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Sample records for provincial health department

  1. Downsizing of a provincial department of health - Causes and ...

    African Journals Online (AJOL)

    Objectives. To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Design. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Setting. Western Cape (WC) Department of Health (DOH).

  2. Downsizing of a provincial department of health--causes and implications for fiscal policy.

    Science.gov (United States)

    Blecher, Mark

    2002-06-01

    To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

  3. Disparity and convergence: Chinese provincial government health expenditures.

    Directory of Open Access Journals (Sweden)

    Jay Pan

    Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

  4. Disparity and Convergence: Chinese Provincial Government Health Expenditures

    Science.gov (United States)

    Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

    2013-01-01

    The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed. PMID:23977049

  5. The determinants of Chinese provincial government health expenditures: evidence from 2002-2006 data.

    Science.gov (United States)

    Pan, Jay; Liu, Gordon G

    2012-07-01

    There is great divergence in provincial government health expenditures in China. Real per capita provincial government health expenditures (GHE) over the period 2002-2006 are examined using panel regression analysis. Key determinants of real per capita provincial GHE are real provincial per capita general budget revenue, real provincial per capita transfers from the central government, the proportion of provincial population under age 15, urban employee basic health insurance coverage, and proportion of urban population. Roughly equal and relatively low elasticities of budget revenue and transfers imply that the GHE is a necessity rather than a luxury good, and transfers have yet to become efficient instruments for the fair allocation of health resources by policy makers. Moreover, severe acute respiratory syndrome outbreak has increased the GHE, but we find no statistical evidence that provincial GHE have fluctuated according to the public health status. Copyright © 2011 John Wiley & Sons, Ltd.

  6. State and use of monitoring and evaluation systems in national and provincial departments

    Directory of Open Access Journals (Sweden)

    Futhi Umlaw

    2015-09-01

    Full Text Available Since 2009, South Africa has seen a major shift in emphasis concerning monitoring and evaluation (M&E systems. This shift was partially stimulated by the South African government being faced with a number of pressures, key amongst which were persistent poverty and inequality and widespread service delivery protests. These pressures resulted ina greater willingness by government to address the poor quality of public services, and other governance problems that needed a greater focus on M&E to address these challenges. This led to the establishment of the Department of Performance Monitoring and Evaluation (DPME in early 2010. A comprehensive survey on the state and use of M&E systems in national and provincial government was conducted by the DPME as an attempt to understand the M&E landscape since 1994. The results were used to make informed policy and programme decisions. This paper outlines the findings of the survey.

  7. Challenges in reporting on predetermined objectives to the Auditor-General: The case of Limpopo provincial departments

    Directory of Open Access Journals (Sweden)

    Melvin Diedericks

    2017-04-01

    Full Text Available Limpopo provincial departments like all other South African government departments are required to report on performance against predetermined objectives in terms of Section 40 of the Public Finance Management Act 1 of 1999, read in conjunction with Section 5.1.1 of the Treasury Regulations. The purpose of this article is to report on a study that was undertaken to establish the challenges faced by the Limpopo provincial departments in reporting on performance against predetermined objectives to the Auditor-General (AG. Reporting on predetermined objectives has been a challenge over the past financial years and this is evident in the AG’s reports, in which Limpopo provincial departments continued to receive qualified audit reports. The literature review carried out for purposes of this study revealed that performance management is fundamental to enhancing organisational performance. A qualitative research design was used to collect and analyse data. Key findings of the study included that management should prioritise strategic planning, performance reporting, monitoring and evaluation to enable it to be in a position to make a determination as to whether what was planned by the department was actually realised. It is also of paramount importance that performance reporting is highly prioritised at strategic, tactical and operational management meetings to ensure more effective and efficient organisational performance.

  8. Regional health accounts for Pakistan--expenditure disparities on provincial and district level.

    Science.gov (United States)

    Lorenz, Christian; Khalid, Muhammad

    2011-05-01

    Since May 2009 the first National Health Accounts (NHA) for Pakistan have been finalised and published by Federal Bureau of Statistics (FBS) in cooperation with German Technical Cooperation (GTZ). This paper goes one step ahead of the report and analyses in more detail the regional differences in health expenditure structures in Pakistan. The further analyses can be divided into four parts: health expenditures in provinces (Provincial Health Accounts, PHA), Punjab provincial and district governments health expenditures and its comparison with ADB figures, all districts of Pakistan and comparison between total district government and provincial government expenditure for each province; the latter calculation is applied as indication for the degree of fiscal autonomy of the districts in each province. Consequently, first the provincial health expenditures by Financial Agents is analysed and compared between the provinces which leads to very heterogeneous results (section 2); the per capita health expenditures differ from 16 to 23 USD. Secondly, NHA results on Punjab district government are compared with available ADB results and differences in methods as possible reasons for different results are presented (section 3). Third, district data of all district governments in all four Pakistani provinces are analysed on the level of detailed function codes in section 4; the aim is to discover regional differences between districts of the same as well as of different provinces. Fourth, in section 5 the degree of fiscal autonomy on health of the districts in each province is analysed; therefore the ordinance description is reviewed and total district government with total provincial government expenditures are compared per province. Finally recommendations for future rounds of NHA in Pakistan are given regarding formats and necessities of detailed health expenditure data collection to ensure evidence based decision making not only on federal, but also on provincial and

  9. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    Directory of Open Access Journals (Sweden)

    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  10. Provincial Health Accounts in Kerman, Iran: An Evidence of a “Mixed” Healthcare Financing System

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Mehrolhassani

    2014-02-01

    Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor

  11. An Assessment of Epidemiology Capacity in a One Health Team at the Provincial Level in Thailand

    Directory of Open Access Journals (Sweden)

    Soawapak Hinjoy

    2016-10-01

    Full Text Available A multi-sectoral core epidemiology capacity assessment was conducted in provinces that implemented One Health services in order to assess the efficacy of a One Health approach in Thailand. In order to conduct the assessment, four provinces were randomly selected as a study group from a total of 19 Thai provinces that are currently using a One Health approach. As a control group, four additional provinces that never implemented a One Health approach were also sampled. The provincial officers were interviewed on the epidemiologic capacity of their respective provinces. The average score of epidemiologic capacity in the provinces implementing the One Health approach was 66.45%, while the provinces that did not implement this approach earned a score of 54.61%. The epidemiologic capacity of surveillance systems in provinces that utilized the One Health approach earned higher scores in comparison to provinces that did not implement the approach (75.00% vs. 53.13%, p-value 0.13. Although none of the capacity evaluations showed significant differences between the two groups, we found evidence that provinces implementing the One Health approach gained higher scores in both surveillance and outbreak investigation capacities. This may be explained by more efficient capacity when using a One Health approach, specifically in preventing, protecting, and responding to threats in local communities.

  12. Skills development for non-core financial managers in the North West Provincial Departments - a financial management perspective and an imperative for service delivery improvement / Peter Thelele

    OpenAIRE

    Thelele, Peter

    2013-01-01

    The primary research problem revolves around lack of basic financial management skills (e.g. financial management, project management, strategic management, computer literacy, supply chain management, risk management, compliance with legislation and various regulations) among the non-core financial managers in the North West Provincial departments. These managers have been entrusted with the responsibility to manage public funds, and subsequently deliver services in terms of ...

  13. Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

    Science.gov (United States)

    Schneider, Helen; Nxumalo, Nonhlanhla

    2017-09-15

    National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes

  14. Human Resources and Vaccine Management at Provincial Health Office, District/City Health Office and Primary Health Centre

    Directory of Open Access Journals (Sweden)

    Andi Leny Susyanty

    2015-03-01

    (GAIN UCI 2010–2014 stated that the general problems of decline in immunization coverage and quality of service were caused by several things, one of which is the lack of quantity, quality and distribution of human resources. Methods: A cross-sectional mix-method study to investigate human resources in vaccine management had been conducted in two provinces in 2012. Primary data were collected by interviewing stakeholders thoroughly, secondary data collection and observation were also carried out. Analysis was done by scoring for data concerning education, length of employment, training experience and knowledge. Result:The number of Vaccine management officers are still lacking. While the immunization guidelines required minimal two officers for each health centers. Officers’ knowledge in primary health centers is still inadequate, especially in terms of the vaccine and Coldchain (Ice Lined Refrigerators. Officers at Provincial Health Office had been trained in vaccine management, but not all officers at District Health Office and Primary Health Centers had received training yet. Suggestion: This study suggests the addition of the quantity and quality of human resources in vaccine management, because the officers can affect the quality of the vaccines, because vaccines need a special handling to maintain the quality to provide immunity and prevent the occurrence of diseases that can be prevented by immunization (PD3I.Key words: vaccine, human resources, training, knowledge

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

    Science.gov (United States)

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

    2013-01-01

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

  16. The impact of HIV/AIDS on morale and productivity in a provincial government department : a case study / E. Zwane.

    OpenAIRE

    Zwane, Engeline

    2008-01-01

    The HIV/AIDS epidemic is likely to result in increased costs and declining productivity for the public sector, which eventually could lead to a decline in the morale of the employees. The enormity of the impact of HIV/AIDS will depend on the number of employees infected and affected, the composition and sustainability of the invention process and the benefits provided by the department, the capability of affected directorates and units to work with the skeleton staff and the ...

  17. Calgary Laboratory Services: A Unique Canadian Model for an Academic Department of Pathology and Laboratory Medicine Succeeding in the Face of Provincial Integration of Public, Private, and Academic Laboratories.

    Science.gov (United States)

    Wright, James R

    2015-01-01

    Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million) and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta's debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an "unhappy shotgun marriage" by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context.

