; Noel, Mary Margaret
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
... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...
... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...
... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...
Wang, Fuhmei; Wang, Jung-Der; Huang, Yu-Xiu
Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting. Based on the US experiences over the period from 1975 to 2013, this research further examines the model's predictions on the relationship between preventive health expenditure and economic performance. Theoretical analysis and numerical simulations show that an inverse U-shaped relationship exists between the proportion of GDP spent on prevention and social welfare, as well as between the proportion spent on prevention and economic growth. Empirical analysis shows an under-investment in prevention in Taiwan. The spending of preventive healthcare in Taiwan government was 0.0027 GDP in 2014, while the optimization levels for economic development and social welfare would be 0 · 0119 and 0 · 0203, respectively. There is a statistically significant nonlinear relationship between health expenditure on prevention and the estimated real impact of economic performance from US experiences. The welfare-maximizing proportion of preventive expenditure is usually greater than the proportion maximizing economic growth, indicating a conflict between economic growth and welfare after a marginal share. Our findings indicate that it is worthwhile increasing investment on prevention up until an optimization level for economic development and social welfare. Such levels could also be estimated in other economies.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS), Delegation of Authority Notice is hereby given that I have delegated to the Director... Secretary of Health and Human Services under the following section under Title XXVI of the Public Health...
Lukaszyk, Caroline; Coombes, Julieann; Keay, Lisa; Sherrington, Catherine; Tiedemann, Anne; Broe, Tony; Lovitt, Lorraine; Ivers, Rebecca
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
Li, Yao; Kaur, Bipjeet; Andersen, Birger
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...
Griswold, Kim S; Pottie, Kevin; Kim, Isok; Kim, Wooksoo; Lin, Li
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.
Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene
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.
Background: There is no adequate health service or counseling specifically suitable for adolescents in Ethiopia. Adolescents' satisfaction on the health service provided is important to increase utilization and quality of care. The objective of this study was to assess health service utilization, reported satisfaction and ...
Stewart, Clarence, M., Jr.
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…
Fox, Amanda; Gardner, Glenn; Osborne, Sonya
Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation. This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation. If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.
Take detection,prevention and treatment of superbugs seriously: interpretation and deliberation of the Guidance on Carbapenem Resistance Producers published by National Health Service of Great Britain
Full Text Available The term "superbugs" refers to microbes with resistance to almost all antibiotics specifically recommended for the treatment.The infection caused by Gram negative bacilli with resistance to carbapenem antibiotics has posed a great challenge to clinical work in recent years,and it has become tougher with the improper use of antibiotics.As for prevention from formation and spread of carbapenem resistance producers,detection and monitoring of carbapenemase should be strengthened,in which the engagement of the board and executive of hospitals,quality control in laboratory,optimized and proper use of antibiotics,and prevention of hospital infection are of great importance.
Effective health services form the backbone of health interventions. Accessibility, quality, capacity, organization, availability of human and physical resources and equity in the provision of health services are essential for a healthcare system to deliver desired health and related sustainable development outcomes. This paper focuses on the impact of health services trade on the realization of sustainable development goals and the various modalities through which this impact may occur. The ...
Mamdani, Masuma; Bangser, Maggie
Tanzania faces serious challenges to improving the health and well-being of its people. The Ministry of Health and its partners in government, the donor community and civil society have responded with concerted action, in many cases achieving significant gains. Services for prevention of mother-to child transmission of HIV are being expanded, a new protocol for malaria treatment is being implemented and evaluated, hundreds of service providers are now trained in life-saving skills for childbi...
Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A
Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510
... Safety Motor Vehicle Safety Motor-Vehicle Safety of Law Enforcement Officers Nail Gun Safety National Occupational Mortality Surveillance (NOMS) Noise and Hearing Loss Prevention Occupational Health Safety Network (OHSN) Occupational Hearing Loss Surveillance Occupational ...
... Healthy People healthfinder Office of Disease Prevention and Health Promotion Spotlight: This Diabetes Month, Don’t Forget About the Importance of Exercise for People with Type 1 Diabetes In honor ...
Using examples of preventing pollution and reducing risk of exposure to communities, this guide answers basic interest and start-up questions, addresses benefits and limitations and illustrates the value of GIS for local health departments.
Meldrum, Rebecca; Ho, Hillary; Satur, Julie
People with a lived experience of mental illness are at a higher risk for developing oral diseases and having poorer oral health than the broader population. This paper explores the role of Australian community mental health services in supporting the prevention and management of poor oral health among people living with mental illness. Through focus groups and semi-structured interviews, participants identified the value of receiving oral health support within a community mental health setting, in particular the delivery of basic education, preventive strategies, assistance with making or attending appointments and obtaining priority access to oral health services. Engagement with Community Health Services and referrals generated through the priority access system were identified as key enablers to addressing oral health issues. This study provides new insight into the importance of undertaking an integrated approach to reducing the oral health disparities experienced by those living with mental illness.
Full Text Available We assessed the integration of PMTCT services during the postpartum period including early infant diagnosis of HIV (EID and adult and pediatric antiretroviral therapy (ART in maternal and child health (MCH facilities in Zimbabwe.From August to December 2012 we conducted a cross-sectional survey of a nationally representative sample of 151 MCH facilities. A questionnaire was used to survey each site about staff training, dried blood spot sample (DBS collection, turnaround time (TAT for test results, PMTCT services, and HIV care and treatment linkages for HIV-infected mothers and children and HIV-exposed infants. Descriptive analyses were used. Of the facilities surveyed, all facilities were trained on DBS collection and 92% responded. Approximately, 99% of responding facilities reported providing DBS collection and a basic HIV-exposed infant service package including EID, extended nevirapine prophylaxis, and use of cotrimoxazole. DBS collection was integrated with immunisations at 83% of facilities, CD4 testing with point-of-care machines was available at 37% of facilities, and ART for both mothers and children was provided at 27% of facilities. More than 80% of facilities reported that DBS test results take >4 weeks to return; TAT did not have a direct association with any specific type of transport, distance to the lab, or intermediate stops for data to travel.Zimbabwe has successfully scaled up and integrated the national EID and PMTCT programs into the existing MCH setting. The long TAT of infant DBS test results and the lack of integrated ART programs in the MCH setting could reduce effectiveness of the national PMTCT and ART programs. Addressing these important gaps will support successful implementation of the 2014 Zimbabwe's PMTCT guidelines under which all HIV-infected pregnant and breastfeeding women will be offered life-long ART and decentralized ART care.
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.
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
Strazicich, Mirko, Ed.
This publication provides a standard by which California migrant education health staff can plan, implement, and evaluate a health program for students in grades K-12. Following sections which describe current state legislation, the need for health services, and California's objectives and activities regarding health services for migrant students…
This article examines the consequences of a "population-as-crisis" theme on the institutional configuration and resource endowments of health care services in an integrated Ministry of Health and Population Control in Bangladesh. The Ministry's focus on women as child bearers and its emphasis on sterilization supported by incentives has contradictory consequences as women become vulnerable to a limited health service and incentives encourage a focus on meeting sterilization targets. Both undermine people's access to and use of primary health care services. Findings from three studies, undertaken between 1978 and 1983, support the argument that despite international concern with preventive and promotive primary health care, simultaneous support for and emphasis on population control inhibits meeting the goals of a broad-based rural primary health care service.
Allen, Jennifer D; Mars, Dana R; Tom, Laura; Apollon, Guy; Hilaire, Dany; Iralien, Gerald; Cloutier, Lindsay B; Sheets, Margaret M; Zamor, Riché
Understanding the factors that influence health beliefs, attitudes, and service use among Haitians in the United States is increasingly important for this growing population. We undertook a qualitative analysis to explore the factors related to cancer screening and utilization of health services among Haitians in Boston. Key informant interviews (n=42) and nine focus groups (n=78) revealed that Haitians experience unique barriers to health services. These include language barriers, unfamiliarity with preventive care, confidentiality concerns, mistrust and stigma concerning Western medicine, and a preference for natural remedies. Results suggest that many Haitians could benefit from health system navigation assistance, and highlight the need for comprehensive, rather than disease-focused programs, to decrease stigma and increase programmatic reach. Faith-based organizations, social service agencies, and Haitian media were identified as promising channels for disseminating health information. Leveraging positive cultural traditions and existing communication networks could increase the impact of Haitian health initiatives.
Recently, a great deal of research in the field of neuroscience and human microbiome indicates the primal period (from preconceptional up to the early years of a child's life) as crucial to the future of the individual, opening new scenarios for the understanding of the processes underlying the human health. In recent decades, the social representation of infant feeding moved in fact from the normality of breastfeeding to the normal use of artificial formulas and bottle-feeding. Even the scientific thinking and the research production have been influenced by this phenomenon. In fact, a clear dominance of studies aimed to show the benefits of breast milk compared to formula milk rather than the risks of the latter compared to the biological norm of breastfeeding. Mother milk affects infant health also through his/her microbiome. Microbial colonisation startes during intrauterine life and continues through the vaginal canal at birth, during skin to skin contact immediately after birth, with colostrum and breastfeeding. The microbial exposure of infants delivered by the mother influences the development of the child microbiota, by programming his/her future health. However, rewriting the biological normality implies also a health professional paradigm shift such as departing from the systematic separation mother-child at birth, sticking at fixed schedules for breastfeeding time and duration, as it still happens in many birth centres. Breastfeeding has economic implications and the increase of its prevalence is associated with significant reduction of avoidable hospital admissions and medical care costs, both for the child and for the mother. Success in breastfeeding is the result of complex social interactions and not simply of an individual choice. However, any successful strategy must be oriented to the mother empowerment. Therefore, health professionals and community stakeholders have to learn and practice the health promotion approach, particularly avoiding
Lina M. Gomez Vasquez
Full Text Available Social media platforms have changed the way people stayinformed, communicate with others, and share ideas. These interactive social platforms are used for many purposes from being in contact with family and friends to promote products and services. However, little is known about the use and importance of social media for health prevention, especially for communication among Hispanic communities.The purpose of this paper is to analyze how social media platforms, especially Twitter, are used for health prevention and communication in Hispanic communities. In doing so, a quantitative content analysis was performed on 3000 tweets with the hashtag #prevención (prevention. Results indicate that most of the prevention messages shared among organizations and users on Twitter were informational messages and very few users promoted interactive communication and mobilization. Mass media and governmental institutions posted more messages to encourage health prevention, especially about publichealth and healthy cities. This study stresses the many social media platforms’ potentialities and functionalities, especially Twitter, that contribute to health prevention and communication. Findings are useful for organizations and users when planning prevention content or campaigns through these platforms.
As a next step in the Florida Department of Transportation (FDOT) plan to reduce the number of traffic injury : and fatality crashes among Floridas older adult population, SRA Research Group (SRA) conducted a health care : needs assessment to supp...
Full Text Available Abstract Background The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB and investigate their influence in the context of an adapted health cognition model. Methods A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Results and discussion Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. Conclusion The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly
Petrovici, Dan A; Ritson, Christopher
The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB) and investigate their influence in the context of an adapted health cognition model. A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels) is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly sources and risks associated with dietary fat and cholesterol) may induce people to
Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie
Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. Copyright 2014, SLACK Incorporated.
Hauff, Alicia J; Secor-Turner, Molly
The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel
To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.
This podcast discusses bullying as a public health problem, and provides information and resources for public health practitioners. Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC). Date Released: 1/19/2012.
... TM Help Prevent Errors in Your Care Behavioral Health Care To prevent health care errors, patients are urged to... SpeakUP TM Service ... individuals should be involved in their own behavioral health care. These efforts to increase consumer awareness and involvement ...
Ningsih, Haryati; Syafar, Muh; Nyorong, Mappeaty
A mother's role is very important when baby suffers from diarrhea, because mother is the figure most responsible for the baby's growth. According to the data from the Health Department, in 2011 until 2012 there were 12.942 babies who suffered from diarrhea in Wajo Regency, South Sulawesi. This study implemented a qualitative method with phenomenology approach. Informants were selected using the purposive sampling method, which is a method to select informants based on certain criterias. 11 in...
Mitchell, P; Malak, A; Small, D
This paper presents results from research that explored the roles of bilingual professionals in community mental health services in the Sydney metropolitan area of New South Wales. There were two main objectives to the research: (i) to identify and describe the roles of bilingual professionals that are important in improving the quality of community mental health services for clients from non-English-speaking backgrounds (NESB); and (ii) to identify and describe the factors that facilitate and inhibit the conduct of these roles. Data collection involved indepth interviews with bilingual professionals and team leaders in community mental health services and various other community health services; and various staff responsible for policy and service development with regard to cultural diversity. Bilingual mental health workers were found to have at least four critical roles. These were (i) direct clinical service provision to NESB clients; (ii) mental health promotion and community development; (iii) cultural consultancy; and (iv) service development. Respondents reported that the latter three roles were seriously underdeveloped compared to the clinical service provision role. It is critical that service managers implement strategies to make better use of the linguistic and cultural skills of bilingual professionals. In addition to their role in clinical service provision ways must be found to facilitate the community-focused, cultural consultancy and service development roles of bilingual professionals employed in mental health services.