  18. Economic Impacts from PM2.5 Pollution-Related Health Effects in China: A Provincial-Level Analysis.

    Science.gov (United States)

    Xie, Yang; Dai, Hancheng; Dong, Huijuan; Hanaoka, Tatsuya; Masui, Toshihiko

    2016-05-03

    This study evaluates the PM2.5 pollution-related health impacts on the national and provincial economy of China using a computable general equilibrium (CGE) model and the latest nonlinear exposure-response functions. Results show that the health and economic impacts may be substantial in provinces with a high PM2.5 concentration. In the WoPol scenario without PM2.5 pollution control policy, we estimate that China experiences a 2.00% GDP loss and 25.2 billion USD in health expenditure from PM2.5 pollution in 2030. In contrast, with control policy in the WPol scenario, a control investment of 101.8 billion USD (0.79% of GDP) and a gain of 1.17% of China's GDP from improving PM2.5 pollution are projected. At the provincial level, GDP loss in 2030 in the WoPol scenario is high in Tianjin (3.08%), Shanghai (2.98%), Henan (2.32%), Beijing (2.75%), and Hebei (2.60%) and the top five provinces with the highest additional health expenditure are Henan, Sichuan, Shandong, Hebei, and Jiangsu. Controlling PM2.5 pollution could bring positive benefits in two-thirds of provinces. Tianjin, Shanghai, Beijing, Henan, Jiangsu, and Hebei experience most benefits from PM2.5 pollution control as a result of a higher PM2.5 pollution and dense population distribution. Conversely, the control investment is higher than GDP gain in some underdeveloped provinces, such as Ningxia, Guizhou, Shanxi, Gansu, and Yunnan.

  19. [Adolescents' sexual and reproductive health knowledge and practice in a provincial Colombian town].

    Science.gov (United States)

    Rengifo-Reina, Herney A; Córdoba-Espinal, Alexandra; Serrano-Rodriguez, Mayerlin

    2012-08-01

    Identifying the sexual and reproductive health knowledge and practice of adolescents living in the town of Miranda in the Cauca department of Colombia. Across-sectional, descriptive, observational study was made. The sample involved 406 adolescents. Sociodemographic, knowledge-related and practice-based variables were explored. The adolescents had high and very high levels of knowledge; 90.5 % of the adolescents had received information about sex and pregnancy; the main source of information came from their parents (67.5 %). Safe sex for 26.7 % of the adolescents meant just using a condom. Regarding their sexuality (practice), 42 % stated that they had had sexual relationships, beginning on average when around 13-years-old. Condom use was the most used protection mechanism. 12.5 % stated that they had used psychoactive substances or alcohol to intensify sexual experience; 87.7 % stated that they would seek counselling or treatment in a hospital or health centre without telling their parents if they contracted a sexually- transmitted infection (STI). The adolescents involved in this study had high levels of knowledge; however, such knowledge is not enough to stop them beginning their sexual life early and/or increasing the probability of using a condom or contraceptive when beginning their sexual relationships.

  20. S. С Bii, MBChB,MPH, Ministry of Health, NASCOP, Provincial AIDS ...

    African Journals Online (AJOL)

    2008-01-01

    Jan 1, 2008 ... Objectives: To determine the usage of family planning services and safer sex practices among HIV infected ... general population, family planning usage is still contraception and high quality reproductive health very low. The Kenya ... Data management and analysis: Data from the structured questionnaires ...

  1. The provincial health office as performance manager: change in the local healthcare system after Thailand's universal coverage reforms.

    Science.gov (United States)

    Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

    2012-01-01

    This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.

  2. How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

    Science.gov (United States)

    Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

    2017-08-01

    Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various

  3. The effect of socioeconomic status and social inclusion on the mental health of Chinese migrants: A comparison between interprovincial and intra-provincial migrants.

    Science.gov (United States)

    Yi, Yingying; Liang, Ying

    2017-07-01

    This article sought to explore the impacts of socioeconomic status and social inclusion on intra-provincial and interprovincial migrants' mental health by constructing the Bayesian structural equation model. A total of 14,584 migrants aged 15-59 years living in eight cities of China were selected. It was found that the impacts of socioeconomic status and social inclusion on mental health were converse for these two groups. And the manifest variables coefficients of socioeconomic status and social inclusion were also converse. Therefore, governments should make some policies to further improve the mental health of migrants, including strengthening the community cohesion, social atmosphere, and governmental support.

  4. Local Fiscal Allocation for Public Health Departments.

    Science.gov (United States)

    McCullough, J Mac; Leider, Jonathon P; Riley, William J

    2015-12-01

    We examined the percentage of local government taxes ("fiscal allocation") dedicated to local health departments on a national level, as well as correlates of local investment in public health. Using the most recent data available--the 2008 National Association of City and County Health Officials Profile survey and the 2007 U.S. Census Bureau Census of Local Governments-generalized linear regression models examined associations between fiscal allocation and local health department setting, governance, finance, and service provision. Models were stratified by the extent of long-term debt for the jurisdiction. Analyses were performed in 2014. Average fiscal allocation for public health was 3.31% of total local taxes. In multivariate regressions, per capita expenditures, having a local board of health and public health service provision were associated with higher fiscal allocation. Stratified models showed that local board of health and local health department taxing authority were associated with fiscal allocation in low and high long-term debt areas, respectively. The proportion of all local taxes allocated to local public health is related to local health department expenditures, service provision, and governance. These relationships depend upon the extent of long-term debt in the jurisdiction. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Analyzing organizational practices in local health departments.

    Science.gov (United States)

    Studnicki, J; Steverson, B; Blais, H N; Goley, E; Richards, T B; Thornton, J N

    1994-01-01

    Few researchers have examined the problem of comparing the performances of local health departments. A contributing factor is the lack of a uniform method for describing the range of public health activities. The Centers for Disease Control and Prevention's Public Health Practice Program Office has identified 10 organizational practices that may be used to assure that the core functions of public health are being carried out at a local health department. The researchers determined the percentage of time devoted to each of the 10 practices by individual employees at a local public health unit in Tampa, FL. They identified the manpower expenditures and hours allocated to each of the 10 practices within the major program divisions of the unit. They found that the largest portion of manpower resources was allocated to implementing programs. A much smaller fraction of agency resources was devoted to analysis of the health needs of the community and to the development of plans and policies. Together, primary care and communicable disease programs accounted for fully three-quarters of the resources, environmental health for 11 percent, and administrative support services for 13 percent. With continuing refinement and modification, the methodology could provide a highly effective basis for describing and analyzing the activities and performances of local health departments.

  6. Forging Provincial Reconstruction Teams

    National Research Council Canada - National Science Library

    Honore, Russel L; Boslego, David V

    2007-01-01

    The Provincial Reconstruction Team (PRT) training mission completed by First U.S. Army in April 2006 was a joint Service effort to meet a requirement from the combatant commander to support goals in Afghanistan...

  7. Academic health departments: from theory to practice.

    Science.gov (United States)

    Conte, Christopher; Chang, Carol S; Malcolm, Jan; Russo, Pamela G

    2006-01-01

    In August of 2003, 23 institutions submitted proposals to build closer ties between state and local public health departments and schools of public health in response to a solicitation from the Association of Schools of Public Health supported by the Centers for Disease Control and Prevention. This article describes the strategies proposed to build collaboration between public health academia and practice. Qualitative analysis discerned five principal approaches: the development of comprehensive planning processes; reform of the way practica are planned and implemented; the identification and nurturing of boundary-spanning individuals in academia and health agencies; the fostering of new approaches to joint research; and workforce development programs. Major themes that emerged included the importance of achieving a balance of power between academic and health department partners; the need to address cultural differences between institutions; a conviction that efforts at institutional change require both strong leadership and the cultivation of boundary spanners farther down the chain of command; and the idea that prospects for success may be improved if faculty and practitioners have tangible incentives to collaborate.

  8. Provincialism within limits?

    DEFF Research Database (Denmark)

    Hesselager, Jens

    2015-01-01

    This article argues that provincial culture in the 19th century, even while presenting itself as patriotic and nationalist, may sometimes contain elements in which a certain aspiration to overcome provincialism and introduce a cosmopolitan quality to local culture is detectable. The themes...... of nationalist political propaganda, in effect – is analysed, and it is suggested that while it is certainly suffused with patriotic rhetoric (such as the occasion demanded), Rung nevertheless at the same time took the opportunity to incorporate a number of significant international musical influences, notably...

  9. W-320 Department of Health documentation

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, J.W.

    1998-08-07

    The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system.

  10. How local health departments work towards health equity.

    Science.gov (United States)

    Sokol, Rebeccah; Moracco, Beth; Nelson, Sharon; Rushing, Jill; Singletary, Tish; Stanley, Karen; Stein, Anna

    2017-12-01

    Health inequities are exacerbated when health promotion programs and resources do not reach selected populations. Local health departments (LHDs) 1 have the potential to address health equity via engaging priority populations in their work. However, we do not have an understanding of what local agencies are doing on this front. In the summer of 2016, we collaborated with informants from thirteen LHDs across North Carolina. Via semi-structured interviews, the research team asked informants about their LHD's understanding of health equity and engaging priority populations in program planning, implementation, and evaluation. All informants discussed that a key function of their LHD was to improve the health of all residents. LHDs with a more comprehensive understanding of health equity engaged members of priority populations in their organizations' efforts to a greater extent than LHDs with a more limited understanding. Additionally, while all LHDs identified similar barriers to engaging priority populations, LHDs that identified facilitators more comprehensively engaged members of the priority population in program planning, implementation, and evaluation. LHDs are ideally situated between the research and practice worlds to address health equity locally. To promote this work, we should ensure LHDs hold an understanding of health equity, have the means to realize facilitators of health equity work, and recognize the complex context in which health equity work exists. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Modeling the Dynamics and Spillovers of the Health Labor Market: Evidence from China’s Provincial Panel Data

    Directory of Open Access Journals (Sweden)

    Bin Zhu

    2018-01-01

    Full Text Available Health workforce misdistribution is a major challenge faced by almost all countries. A more profound understanding of the dynamics of the health labor market provides evidence for policy makers to balance health workforce distribution with solid evidence. However, one major deficit of existing theoretical and empirical studies is that they often ignore the intra-regional spillovers of the health labor market. This study builds a theoretical “supply–demand–spillover” model that considers both intra-regional supply and demand-side factors, and inter-regional spillovers, hence providing a theoretical reference point for further in-depth studies. Using spatial econometric panel models, the effect of all determinants and spillovers were empirically measured based on a Chinese panel data set, shedding light on health workforce policies in China.

  12. Tuberculosis in hospital department health care workers

    Directory of Open Access Journals (Sweden)

    Sandra Saleiro

    2007-11-01

    Full Text Available Introduction: Tuberculosis (TB is considered an occupational disease in health care workers (HCW and its transmission in health care facilities is an important concern. Some hospital departments are at higher risk of infection. Objective: To describe TB cases detected after TB screening in HCW from a hospital department (Ear, Nose and Throat – ENT who had had contact with active TB cases. Material and methods: All HCW (73 from Hospital São João's ENT Unit who had been in contact with two in-patients with active TB underwent TB screening. Those who had symptoms underwent chest X-ray and mycobacteriological sputum exam. Results: Of 73 HCW who underwent TB screening, TB diagnosis was established in 9 (8 female; median age: 30 years; 1 doctor, 6 nurses, 2 nursing auxiliaries. Pulmonary TB was found in 8 and extra- -pulmonary TB in 1. Microbiology diagnosis was obtained in 7 cases by sputum smear, n = 2; culture exam in bronchial lavage, n = 4 and histological exam of pleural tissue, n = 1. In 4 cases, Mycobacterium tuberculosis genomic DNA was extracted from cultures and molecular typing was done. All cases had identical MIRU types, which allowed identification of the epidemiological link. Conclusion: Nosocomial TB is prominent and efforts should be made to implement successful infection control measures in health care facilities and an effective TB screening program in HCW. Molecular typing of Mycobacterium tuberculosis facilitates cluster identification. Resumo: Introdução: A tuberculose é considerada uma doença ocupacional nos profissionais de saúde e a sua transmissão, nas instituições de saúde, constitui um problema importante. Alguns serviços hospitalares estão particularmente expostos a risco de infecção. Objectivo: Caracterizar os casos de tuberculose detectados na sequência de um rastreio efectuado aos profissionais de saúde de um serviço hospitalar

  13. The Tennessee Department of Health WORKshops on Use of Secondary Data for Community Health Assessment, 2012

    OpenAIRE

    Behringer, Bruce A.; Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B.

    2014-01-01

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community’s health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county publi...

  14. Initial integration of chiropractic services into a provincially funded inner city community health centre: a program description

    Science.gov (United States)

    Passmore, Steven R.; Toth, Audrey; Kanovsky, Joel; Olin, Gerald

    2015-01-01

    Background: The burden of fees for chiropractic services rendered often falls on the patient and must be provided out-of-pocket regardless of their socioeconomic status and clinical need. Universal healthcare coverage reduces the financial barrier to healthcare utilization, thereby increasing the opportunity for the financially disadvantaged to have access to care. In 2011 the Canadian Province of Manitoba initiated a pilot program providing access to chiropractic care within the Mount Carmel Clinic (MCC), a non-secular, non-profit, inner city community health centre. Objective: To describe the initial integration of chiropractic services into a publically funded healthcare facility including patient demographics, referral patterns, treatment practices and clinical outcomes. Method: A retrospective database review of chiropractic consultations in 2011 (N=177) was performed. Results: The typical patient referred for chiropractic care was a non-working (86%), 47.3(SD=16.8) year old, who self-identified as Caucasian (52.2%), or Aboriginal (35.8%) and female (68.3%) with a body mass index considered obese at 30.4(SD=7.0). New patient consultations were primarily referrals from other health providers internal to the MCC (71.2%), frequently primary care physicians (76%). Baseline to discharge comparisons of numeric rating scale scores for the cervical, thoracic, lumbar, sacroiliac and extremity regions all exceeded the minimally clinically important difference for reduction in musculoskeletal pain. Improvements occurred over an average of 12.7 (SD=14.3) treatments, and pain reductions were also statistically significant at pChiropractic services are being utilized by patients, and referring providers. Clinical outcomes indicate that services rendered decrease musculoskeletal pain in an inner city population. PMID:26816049

  15. Department of Defense, Deployment Health Clinical Center

    Science.gov (United States)

    ... Military Family Support Military Medical Organizations Mobile Applications Psychological Health Policy Library Real Warriors Campaign 2017 Awareness Month Campaigns inTransition News, Blog & Media PHCoE in ...

  16. Federally Qualified Health Center Substitution of Local Health Department Services.

    Science.gov (United States)

    Snider, Jeremy W; Bekemeier, Betty R; Conrad, Douglas A; Grembowski, David E

    2017-10-01

    Strategic and budgetary considerations have shifted local health departments (LHDs) away from safety net clinical services and toward population-focused services. Federally Qualified Health Centers (FQHCs) play an increasing role in the safety net, and may complement or substitute for LHD clinical services. The authors examined the association between FQHC service levels in communities and the presence of specific LHD clinical services in 2010 and 2013. Data from LHD surveys and FQHC service data were merged for 2010 and 2013. Multivariate regression and instrumental variable methods were used to examine FQHC service levels that might predict related LHD service presence or discontinuation from 2010 to 2013. There were modest reductions in LHD service presence and increases in FQHC service volume over the time period. LHD primary care and dental service presence were inversely associated with higher related FQHC service volume. LHD prenatal care service presence, as well as a measure of change in general service approach, were not significantly associated with FQHC service volume. LHDs were less likely to provide certain clinical services where FQHCs provide a greater volume of services, suggesting a substitution effect. However, certain clinical services, such as prenatal care, may complement the public health mission-and LHDs may be strategically placed to continue to deliver these services. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Chaplaincy and mental health in the department of Veterans affairs and department of defense.

    Science.gov (United States)

    Nieuwsma, Jason A; Rhodes, Jeffrey E; Jackson, George L; Cantrell, William C; Lane, Marian E; Bates, Mark J; Dekraai, Mark B; Bulling, Denise J; Ethridge, Keith; Drescher, Kent D; Fitchett, George; Tenhula, Wendy N; Milstein, Glen; Bray, Robert M; Meador, Keith G

    2013-01-01

    Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

  18. Adoption and use of social media among public health departments

    OpenAIRE

    Thackeray Rosemary; Neiger Brad L; Smith Amanda K; Van Wagenen Sarah B

    2012-01-01

    Abstract Background Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applicat...

  19. Are public health organizations tweeting to the choir? Understanding local health department Twitter followership.

    Science.gov (United States)

    Harris, Jenine K; Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

    2014-02-26

    One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and "tweeting" more frequently were associated with having a higher percentage of local followers. Social media has the potential to reach a wide and diverse audience

  20. Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership

    Science.gov (United States)

    Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

    2014-01-01

    Background One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. Conclusions Social media has the

  1. Local Health Departments’ Use of Twitter

    Centers for Disease Control (CDC) Podcasts

    2013-05-02

    This podcast is an interview with Jenine K. Harris, PhD, from the Brown School at Washington University in St. Louis, MO, about local health departments’ use of Twitter to disseminate diabetes information.  Created: 5/2/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/2/2013.

  2. The state mental hospital: a local health department's role.

    Science.gov (United States)

    Anthony, N; Leff, A M

    1979-01-01

    The publicizing of the abysmal conditions in state mental institutions and the problems precipitated by their deinstitutionalization programs, have challenged local health authorities to develop effective roles in ameliorating these difficulties. Long-view State Hospital is a state mental hospital in Cincinnati, Ohio. The Cincinnati Health Department acted as a change agent to deal with the hospital's many chronic problems and the new difficulties precipitated by moving patients into the community for care. The city conducted its own evaluation of the hospital and its deinstitutionalization program and strongly advocated needed improvements. Problems were encountered in implementing this advocacy role, particularly in relation to the local health department's authority regarding this state-funded and operated institution. However, the many city recommendations that were implemented, the increased funding given the hospital and the community mental health centers, the continuing communication between city and state officials, as well as a follow-up evaluation indicated that the Cincinnati Health Department had played a positive role in the change process. (Am. J. Public Health 69:64-67, 1979.)

  3. Department of Surgery, College of Health Sciences, University of ...

    African Journals Online (AJOL)

    East African Medical Journal Vol. 85 No. 1 January 2008. RACHS -1 SYSTEM IN RISK STRATIFICATION FOR CONGENITAL HEART DISEASE SURGERY OUTCOME. M. N. Awori, MBChB, MMed (Surg), Tutorial Fellow, and S. W. O. Ogendo, MBChB, MMed, Associate Professor,. Department of Surgery, College of Health ...

  4. Lecturer, Department of Child Health and Paediatrics, KK Kamar ...

    African Journals Online (AJOL)

    2001-10-01

    Oct 1, 2001 ... S. О. Луауа, MBChB, MMed (Paed) (Nrb), FDERM (USA), Lecturer, Department of Child Health and Paediatrics, K.K. Kamar, BVM (Nrb),. Msc (Medical ... agents responsible for it and; to recommend the correct mode of treatment in school children attending a .... chemotherapy, antibiotics, HIV/AIDS, poverty,.

  5. [A look through the Mexican Department of Health's film archive].

    Science.gov (United States)

    Gudiño Cejudo, María Rosa

    2012-03-01

    Since the late 1920s, cinema has been a popular tool in health education in Mexico; over the years, it functioned as an efficient means of propaganda through which the State and public health authorities promoted their projects and re-created the image of a healthy, modern country on screen. The article presents the results of an effort to recover and catalogue the Mexican Department of Health's film archive, an endeavor that allowed for the reconstruction of a list of national and international films screened and produced in Mexico from 1943 to 1960, especially from the United States.

  6. Hepatitis B among young people in Lere health department (Chad)

    OpenAIRE

    Djongali Tchonchimbo; Ali Mahamat Moussa; Gabkika Bray Madoue; Djongali Berniba; Julian Süsstrunk

    2016-01-01

    Background: Hepatitis B is an infectious disease that affects many people worldwide. It may be acute or chronic. Age-specific prevalence varies by geographical region with highest endemicity levels in sub-Saharan Africa and prevalence below 2% in regions such as tropical and central Latin America, North America and Western Europe. Objective: To determine the frequency and characteristics of infected persons with hepatitis B among people from the Lere health department. Participants an...

  7. Comparison of brief health literacy screens in the emergency department.

    Science.gov (United States)

    Kiechle, Eric S; Hnat, Andrew T; Norman, Kenneth E; Viera, Anthony J; DeWalt, Darren A; Brice, Jane H

    2015-01-01

    Measuring health literacy efficiently yet accurately is of interest both clinically and in research. The authors examined 6 brief health literacy measures and compared their categorization of patient health literacy levels and their comparative associations with patients' health status. The authors assessed 400 emergency department patients with the Short Test of Functional Health Literacy in Adults, the Newest Vital Sign, Single Item Literacy Screen, brief screening questions, Rapid Estimate of Adult Literacy in Medicine-Revised, and the Medical Term Recognition Test. The authors analyzed data using Spearman's correlation coefficients and ran separate logistic regressions for each instrument for patient self-reported health status. Tests differed in the proportion of patients' skills classified as adequate, but all instruments were significantly correlated; instruments targeting similar skills were more strongly correlated. Scoring poorly on any instrument was significantly associated with worse health status after adjusting for age, sex and race, with a score in the combined inadequate/marginal category on the Short Test of Functional Health Literacy in Adults carrying the largest risk (OR = 2.94, 95% CI [1.23, 7.05]). Future research will need to further elaborate instrument differences in predicting different outcomes.