Rasch, Vibeke; Yambesi, Fortunata; Massawe, Siriel
OBJECTIVE: To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion. METHOD: 706 women were provided with post-abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use...... and determined the HIV status of those who accepted VCT. Using a nested case-control design, we compared women who accepted HIV testing with women who did not. To study the association between socioeconomic factors, HIV testing acceptance and condom use in more detail, we did stratified analyses based on age...... and marital status. RESULTS: 58% of the women who had an unsafe abortion accepted HIV testing. Women who earned an income were more likely to accept testing than housewives. Women who accepted testing were more likely to accept using a condom. The HIV prevalence rate was 19% among single women aged 20...
Brennan, D S; Spencer, A J
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
Butler, Louise; Phelan, Jim
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...
According to this study, living conditions and access to health services have improved in Thailand. However, improvements have been greater in urban areas, and migration from rural to urban areas has been responsive to the unequal distribution of economic opportunities. The health service needs vary between urban and rural populations. Migrants to cities are in good health. Disadvantaged populations in rural areas need the same opportunities as those available in cities. Cities need to strengthen health services targeted to the young, and especially females. Urbanization is likely to increase throughout Southeast Asia over the coming years. Southeast Asia is well advanced in the fertility and mortality transitions, but less advanced in the urbanization transition. The urban transition has implications for the supply and demand for health services. Described are the variation in demographic structures of urban and rural areas, the concentration of resources in urban areas, the patterns of urbanization, and the potential paths through which urbanization is related to the distribution of health services in Thailand. A broad overview is given for Southeast Asia. Demand for services is a function of the age and sex composition of population, resources available, and preferences for particular types of services. Supply of services is related to government health allocation decisions and private health supplier's locations of services. Urbanization affects the distribution of health services mainly through demand, and is an outcome of economic development. Migration is the main contributor to Thai urbanization.
Wang, N J; Aspelund, G Ø
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.
Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior
Behr, Joshua G; Diaz, Rafael; Akpinar-Elci, Muge
The management and treatment of adult asthma has been associated with utilization of health services. First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Those with asthma are found more likely (OR 1.50, 95% CI 1.05-2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56-11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32-2.65) and hospitalization (OR 2.21, 95% CI 1.39-3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are increasingly more likely to be characterized as frequent utilizers of
Full Text Available In a nutshell SPA is something old and good, but nowadays enriched with the miraculous impact of the water culture and aqua practices. But in our opinion is very important to know that the SPA is the health prevention of a healthy people for their recovery from social and professional everyday stress. In most European countries and it became another kind of SPA effects called a short - Medical SPA. Our working hypothesis is based on the assumption that the development of modules for practicing aquaspinning will allow to optimize the proposed relaxing and procreative prevention programs and promoting the health and beauty. The aim of this study was to determine the specificity of the effects aquaspinning through the application of current methods of prevention and health promotion.
Full Text Available BACKGROUND: Multidrug antiretroviral (ARV regimens including HAART and short-course dual antiretroviral (sc-dARV regimens were introduced in 2004 to improve Prevention of Mother-to-Child Transmission (PMTCT in Cameroon. We assessed the effectiveness of these regimens from 6-10 weeks and 12 months of age, respectively. METHODOLOGY/FINDINGS: We conducted a retrospective cohort study covering the period from October 2004 to March 2008 in a reference hospital in Cameroon. HIV-positive pregnant women with CD4 or = 37 weeks, women received sd-NVP during labour [regimen 4]. Infants received sd-NVP plus ZDV and 3TC for 7 days or 30 days. Early diagnosis (6-10 weeks was done, using b-DNA and subsequently RT-PCR. We determined early MTCT rate and associated risk factors using logistic regression. The 12-month HIV-free survival was assessed using Cox regression. Among 418 mothers, 335 (80% received multidrug ARV regimens (1, 2, and 3 and MTCT rate with multidrug regimens was 6.6% [95%CI: 4.3-9.6] at 6 weeks, without any significant difference between regimens. Duration of mother's ARV regimen < 4 weeks [OR = 4.7, 95%CI: 1.3-17.6], mother's CD4 < 350 cells/mm(3 [OR = 6.4, 95%CI: 1.8-22.5] and low birth weight [OR = 4.0, 95%CI: 1.4-11.3] were associated with early MTCT. By 12 months, mixed feeding [HR = 8.7, 95%CI: 3.6-20.6], prematurity [HR = 2.3, 95%CI: 1.2-4.3] and low birth weight were associated with children's risk of progressing to infection or death. CONCLUSIONS: Multidrug ARV regimens for PMTCT are feasible and effective in routine reference hospital. Early initiation of ARV during pregnancy and proper obstetrical care are essential to improve PMTCT.
Wilcox, Holly C; Wyman, Peter A
Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.
Olsen, Jonathan R; Cook, Penny A; Forster, Sue; Phillips-Howard, Penelope A
Teenage pregnancy rates in the UK are the highest in Western Europe. Causes of teenage pregnancies are multifaceted with complex interplay of social, lifestyle and wider determinants influencing risk. Improving access to sexual health services through community services is an important factor in attempting to tackle this issue, but few studies have examined factors that influence this. Geospatial analysis was conducted on community sexual health service users and teenage conceptions from local sexual health services were recorded. Univariate and multinomial regression was performed to test associations between service type and socio-economic status. No significant differences in accessibility of services between teenage girls who have conceived and those seeking sexual health services were found. Females aged 17 and under were more likely to use a young people's sexual health service than mainstream services (P health services. The study supports policy for locating young person services within the most deprived areas of a community.
Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.
Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J
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.
Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony
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.
The Defense Health Services (DHS) Steering Committee has considered the concept of Mentoring as part of an effort to assist in the development of future health leaders in the Australian Defense Force (ADF...
Sebai, Zohair A.; Milaat, Waleed A.; Al-Zulaibani, Abdulmohsen A.
Health services in Saudi Arabia have developed enormously over the last two decades, as evidenced by the availability of health facilities throughout all parts of the vast Kingdom. The Saudi Ministry of Health (MOH) provides over 60% of these services while the rest are shared among other government agencies and the private sector. A series of development plans in Saudi Arabia have established the infra-structure for the expansion of curative services all over the country. Rapid development in medical education and the training of future Saudi health manpower have also taken place. Future challenges facing the Saudi health system are to be addressed in order to achieve the ambitious goals set by the most recent health development plan. These include the optimum utilization of current health resources with competent health managerial skills, the search for alternative means of financing these services, the maintenance of a balance between curative and preventive services, the expansion of training Saudi health manpower to meet the increasing demand, and the implementation of a comprehensive primary health care program. PMID:23008647
Full Text Available Abstract Background Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of European guidelines on the use of treatment and goal attainment for blood pressure (BP and lipids in the primary care of Cyprus. Methods Retrospective chart review of 1101 randomly selected patients with type 2 diabetes mellitus (DM2, or hypertension or hyperlipidemia in four primary care health centres. The SCORE risk function for high-risk regions was used to calculate 10-year risk of cardiovascular fatal event. Most recent values of BP and lipids were used to assess goal attainment to international standards. Most updated medications lists were used to compare proportions of current with recommended antihypertensive and lipid-lowering drug (LLD users according to European guidelines. Results Implementation of the SCORE risk model labelled overall 39.7% (53.6% of men, 31.3% of women of the study population as high risk individuals (CVD, DM2 or SCORE ≥5%. The SCORE risk chart was not applicable in 563 patients (51.1% due to missing data in the patient records, mostly on smoking habits. The LDL-C goal was achieved in 28.6%, 19.5% and 20.9% of patients with established CVD, DM2 (no CVD and SCORE ≥5%, respectively. BP targets were achieved in 55.4%, 5.6% and 41.9% respectively for the above groups. There was under prescription of antihypertensive drugs, LLD and aspirin for all three high risk groups. Conclusion This study demonstrated suboptimal control and under-treatment of patients with cardiovascular risk factors in the primary care in Cyprus. Improvement of documentation of clinical information in the medical records as well as GPs training for implementation
The health status of the populations of developed countries has never been as satisfactory, but will it stay that way? Research on the subject is difficult due to the complex interactions between our environment and our health, with risks inherent to each noxious agent. Preventing the risks proven to be linked to the quality of our living environments is usually the responsibility of authorities, but individuals can also adopt precautionary practices. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Gunnarsson, Kristina; Andersson, Ing-Marie; Josephson, Malin
Small-scale enterprises are less often covered by occupational health services and have insufficient awareness about health and risks in the work environment. This study investigated how Swedish entrepreneurs in small-scale enterprises use occupational health services. The study used a questionnaire sent in two waves, 5 years apart. At baseline, 496 entrepreneurs responded, and 251 participated 5 years later. The questionnaire included items about affiliation with and use of occupational health services, physical and psychosocial work environments, work environment management, sources of work environment information, and membership in professional networks. Only 3% of entrepreneurs without employees and 19% of entrepreneurs with employees were affiliated with an occupational health service. Entrepreneurs affiliated with occupational health services were more active in work environment management and gathering information about the work environment. The occupational health services most used were health examinations, health care, and ergonomic risk assessments. Affiliation with occupational health services was 6% at both measurements, 4% at baseline, and 10% 5 years later. 2011, SLACK Incorporated.
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.
Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim
The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and
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.
Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...
Jung, Mary-Louise; Loria, Karla
Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860
May 5, 1999 ... Objective: To identify current problems in laboratory services and elicit suggestions from the technicians aimed at improving the services in health centres within Amhara region, north Ethiopia. Design: Cross-sectional study using a pre-tested questionnaire. Settings: Twenty seven health centres in Amhara ...
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Avila, Noemí; Orellana, Ana; Cano, Marta G; Antúnez, Noelia; Claver, Dolores
This article presents a summary of the first 2 years of the collaboration between the Faculty of Fine Arts of the Universidad Complutense in Madrid and Madrid Health, an autonomous organism of Madrid Council. This collaboration has allowed the development of joint experiences and projects among distinct professionals with highly diverse profiles: health professionals (sexologists, psychiatrists, nurses, etc.), and teachers, researchers, artists and students in the Faculty of Fine Arts. As a result, these experiences could be the beginning of future collaborations between the arts, health and prevention. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
O'Mullane, Denis; And Others
Data on the relative levels of men's and women's dental health are scarce, but the available data do indicate differences in tooth loss and health-related behavior patterns. Better methods for recording and reporting this information are recommended. (MSE)
Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S
Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...
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.
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
Kim, Dae Hyun; Sagar, Utpal N; Adams, Suzanne; Whellan, David J
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.
Mandiracioglu, Aliye; Dogan, Fethi
Objectives: A Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views of pharmacy and dentistry students on a public health course and preventive health care. Methods: 173 students enrolled at Ege University, Faculties of Pharmacy and Dentistry completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and replied to 18 Likert type question to determine their perceptions on a public health course and preventive health care. The comments of the students were reviewed and categorized into key themes. Results: SWOT analysis and the results of quantitative Likert type questions supported each other. According to the quantitative results, there was no significant difference between the scores of students from both schools in terms of their statements about the public health course and preventive care. Both groups of students mentioned the contribution of the public health course to their professions in the future. They also appreciated the importance of preventive care in the health services. PMID:22347604
... 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 ...
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
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
Natalya Vasilyevna Krivenko
Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market
Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas
In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN).
Ruffolo, Mary C.; Evans, Mary E.; Lukens, Ellen P.
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.…
The provision of adolescent preventive services (APS) is imperative globally among clinicians, especially paediatricians. 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 ...
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
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
Koplan, Jeffrey; Liverman, Catharyn T; Kraak, Vivica I
... for the report were chosen for their special competences and with regard for appropriate balance. The study was supported by Contract No. 200-2000-00629, T.O. #14 between the National Academy of Sciences and the Centers for Disease Control and Prevention; by Contract No. N01-OD-4-2139, T.O. #126 with the National Institutes of Health; and by Grant No. 04...
Pâmela Ferreira Todendi
Full Text Available At present, obesity configures a public health problem which calls for attention from different sectors, given the proportion it assumes all over the world. Several studies relate this problem to metabolic health problems, including endocrinal, cardiovascular, lung, gastrointestinal, psychiatric, hematological disturbances, among others. Obesity is not only associated with genetic and environmental factors, but also with unhealthy lifestyles. In view of its social importance, it is ascertained, through analyses of studies, that there are not many health prevention strategies focused on this situation. As a result of this ascertainment, the proposal is for updating prevention actions in the realm of obese schoolchildren, resulting from a work conducted during the Master’s Degree lessons in Health Promotion at the University of Santa Cruz do Sul (UNISC. The point in question is the fact that many schools pose no restrictions to products sold in their canteens. Food stuffs sold in schools should have adequate nutritional quality, and snacks prepared at school are extremely important in meeting all nutritional requirements. However, many children do not consume these school lunches, but they bring them from home or purchase them at the canteen, spending public resources, along with not taking in healthy foods and, as a consequence, leading to health problems over the years. For all this, it is of fundamental importance to carry out investigating processes with regard to how public actions and policies are being implemented towards this end, in view of the fact that obesity in schoolchildren is on a rising trend.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Health Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment..., Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Road, NE., Mailstop E-07, Atlanta, Georgia 30333...
Jepson, Lisa; Juszczak, Linda; Fisher, Martin
Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…
This study determines the prevalence of types of sicknesses and diseases affecting patients visiting health service facilities and the available health services within the Selebi Phikwe Ni-Cu mine area, Botswana. Through the administration of questionnaires and structured questions, attempts were made to establish and ...
Fuller Jeffrey D
Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Objective:: Mental health treatment today incorporates neurobiology, genetics, neuro-imaging, and pharmacologic mechanisms, offering more options to patients. For some, these modern approaches are not viable choices due to reasons such as limited access to care, cost, intolerable side effects, and, in the pediatric population, fears of potential long-term effects. With the growing prevalence of chronic health conditions, concerns for age of onset, (McGorry, Purcell, Goldstone, & Amminger, 201...
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…
Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S
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.
Isaacs, Diana; Riley, Angela C; Prasad-Reddy, Lalita; Castner, Rebecca; Fields, Heather; Harper-Brown, Deborah; Hussein, Sabah; Johnson, Charisse L; Mangum, Traiana; Srivastava, Sneha
Health-related disparities are a significant public health concern. In conjunction with a university concert series, healthcare professionals and students provided education, clinical services, and preventive care using an interdisciplinary approach to a primarily African American cohort. The objective was to assess cardiovascular risk factors and readiness to change health-related behaviors. Six outreach events were conducted over 3 years by an interdisciplinary team including pharmacy, medicine, nursing, nutrition, occupational therapy, public health, optometry, and health information technology. Clinical services, such as health screenings for glucose, blood pressure, cholesterol, and body fat along with counseling on the results and smoking cessation behavioral counseling, were provided. Education initiatives addressed bone health, heart disease, HIV risk, nutrition, and access to physician care. Preventative care included vaccinations and eye exams. There were 285 participants that were predominantly African American (95.8 %), female (71.5 %), and age within 55-64 years (45.1 %). Hypertension (50.8 %) and obesity (65.1 %) were the most common cardiovascular risk factors. Of those advised to make health behavior changes, 76.4 % reported they planned to make changes within 1 month. These interdisciplinary outreach events provided health information and access to care in a novel setting and led to a high rate of planned health behavior changes.
The work of health service access points highlights the process of exclusion through marginalisation, the phenomenon of precarity and anthropological tensions between hospitality and inhospitality or between the desirable and undesirable. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
.... 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...
Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
Kulyk, Olga Anatoliyivna
In oktober heeft een workshop 'Kwaliteitseisen Digitale Hulpverlening in het Kader van e-health Sense' plaatsgevonden tijdens de digitale leerweek van Soa Aids Nederland en V&VN. Tijdens een focusgroepdiscussie met sociaal-verpleegkundigen seksuele gezondheid kwamen vragen aan de orde over het
Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul
Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.
Ryan-Fogarty, Yvonne; Becker, Genevieve; Moles, Richard; O'Regan, Bernadette
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.
... Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with authority to redelegate, the authority vested in the Secretary of the...
Huebner, Colleen E; Chi, Donald L; Masterson, Erin; Milgrom, Peter
This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Study methods included 90 parent interviews and dental examinations of their preschool-age children. Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600 Fishers Lane, Room... and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers Lane, Rockville, Maryland...
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.
... Public Health Research on the Causes and Prevention of Gun Violence Memorandum for the Secretary of Health and Human Services In addition to being a law enforcement challenge, gun violence is also a... public health perspective is imperative. Significant strides can be made by assessing the causes of gun...
Purcell, Rachael; McGirr, Joe
To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.
H. de Vries (Harwin); J.J. van de Klundert (Joris); A.P.M. Wagelmans (Albert)
markdownabstractProviding long distance truck drivers with adequate access to prevention, testing, and treatment services for HIV, Sexually Transmitted Infections (STIs), Tuberculosis (TB), and Malaria is suggested to be an extremely effective way to reduce the burden and the spread of these
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice; correction. SUMMARY: HRSA published a document in the Federal...
White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia
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.
positioning (choosing to be receptive in anal sex if HIV-positive and penetrative if HIV-negative). • Address alcohol, recreational drug and tobacco use. • Screen and address mental health issues. (e.g. depression). • Screen and treat ...
Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...
Rijckevorsel, J.L.A. van; Bijleveld, C.C.J.H.
Contributions to this volume discuss the application of statistics in public health and prevention, dealing with subjects in the field of working conditions and occupational health, sexually transmissible disease, dental health, public health tables, the geographical distribution of diseases,
On May 14, 2013, Angelina Jolie disclosed she carries BRCA1, which means she has an 87% risk of developing breast cancer during her lifetime. Jolie decided to undergo a preventative bilateral mastectomy (PBM), reducing her risk to 5%. The purpose of this study was to analyze the type of information individuals are exposed to when using the Internet to search health information regarding Jolie's decision. Qualitative content analysis revealed four main themes--information about genetics, information about a PBM, information about health care, and information about Jolie's gender identity. Broadly, the identified websites mention Jolie's high risk for developing cancer due to the genetic mutation BRCA1, describe a PBM occasionally noting reasons why she had this surgery and providing alternatives to the surgery, discuss issues related to health care services, costs, and insurances about Jolie's health decision, and portray Jolie as a sexual icon, a partner to Brad Pitt, a mother of six children, and an inspirational humanitarian. The websites also depict Jolie's health decision in positive, negative, and/or both ways. Discussion centers on how this actress' health decision impacts the public.
The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.
Dabelko, Holly I.; DeCoster, Vaughn A.
The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…
Somasundaram, D J; van de Put, W A; Eisenbruch, M; de Jong, J T
Cambodia has undergone massive psychosocial trauma in the last few decades, but has had virtually no western-style mental health services. For the first time in Cambodia a number of mental health clinics in rural areas have been started. This experience is used to discuss the risks and opportunities in introducing these services in the present war-torn situation. Basic statistics from the clinics are presented in the context of the historical and traditional setting, and the effort to maintain a culturally informed approach is described. The contrasting results in the clinics are analyzed in relation to factors intrinsic to the health care system and those related to the local population in order to highlight the issues involved in establishing future mental health services, both locally in other provinces and in situations similar to Cambodia. The efficacy of introducing low-cost, basic mental health care is shown, and related to the need to find solutions for prevailing problems on the psychosocial level. They can be introduced with modest means, and can be complementary to local health beliefs and traditional healing. In introducing mental health services, an approach is needed which adapts to the absorption potential of the health system as well as to the patients' need to find meaningful help. Existing resources, from the traditional healing sector to rudimentary village structures, cannot be neglected in the rehabilitation of the community, or in interventions to help the individual patient.
Ma, Wei-Fen; Chao, Fen-Hao; Chang, Hsiu-Ju; Liou, Yiing-Mei; Chiang, Li-Chi
As adolescent girls have specific healthcare needs, this paper was designed to provide a better understanding of their healthcare needs in both physical and psychosocial terms. After conducting a targeted review of the literature on children and adolescents, we identified factors of importance to physical health as body weight, physical activity, menstruation, sexual knowledge and attitude and to psychosocial health as anxiety, interpersonal relationships, depression, and suicide behavior. Reflecting these factors, this paper presents four preventive suggestions to clinical practice, education, and research to facilitate improvements in adolescent girl's health. These suggestions include: 1) strengthening health education and media responsibility with regard to adolescent girl health; 2) improving awareness of the needs of adolescent girls within healthcare and education organizations; 3) making health guidelines for promoting proper health behavior in adolescent girls; and 4) mobilizing nurses to assert the health of adolescent girls in clinical, education, and research fields. This is the first paper that focuses on the health needs of adolescent Taiwanese girls. The authors hope that more people become involved in the care of adolescent girl's health in Taiwan.
Shinn, Marybeth; Greer, Andrew L; Bainbridge, Jay; Kwon, Jonathan; Zuiderveen, Sara
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.
Marjaneh M. Fooladi
Full Text Available With access to multimedia through social networks at global level, one wonders why some of the preventive healthcare services such as children and adult immunizations, annual screening for men and women, prenatal and dental care for childbearing women and adolescents are not provided at a 100% rate. Community awareness is a crucial aspect of preventative healthcare and perhaps those responsible for implementing the national health initiatives seek to realize other key factors influencing community health. In a study of 190 community health nurses caring for blacks, Puerto Ricans and Southeast Asians, the confidence scores for cultural self-efficacy was high when nurses cared for blacks and they were low when they cared for Asians and Latinos. The lowest scores belonged to items related to knowledge of health beliefs and practices regarding respect, authority and modesty within each culture. Scores were higher when interpreters were used correctly to convey meaningful messages. Researchers concluded that nurses lacked confidence when caring for culturally diverse patients and found weaknesses across the nursing curriculum preparing nurses to care for various demographic groups.1 In most countries, including Iran, governmental agencies have the budget and the man- power to apply preplanned initiatives and provide community-based preventive healthcare services to address the majority of the preventable health related issues through satellite clinics, health department and outpatient facilities. Meanwhile, private sectors in metropolitan cities offer cure-based services to urban and suburban communities. Remote and rural areas should be the focus of primary care and preventive health services, because access to multimedia is limited, healthcare providers refuse to work in outreach areas, and unpaved roads are barriers to easy access to the locals and outsiders. To implement an effective community-based preventive program, recognition of resiliency
Full Text Available Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
Coutts, Christopher; Hahn, Micah
Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.
Full Text Available The importance of preventive health care practices has increasingly been recognized in the wake of changing disease profile in India. The disease burden has been shifting from communicable to non-communicable diseases as a result of greater focus on achieving competitiveness in a fast globalizing economy. The rapid pace of social and technological changes has led to adverse life style choices resulting in higher incidence of heart diseases, diabetes, obesity, cancer, and deteriorating inter-personal relations and psychological well-being among individuals. Most of these health risks can considerably be reduced through disseminating science-based information on health promotion and disease prevention including exercise, nutrition, smoking and tobacco cessation, immunization, counseling, fostering good habits of health and hygiene, disease screening and preventive medicine. Prior evidences indicate that preventive health interventions can improve health outcomes in a great deal. In a regressive health delivery system of India where major health expenses on curative health is met by out-of-pocket money, preventive health services hold promise to be cost efficient, clinically effective and equity promoting. This article, therefore, examines in depth the issues and prospects of preventive and promotive health care services in realizing optimum health care needs of the people.
Today, a substantial reorientation of the Public Health services in the Federal Republic of Germany is broadly seen necessary. Patterns of functional and organisational restructuring of Public Health services on the regional and the communal level are closely linked with concepts of prevention and health promotion. Hence, a number of agencies have already adopted new tasks and functions like comprehensive and transorganizational planning, coordination and evaluation as well as the establishment of new reporting systems. Presently, the transformation process from the bureaucratic mode of administering matters of health to a new Public Health orientation receives new impacts from the international "New Public Management" movement. Comparatively late, with the beginning of the 1990s, a growing number of German municipalities has introduced new concepts of administration. Local government administrations, of which the Public Health services are a part, follow the model of modern service organizations producing services in a more efficient, professionalized and consumer-oriented way. Specific elements of economising modernisation programmes like re-distribution of tasks, de-centralisation, extension of managerial capacities, setting of stimulating working conditions that provide employees with greater independence of action as well as career opportunities, are at the same time prerequisites for innovative strategies of health protection and coordination policies of Public Health services.
The Public Health Service must assume the role of the overall Public Health Coordinator, seeking to afford the highest level of health protection both to the nearby population as well as to the more distant groups. Data will be given relative to the limited experience the PHS has had in the removal of populations from areas of suspected hazards. Problems inherent in the evacuation of civilians of all ages will be discussed. (author)
Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence
Anderson, E A; Zwelling, L A
Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes.
Off-Site Radiological Safety Programs conducted on past Plowshare experimental projects by the Southwestern Radiological Health Laboratory for the AEC will be presented. Emphasis will be placed on the evaluation of the potential radiation hazard to off-site residents, the development of an appropriate safety plan, pre- and post-shot surveillance activities, and the necessity for a comprehensive and continuing community relations program. In consideration of the possible wide use of nuclear explosives in industrial applications, a new approach to off-site radiological safety will be discussed. (author)
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.
Bell, Janice F; Huebner, Colleen E; Reed, Sarah C
This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.
Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L
There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...
Diab, Marwan; Jamei, Yasser Abu; Kagee, Ashraf; Veronese, Guido
In the context of violations of human rights and insecurity, the Gaza Community Mental Health Programme (GCMHP) provides mental health services and psychosocial interventions that match local cultural and social norms. The GCMHP uses a community mental health approach to promote the psychological wellbeing of the people living in the Gaza Strip and advocate on mental health issues. The GCMHP provides preventive and therapeutic care to a broad public health spectrum of Gazan society. Services are provided in terms of preventative public health at the primary, secondary, and tertiary levels. Data reported here are from 2014-16. For primary prevention, our services include advocacy, public awareness, and media campaigns aimed at raising awareness about and preventing common mental disorders and behavioural difficulties in children. 35 878 people are estimated to have benefited from these programmes. The GCMHP also provides psychological first aid and crisis intervention to vulnerable persons and a free telephone counselling service. About 12 943 persons have received individual sessions, and 2590 persons have received telephone counselling. The GCMHP also provides training to enhance the skills of professionals of local organisations working in mental health and psychosocial services. 3557 people have attended these programmes. As secondary prevention, the GCMHP offers individual and group psychotherapy, and routine home visits are provided for torture survivors and individuals and families exposed to cumulative trauma. 11 713 individuals have received such services. As tertiary prevention, rehabilitation services including physiotherapy and occupational therapy are provided to help patients regain their role as active members of the community. 398 people have received these services. A public health-oriented approach to mental health services fits the socioecological model that locates individuals and families within the context of their community, religious
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA) Advisory Committee on HIV, Viral... announcements of meetings and other committee management activities, for both the Centers for Disease Control...