  8. A rural local health department-hospital collaborative for a countywide community health assessment.

    Science.gov (United States)

    Sampson, Gretchen; Miner Gearin, Kim J; Boe, Mary

    2015-01-01

    In mid-2012, the Polk County Health Department initiated a community health needs assessment process with the 3 medical centers serving this rural Wisconsin county of 45 000 residents. The collaborative process drew on primary and secondary data, including clinical data pooled from health care organizations, to assess population health. Community health assessment ultimately engaged more than 1800 county residents through coordinated surveys and community forums. Although the Polk County Health Department has a long history of collaboration with the local health care community, the Patient Protection and Affordable Care Act, coupled with meaningful use requirements for health care providers, sharply increased engagement, contributed to shared priorities, and brought this relationship to a new level. Partners have now convened community-based workgroups around the top 3 health focus areas selected from the assessment process. Community health assessment emphasized the social determinants of health as a step toward a more "upstream" orientation to population health goals.

  9. The Public Health Nurse Workforce in U.S. State and Local Health Departments, 2012.

    Science.gov (United States)

    Beck, Angela J; Boulton, Matthew L

    2016-01-01

    Public health nurses (PHNs) represent the single largest group of public health practitioners working in U.S. state and local health departments. Despite the important role of PHNs in the delivery and administration of public health services, little research has been conducted on this group and relatively little is known about PHN education, training, and retirement intentions. We describe the findings of a nationally representative survey of PHNs working in state and local health departments by characterizing their educational background and plans for retirement. An advisory committee convened by the University of Michigan Center of Excellence in Public Health Workforce Studies developed the Public Health Nurse Workforce Survey and disseminated it in 2012 to 50 U.S. state and 328 local health departments. The 377 responding state and local health departments reported an estimated 34,521 full-time equivalent registered nurses in their employ, with PHNs or community health nurses as the largest group of workers (63%). Nearly 20% of state health department PHNs and 31% of local health department PHNs were educated at the diploma or associate's degree level. Approximately one-quarter of PHNs were determined to be eligible for retirement by 2016. Professional development and promotion opportunities, competitive benefits and salary, and hiring procedures were among the recruitment and retention issues reported by health departments. PHNs were reported to have highly variable occupational classifications and educational backgrounds in health departments. Additional training opportunities are needed for PHNs with diploma and associate's degrees. A shortage of PHNs is possible due to retirement eligibility and administrative barriers to recruitment and retention.

  10. Quality improvement in local health departments: progress, pitfalls, and potential.

    Science.gov (United States)

    Leep, Carolyn; Beitsch, Leslie M; Gorenflo, Grace; Solomon, Jessica; Brooks, Robert G

    2009-01-01

    To assess the current deployment of quality improvement (QI) approaches within local health departments (LHDs) and gain a better understanding of the depth and intensity of QI activities. A mixed quantitative and qualitative approach was employed to determine the current status of QI utilization within LHDs. All respondents from the 2005 NACCHO Profile QI module questionnaire who indicated that their LHD was involved in some kind of QI activity received a follow-up Web-based survey in 2007. A smaller convenience sample of 30 LHDs representing all groups of respondents was selected for the follow-up interview to validate and expound upon survey data. Survey response rate was 62 percent (181/292). Eighty-one percent of LHDs reported QI programmatic activities, with 39 percent occurring agency-wide. Seventy-four percent of health departments had staff trained in QI methods. External funding sources for QI were infrequent (28%). LHDs that were serving large jurisdictions and LHDs that were subunits of state health agencies (centralized states) were more likely to engage in most QI activities. However, interview responses did not consistently corroborate survey results and noted a need for shared definitions. Multiple factors, including funders and accreditation, may be driving the increase of QI for public health. Additional research to confirm and validate these findings is necessary. A common QI vocabulary is also recommended.

  11. Good medical ethics, justice and provincial globalism.

    Science.gov (United States)

    Prah Ruger, Jennifer

    2015-01-01

    The summer 2014 Ebola virus outbreak in Western Africa illustrates global health's striking inequalities. Globalisation has also increased pandemics, and disparate health system conditions mean that where one falls ill or is injured in the world can mean the difference between quality care, substandard care or no care at all, between full recovery, permanent ill effects and death. Yet attention to the normative underpinnings of global health justice and distribution remains, despite some important exceptions, inadequate in medical ethics, bioethics and political philosophy. We need a theoretical foundation on which to build a more just world. Provincial globalism (PG), grounded in capability theory, offers a foundation; it provides the components of a global health justice framework that can guide implementation. Under PG, all persons possess certain health entitlements. Global health justice requires progressively securing this health capabilities threshold for every person. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. [Health care system sustainability and the contribution of emergency departments].

    Science.gov (United States)

    Urbanos-Garrido, Rosa María; López-Valcárcel, Beatriz G

    2015-06-01

    The purpose of this paper is to describe the main proposals for ensuring national health service sustainability, in the light of a review of the most relevant diagnostic reports and guidelines published since the onset of the economic crisis. The following proposals are among the most frequently mentioned in the literature: selective financing of technology, reorganization to provide more care for chronic conditions and better coordination between levels of care and the network of social and health care services, and the reinforcement of primary care. Also commonly suggested is the reform of health care governance. Likewise, the authors briefly examine the measures adopted to date to promote the system's sustainability and discuss how the emergency department can further this aim.

  13. Development of a Research Agenda Focused on Academic Health Departments.

    Science.gov (United States)

    Erwin, Paul Campbell; Brownson, Ross C; Livingood, William C; Keck, C William; Amos, Kathleen

    2017-09-01

    An academic health department (AHD) is a formal partnership between an academic institution and a governmental public health agency. Case studies have described the value of individual AHDs in the areas of student engagement, practice-based research, workforce development, and service. With growing interest in AHDs and the increasing importance of academic-practice linkages in both academic programs' and public health agencies' accreditation processes, articulating a research agenda focused on the AHD model can be useful for stimulating the research and practice fields to further develop the evidence base for AHDs. We provide a research agenda, developed through an iterative process involving academicians, practitioners, and others interested in academic-practice linkages.

  14. Social media adoption in local health departments nationwide.

    Science.gov (United States)

    Harris, Jenine K; Mueller, Nancy L; Snider, Doneisha

    2013-09-01

    We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs. In 2012, we searched for Facebook and Twitter accounts for 2565 LHDs nationwide, and collected adoption date and number of connections for each account. Number of tweets sent indicated LHD use of social media. LHDs were classified as innovators, early adopters, or nonadopters. Characteristics of LHDs were compared across adoption categories, and we examined geographic characteristics, connections, and use. Twenty-four percent of LHDs had Facebook, 8% had Twitter, and 7% had both. LHDs serving larger populations were more likely to be innovators, tweeted more often, and had more social media connections. Frequency of tweeting was not associated with adoption category. There were differences in adoption across geographic regions, with western states more likely to be innovators. Innovation was also higher in states where the state health department adopted social media. Social media has the potential to aid LHDs in disseminating information across the public health system. More evidence is needed to develop best practices for this emerging tool.

  15. Analysis of the current status of public health practice in local health departments.

    Science.gov (United States)

    Suen, J; Christenson, G M; Cooper, A; Taylor, M

    1995-01-01

    This article describes the performance by local health departments of core public health functions. A post hoc analysis based on these essential functions was implemented using the 1994 dataset from a cooperative project with the Centers for Disease Control and Prevention (CDC) and National Association of County and City Health Officials, which involved a survey of the nation's 2,888 local health departments. Applying guidelines for each functional area drafted by the Office of Disease Prevention and Health Promotion/Office of the Assistant Secretary for Health, CDC, and the Public Health Foundation in conjunction with the health officers in five states, a score was created for each core public health function: (1) health-related data collection, surveillance, and outcomes monitoring, (2) protection of environment, housing, food, and water, (3) investigation and control of diseases and injuries, (4) public information and education, (5) accountability and quality assurance, (6) laboratory services, (7) training and education, and (8) leadership, policy development, and administration. The individual and summary scores provide a mechanism to measure and describe the 2,079 local health departments' performance of these core functions and to examine their relationship to several characteristics and practices--planning, administrative units, annual total expenditures, and jurisdiction population size. This article shows that the core performance index is highest for the data function and for local health departments serving a population of 50,000 or more people. In addition, the performance index increases as budget increases and is greater for all eight functions in those local health departments using health planning models such as Assessment Protocol for Excellence in Public Health (APEX-PH), Planned Approach to Community Health (PATCH), Healthy People 2000, or Healthy Communities 2000. These results may be used to facilitate cooperation between local, state, and

  16. Local Health Department Engagement in Community Physical Activity Policy.

    Science.gov (United States)

    Goins, Karin V; Ye, Jiali; Leep, Carolyn J; Robin, Nathalie; Lemon, Stephenie C

    2016-01-01

    This study assessed correlates of self-reported local health department (LHD) participation in community policy/advocacy activities that support physical activity. In 2014, cross-sectional data from the nationally representative 2013 National Profile of Local Health Departments study administered by the National Association of County and City Health Officials were analyzed. Outcomes were participation in policy/advocacy activities related to urban design/land use, active transportation, and access to recreational facilities. Independent variables included structural characteristics, performance improvement efforts, and collaboration. Multivariate logistic regression models were computed. Representatives of 490 LHDs participated (79% response rate). Respondents reported similar participation in urban design/land use (25%); active transportation (16%); and recreational facility access (23%) policy/advocacy. LHDs with populations of ≥500,000 were more likely to report urban design/land use (p=0.004) as well as active transportation policy/advocacy participation (p=0.007) compared with those with populations of ≤50,000. LHDs with a community health improvement plan were more likely to participate in urban design/land use policy/advocacy (p=0.001). LHDs who regularly use the Community Guide were more likely to report policy/advocacy activity on active transportation (p=0.007) and expanding access to recreation facilities (p=0.009). LHDs engaged in a land use partnership were more likely to report urban design/land use (ptransportation (p=0.001) policy/advocacy participation. Participation in community physical activity policy/advocacy among LHDs was low in this study and varied by LHD characteristics. Intervention opportunities include assisting smaller LHDs and promoting performance improvement efforts and evidence-based practice resources. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Hepatitis B among young people in Lere health department (Chad

    Directory of Open Access Journals (Sweden)

    Djongali Tchonchimbo

    2016-08-01

    Full Text Available Background: Hepatitis B is an infectious disease that affects many people worldwide. It may be acute or chronic. Age-specific prevalence varies by geographical region with highest endemicity levels in sub-Saharan Africa and prevalence below 2% in regions such as tropical and central Latin America, North America and Western Europe. Objective: To determine the frequency and characteristics of infected persons with hepatitis B among people from the Lere health department. Participants and method: A 2-month cross-sectional survey was performed in eleven villages in the Lere health department, Chad. At least 100 young people were screened in each village giving a total study population of 1,150 (607 males and 543 females aged ≤ 25 years. Those immunized against hepatitis B were excluded. Studied variables were: age, sex, ethnic group and the results of testing. Results: Hepatitis B tests were positive in 268 cases (23.3% – 95% of these were from the Moundang ethnic group. Thirty two per cent of boys and 19% of girls aged ≤15 years were infected; 25% of boys and 13% of girls aged over 15 years were infected. Conclusion: This study shows a high prevalence of hepatitis B in a rural area in Chad. The high proportion among youths aged ≤15 years indicates that the main way of infection is likely to be the fetal- maternal transmission.

  18. Downsizing and health at the United States Department of Energy.

    Science.gov (United States)

    Pepper, Lewis; Messinger, Miriam; Weinberg, Janice; Campbell, Richard

    2003-11-01

    Downsizing and reorganization not only affect workers who lose their jobs, but even workers who retain their jobs are affected in negative ways. The present study measured how downsizing was accomplished at five Department of Energy facilities by evaluating communication with workers, perceived fairness of the process, and job characteristics, and how each of these were associated with worker health and well-being. The researchers collected quantitative data using structured surveys, and captured qualitative data using interviews, focus groups, and open-ended survey responses. Employees, who felt that the downsizing process was fair, and that communication was open and honest, reported fewer medical symptoms, lower survivor syndrome, and more job security than their counterparts. Employees who were less immediately impacted by downsizing reported fewer medical symptoms than those who were more directly involved (e.g., delivered layoff notices, changed jobs, etc.) Thus, downsizing appears to affect the health of survivors, through the effects of the downsizing process. This examination of the effect of downsizing on the physical and mental health of surviving employees supports the conclusion that the impact of downsizing is not limited to those who lose their jobs and highlights the potential repercussions of downsizing on the emotional health of employees. Copyright 2003 Wiley-Liss, Inc.

  19. Public Health Staff Development Needs in Informatics: Findings From a National Survey of Local Health Departments

    OpenAIRE

    Massoudi, Barbara L; Chester, Kelley; Shah, Gulzar H.

    2016-01-01

    Context: Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area. Objective: To describe the staff development needs of local health departments (LHDs) related to informatics. Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & ...

  20. Organizing emergency preparedness within United States public health departments.

    Science.gov (United States)

    Duncan, W J; Ginter, P M; Rucks, A C; Wingate, M S; McCormick, L C

    2007-04-01

    We examined the manner in which state public health agencies have organized their operations to accomplish the goals associated with emergency preparedness (EP) funds. We also examined the leadership challenges associated with the effective utilization of preparedness funds. The websites of all 50 state public health organizations in the USA were examined in order to determine the different approaches that states have used to organize for preparedness. Thirty-eight states provided sufficient information to allow for classification of their organizational approach to EP. Telephone interviews were conducted with representatives in three model states to obtain deeper insights into the organizational approach. Three predominant organizational models were identified as a means to address the challenge of organizing for preparedness. The results confirmed the equifinality principle of organization (there may be more than one equally effective way to organize) and demonstrated that, contrary to the prescription of early management thought, there is no 'one best way' to organize. Leadership rather than formal management emerged as the primary contributor to perceived EP. Specifically, interviews with preparedness professionals indicated that they believed expert power was more important than position power and the ability to negotiate and influence through persuasion was more important than formal authority. All three models contained, to a greater or lesser degree, elements of matrix management with the associated leadership challenges for emergency preparedness (EP) directors. Recommendations were provided for successful leadership in the context of EP directors in state departments of public health.

  1. State procurement law: facilitating the collaboration between health department and school of public health.

    Science.gov (United States)

    Huber, George A; Barron, Gerald M; Duchak, Linda S; Raniowski, Martin; Alsahlani, Hazem S; Potter, Margaret A

    2014-01-01

    The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.

  2. Assessing Skills and Capacity for Informatics: Activities Most Commonly Performed by or for Local Health Departments.

    Science.gov (United States)

    Drezner, Kate; McKeown, Lisa; Shah, Gulzar H

    2016-01-01

    To describe the informatics activities performed by and for local health departments. Analysis of data from the 2015 Informatics Capacity and Needs Assessment Survey of local health departments conducted by the Jiann-Ping Hsu College of Public Health at Georgia Southern University in collaboration with the National Association of County & City Health Officials. 324 local health departments. Informatics activities performed at or for local health departments in use and analysis of data, system design, and routine use of information systems. A majority of local health departments extract data from information systems (69.5%) and use and interpret quantitative (66.4%) and qualitative (55.1%) data. Almost half use geographic information systems (45.0%) or statistical or other analytical software (39.7%). Local health departments were less likely to perform project management (35.8%), business process analysis and redesign (24.0%), and developing requirements for informatics system development (19.7%). Local health departments were most likely to maintain or modify content of a Web site (72.1%). A third of local health departments (35.8%) reported acting as "super users" for their information systems. A significantly higher proportion of local health departments serving larger jurisdictions (500 000+) and those with shared governance reported conducting informatics activities. Most local health department informatics activities are completed by local health department staff within each department or a central department, but many state health departments also contribute to informatics at the local level. Larger local health departments and those with shared governance were more likely to perform informatics activities. Local health departments need effective leadership, a skilled workforce, strong partnerships, and policies that foster implementation of health information systems to successfully engage in informatics. Local health departments also face important

  3. Improving public health preparedness capacity measurement: development of the local health department preparedness capacities assessment survey.

    Science.gov (United States)

    Davis, Mary V; Mays, Glen P; Bellamy, James; Bevc, Christine A; Marti, Cammie

    2013-12-01

    To address limitations in measuring the preparedness capacities of health departments, we developed and tested the Local Health Department Preparedness Capacities Assessment Survey (PCAS). Preexisting instruments and a modified 4-cycle Delphi panel process were used to select instrument items. Pilot test data were analyzed using exploratory factor analysis. Kappa statistics were calculated to examine rater agreement within items. The final instrument was fielded with 85 North Carolina health departments and a national matched comparison group of 248 health departments. Factor analysis identified 8 initial domains: communications, surveillance and investigation, plans and protocols, workforce and volunteers, legal infrastructure, incident command, exercises and events, and corrective action. Kappa statistics and z scores indicated substantial to moderate agreement among respondents in 7 domains. Cronbach α coefficients ranged from 0.605 for legal infrastructure to 0.929 for corrective action. Mean scores and standard deviations were also calculated for each domain and ranged from 0.41 to 0.72, indicating sufficient variation in the sample to detect changes over time. The PCAS is a useful tool to determine how well health departments are performing on preparedness measures and identify opportunities for future preparedness improvements. Future survey implementation will incorporate recent Centers for Disease Control and Prevention's Public Health Preparedness Capabilities: National Standards for State and Local Planning.

  4. Adoption and use of social media among public health departments

    Directory of Open Access Journals (Sweden)

    Thackeray Rosemary

    2012-03-01

    Full Text Available Abstract Background Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1 the extent to which state public health departments (SHDs are using social media; 2 which social media applications are used most often; and 3 how often social media is used interactively to engage audiences. Methods This was a non-experimental, cross sectional study of SHD social media sites. Screen capture software Snag-It® was used to obtain screenshots of SHD social media sites across five applications. These sites were coded for social media presence, interactivity, reach, and topic. Results Sixty percent of SHDs reported using at least one social media application. Of these, 86.7% had a Twitter account, 56% a Facebook account, and 43% a YouTube channel. There was a statistically significant difference between average population density and use of social media (p = .01. On average, SHDs made one post per day on social media sites, and this was primarily to distribute information; there was very little interaction with audiences. SHDs have few followers or friends on their social media sites. The most common topics for posts and tweets related to staying healthy and diseases and conditions. Limitations include the absence of a standard by which social media metrics measure presence, reach, or interactivity; SHDs were only included if they had an institutionally maintained account; and the study was cross sectional. Conclusions Social media use by public health agencies is in the early adoption stage. However, the reach of social media is limited. SHDs are using social media as a channel to distribute information rather than capitalizing on the interactivity

  5. Adoption and use of social media among public health departments.

    Science.gov (United States)

    Thackeray, Rosemary; Neiger, Brad L; Smith, Amanda K; Van Wagenen, Sarah B

    2012-03-26

    Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applications are used most often; and 3) how often social media is used interactively to engage audiences. This was a non-experimental, cross sectional study of SHD social media sites. Screen capture software Snag-It® was used to obtain screenshots of SHD social media sites across five applications. These sites were coded for social media presence, interactivity, reach, and topic. Sixty percent of SHDs reported using at least one social media application. Of these, 86.7% had a Twitter account, 56% a Facebook account, and 43% a YouTube channel. There was a statistically significant difference between average population density and use of social media (p = .01). On average, SHDs made one post per day on social media sites, and this was primarily to distribute information; there was very little interaction with audiences. SHDs have few followers or friends on their social media sites. The most common topics for posts and tweets related to staying healthy and diseases and conditions. Limitations include the absence of a standard by which social media metrics measure presence, reach, or interactivity; SHDs were only included if they had an institutionally maintained account; and the study was cross sectional. Social media use by public health agencies is in the early adoption stage. However, the reach of social media is limited. SHDs are using social media as a channel to distribute information rather than capitalizing on the interactivity available to create conversations and engage with the audience. If