Cummings, Janet R.; Lynch, Frances L.; Rust, Kristal C.; Coleman, Karen J.; Madden, Jeanne M.; Owen-Smith, Ashli A.; Yau, Vincent M.; Qian, Yinge; Pearson, Kathryn A.; Crawford, Phillip M.; Massolo, Maria L.; Quinn, Virginia P.; Croen, Lisa A.
Using data from multiple health systems (2009-2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)--including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic…
Fariña, Diana; Rodríguez, Susana; Erpen, Norma
Argentine's neonatal mortality rate represents 60% of infant mortality; implementation of strategies that improve quality of neonatal care is a priority. Traditionally, the training of health professionals is accomplished through scientific meetings with little capacity for exchange; in-service training incorporates the identification and resolution of problems joining the daily patient care. To describe the in-service training program (ISTP), to identify its strengths as strategies for quality of care improvement and to evaluate its impact in four different Argentine maternity services. health services research intervention study, not controlled, before and after evaluation. This program is a multidimensional strategy consisting in regular visits by a neonatologist and a nurse to health professionals in their own settings. Program stages: 1) service assessment and design of the action plan according to the priorities, 2) implementation, 3) consolidation and analysis through indicators. Greatest impact was found over equipment and human resources improvement; we also observed an improvement in management related aspects like organization and coordination of care. The reduction of preventable deaths varied between centers. The in-service training program is an effective tool with measurable quantitative and qualitative results with positive impact on the quality of care. Conjunctural factors and political will were determinant on the program's success, as it is commonly seen in the implementation of strategies that involve changing established structures.
Full Text Available A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data, along with institutional interaction with policy makers.
Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719
Ali, Ather; Katz, David L.
As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels o...
Ståhl, Christian; Åborg, Carl; Toomingas, Allan; Parmsund, Marianne; Kjellberg, Katarina
Occupational health services may have a strategic role in the prevention of sickness absence, as well as in rehabilitation and return to work after sick leave, because of their medical expertise in combination with a close connection to workplaces. The purpose of this study was to explore how employers and occupational health service providers describe their business relations and the use of occupational health services in rehabilitation in relation to the organization of such services. The study uses a theoretical framework based on social capital to analyse the findings. Interviews and focus groups with managers with Swedish public employers (n = 60), and interviews with occupational health services professionals (n = 25). Employers emphasized trustful relationships, local workplace knowledge, long-term contracts and dialogue about services for good relationships with occupational health providers. Occupational health providers strove to be strategic partners to employers, promoting preventive work, which was more easily achieved in situations where the services were organized in-house. Employers with outsourced occupational health services expressed less trust in their providers than employers with internal occupational health provision. Social capital emerges as central to understanding the conditions for cooperation and collective action in the use of occupational health services, with reference to structural (e.g. contracts), relational (e.g. trust) as well as cognitive (e.g. shared vision) dimensions. The study suggests that attention to the quality of relationships is imperative for developing purposeful occupational health service delivery in rehabilitation and return to work.
Holde, Gro Eirin; Baker, Sarah R; Jönsson, Birgitta
To utilise Andersen's behavioral model as the theoretical framework to examine direct and indirect relationships between population characteristics, oral health behaviours and periodontitis and oral health impacts. The model was tested in a general adult population (n = 1,886) in Norway, using structural equation modelling. Socioeconomic status, sense of coherence (SOC), dental anxiety, perceived treatment need, oral health behaviours and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal examinations consisted of full-mouth recordings. Andersen's model explained a large part of the variance in use of dental services (58%) and oral health-related impacts (55%), and to a less extent periodontitis (19%). More social structure and stronger SOC was related to more enabling resources, which in turn was associated with more use of dental services. More use of dental services was related to more periodontitis and more periodontitis was associated with increased oral health impacts. There was no association between use of dental services and oral health impacts. The result demonstrated complex relationships between population characteristics, oral health-related behaviours and oral health outcomes. The findings suggest a need for further studies examining the effectiveness of dental health care utilization related to periodontitis prevention and control. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Martins, Jo M; Isouard, Godfrey; Freshman, Brenda
This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevance to the human dimension of health management, namely personal engagement at work, emotional intelligence and conflict resolution, were found to: (1) have concept validity; (2) be associated with personal and organisational performance; and (3) be capable of being imparted by training. The analysis indicated that none of the competencies and/or skills identified has been given emphasis in postgraduate health management courses in Australia. Competence in the management of human relationships in health services has been given low priority in university postgraduate training in health management in Australia. The current situation poses challenges to all stakeholders of health services.
Geissler, Kimberley H; Leatherman, Sheila
The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic
Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system
Healey, Priscilla; Stager, Megan L; Woodmass, Kyler; Dettlaff, Alan J; Vergara, Andrew; Janke, Robert; Wells, Susan J
Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider's behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies
Full Text Available Orientation: The community service initiative, a 1-year placement of health graduates, significantly improved human resource availability in the South African public health sector, even though the process was fraught with challenges. Although experiences in the curative health sector were assessed, the experiences of environmental health practitioners were yet to be studied. Research purpose: This study assessed the experiences of environmental health practitioners during their community service year. Motivation for the study: Anecdotal evidence suggested problems with the process. This study endeavoured to identify the challenges whilst taking cognisance of its effectiveness. Method: A total of n = 40 environmental health graduates from the Durban University of Technology who had concluded community service completed questionnaires in this crosssectional quantitative study. Descriptive statistics, means and standard deviations were used to analyse the data. Main findings: The timing of community service placements was critical as 58% of respondents had to repay study loans. The placement of married respondents (10% outside KwaZuluNatal, however, could have had impacts on family structures. Only 68% felt stimulated by their job functions, and there arose challenges with accommodation and overtime duties. Respondents felt that their tertiary education did equip them and that engagement with senior personnel helped in their professional development. Even though most of the review of the community service year appeared to be positive, a majority of respondents did not intend to continue working or recommending their workplaces. Future career pathing showed that 79% would prefer to be employed outside the public sector. Practical and managerial implications: The process needs to be reviewed to strengthen human resource management and enhance retention in the often overloaded and under-resourced South African public health sector. Contribution
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
This report reviews the findings since 1987 in the field of research related to the possible impact of nuclear war and nuclear explosions on health and health services. An annex contains the finding and conclusions of a 1989 United Nations study on the climatic and other effects of nuclear war. 1 tab
Liang Youxin; Xiang Quanyong
In China, the origin of occupational health started in the mid 1950s soon after the founding of the People's Republic of China. However, more complete concept and practice of occupational health was defined after the early 1980s, when China started her full-scale drive for economic reform and policy of openness. The integrity intends to cover occupational health, occupational medicine, industrial toxicology, industrial hygiene, occupational ergonomics, and occupational psychology as theoretical and practical components of occupational health. As a result, occupational health in China has undergone many changes and has improved over the past decades. These changes and improvements came about, most likely due to a new scheme, where a holistic approach of the recognition, regulation, and provision of occupational health services in a wider coverage is gradually formed and brought into effect. This presentation provides the current status of occupational health and safety problems, the latest legislative to occupational health and safety, and a general scenario of the organizational structure and function of occupational health services in China. It attempts to share with participants both our experience and lessons learned towards creating a more open and effective channel of ideas and information sharing
Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne
Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.
Evans, Marion W
To describe the importance of health promotion techniques and use of active disease prevention techniques as part of chiropractic practice through a selective review of literature using a mnemonic device. There is evidence that doctors of chiropractic use some health promotion techniques in practice such as instruction on exercise, dietary advice, smoking cessation recommendations and the encouraging of preventive chiropractic visits. Healthy People goals for the nation suggest that providers encourage preventive services, work toward better access to care and stress disease prevention. However, information on how this can be routinely done in chiropractic practice is fragmented. This article suggests ways to implement health promotion into the everyday management of the chiropractic patient. Health promotion and disease prevention can be easily performed in chiropractic practice. The nature of the chiropractic supportive or maintenance visit gives doctors a unique platform on which they can launch full-scale health promotion efforts on their patients.
Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick
In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.
Gittner, LisaAnn S; Husaini, Baqar A; Hull, Pamela C; Emerson, Janice S; Tropez-Sims, Suzanne; Reece, Michelle C; Zoorob, Roger; Levine, Robert S
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.
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the Federal...
Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra
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
Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D
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.
Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi
Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.
Ferracane, J; Hilton, T; Korpak, A; Gillette, J; McIntyre, P Speed; Berg, J
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
Strengthening youth friendly health services through expanding method choice to include long-acting reversible contraceptives for Ethiopian youth. ... Odds of adopting LARCs at pre-intervention (0.70); rose to 1.30 for the post-intervention phase (p-value <0.0001); comparing intervention to non-intervention study arms.
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
Neofytou, M S; Neokleous, K; Aristodemou, A; Constantinou, I; Antoniou, Z; Schiza, E C; Pattichis, C S; Schizas, C N
There is a huge need for open source software solutions in the healthcare domain, given the flexibility, interoperability and resource savings characteristics they offer. In this context, this paper presents the development of three open source libraries - Specific Enablers (SEs) for eHealth applications that were developed under the European project titled "Future Internet Social and Technological Alignment Research" (FI-STAR) funded under the "Future Internet Public Private Partnership" (FI-PPP) program. The three SEs developed under the Electronic Health Record Application Support Service Enablers (EHR-EN) correspond to: a) an Electronic Health Record enabler (EHR SE), b) a patient summary enabler based on the EU project "European patient Summary Open Source services" (epSOS SE) supporting patient mobility and the offering of interoperable services, and c) a Picture Archiving and Communications System (PACS) enabler (PACS SE) based on the dcm4che open source system for the support of medical imaging functionality. The EHR SE follows the HL7 Clinical Document Architecture (CDA) V2.0 and supports the Integrating the Healthcare Enterprise (IHE) profiles (recently awarded in Connectathon 2015). These three FI-STAR platform enablers are designed to facilitate the deployment of innovative applications and value added services in the health care sector. They can be downloaded from the FI-STAR cataloque website. Work in progress focuses in the validation and evaluation scenarios for the proving and demonstration of the usability, applicability and adaptability of the proposed enablers.
toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples' sexual health ... homme-femme afin d'avoir une compréhension plus approfondie de la manière dont les normes des sexes influent sur .... abandonment or divorce, physical and emotional abuse, and ...
Medical doctors are bound by ethics in their clinical practice – health service delivery. They often discharge their contractual responsibilities under the provisions of their professional ethical code and personal morality. Ethical principles in clinical care include i) Respect for patient's autonomy ii) Doing good (beneficence) ...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... nursing research. Applications are reviewed for scientific and technical merit, mission relevance, and the... Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research...
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Oborn, Eivor; Barrett, Michael; Darzi, Ara
Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.
Golińska-Zach, Aleksandra; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta
Hairdressing is one of the most developing branch of the service industry in Poland. Providing representatives of this occupational group with preventive health care services it should be remembered that they are at risk of skin and respiratory diseases, which occur due to a quite frequent exposure to harmful agents in the work environment of hairdressers and hairdressing apprentices. Interestingly, a much lower number of researches concentrate on respiratory symptoms than on skin disorders in hairdressers. The authors of this article have carried out the first Polish follow-up study focused not only on skin disorders but also on respiratory tract symptoms in hairdressing apprentices. The results of the study have been reported in other publications while this paper presents a literature review based on EBSCO and PubMed databases, Elsevier and contained articles (on the subject discussed in this paper). On the basis of information obtained from the authors' own research evidence and from the literature review, the guidelines for the preventive health care of hairdressing apprentices were developed. It was confirmed that neither determination of allergen-specific immunoglobulin E (IgE) nor performance of skin prick tests (SPTs) and patch tests for hairdressing factors are necessary. They should be performed as a part of preventive medical examination only in those apprentice candidates and trainees in this profession who report work-related symptoms and it is suspected that they result from exposure to particular factor in the work environment. Med Pr 2017;68(5):677-687. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Full Text Available Hairdressing is one of the most developing branch of the service industry in Poland. Providing representatives of this occupational group with preventive health care services it should be remembered that they are at risk of skin and respiratory diseases, which occur due to a quite frequent exposure to harmful agents in the work environment of hairdressers and hairdressing apprentices. Interestingly, a much lower number of researches concentrate on respiratory symptoms than on skin disorders in hairdressers. The authors of this article have carried out the first Polish follow-up study focused not only on skin disorders but also on respiratory tract symptoms in hairdressing apprentices. The results of the study have been reported in other publications while this paper presents a literature review based on EBSCO and PubMed databases, Elsevier and contained articles (on the subject discussed in this paper. On the basis of information obtained from the authors’ own research evidence and from the literature review, the guidelines for the preventive health care of hairdressing apprentices were developed. It was confirmed that neither determination of allergen-specific immunoglobulin E (IgE nor performance of skin prick tests (SPTs and patch tests for hairdressing factors are necessary. They should be performed as a part of preventive medical examination only in those apprentice candidates and trainees in this profession who report work-related symptoms and it is suspected that they result from exposure to particular factor in the work environment. Med Pr 2017;68(5:677–687
BACKGROUN D: Accessibility of health services for reproductive health (RH) is an important factor in increasing use of reproductive health services. Reports show that reproductive health services access in Ethiopia varies by region. A better understanding of the accessibility and utilization of existing reproductive health ...
exists. The following causes of health inequalities are analyzed: life styles or health behaviors, health services, material or structural factors, income inequalities and political factors. Health services are not the main determinants of health or of health inequalities. But the existence of health services is a fundamental need for everyone and the access to them should be a right for all people independently of their social characteristics. Quality and coverage of health services is an important part of development and they constitute main indicators of social wellbeing. Finally, it is shown an example of social class inequalities in health services utilization in Catalonia in 1994 and 2002, inequalities that are non existent for curative services but that still remain for preventive services.
Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.
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Peng, Yu-I; Lin, Tsui-Fang
The National Health Insurance (NHI) system in Taiwan provides free annual preventive care services and other disease-specific preventive care services under low copayments to people aged 65 and older, yet their utilization rates remain low ever since implementation. This study investigates whether social capital is associated with preventive care use among people aged 65 and older. Using the 2009 National Health Interview Study, this study measures social capital by the elderly's social network and social participation, and employs the logistic regressions to estimate the association between social capital and the odds of using a variety of preventive care services. The results show that social capital in terms of social network and social participation is significantly associated with the use of NHI general preventive care services. For disease-specific preventive care, it is social participation, rather than social network, that is related to the utilization rate. The associations between social capital and different types of preventive care use found in our study could be considered as an important factor when making policies to promote the utilization of preventive care. Copyright © 2017 Elsevier B.V. All rights reserved.
Hubbard, Brian; Gelting, Richard; Baffigo, Virginia; Sarisky, John
In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities
Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.
Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.
Wissow, Lawrence S
While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common...
Wissow, Lawrence S
While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common outcomes of heterogeneous interventions tailored to diverse communities.
Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert
health equity for refugees. Dependence of refugees on the public facilities for primary and specialist care has placed a great burden on the Jordanian health system. To improve accessibility and affordability of health services in an equitable manner for both refugees and Jordanian host communities, strategies that should be considered going forward include shifting resources for non-communicable diseases and other traditional hospital services to the primary level and creating strong health promotion programs emphasizing prevention and self-care are strategies.
Niniek Lely Pratiwi
Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.
Full Text Available The typical worker spends about 47 hours a week commuting sitting in cars, trains, buses, or sitting at their desks. These statistics show that maintaining a healthy work and life balance has become progressively important. Workplace wellness and health promotion are of central importance for any organization in today's world. People are becoming highly conscious about their health and seek to ensure that they are provided with best medical services and facilities in case of any health issue. Organizations have switched to proactive strategies for the healthcare of their employees. Billions of dollars are spent on the workforce only after illnesses or injuries have occurred. Over the past several decades, healthcare services have drastically changed, altering the manner in which healthcare was previously managed. Technological advancements in medical systems have revolutionized the healthcare industry, and digital health tracking has been quite successful in monitoring patients’ health. Since patients are continuously monitored, no matter where they are, these systems can indicate patients’ adherence to medical protocols and act as a warning sign for such diseases as heart problems, Alzheimer’s disease, and many others. Health Relationship Management Services (HRMS is a new paradigm which defines comprehensive healthcare for an individual. HRMS is a complete health ecosystem suitable for the workplace, which enables healthcare providers to collect personal health data from various sources, analyze it for positive outcomes, and take action to preserve an employee’s good health to reduce absenteeism or turnover. HRMS can act as a preventative sentinel for corporate well-being as well.
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
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.
Medina, Carmen; Salvador, Xavier; Faixedas, M Teresa; Gallo, Pedro
The purpose of this article is disclose services utilization patterns among the Catalan population with particular emphasis on primary care, specialised care, hospital care and emergency care. A number of logistic regression models were used to explain the utilization of the various types of services. Variables in the analysis included self-perceived need, lifestyles, and sociodemographic variables. Separate analyses were performed for male, female, adults, and children as well as for the general population. Women use all types of services more often than men. Children and people over 64 are more frequent users of primary care. Primary care is also associated to lower socioeconomic conditions. Young adults and the migrant population in general are found to be under users of services, except of emergency care services. The use of specialised care is associated to the better-off, to those with university level education attainment, individual private insurance, and those living in the city of Barcelona. Hospital care is largely associated to need variables. The use of health services is explained by self-perceived need as well as by demographic, socioeconomic and geographical factors. Copyright © 2011 Elsevier España S.L. All rights reserved.
Lafata, Jennifer Elston; Shay, L Aubree; Brown, Richard; Street, Richard L
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
health services: out-patient curative care for sick children, routine childhood vaccination services (EPI), and routine growth monitoring services. Figure 1: Percentage of facilities offering all three basic child vaccination services by facility type, Ethiopia. Figure 2: Percentage of facilities providing basic child health services, ...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency... Services Administration, HHS. ACTION: Notice. SUMMARY: In compliance with the requirement for opportunity... Reduction Act of 1995), the Health Resources and Services Administration (HRSA) announces plans to submit an...
Full Text Available Objectives: The study aimed to assess the oral health promotion services provided as part of the maternal and child health (MCH services in the Tshwane Health District, Pretoria, South Africa.Methods: The research design was a descriptive cross-sectional study using a modified standard questionnaire. The population was drawn from the parents/caregivers (PCGs and the MCH nurses at seven clinics during June 2012 and June 2013 in Pretoria.Results: The nurses’ response rate was 83%; average age of 37 years. The majority of the nurses (65% were females; 60% were professional nurses. Most (63% of the nurses reported that they provided oral health education (OHE services. A shortage of dental education materials (43%, staff time (48%, and staff training (52% were large constraints to nurses providing OHE. The majority of PCGs (n = 382; mean age 31.5 years had a low education level (76%. About 55% of PCGs received information on children’s oral health from the television and 35% at the MCH clinics. PCGs beliefs were worrying as about 38% believed primary dentition is not important and need not be saved.Conclusion: There is evidence of minimal integration of OHE at MCH sites. Parents’ beliefs are still worrying as a significant number do not regard the primary dentition as important. The MCH site remains an important easily accessible area for integration of oral health services with general health in complementing efforts in prevention of early childhood caries.Keywords: Oral health; Promotion integration
Full Text Available Objectives: The study aimed to assess the oral health promotion services provided as part of the maternal and child health (MCH services in the Tshwane Health District, Pretoria, South Africa. Methods: The research design was a descriptive cross-sectional study using a modified standard questionnaire. The population was drawn from the parents/caregivers (PCGs and the MCH nurses at seven clinics during June 2012 and June 2013 in Pretoria. Results: The nurses’ response rate was 83%; average age of 37 years. The majority of the nurses (65% were females; 60% were professional nurses. Most (63% of the nurses reported that they provided oral health education (OHE services. A shortage of dental education materials (43%, staff time (48%, and staff training (52% were large constraints to nurses providing OHE. The majority of PCGs (n = 382; mean age 31.5 years had a low education level (76%. About 55% of PCGs received information on children’s oral health from the television and 35% at the MCH clinics. PCGs beliefs were worrying as about 38% believed primary dentition is not important and need not be saved. Conclusion: There is evidence of minimal integration of OHE at MCH sites. Parents’ beliefs are still worrying as a significant number do not regard the primary dentition as important. The MCH site remains an important easily accessible area for integration of oral health services with general health in complementing efforts in prevention of early childhood caries. Keywords: Oral health; Promotion integration
Jacobs, Elizabeth A; Lauderdale, Diane S; Meltzer, David; Shorey, Jeanette M; Levinson, Wendy; Thisted, Ronald A
OBJECTIVE To determine whether professional interpreter services increase the delivery of health care to limited–English-proficient patients. DESIGN Two-year retrospective cohort study during which professional interpreter services for Portuguese and Spanish-speaking patients were instituted between years one and two. Preventive and clinical service information was extracted from computerized medical records. SETTING A large HMO in New England. PARTICIPANTS A total of 4,380 adults continuously enrolled in a staff model health maintenance organization for the two years of the study, who either used the comprehensive interpreter services (interpreter service group [ISG]; N = 327) or were randomly selected into a 10% comparison group of all other eligible adults (comparison group [CG]; N = 4,053). MEASUREMENTS AND MAIN RESULTS The measures were change in receipt of clinical services and preventive service use. Clinical service use and receipt of preventive services increased in both groups from year one to year two. Clinical service use increased significantly in the ISG compared to the CG for office visits (1.80 vs 0.70; P interpreter services. CONCLUSION Professional interpreter services can increase delivery of health care to limited–English-speaking patients. PMID:11520385
Mathers, Jonathan; Taylor, Rebecca; Parry, Jayne
paradox is that policymakers and practitioners recognize the need to have a different service model for traditional NHS services if they want hard-to-reach populations to engage in preventive actions as a first step to redress health inequalities. The long-term sustainability of any new service model, however, depends on its aligning with the established medical system's (ie, the NHS's) characteristics. © 2014 Milbank Memorial Fund.
In 1981 the World Health Assembly decided to establish an international committee of scientists and experts to study and report on the effects of nuclear war on health and health services. The first report, published in 1984, concluded that it was impossible to prepare health services to deal in any systematic way with a catastrophe resulting from nuclear warfare. This second report incorporates the results of new studies using modern analytical techniques. It focuses not only on the direct effects of nuclear conflict on human beings, but also on the environmental effects - on climate, agriculture and social and economic infrastructure, all of which would profoundly influence human life in both the short- and long-term. The psychological effects of living under the threat of nuclear war are also examined. The experts concluded that no health service anywhere in the world would be able to deal significantly with the appalling health consequences of nuclear war, especially since the health services themselves would be largely destroyed or incapacitated. In the circumstances the experts emphasized the importance of preventing a nuclear conflict. Refs, figs and tabs
Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A
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
Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic
Köhler, M; Emmelin, M; Hjern, A; Rosvall, M
This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)
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)
Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz
We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.
Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu
As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.
Jung, Mary-Louise; Loria, Karla
Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...
Hänsel Petersson, G; Ericson, E; Twetman, S
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.
Full Text Available Birth defects refer to a group of diverse congenital conditions, which are responsible for stillbirths, neonatal deaths, chronic medical conditions and disability. Due to their low prevalence and high mortality, birth defects are not considered to be a significant health problem in India. Various data however identify that India may harbour a significant burden of birth defects, and that these conditions may be responsible for a considerable proportion of neonatal deaths in India. Although it is widely assumed that survival of patients with birth defects is low, data suggests that in 2002, there were nearly six million Indians living with impairments arising at birth. These data urge the need for implementation of a national birth defects programme in India, with a strong component of prevention. The need for significant research investments to understand the epidemiology and public health impact of birth defects in India is identified. Translation research, transcending the disciplines of medicine, public health and genetics is required to develop a low cost birth defects service as a component of the existing maternal and child health programme.
Touzet, Rodolfo; Pittaluga, Roberto R.
The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)
Campo-Arias, Adalberto; Oviedo, Heidi Celina; Herazo, Edwin
The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care. To update institutional mechanisms by which stigma related to mental disorders, perceived and perpetrated, acts as a barrier to mental health access. Stigma as a barrier to access to mental health services is due to a reduction in service requests, the allocation of limited resources to mental health, the systematic process of impoverishment of the people who suffer a mental disorder, increased risk of crime, and implications in contact with the legal system, and the invisibility of the vulnerability of these people. Structured awareness and education programs are needed to promote awareness about mental disorders, promote community-based psychosocial rehabilitation, and reintegration into productive life process. In Colombia, the frequency and variables associated with the stigma of mental disorders needs to be studied. This knowledge will enable the implementation of measures to promote the social and labor inclusion of people who meet the criteria for mental disorders. Copyright © 2014 Asociación Colombiana de Psiquiatría. All rights reserved.
This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...
André I. Wierdsma
Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.
... [Federal Register Volume 75, Number 169 (Wednesday, September 1, 2010)] [Notices] [Page 53703] [FR Doc No: 2010-21803] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)--Health...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention--Health Disparities Subcommittee (HDS) Notice of Cancellatiion...
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.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Committee on Rural Health and Human Services, Health Resources and Services Administration, Parklawn..., and administration of health and human services in rural areas. Agenda: Wednesday morning, September 4...
Wilson Giovanni Jiménez Barbosa
Full Text Available Background: The e-health and telemedicine have emerged as tools to facilitate access to health services, both populations far from the centres, and those who reside near them is not easily accessible or require constant controls by their professionals health traffickers. Objective: To reflect on the uses, progress and difficulties faced by Information and Communication Technologies (ICT as a strategy to bring health services to users. Methodology: qualitative hermeneutic research; advanced in two phases. The first, theoretical review by finding relevant articles in scientific databases. The second phase, critical analysis of literature found, in order to understand the dynamics generated from the use of ICT in the health sector, its current uses and prospected, and the risk that can generate its implementation for providers and patients. Results: The e-health and telemedicine have advanced in their development process andColombiahas not been outside, but there are still drawbacks of ethical, legal and operational order, which are not static and show great variation over time, becoming challenges are not independent but are associated with the dynamic progress of ICT. Conclusion: e-health and telemedicine are valid strategies to improve access to health services to communities. But require the development of processes to prevent, mitigate and / or exceed the inconveniences that may arise from its use.