  6. Local Health Departments Tweeting About Ebola: Characteristics and Messaging.

    Science.gov (United States)

    Wong, Roger; Harris, Jenine K; Staub, Mackenzie; Bernhardt, Jay M

    The first imported US Ebola hemorrhagic fever case during the 2014 West Africa Ebola outbreak triggered an increase in online activity through various social media platforms, including Twitter. The purpose of our study was to examine characteristics of local health departments (LHDs) tweeting about Ebola, in addition to how and when LHDs were communicating Ebola-related messages. All tweets sent by 287 LHDs known to be using Twitter were collected from September 3 to November 2, 2014. Twitter data were merged with the 2013 National Association of County & City Health Officials Profile study to assess LHD characteristics associated with sending Ebola-related tweets. To examine the content of Ebola tweets, we reviewed all such tweets and developed a codebook including 4 major message categories: information giving, news update, event promotion, and preparedness. A time line tracking the trends in Ebola tweets was created by aligning daily tweets with major Ebola news events posted on the Centers for Disease Control and Prevention Ebola Web site. Approximately 60% (n = 174) of all LHDs using Twitter sent a total of 1648 Ebola-related tweets during the study period. Sending more tweets in general (odds ratio: 2.42; 95% confidence interval, 1.00-5.84) and employing at least 1 public information specialist (odds ratio: 2.61; 95% confidence interval, 1.14-5.95) significantly increased the odds that an LHD tweeted about Ebola. Of all the Ebola tweets collected, 78.6% were information giving, 22.5% were on preparedness, 20.8% were news updates, and 10.3% were event promotion tweets. A temporal analysis of Ebola tweets indicated 5 distinct waves, each corresponding with major Ebola news events. Twitter has become a communication tool frequently used by many LHDs to respond to novel outbreaks, but messaging strategies vary widely across LHDs. We recommend that LHDs increase tweet frequency during public health emergencies in order to ensure timely dissemination of critical

  7. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

    Data.gov (United States)

    Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

  8. Mindfulness and mental toughness among provincial adolescent ...

    African Journals Online (AJOL)

    , scant attention has been paid to the psychological processes that underpin mental toughness. Objectives: To explore the relationship between mindfulness and mental toughness among provincial adolescent female hockey players.

  9. Variation in local health department primary care services as a function of health center availability.

    Science.gov (United States)

    Wright, Brad; Nice, Andrew J

    2015-01-01

    We aim to gain a clearer understanding of the effect of colocated federally qualified health centers (FQHCs) on the delivery of primary care and preventive services by local health departments (LHDs). We collected data from the 2010 National Association of County & City Health Officials Profile of Local Health Departments, the 2010 Uniform Data System, and the 2011 Area Resource File. Forty-eight states, excluding Rhode Island and Hawaii. The analytic sample contained data on 2107 LHDs across the country. We modeled 4 measures of primary care activity for each LHD: provision of screening for (1) heart disease, (2) diabetes, and (3) hypertension, and (4) provision of comprehensive primary care. Local health departments in counties with an FQHC grantee have, on average, 32% lower odds of providing hypertension screening, but having an FQHC grantee in the county does not influence LHDs' primary care provision or screening for heart disease or diabetes. However, in an alternate model examining FQHC delivery sites per capita, each site is associated with a decrease in the odds of LHDs providing primary care (4% lower odds) or screening for heart disease (2% lower odds), diabetes, or hypertension (both 1% lower odds). Local health departments are more involved in disease screening than the provision of primary care. However, larger LHDs are more likely to provide both screening and primary care. Our current study provides evidence that the availability of an FQHC in the same county as an LHD partially explains the variation in LHDs' provision of primary care services. Local health departments with colocated FQHCs can focus on more traditional public health activities, while LHDs in areas without an FQHC may find that ensuring access to care is more challenging, possibly leading LHDs to directly provide primary care services.

  10. Human health hazards of veterinary medications: information for emergency departments.

    Science.gov (United States)

    Lust, Elaine Blythe; Barthold, Claudia; Malesker, Mark A; Wichman, Tammy O

    2011-02-01

    There are over 5000 approved prescription and over-the-counter medications, as well as vaccines, with labeled indications for veterinary patients. Of these, there are several products that have significant human health hazards upon accidental or intentional exposure or ingestion in humans: carfentanil, clenbuterol (Ventipulmin), ketamine, tilmicosin (Micotil), testosterone/estradiol (Component E-H and Synovex H), dinoprost (Lutalyse/Prostamate), and cloprostenol (Estromate/EstroPlan). The hazards range from mild to life-threatening in terms of severity, and include bronchospasm, central nervous system stimulation, induction of miscarriage, and sudden death. To report medication descriptions, human toxicity information, and medical management for the emergent care of patients who may have had exposure to veterinary medications when they present to an emergency department (ED). The intended use of this article is to inform and support ED personnel, drug information centers, and poison control centers on veterinary medication hazards. There is a need for increased awareness of the potential hazards of veterinary medications within human medicine circles. Timely reporting of veterinary medication hazards and their medical management may help to prepare the human medical community to deal with such exposures or abuses when time is of the essence. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and Other Informatics Systems.

    Science.gov (United States)

    Shah, Gulzar H; Leider, Jonathon P; Castrucci, Brian C; Williams, Karmen S; Luo, Huabin

    2016-01-01

    Assessing local health departments' (LHDs') informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs' adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting. We used data from the National Association of County and City Health Officials' 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity. Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job. Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls.

  12. Emergency department naloxone distribution: a Rhode Island department of health, recovery community, and emergency department partnership to reduce opioid overdose deaths.

    Science.gov (United States)

    Samuels, Elizabeth

    2014-10-01

    In response to increasing rates of opioid overdose deaths in Rhode Island (RI), the RI Department of Health, RI emergency physicians, and Anchor Community Recovery Center designed an emergency department (ED) naloxone distribution and peer-recovery coach program for people at risk of opioid overdose. ED patients at risk for overdose are offered a take home naloxone kit, patient education video, and, when available, an Anchor peer recovery coach to provide recovery support and referral to treatment. In August 2014, the program launched at Kent, Miriam, and Rhode Island Hospital Emergency Departments.

  13. Evaluating the level of adherence to Ministry of Health guidelines in the management of Severe Acute Malnutrition at Garissa Provincial General hospital, Garissa, Kenya

    Science.gov (United States)

    Warfa, Osman; Njai, Daniel; Ahmed, Laving; Admani, Bashir; Were, Fred; Wamalwa, Dalton; Osano, Boniface; Mburugu, Patrick; Mohamed, Musa

    2014-01-01

    Introduction Half of Kenya's high infant and under five mortality rates is due to malnutrition. Proper implementation of World Health Organization's (WHO) Evidence Based Guidelines (EBG) in management of severe acute malnutrition can reduce mortality rates to less than 5%. The objectives were to establish the level of adherence to WHO guideline and the proportion of children appropriately managed for severe acute malnutrition (steps 1-8) as per the WHO protocol in the management of severe acute malnutrition. This was a short longitudinal study of 96 children, aged 6-59 months admitted to the pediatric ward with diagnosis of severe acute malnutrition. Methods Data was extracted from patients’ medical files and recorded into an audit tool to compare care provided in this hospital with WHO guidelines. Results Non-edematous malnutrition was the commonest presentation (93.8%). A higher proportion (63.5%) of patients was male. Most (85.4%) of patients were younger than 2 years. Patients with non-edematous malnutrition were younger (mean age for non-edematous malnutrition was 16 (± 10.6) months versus 25 (± 13.7) months in edematous malnutrition). The commonest co- morbid condition was diarrhea (52.1%). Overall, 13 children died giving an inpatient case fatality rate of 13.5%. Appropriate management was documented in only 14.6% for hypoglycemia (step1), 5.2% for hypothermia (step 2) and 31.3% for dehydration (step 3). Conclusion The level of adherence to MOH guidelines was documented in 5 out of the 8 steps. Appropriate management of children with severe acute malnutrition was inadequate at Garissa hospital. PMID:25237411

  14. Primary Health Care and partnerships: collaboration of a community agency, health department, and university nursing program.

    Science.gov (United States)

    Leonard, L G

    1998-03-01

    Health care reform proposals emphasize health care that is essential, practical, scientifically sound, coordinated, accessible, appropriately delivered, and affordable. One route to achievement of improved health outcomes within these parameters is the formation of partnerships. Partnerships adopting the philosophy and five principles of Primary Health Care (PHC) focus on health promotion and prevention of illness and disability, maximum community participation, accessibility to health and health services, interdisciplinary and intersectoral collaboration, and use of appropriate technologies such as resources and strategies. A community service agency serving a multicultural population initiated a partnership with a health department and a university undergraduate nursing program. The result was a preschool health fair and there were benefits for each partner-benefits which could not have been realized without the collaboration. The health fair partnership planning, implementation, and evaluation process was guided by a framework shaped by the philosophy and five principles of PHC. The educational process described can be applied to other learning experiences where the goal is to help students understand and apply the concepts of PHC, develop myriad nursing competencies, and form collaborative relationships with the community and health agencies. Community health care dilemmas and nursing education challenges can be successfully addressed when various disciplines and sectors form effective partnerships.

  15. 32 CFR 644.432 - Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health...

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Assignment to Department of Health, Education... to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational... Health, Education, and Welfare (HEW), to sell or lease surplus real property for such purposes. Pursuant...

  16. Network analysis of Chinese provincial economies

    Science.gov (United States)

    Sun, Xiaoqi; An, Haizhong; Liu, Xiaojia

    2018-02-01

    Global economic system is a huge network formed by national subnetworks that contains the provincial networks. As the second largest world economy, China has "too big to fail" impact on the interconnected global economy. Detecting the critical sectors and vital linkages inside Chinese economic network is meaningful for understanding the origin of this Chinese impact. Different from tradition network research at national level, this paper focuses on the provincial networks and inter-provincial network. Using Chinese inter-regional input-output table to construct 30 provincial input-output networks and one inter-provincial input-output network, we identify central sectors and vital linkages, as well as analyze economic structure similarity. Results show that (1) Communication Devices sector in Guangdong and that in Jiangsu, Transportation and Storage sector in Shanghai play critical roles in Chinese economy. (2) Advanced manufactures and services industry occupy the central positions in eastern provincial economies, while Construction sector, Heavy industry, and Wholesale and Retail Trades sector are influential in middle and western provinces. (3) The critical monetary flow paths in Chinese economy are Communication Devices sector to Communication Devices sector in Guangdong, Metals Mining sector to Iron and Steel Smelting sector in Henan, Communication Devices sector to Communication Devices sector in Jiangsu, as well as Petroleum Mining sector in Heilongjiang to Petroleum Processing sector in Liaoning. (4) Collective influence results suggest that Finance sector, Transportation and Storage sector, Production of Electricity and Heat sector, and Rubber and Plastics sector in Hainan are strategic influencers, despite being weakly connected. These sectors and input-output relations are worthy of close attention for monitoring Chinese economy.