Coker, Tumaini R; Sareen, Harvinder G; Chung, Paul J; Kennedy, David P; Weidmer, Beverly A; Schuster, Mark A
To examine the perspectives of publicly insured adolescents and their parents on ways to encourage adolescent utilization of preventive health services. We conducted eight focus groups with 77 adolescents enrolled in a large Medicaid managed care plan in Los Angeles County, California, and two focus groups with 21 of their parents. Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. Adolescents and parents reported that the most effective way to encourage preventive care utilization among teens was to directly address provider-level barriers related to the timeliness, privacy, confidentiality, comprehensiveness, and continuity of their preventive care. They reported that incentives (e.g., cash, movie tickets, gift cards) might also be an effective way to increase preventive care utilization. To improve adolescent receipt of surveillance and guidance on sensitive health-related topics, most adolescents suggested that the best way to encourage clinician-adolescent discussion was to increase private face-to-face discussions with a clinician with whom they had a continuous and confidential relationship. Adolescents reported that the use of text messaging, e-mail, and Internet for providing information and counseling on various sensitive health-related topics would also encourage adolescent utilization of preventive health services. Parents, however, more often preferred that their teen receive these services through in-office discussions and clinician-provided brochures. State agencies, health plans, clinics, and individual providers may consider focusing their efforts to improve adolescents' utilization of preventive services on basic structural and quality of care issues related to the clinician-patient relationship, access to services, and confidentiality. (c) 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Levkoff, Sue; And Others
Describes 10 modules for primary care practitioners on health promotion/disease prevention for the elderly on these topics: Alzheimer's disease in minorities, dehydration, diabetes, elder abuse, geriatric nutrition, oncology, oral health in long-term care, incontinence, injury prevention, and physical activity. These areas are significant for…
Baum, Fran; Freeman, Toby; Jolley, Gwyn; Lawless, Angela; Bentley, Michael; Värttö, Kaisu; Boffa, John; Labonte, Ronald; Sanders, David
This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
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
Brown, Jonathan D
Involuntary outpatient commitment (IOC) statutes exist in response to disorganized community mental health service delivery and perceived treatment non-compliance. These statutes attempt to force psychiatric patients to comply with outpatient mental health services. Mental health service consumers, providers, and advocates have increasingly questioned the necessity and legality of IOC. Credible research indicates that IOC does not substantially benefit consumers and may increase mental health deterioration. IOC has proven difficult to implement, enforce, and successfully measure. Rather than resorting to expanding coercive measures, mental health systems and policymakers must ensure provision of voluntary and accessible mental health services. Furthermore, IOC cannot be legally or ethically justified even if hypothetical research supporting its alleged effectiveness exists. This article summarizes influential and contradictory IOC research, explores legal issues, and proposes that providing voluntary consumer-driven services would reduce IOC usage and prevent criminalizing individuals experiencing serious emotional distress.
Devlin, Dee; Henshaw, Michelle
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.
McGinnis, Sandra; Moore, Jean
Objective To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. Data Sources (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Study Design Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the “core” versus related disciplines and to investigate the extent to which the “core” researchers publish, present, or participate in disciplinary venues. Principal Findings The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self-identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. Conclusions The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security. PMID:20459584
McGinnis, Sandra; Moore, Jean
To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the "core" versus related disciplines and to investigate the extent to which the "core" researchers publish, present, or participate in disciplinary venues. The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self-identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security.
Gofin, Rosa; Donchin, Milka
Although School Health Services (SHS) are an efficient way of providing health care to children and adolescents, in recent years they have been curtailed in Israel. To study parents' and teachers' knowledge about the content of SHS, their use and importance, and their preferred way of delivering these services. From December 2006 - January 2007, teachers (n=304) of 2nd-12th-grade pupils and the pupils' parents (n=808) in state schools of the Hebrew education system (both secular and religious) were interviewed by phone. Parents were located by random dialing (response rate 63%), and the teachers from a Ministry of Education list (response rate 70%). About 70% of parents and teachers knew that SHS provide immunizations; 70% and 80% respectively, reported they provided first aid. Only 8% of the parents and 13% of the teachers reported that a nurse came at least three days a week to the school and most of them preferred that the nurse should come every day. Most respondents said that the SHS did important work. About a third of parents and 40% of teachers preferred that all health care services be provided in the schools by doctor and nurse; 40% of parents and teachers wanted the nurse to provide counseling and that the rest of SHS content be provided by the regular primary health care providers; 20% of parents and 14% of teachers preferred other options. Parents and teachers rate SHS as important and are prepared to consider alternatives for their delivery. This should be considered when re-organizing the SHS.
Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida
New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.
Kimla, Katarina; Nathanson, Dania; Woolfenden, Susan; Zwi, Karen
Objective The aims of the present study were to describe the prevalence of vulnerability in a cohort of newborns, identify the factors that increase the risk of vulnerability and examine whether those who are most vulnerable are receiving home visits. Methods A prospective cross-sectional study was performed using data collected from questionnaires completed by child and family health nurses and obstetric discharge summaries for each mother-baby dyad. Descriptive frequencies and percentages are used to describe the proportions of children who were vulnerable, offered services and had risk factors for vulnerability. Categorical data were compared using Pearson's Chi-squared analysis. Results In all, 1517 newborns were included in the present study. Of these, 40.5% were identified as vulnerable and 13.9% had two or more risk factors for vulnerability (95% confidence interval (CI) 12-16%). The most common risk factors were biological. Across all newborns, 33.7% were visited at home, and 74.6% of vulnerable newborns were offered a home visit. Children identified as vulnerable were more likely to have a home visit than those who were not (z for 95% CI=1.96; Prisk needs to be confirmed in further studies, identifying vulnerability allowed the offer of home visiting to be directed towards those most likely to benefit. What is known about the topic? Of the Australian child population, 10-20% are vulnerable to adverse health, developmental and wellbeing outcomes. Vulnerable infants are at a greater risk of becoming vulnerable children, adolescents and adults over the life course. Biological and psychosocial risk factors for vulnerability are well described. Families with the greatest need are often the least likely to access or receive support, and have lower utilisation of preventative health services despite evidence that support in the first few years of life can significantly improve long-term outcomes. What does this paper add? This paper provides a detailed
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
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.
Full Text Available OBJECTIVES: To reveal the equity of health workforce distribution in urban community health service (CHS, and to provide evidence for further development of community health service in China. METHODS: A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. RESULTS: On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39 was better than that of doctors per square kilometer (G = 0.44 (P = 0.005. Among the total 6,573 health workers, 1,755(26.7% had undergraduate degree or above, 2,722(41.4%had junior college degree and 215(3.3% had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52, which was worse than that of health works per 10000 population (P<0.001. CONCLUSIONS: Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.
husband's level of educational were found to be ... Conclusion: In order to increase utilization of mother health care services and improve maternal health care utilization services ..... and the corresponding estimates of the 95% confidence intervals.
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
Wilkinson, Shelley A; Duncan, Leyanne; Barrett, Catherine; Turnbull, Robin; McCray, Sally
Allied health professionals (AHPs) in maternity and neonatology services are essential for quality care and outcomes, reflected in the minimum service delivery requirements in the Queensland Health clinical services capability framework (CSCF). However, allied health (AH) capacity across the Southern Queensland Health Service Districts (SQHSD) is not known. The aim of this project was to redress this knowledge gap to inform ongoing service planning and delivery. Maternity and neonatal AH clinicians in all birthing facilities in SQHSD were surveyed between October and December 2011 to investigate AHP staffing, practices and models of care. The professions surveyed included dietitians, occupational therapists, physiotherapists, psychologists, social workers and speech pathologists. Results were grouped per question, with stratification by CSCF and/or profession. Fifty-five valid surveys from the 16 facilities were received. All professions were represented. Gaps in maternity AH services were identified. Awareness and use of evidence-based practices were more likely to be reported where higher full-time equivalents (FTE) were allocated. Very low staffing levels have been recorded in all Maternity and Neonatology Services AHPs in the SQHSD. Gaps exist between actual and recommended CSCF staffing standards across all levels and professions. The results indicate that profession-specific support networks for AHPs have positive effects in the spreading of information, and continued promotion, support and involvement in these profession-specific networks is suggested for all facilities.
Menegueti, Mayra Gonçalves; Canini, Silvia Rita Marin da Silva; Bellissimo-Rodrigues, Fernando; Laus, Ana Maria
to evaluate the Nosocomial Infection Control Programs in hospital institutions regarding structure and process indicators. this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used. The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%). The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.
In the late Qing Dynasty, the railway authority of China commenced establishing their self-run medical institutions, setting up the hygienic standards of railway system, and opening a new prospects of railway health services and epidemic prevention, reflecting the emergence of China's Railway Health Services. The motivations of all these approaches were related to three factors, that is,"the eastward dissemination of western medicine","the medical requirement of railway employees", and"the emergent situation of railway health and epidemic prevention".
Introduction: The patient's view as a recipient of health care service is rarely taken into consideration in assessing the quality of healthcare service delivery in many developing countries. The views and opinions of patients on the quality of service, coupled with their satisfaction with health care services can assist ...
Rosenthal, Beth Spenciner; Wilson, William Cody
The authors present and empirically test a multivariate model of the use of mental health counseling services. Use of such services by 1st-year college students is directly a result of need for these services and willingness to use them. Beliefs about mental health services and demographic characteristics are not directly related to use, but…
... activities you enjoy, from brisk walking to ballroom dancing. Limit alcohol. If you choose to drink alcohol, ... lifestyle also might play a role in preventing Alzheimer's disease. Women are more vulnerable than men to ...
Chemtob, Claude M.; Griffing, Sascha; Tullberg, Erika; Roberts, Elizabeth; Ellis, Peggy
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…
Thorpe, Kenneth E; Ogden, Lydia L
The Patient Protection and Affordable Care Act represents a major opportunity to achieve several key goals at once: improving disease prevention; reforming care delivery; and bending the cost curve of health spending while also realizing greater value for the dollars spent. Reform-based initiatives could produce major gains in a relatively short time. The U.S. Department of Health and Human Services should develop an action plan detailing how the programs that the health reform law sets into motion throughout various agencies can work synergistically. It should also detail how best practices in finance and payment, in the organization and delivery of care, and in prevention can be expanded nationally.
Dho, María Silvina
This paper seeks to analyze the factors associated with the use of dental health services (UDHS) by adults in the city of Corrientes, Argentina. A cross-sectional study was conducted. Information concerning the study variables was collected via a home survey. The sample size was established with a 95% confidence interval level (381 individuals). A simple random sampling design was used, which was complemented with a non-probability quota sampling. The data was analyzed using SPSS version 21.0 and Epidat version 3.1 softwares. Socio-economic level, dental health coverage, perception of oral health care, perception of oral health, knowledge about oral health, and oral hygiene habits were significantly associated with the UDHS over the last twelve months. These same factors, excluding dental health coverage and knowledge about oral health, were associated with the UDHS for routine dental check-ups. Measures should be implemented to increase the UDHS for prevention purposes in men and women of all socio-economic levels, particularly in less-privileged individuals.
Nelson, H Wayne
This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.
... can significantly lower your risk of these common killers. Take charge of your health by making better ... other substances, and don't drive while sleepy. Suicide is another leading men's health risk. An important ...
Palinkas, Lawrence A.
Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675
Yoong, Sze Lin; Finch, Meghan; Nathan, Nicole; Wiggers, John; Lecathelinais, Christophe; Jones, Jannah; Dodds, Pennie; Wolfenden, Luke
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).
Examines forces motivating reform in mental health services, suggesting that mental health practitioners and researchers have relied on traditional and apparently unsuccessful methods (with little or no scientific support) to ensure service quality and effectiveness; debunking six myths about mental health services; and suggesting that…
... services. The center operator shall provide a health program, including basic medical, dental, and mental health services, for all students from admission until termination from the Job Corps. The program shall... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Health care and services. 638.510 Section 638...
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service. [T.D. 00-4, 65 FR 2874, Jan. 19, 2000] ...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956, as...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran, bereavement... mental health services in connection with treatment of the veteran under 38 U.S.C. 1710, 1712, 1712A...
Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: Assess perceived morbidity and examine the factors associated with utilization of health services by a sample of the population of the Amhara Region. Methods: Questionnaire was ...
Schonbrun, Yael Chatav; Whisman, Mark A.
Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency..., Public Law 104-13), the Health Resources and Services Administration (HRSA) publishes periodic summaries... Administration (HRSA) plans to conduct a survey of the National Practitioner Data Bank and the Healthcare...
Cook, Royer; Schlenger, William
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.…
West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Full Text Available Background and objectives: This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV and the capacity of health services for addressing these. Design: In-depth interviews (IDIs and focus group discussions (FGDs were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. Results: The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Conclusion: Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.
Yang, Yongbin; Brown, Cynthia J.; Burgio, Kathryn L.; Kilgore, Meredith L.; Ritchie, Christine S.; Roth, David L.; West, Delia Smith; Locher, Julie L.