  17. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    Science.gov (United States)

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell

    2008-03-01

    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served.

  18. Involving Local Health Departments in Community Health Partnerships: Evaluation Results from the Partnership for the Public’s Health Initiative

    Science.gov (United States)

    Hsu, Clarissa; Schwartz, Pamela M.; Pearson, David; Greenwald, Howard P.; Beery, William L.; Flores, George; Casey, Maria Campbell

    2008-01-01

    Improving community health “from the ground up” entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an “inter-sector” enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public’s Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative’s five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served. PMID:18259870

  19. Measures of Local Segregation for Monitoring Health Inequities by Local Health Departments.

    Science.gov (United States)

    Krieger, Nancy; Waterman, Pamela D; Batra, Neelesh; Murphy, Johnna S; Dooley, Daniel P; Shah, Snehal N

    2017-06-01

    To assess the use of local measures of segregation for monitoring health inequities by local health departments. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43, 1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40, 1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.

  20. Provincial corruption and local development bank performance

    Directory of Open Access Journals (Sweden)

    Murharsito Murharsito

    2017-03-01

    Full Text Available This paper investigates the effect of provincial corruption on the performance of local development bank, specifically to the profitability and credit quality. We use the data of 26 local development banks in 2012 and 2013. For the provincial corruption measurement we use “Public Institution Openness Index”. Results of this study are first, corruption significantly has a negative effect on the profitability of local development bank. Second, corruption doesn’t affect the credit quality of local development bank. These results are expected to enrich the within country corruption effect to the economic studies, particularly to the local development bank which is infrequently investigated.

  1. Leadership matters: local health department clinician leaders and their relationship to decreasing health disparities.

    Science.gov (United States)

    Bekemeier, Betty; Grembowski, David; Yang, Youngran; Herting, Jerald R

    2012-01-01

    The activities that local health departments (LHDs) conduct and their workforce characteristics change over time. We know little, however, about how changes among the services LHDs conduct are associated with the nature of LHD leadership and how these factors impact health. This study investigated changes in LHD services and leadership and how these changes are associated with mortality disparities. We conducted regression analyses of secondary data using an exploratory panel time series design. We used secondary data to investigate changes in LHD services and leadership and how these changes were associated with each other and with 1993 to 2005 changes in black-white mortality disparities. Local health department services were examined relative to change in breadth of services within each of 10 program domains between 1993 and 2005. LHD leadership was examined for discipline of the lead executive in 1993 and 2005. Our sample included 558 county or multicounty "common local areas," representing county-level data for LHDs and their jurisdictions. Significant beneficial relationships exist between having a clinician as lead executive in an LHD and reductions in black-white mortality disparities. Local health departments with a clinician (usually a nurse or physician) as their lead executive in 1993 and/or 2005 experienced a significant decrease in black-white mortality disparities for young adults (age 15-44 years) in their jurisdictions from 1993 to 2005 when compared with LHDs with nonclinician leaders. The discipline of an LHD's lead executive as a clinician appears to have a significant relationship with the impact of LHD practice on reducing black-white mortality disparities. This study suggests that the discipline of an LHD's leadership may be an important factor to consider in relation to local public health capacity to impact health disparities. Further research related to the mechanisms at play in these relationships is warranted.

  2. [Processes maps in public health organizations: the experience of the Galician Department of Public Health].

    Science.gov (United States)

    Aboal-Viñas, José Luis; Lado-Lema, María Eugenia; Amigo-Quintana, Manuel; Hervada-Vidal, Xurxo; Gómez-Amorín, Angel; Fernández-Abreu, Carlos

    2008-01-01

    To design the processes map of the Galician Department of Public Health, we performed document reviews, held meetings and interviewed persons in charge of programs and departments to identify the processes carried out. The processes were classified into strategic, key and support processes. We defined 4 levels of disaggregation and management and staff were kept informed throughout the process. At level 0, we included 4 key processes that defined the organization's mission. At level 1, 5 strategic, 5 support and 10 key processes were defined. The key processes at level 2 identified the health programs' services. A processes map was obtained by consensus and was then approved by management and staff as a first step in implanting a process management system to improve the organization's performance.

  3. Public Health Agency Accreditation Among Rural Local Health Departments: Influencers and Barriers.

    Science.gov (United States)

    Beatty, Kate E; Erwin, Paul Campbell; Brownson, Ross C; Meit, Michael; Fey, James

    2017-01-11

    Health department accreditation is a crucial strategy for strengthening public health infrastructure. The purpose of this study was to investigate local health department (LHD) characteristics that are associated with accreditation-seeking behavior. This study sought to ascertain the effects of rurality on the likelihood of seeking accreditation through the Public Health Accreditation Board (PHAB). Cross-sectional study using secondary data from the 2013 National Association of County & City Health Officials (NACCHO) National Profile of Local Health Departments Study (Profile Study). United States. LHDs (n = 490) that responded to the 2013 NACCHO Profile Survey. LHDs decision to seek PHAB accreditation. Significantly more accreditation-seeking LHDs were located in urban areas (87.0%) than in micropolition (8.9%) or rural areas (4.1%) (P < .001). LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs (RLHDs). LHDs that had completed an agency-wide strategic plan were 8.5 times (95% CI, 4.0-17.9), LHDs with a local board of health were 3.3 times (95% CI, 1.5-7.0), and LHDs governed by their state health department were 12.9 times (95% CI, 3.3-50.0) more likely to seek accreditation. The most commonly cited barrier was time and effort required for accreditation application exceeded benefits (73.5%). The strongest predictor for seeking PHAB accreditation was serving an urban jurisdiction. Micropolitan LHDs were more likely to seek accreditation than smaller RLHDs, which are typically understaffed and underfunded. Major barriers identified by the RLHDs included fees being too high and the time and effort needed for accreditation exceeded their perceived benefits. RLHDs will need additional financial and technical support to achieve accreditation. Even with additional funds, clear messaging of the benefits of accreditation

  4. The health of healthcare: Emergency department physician well-being

    Directory of Open Access Journals (Sweden)

    Martin Gagne

    2017-07-01

    Full Text Available Introduction: Physician health and well-being is an important issue that ultimately affects job performance. We compared the self-reported incidence of known medical issues, physical and mental health symptoms, and health behaviors of Emergency Physicians (EPs with the general public in the United States. Methods: Questions selected from a national survey conducted by the Center for Disease Control (CDC about public health trends were distributed to via Facebook to a private group of 12,917 EPs. Responses were compared between EPs and the general population using Chi-square tests of independence. Results: Our results demonstrated that EPs suffer less from chronic diseases, especially those related to the cardiopulmonary system; however, they suff er from a higher incidence of musculoskeletal pain and infectious disease complaints. EPs also exhibit higher rates of mental health symptoms, sleep-related complications, and alcohol consumption. Conclusions: Awareness, education, and advocacy may help improve physician health and ultimately job performance.

  5. Lesotho - Renovation of Health Centers and Out-Patient Departments

    Data.gov (United States)

    Millennium Challenge Corporation — The randomized rollout design that was developed for the Lesotho Health Centers was rendered infeasible due to infrastructure delays. Before pursuing an alternative...

  6. Assessing Emergency Department Utilization in the Era of Population Health.

    Science.gov (United States)

    Schold, Jesse D; Locke, Jayme E

    2017-12-30

    Population health has been broadly defined as "health outcomes of a group of individuals, including the distribution of such outcomes within the group." (1) Increasingly, population health has gained prominence and impact with emergence of Accountable Care Organizations that serve populations across transitions of care and different providers (often extended to communities). Population health has also been a focus of healthcare reform and development of policies and interventions aimed at simultaneously improving quality and reducing costs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Local health department priority setting: an exploratory study.

    Science.gov (United States)

    Platonova, Elena A; Studnicki, James; Fisher, John W; Bridger, Colleen

    2010-01-01

    Priority setting is an integral part of the community health assessment process since it helps direct the allocation of limited public health resources among competing needs. There is a recognized need for a systematic mechanism to prioritize community health issues in objective, data-driven, quantifiable measures. This exploratory study examined the extent to which data-driven objective criteria were considered important to public health officials in North Carolina and, specifically, the extent to which they chose between objective and subjective criteria in establishing public health priorities. The differences between the health officers' practice (criteria they actually used) and their preferences (criteria thought to be important) were also assessed. It was found that NC health directors generally used subjective criteria more often than objective criteria when deciding on the most important health issues in their communities. A considerable segment of the respondents, however, considered objective criteria more important, even though subjective criteria were the dominant influence in their actual practice of priority setting. Our preliminary results suggest that officers' education and tenure may influence their practice and preferences. Perceived and real barriers to the use of data-driven objective criteria for priority setting are an important topic for future public health research.

  8. Assessing the Knowledge, Skills, and Abilities of Public Health Professionals in Big City Governmental Health Departments.