Objective Older adults receiving Medicare home health services who experience under-nutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a one-year period in older adults receiving Medicare home health services. Design This was a longitudinal study using questionnaires and anthropometric measures designed to assess nutritional status (Mini-Nutritional Assessment [MNA]) at baseline and health services utilization and mortality status at six-month and one-year follow-ups. Setting Participants were evaluated in their homes. Participants 198 older adults who were receiving Medicare home health services. Results Based upon MNA, 12.0% of patients were Malnourished, 51.0% were At Risk for Malnourishment, and 36.9% had Normal Nutrition Status. Based upon body mass index (BMI), 8.1% of participants were underweight, 37.9% were normal weight, 25.3% were overweight, and 28.8% were obese. Using multivariate binary logistic regression analyses, participants who were Malnourished or At Risk for Malnourishment were more likely to experience subsequent hospitalization, emergency room visit, home health aide use, and mortality for the entire sample and hospitalization and nursing home stay for overweight and obese participants. Conclusions Experiencing under-nutrition at the time of receipt of Medicare home health services was associated with increased health services utilization and mortality for the entire sample, and with increased health services utilization only for the overweight and obese subsample. Opportunities exist to address risk of under-nutrition in patients receiving home health services, including those who are overweight or obese, to prevent subsequent adverse health outcomes. PMID:21527170
Jacobs, Elizabeth A.; Shepard, Donald S.; Suaya, Jose A.; Stone, Esta-Lee
Objectives. We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. Methods. We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. Results. Compared with English-speaking patients, patients who used the interpreter services received significantly more recommended preventive services, made more office visits, and had more prescriptions written and filled. The estimated cost of providing interpreter services was $279 per person per year. Conclusions. Providing interpreter services is a financially viable method for enhancing delivery of health care to patients with limited English proficiency. PMID:15117713
Majid, Sanaa; Douglas, Rachel; Lee, Victoria; Stacy, Elizabeth; Garg, Arun K; Ho, Kendall
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
from migraine, many people go untreated and do not seek care for the illness or self -manage the condition with over-the- counter products (Lipton...Hemodialysis DGD Peritoneal Dialysis DGE Ambulatory Nursing Services DGX Same Day Services Cost Pool DGZ Ambulatory Procedures Visits NEC DH...headaches. While the safety and efficacy of this treatment has been established, it is unclear what impact migraine prevention has on health care resource
Sobczyk, Karolina; Woźniak-Holecka, Joanna; Holecki, Tomasz; Szałabska, Dorota
The main objective of the project was the evaluation of the organizational and financial aspects of midwives in primary health care (PHC), functioning under The Population Program for the Early Detection of Cervical Cancer two years after the implementation of new law regulations, which enable this occupational group to collect cytological material for screening. Under this project, the data of the Program's Coordinating Centre, affecting midwives' postgraduate education in the field of pap smear tests, was taken into analysis. Furthermore, The National Health Fund (NFZ) reports on contracts entered in the field of the discussed topics, taking into consideration the value of health services performed within the Program in respect of ambulatory care and primary care units. NFZ concluded contracts for the provision of PHC service with 6124 service providers in 2016, including the contracts in the field of providing health services under the cervical cancer prevention program by PHC midwifes, which were entered into by 358 institutions (5.85%). The value of the basic services under the Program, carried out under NFZ contracts in 2014, amounted to approx. PLN 12.3 million, while the value of services performed by PHC midwives represented only 0.38% of this sum. The introduction of legislative changes, allowing PHC midwives to collect cytological material for screening, did not cause, in the period of the observation on a national scale, the expected growth of availability of basic stage services within the cervical cancer prevention program.
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service, Scientific Merit... management, and nursing research. Applications are reviewed for scientific and technical merit, mission... Advisory Committee Act, 5 U.S.C. App. 2, that the Health Services Research and Development Service (HSR&D...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on August 28-30, 2012, at the Boston Omni Parker...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on March 6-8, 2012, at the Hilton New Orleans...
Gmelin, Theresa; Raible, Claire A; Dick, Rebecca; Kukke, Surabhi; Miller, Elizabeth
This study assessed the feasibility of integrating reproductive health services into intimate partner violence/sexual violence (IPV/SV) programs. After a training for victim service agencies on integration of health services, we conducted semistructured interviews with IPV/SV program leadership. Leadership reported advocates were more likely to recognize the need to refer clients to health services, and revealed challenges operationalizing partnerships with health care centers. Training to integrate basic health assessment into victim services may be one way to address women's urgent health needs. Formal partnership agreements, protocols to facilitate referrals, and opportunities to cross-train are needed to nurture these cross-sector collaborations.
Petersen, Poul Erik
national intervention programmes. Epidemiological data on oral cancer (ICD-10: C00-C08) incidence and mortality are stored in the Global Oral Health Data Bank. In 2007, the World Health Assembly (WHA) passed a resolution on oral health for the first time in 25 years, which also considers oral cancer...... risk factors such as environmental carcinogens, alcohol, infectious agents, and tobacco use. These groups also have less access to the health services and health education that would empower them to make decisions to protect and improve their own health. Oro-pharyngeal cancer is significant component....... Prevention of HIV infection will also reduce the incidence of HIV/AIDS-related cancers such as Kaposi sarcoma and lymphoma. The WHO Global Oral Health Programme is committed to work for country capacity building in oral cancer prevention, inter-country exchange of information and experiences from integrated...
Benjamins, Maureen R; Ellison, Christopher G; Krause, Neal M; Marcum, John P
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.
Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael
Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.
... is divided into nine sections, namely organisational structure; education, training and research; mental health service provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.
Olson, C. M.
In the last 10 to 15 years, nutrition has become a major component of health promotion and chronic disease prevention. Two widely recommended strategies for incorporating nutrition education directed toward children and youth into health promotion and disease prevention efforts are school-based nutrition education and the integration of nutritional care into health care. School-based nutrition education programs targeted toward very specific eating behaviors are showing very promising results in regard to behavior and attitude change of children and adolescents. Substantial changes in health care providers' attitudes and practices and in the funding and financing of health care will be needed if nutrition education delivered in the context of routine health care is to be a major force in health promotion and disease prevention for youth. PMID:2629968
Clarke, Greg; Yarborough, Bobbi Jo
A growing number of health information technologies (HIT) are being developed and tested to address mental health conditions. HIT includes Internet and smartphone programs or apps, text messaging protocols and telepsychiatry. We reviewed the promise and evidence that HIT can expand access to mental health care and reduce disparities in use of services across groups in need. Limited reach of mental health services is a pervasive problem in the United States, and solving it will require innovations that enable us to extend our clinical reach into underserved populations without significantly expanding our workforce. In theory, HIT can extend access to mental health care in several ways: by enhancing the reach to priority populations, addressing system capacity issues, supporting training, improving clinical decision making, lowering the "consumer's threshold" for treatment, delivering preventive mental health services, speeding innovation and adoption and reducing cost barriers to treatment. At present, evidence is limited, and research is needed, focusing on consumer engagement strategies, the benefits and harms of HIT for the therapeutic relationship and the comparative effectiveness of various HIT alternatives. Copyright © 2013 Elsevier Inc. All rights reserved.
Robson , Anthony ,
International audience; Diet, lifestyle and environment do not just affect a person's health, they also determine the health of their children and possibly the health of their grandchildren. Mental ill health is an epidemic worldwide because of the combined effect of the modern diet and a sedentary lifestyle. Primary prevention of mental ill health starts, crucially, with optimal adult nutrition before the inception of pregnancy, includes breastfeeding, and continues throughout the life of th...
Background Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. Methods/design This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. Discussion An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences
Al-Taiar, Abdullah; Clark, Allan; Longenecker, Joseph C; Whitty, Christopher J M
Assessment of physical access to health services is extremely important for planning. Complex methods that incorporate data inputs from road networks and transport systems are used to assess physical access to healthcare in industrialised countries. However, such data inputs hardly exist in many developing countries. Straight-line distances between the service provider and resident population are easily obtained but their relationship with driving distance and travel time is unclear. This study aimed to investigate the relationship between different measures of physical access, including straight-line distances, road distances and travel time and the impact of these measures on the vaccination of children in Yemen. Coordinates of houses and health facilities were determined by GPS machine in Urban and rural areas in Taiz province, Yemen. Road distances were measured by an odometer of a vehicle driven from participants' houses to the nearest health centre. Driving time was measured using a stop-watch. Data on children's vaccination were collected by personal interview and verified by inspecting vaccination cards. There was a strong correlation between straight-line distances, driving distances and driving time (straight line distances vs. driving distance r = 0.92, p time r = 0.75; p time r = 0.83, p time are strongly linked and associated with vaccination uptake. Straight-line distances can be used to assess physical access to health services where data inputs on road networks and transport are lacking. Impact of physical access is clear in Yemen, highlighting the need for efforts to target vaccination and other preventive healthcare measures to children who live away from health facilities.
Gary, Tiffany L; Maiese, Eric M; Batts-Turner, Marian; Wang, Nae-Yuh; Brancati, Fredrick L
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.
Rakowski, William; And Others
This issue on preventive health care and health promotion for older adults includes 14 articles on history and definition, development of guidelines, responsibility, implementation of programs for the elderly and how it differs from that for other populations, programs for minorities, access to health care information, and a description of a…
Effect of health education on knowledge and prevention on Hepatitis infection among secondary school students in Ibadan North Local Government Area of Oyo state. ... Based on these findings, the study recommended that health education/ health campaign should be directed to school students and Specific risk practices ...
Hall, Michael; Elise, Eifert
Morbidity and mortality related to chronic diseases are a primary concern of health professionals, including Health Educators. According to the Centers for Disease Control and Prevention, over one half of the adult population in the United States suffer from one or more chronic conditions. Understanding the health risk behaviors that contribute to…
Hemmings, Colin; Bouras, Nick; Craig, Tom
Services for people with Intellectual Disability (ID) and coexisting mental health problems remain undeveloped; research into their effectiveness has been lacking. Three linked recent studies in the UK have provided evidence on essential service provision from staff, service users and carers. Interfaces with mainstream mental health services were seen as problematic: the area of crisis response was seen as a particular problem. Further services’ research is needed, focusing on service components rather than whole service configurations. There was not support for establishing more intensive mental health services for people with ID only. The way forward is in developing new ways of co-working with staff in “mainstream” mental health services. Mental health of ID staff might often be best situated directly within these services. PMID:25158137
Chiang, Chifa; Labeeb, Shokria Adly; Higuchi, Michiyo; Mohamed, Asmaa Ghareds; Aoyama, Atsuko
This cross-sectional study examined potential demand-side barriers to women's use of basic health services in rural southern Egypt (Upper Egypt). Face-to-face interviews with a structured questionnaire were carried out on 205 currently-married women, inquiring about their use of health facilities: regular antenatal care (ANC) during the last pregnancy and medical treatment services when they suffered from common illness. Questions about their perceptions of barriers to the use of health services were categorized into three primary dimensions: structural, financial, and personal/cultural barriers. Distance and transportation to health facilities (structural barriers) prevented about 30 % of the women from seeing a doctor. Forty-two percent of them felt the difficulty paying for health services (financial barriers). Approximately a quarter of women answered that gaining family permission, allocating time to go to health facilities, or concern about lack of female physicians (personal/cultural barriers) was a big problem for them. After controlling for potential confounding factors, structural barriers showed an inverse association with the use of health services. Financial barriers indicated a strong association (OR=0.18, Pbarriers had no statistical significance with women's use of health services. Although the Egyptian government had successfully extended basic health service delivery networks throughout the country, women in rural Upper Egypt were still facing various barriers to the use of the services, especially structural and financial barriers.
Ellis, Randall P; Martins, Bruno; Zhu, Wenjia
We estimate within-year price elasticities of demand for detailed health care services using an instrumental variable strategy, in which individual monthly cost shares are instrumented by employer-year-plan-month average cost shares. A specification using backward myopic prices gives more plausible and stable results than using forward myopic prices. Using 171 million person-months spanning 73 employers from 2008 to 2014, we estimate that the overall demand elasticity by backward myopic consumers is -0.44, with higher elasticities of demand for pharmaceuticals (-0.44), specialists visits (-0.32), MRIs (-0.29) and mental health/substance abuse (-0.26), and lower elasticities for prevention visits (-0.02) and emergency rooms (-0.04). Demand response is lower for children, in larger firms, among hourly waged employees, and for sicker people. Overall the method appears promising for estimating elasticities for highly disaggregated services although the approach does not work well on services that are very expensive or persistent. Copyright © 2017 Elsevier B.V. All rights reserved.
Mental Health Services in South Africa: Scaling up and future directions. ... African Journal of Psychiatry ... Abstract. “No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world.
Beatty, Kate; Harris, Jenine K; Barnes, Priscilla A
With limited resources and increased public health challenges facing the US, the Centers for Disease Control and Prevention and others have identified partnerships between local health departments (LHDs) and nongovernmental organizations (NGOs) as critical to the public health system. LHDs utilize financial, human, and informational resources and develop partnerships with local NGOs to provide public health services. Our study had 2 primary goals: (1) compare resources and partnerships characterizing rural, suburban, and urban LHDs, and (2) determine whether partnerships play a mediating role between LHD resources and the services LHDs provide. We conducted secondary data analysis using the National Association of County and City Health Officials 2005 Profile Study. We used chi-squared and analysis of variance (ANOVA) to examine differences between rural, suburban, and urban LHDs. We used regression-based mediation methods to test whether partnerships mediated the relationship between resources and service provision. We found significant differences between LHDs. Urban LHDs serve larger jurisdictions, have larger budgets and more staff, cultivate more partnerships with local NGOs, and provide more health services than suburban or rural LHDs. We found that partnerships were a partial mediator between resources and service provision. In playing a mediating role, partnerships reduce differences in service provision between rural, suburban, and urban LHDs. Partnerships mediate the relationship between resources and service provision in LHDs. LHDs could place more emphasis on cultivating relationships with local NGOs in order to increase service provision. This strategy may be especially useful for rural LHDs facing limited resources and numerous health disparities.
... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Committee to the Director (ACD... to the CDC Director through the ACD on strategic and other health disparities and health equity... ] disabilities areas, as well as discuss health equity recommendations to the CDC ACD. The agenda is subject to...
Adler, Reva N; Smith, James; Fishman, Paul; Larson, Eric B
To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. (1) Peer-reviewed literature in the fields of public health, violence/injury prevention, medicine, economics, sociology, psychology, history, and genocide studies, (2) demographic and health data bases made available by governments and international organizations, (3) reports on recent episodes of genocide published by international and nongovernmental organizations, (4) newspaper and journalistic accounts of recent and past genocides, (5) archival testimonies of genocide victims and perpetrators, and (6) court transcripts of international genocide prosecutions. The research was conducted as a medical-historical policy analysis synthesizing data within the following framework: (1) Assessment of current violence and injury prevention models for suitability in the prevention of extreme, population-wide violence, (2) analysis of morbidity and mortality data to quantify the impact of genocide on the health of populations, (3) making an inventory of the known societal risk factors for genocidal violence, (4) identification of the theorized, modifiable attitudinal risk factors for genocidal behavior within a population health model, and (5) assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured, public health approach. Mortality rates due to genocidal violence are far in excess of other public health emergencies including malaria and HIV/AIDS. The immediate and long-range health consequences of genocide include the sequelae of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for multiple subsequent generations. The impact of genocide on local health economies is catastrophic, and the opportunity costs of diverting
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
Wansink, Henny J; Janssens, Jan M A M; Hoencamp, Erik; Middelkoop, Barend J C; Hosman, Clemens M H
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).
Oliveira, Karla Regina Dias de; Liberal, Márcia Mello Costa de; Zucchi, Paola
To identify the financial resources and investments provided for preventive medicine programs by health insurance companies of all kinds. Data were collected from 30 large health insurance companies, with over 100 thousand individuals recorded, and registered at the Agência Nacional de Saúde Suplementar. It was possible to identify the percentage of participants of the programs in relation to the total number of beneficiaries of the health insurance companies, the prevention and promotion actions held in preventive medicine programs, the inclusion criteria for the programs, as well as the evaluation of human resources and organizational structure of the preventive medicine programs. Most of the respondents (46.7%) invested more than US$ 50,000.00 in preventive medicine program, while 26.7% invested more than US$ 500,000.00. The remaining, about 20%, invested less than US$ 50,000.00, and 3.3% did not report the value applied.
Guy, Heidi; Downie, Fiona; McIntyre, Lyn; Peters, Jeremy
Pressure ulcers (PUs), their cause and prevention have been discussed in the literature for many decades. Their prevention and management has been the core of a tissue viability nurse's daily clinical and strategic workload. The important point to acknowledge is that not all PUs can be prevented but it is believed most of them can and all preventative measures must be implemented and evaluated. Initial efforts focused on establishing a baseline of incidence and prevalence. More recently, the Department of Health has proposed that PUs could be eliminated in 95% of all NHS patients and incentivised the measurement of PUs and other harms by use of the NHS Safety Thermometer through the introduction of a new initiative. A research company was commissioned to explore which communications interventions would be effective in helping health professionals to prevent and treat PUs. A campaign was subsequently set in motion to educate and inform clinical staff on the cause and prevention of PUs.
Rodríguez-Jareño, Maria Cruz; Molinero, Emilia; de Montserrat, Jaume; Vallès, Antoni; Aymerich, Marta
Despite no evidence in favour, routine workers' health examinations, mostly pre-employment and periodic, are extensively performed worldwide with important allocation of resources. In Spain they are performed within a theoretical job-specific health surveillance system. Our objective was to ascertain their occupational preventive usefulness from the perspective of occupational health professionals. Cross sectional study. Online survey addressed to all physicians and nurses members of the Catalan Society of Safety and Occupational Medicine (n=539) in 2011. Univariate and bivariate analyses of prevalence and prevalence differences of answers. Response rate 53% (n=285). According to more than 70% of respondents the health surveillance system isn't cost-effective, doesn't meet the goal of early detection of health damage related to work, and doesn't contribute to improve the occupational risk prevention system. Further deficiencies were identified regarding specificity and scientific basis for health examinations, quality of collective health surveillance and referral of suspected cases to mutual insurance companies for diagnosis and treatment. Bivariate analysis showed a significantly more negative opinion for several items amongst physicians (versus nurses) and amongst professionals working in external prevention services (versus internal services). This study raises serious concerns about how health examinations are performed within our workers' health surveillance system, which should be reviewed to ensure the fulfilment of its occupational preventive objective. Our results might encourage other countries with similar practices to assess them in order to assure their fitness for purpose. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
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
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
child transmission of HIV. This study assessed health workers' knowledge of the national guidelines on preventing mother-to-child transmission of HIV in Benin City, Edo State, Nigeria Methodology: The study design was a descriptive ...
Fernandes, Iva; Pérez-Gregorio, Rosa; Soares, Susana; Mateus, Nuno; de Freitas, Victor
Wine, and particularly red wine, is a beverage with a great chemical complexity that is in continuous evolution. Chemically, wine is a hydroalcoholic solution (~78% water) that comprises a wide variety of chemical components, including aldehydes, esters, ketones, lipids, minerals, organic acids, phenolics, soluble proteins, sugars and vitamins. Flavonoids constitute a major group of polyphenolic compounds which are directly associated with the organoleptic and health-promoting properties of red wine. However, due to the insufficient epidemiological and in vivo evidences on this subject, the presence of a high number of variables such as human age, metabolism, the presence of alcohol, the complex wine chemistry, and the wide array of in vivo biological effects of these compounds suggest that only cautious conclusions may be drawn from studies focusing on the direct effect of wine and any specific health issue. Nevertheless, there are several reports on the health protective properties of wine phenolics for several diseases such as cardiovascular diseases, some cancers, obesity, neurodegenerative diseases, diabetes, allergies and osteoporosis. The different interactions that wine flavonoids may have with key biological targets are crucial for some of these health-promoting effects. The interaction between some wine flavonoids and some specific enzymes are one example. The way wine flavonoids may be absorbed and metabolized could interfere with their bioavailability and therefore in their health-promoting effect. Hence, some reports have focused on flavonoids absorption, metabolism, microbiota effect and overall on flavonoids bioavailability. This review summarizes some of these major issues which are directly related to the potential health-promoting effects of wine flavonoids. Reports related to flavonoids and health highlight some relevant scientific information. However, there is still a gap between the knowledge of wine flavonoids bioavailability and their health
Discusses application of the Health Belief Model to the prevention of bulimia, describing each model component. The article considers the individual's beliefs about bulimia and bulimic-like behaviors as a means of predicting the likelihood of behavior change to prevent clinically diagnosable bulimia. (SM)
The third sector we need to examine ~ garding progress in prevention is the activities of the dental profeSSionals themselves. As part of the continuing education programme, all dental assistants have attended a workshop' on epidemiology, health education and planning of preventive programmes. They accepted this new.
Impact of health education on home treatment and prevention of malaria. Chirdan O. O. et al. Page | 115 taken at home and dangers of self treatment. Part 3: Treatment of uncomplicated malaria and prevention of malaria. Posters and chloroquine drug charts were used as teaching aids. Post intervention impact assessment.
The increasing scourge of drug abuse among adolescents is a major challenge facing mankind. As the importance of health education in disease prevention is enormous, drug misuse prevention programme requires introducing innovations, flexibility and reinforcement which will be effective in shortest possible time among ...
Hart Graham J
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
Full Text Available Background: The provision of accurate and timely drug information to health care professionals is an important mechanism to promote safe and effective drug therapy for patients. World’s Drug and Poison Information Centers (DPICs are mainly affiliated to hospitals, rather rarely with faculties of pharmacy or with faculties of medicine and other related organizations.Methods: Data was collected from a questionnaire which was distributed among 400 health care providers in April 2009. Data were analyzed using SPSS software (version 17.Results: Medical reference books and drug information textbooks (36.7% and expert colleagues (29.7% were the “most commonly” used drug information resources. In addition, 77.8% of respondents “almost never” use DPICs. About 77% of respondents were non- acquainted with these centers’ activities. Five expectations were considered ‘very important’ by respondents: Provide information on IV drugs incompatibilities (74%, Provide drug interaction information (70.1%, Provide new drugs information (56.5%, Education/training of health care professionals regarding rational drug therapy and prevention of medication errors (54.9%, Providing information on dosage forms of drugs available in Iran (53.5%.Conclusion: Being non acquaintance with services of DPIC centers can be considered as the most important reason of not using them. Considering “announcement of availability of drugs in pharmacy” as one of the activities of DPICs, shows that the health care professionals are not acquainted with real services of these centers. It shows an urgent need for culture building activities to introduce them to these centers services.
Kistler, Christine E; Zimmerman, Sheryl; Ward, Kimberly T; Reed, David; Golin, Carol; Lewis, Carmen L
Older adults in residential care and assisted living (RC/AL) are less healthy than the general elderly population, and some have needs similar to those in nursing homes, making this an important group in which to assess potential overuse or underuse of preventive services. We determined the health status of RC/AL residents and distinguished characteristics between those who may and may not benefit from preventive services requiring a life expectancy ≥5 years. Cross-sectional survey of a nationally representative sample of RC/AL residents using 2010 data from the National Survey of Residential Care Facilities. The primary outcome was the weighted frequency distribution of health states using three predictive mortality indices: Charlson Comorbidity Index, 4-year mortality index, and 9-year mortality index. A total of 666,700 of 733,300 (weighted) residents met criteria for inclusion. Based on the three indices, 10%-15% were in good health, 11%-70% in intermediate health, and 20%-76% in poor health. Using triangulation between 3 well-validated mortality indices, 10%-15% of RC/AL residents are in good health and highly likely to benefit from preventive services that require ≥5 year life expectancy. In addition, many residents have uncertain benefit and would benefit from shared decision making. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
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
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
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
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…
Wansink, H.J.; Hosman, C.M.H.; Janssens, J.M.A.M.; Hoencamp, E.; Willems, W.J.H.
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
Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad
Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.
The limitations of what physical therapists can differ from country to country. In Japan, physical therapists are national licensed health care professionals who can help patients improve or restore their mobility. Most Japanese physical therapists provide care for people in health care facilities, medical-welfare transitional facilities, and welfare facilities for the elderly. Currently, physical therapists are unable to sufficiently contribute to primary preventive health care in Japan. However, there are many health problems that physical therapists could help alleviate. For example, low back pain (LBP) more likely than any other condition prevents people from working; thus, making the establishment of effective measures to prevent and reduce LBP vital. An estimated 20,500,000 Japanese individuals have diabetes mellitus (DM) or are at a high risk of developing the disease. DM commonly accompanies stroke and/or heart disease, and is characterized by complications that result from chronic hyperglycemia. Evidence-based physical therapy is effective for the prevention and treatment of LBP and DM. The Japanese Physical Therapy Association established the Japanese Society of Physical Therapy (JSPT) in June 2013. The JSPT has 12 departmental societies and 10 sections. We believe that the JSPT will advance the study of the potential role of physical therapists in primary preventive health care. In the future, it is expected that Japanese physical therapists will contribute to primary preventive health care.
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
Despite the interest in service quality, little research has been reported in South Africa on health and fitness service quality. The study adopted a conceptual framework for identifying factors that influence fitness service quality in commercial health and fitness centres in South Africa. A structured questionnaire containing 59 ...
Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.
Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…
Satisfaction with outpatient health services at. Jimma Hospital, South West Ethiopia. Lemessa Oljira, Solomon Gebre-Selassie. Abstract. Background: The opinions of users about the health care services and the degree of their satisfaction may indicate the efficiency of the services. Objective: To assess consumer satisfaction ...
Mickenautsch, S.; Hof, M.A. van 't; Frencken, J.E.F.M.
OBJECTIVES: To describe the provision of restorative care and dental operators' opinion about their conditions of service in a South African provincial oral health service system. DESIGN: Assessment of oral health service over a four-month period. SETTING: Gauteng Province, South Africa. SUBJECTS:
Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn
To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement. Eight studies show a significant risk of mental health disorders and poor academic achievement when exposed to childhood trauma. Seven studies found significant disparities in pediatric mental health care in the US. Nine studies reviewed SBHC mental health service access, utilization, quality, funding, and impact on school achievement. Exposure to chronic childhood trauma negatively impacts school achievement when mediated by mental health disorders. Disparities are common in pediatric mental health care in the United States. SBHC mental health services have some showed evidence of their ability to reduce, though not eradicate, mental health care disparities. © 2017, American School Health Association.
Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet
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 c