    Science.gov (United States)

    McGinty, Meghan D; Castrucci, Brian C; Rios, Debra M

    2017-12-13

    To identify essential knowledge, skills, and abilities (KSAs) for and characterize gaps in KSAs of professionals working in large, urban health departments. A survey was disseminated to potentially eligible supervisors within 26 of 28 health departments in the largest, most urban jurisdictions in the country. A supervisor was eligible to participate if he or she supervised at least 1 staff member whose highest level of education was a master's degree. A total of 645 eligible supervisors participated in the workforce survey for a response rate of 27.1% and cooperation rate of 55.2%. Supervisors were asked to rate the importance of KSAs to their masters-level staffs' work and indicate their staffs' proficiency. Fifty-eight percent of supervisors reported supervising staff with a master of public health/master of science in public health degree. More than 30% of supervisors indicated that all of the 30 KSAs were essential. Four of the top 10 KSAs rated as essential by supervisors pertained to the ability to communicate. The top skills gaps perceived by supervisors were professional staffs' ability to apply quality improvement concepts to their work (38.0%), understanding of the political system (37.7%), and ability to anticipate changes (33.8%). Public health practitioners receive training in methods, theories, and evidence-based approaches, yet further investment in the workforce is necessary to advance population health. A focus should be placed developing strategic skills rather than advancing narrow specialties. Findings from this research can guide the creation and implementation of training curricula and professional development programs offered within local health departments or targeted to their staff, as well as satisfaction of accreditation requirements. By focusing on building strategic skills, we can ensure a public health workforce that is equipped with the KSAs necessary to practice Public Health 3.0 and leaders who are able to serve as their communities

  9. Public Health Emergency Management Within the Department of Defense

    Science.gov (United States)

    2010-03-05

    February 20071 (aa) DoD Instruction 1100.21, “ Voluntary Services in the Department of Defense,” March 11, 2002 (ab) DoD Instruction 5210.25...include eradication of disease, identification of affected animals, animal quarantine implementation, euthanasia , carcass disposal, cleaning and

  10. Department of Health and Human Services Semiannual Regulatory Agenda

    Science.gov (United States)

    2010-12-20

    ... regulations. It will modify the dispensing requirements for buprenorphine and buprenorphine combination...), USDA/CVB (Center for Veterinary Biologics), and the Department of Defense (DOD)/United States Army... Veterinary Medicine, Room 101, (MPN-4, HFV-232), 7519 Standish Place, Rockville, MD 20855 Phone: 240 276-9242...

  11. School-Located Influenza Vaccination Clinics: Local Health Department Perspectives

    Science.gov (United States)

    Ransom, James

    2009-01-01

    Universal childhood influenza vaccination presents challenges and opportunities for health care and public health systems to vaccinate the children who fall under the new recommendation. Advisory Committee on Immunization Practices (ACIP) recommendations and guidelines are helpful, but they do not provide strategies on how to deliver immunization…

  12. The provincial sociology of Gabriel Tarde

    Directory of Open Access Journals (Sweden)

    Andrea Mubi Brighenti

    2007-12-01

    Full Text Available To be provincial is to be territorialized. Not simply because the province is a territory, but because it makes a territory, it territorializes people and affects. Territory and belonging should not be taken as primordial features of the province, but rather as the effects of a territorializing act or a series of such acts.

  13. Provincial Fisheries IJ'lStltute, Lydenburg

    African Journals Online (AJOL)

    In the period 1969 to 1971 a research project on the ecology of angling species in the Vaal River was undertaken by the Nature Conservation Division of the Transvaal Provincial Administra- tion. A paper on aspects on the ecology of the yellowfish species appears in this same number. (Mulder 1973) and the present paper ...

  14. Contribution of university departments of rural health to rural health research: An analysis of outputs.

    Science.gov (United States)

    Gausia, Kaniz; Thompson, Sandra C; Lindeman, Melissa A; Brown, Leanne J; Perkins, David

    2015-04-01

    To assess the research contribution of eleven University Departments of Rural Health (UDRH) which were established as a rural health workforce program in the late 1990s through analysis of peer-reviewed journal output. Descriptive study based on validated publications from publication output reported in annual key performance indicator (KPI) reports to the Commonwealth Department of Health, Australia. In addition to counts and the type of publications, articles were examined to assess fields of research, evidence of research collaboration, and potential for influencing policy. Funding acknowledgement was examined to provide insight into funding sources and research consultancies. Of the 182 peer-reviewed articles, UDRH staff members were the first and corresponding author for 45% (n = 82); most (69%, n = 126) were original research. Most publications examined included Australian data only (80%, n = 101). Over half (56%; n = 102) of the articles addressed rural health issues; Aboriginal health was the main subject in 14% (n = 26). Thirty-three articles (18%) discussed the policy implications of the research and only half (51%, n = 93) of the articles listed sources of funding. Number of authors per article ranged from 1-19, with a mean of 5 (SD = 3.2) authors per article, two-thirds of articles included authors from 2-5 universities/organisations but only 5% of articles included an author from more than one UDRH. Staff from UDRHs are regularly publishing peer-reviewed articles, and research productivity demonstrated cooperation with external partners. Better collaboration between UDRH staff and others may help increase the quality and value of Australian rural health research. © 2015 National Rural Health Alliance Inc.

  15. Successful Introduction of an Emergency Department Electronic Health Record

    OpenAIRE

    Propp, Douglas A.

    2012-01-01

    Our emergency department had always relied on a paper-based infrastructure. Our goal was to convert to a paperless, efficient, easily accessible, technologically advanced system to support optimal care. We outline our sequential successful transformation, and describe the resistance, costs, incentives and benefits of the change. Critical factors contributing to the significant change included physician leadership, training and the rate of the endorsed change. We outline various tactics, tools...

  16. Creating and managing a paperless health information management department.

    Science.gov (United States)

    Greene, Zelda B

    2002-08-01

    Over the last 10 to 15 years, the health care industry has experienced dramatic changes in health care delivery, consumer needs, and demands. The medical record, a recapitulation of the care patients receive, continues to be one of the most vital components of the health care delivery system. It serves as a crucial administrative, clinical, financial, and research tool. Health information managers, striving to meet ever-changing requirements, have turned to electronic record processing to meet these changes. The following article describes one hospital's journey from a cumbersome paper environment to an electronic environment that not only resulted in improved customer service but also provided employees with renewed job satisfaction and increased skill levels.

  17. PUBLIC COMMENT ON THE DEPARTMENT OF HEALTH AND HUMAN SERVICES 2018 FEDERAL PHYSICAL ACITIVTY GUIDELINES

    Science.gov (United States)

    Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...

  18. Strengthening Local Health Department Informatics Capacity Through Advocacy, Education, and Workforce Development

    OpenAIRE

    Hasbrouck, LaMar

    2016-01-01

    This editorial outlines how local health department leaders must effectively use information and information technology to make strategic decisions that will promote the public's health and well-being.

  19. Health services use associated with emergency department closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    OBJECTIVE: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. METHOD: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed......, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...

  20. The South African Health Department's contribution to Social ...

    African Journals Online (AJOL)

    Adele

    2004-05-20

    May 20, 2004 ... try, we have to face the fact that international migration of skills will continue. But to address this challenge, we have pressed for the adop- tion of the code of conduct for recruitment of health workers within the Commonwealth. The code seeks to ensure that recruitment is trans- parent and does not harm the ...

  1. The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments.

    Science.gov (United States)

    Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley

    2015-08-06

    The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

  2. The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

    Directory of Open Access Journals (Sweden)

    Jonathon P. Leider

    2015-08-01

    Full Text Available Background: The relationship between policy networks and policy development among local health departments (LHDs is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD. Connectedness was highest among local health officials (density = .55, and slightly lower for chief science officers (d = .33 and chiefs of policy (d = .29. After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

  3. Public Health Staff Development Needs in Informatics: Findings From a National Survey of Local Health Departments.

    Science.gov (United States)

    Massoudi, Barbara L; Chester, Kelley; Shah, Gulzar H

    2016-01-01

    Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area. To describe the staff development needs of local health departments (LHDs) related to informatics. Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & City Health Officials. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Outcome measures included LHDs' specific staff development needs related to informatics. Predictors of interest included jurisdiction size and governance type. Areas of workforce development and improvement in informatics staff of LHDs included using and interpreting quantitative data, designing and running reports from information systems, using and interpreting qualitative data, using statistical or other analytical software, project management, and using geographical information systems. Significant variation in informatics training needs exists depending on the size of the LHD population and governance type. Substantial training needs exist for LHDs across many areas of informatics ranging from very basic to specialized skills and are related to the size of LHD population and governance type.

  4. Current and planned shared service arrangements in Wisconsin local and tribal health departments.

    Science.gov (United States)

    Madamala, Kusuma; Young, Nancy; Young, Dustin; Giese, Lieske; Brandenberg, Terry; Zahner, Susan

    2014-01-01

    The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin. An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place. Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness. There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

  5. Mentoring health information professionals in the Department of Veterans Affairs.

    Science.gov (United States)

    Lloyd, Susan S; Fenton, Susan H

    2008-04-07

    As a major employer of health information professionals, the VA faces significant recruitment and retention challenges. The authors evaluated mentoring as a retention tool through a review of existing literature and the retrospective review of a VA health information management mentoring program. The literature review showed a link between employer mentorship and employee retention, regardless of the nature and structure of the mentoring relationship. Most organizations support employees who are willing to serve as mentors through increased compensation, recognition, and other types of support. No literature was found that studied retention rates for more than three years after a mentoring experience. The review of the VA mentoring program showed increased retention in the three years following enrollment in the program, but the increase was not statistically significant. The review did not demonstrate improvement in retention over a seven-year period. The combined evaluation gives mixed findings for mentorship as a retention tool and demonstrates the need for more research on the topic.

  6. Continuing Education for Department of Defense Health Professionals

    Science.gov (United States)

    2015-11-24

    contracts.html. Accessed April 8, 2015. 79. American Society of Pediatric Hematology/ Oncology . Early career travel stipend award [Web page]. http...current trend in CE has shifted away from simply achieving credit hours to “demonstrably changing professional practice and patient outcomes.” 15(p.16...to its contribution to improved quality, patient safety, provider retention, cost-effectiveness, and overall impact on the health care system.” 18

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

    Science.gov (United States)

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

    2014-01-01

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

  8. Patterns and correlates of public health informatics capacity among local health departments: an empirical typology.

    Science.gov (United States)

    Mac McCullough, J; Goodin, Kate

    2014-01-01

    Little is known about the nationwide patterns in the use of public health informatics systems by local health departments (LHDs) and whether LHDs tend to possess informatics capacity across a broad range of information functionalities or for a narrower range. This study examined patterns and correlates of the presence of public health informatics functionalities within LHDs through the creation of a typology of LHD informatics capacities. Data were available for 459 LHDs from the 2013 National Association of County and City Health Officials Profile survey. An empirical typology was created through cluster analysis of six public health informatics functionalities: immunization registry, electronic disease registry, electronic lab reporting, electronic health records, health information exchange, and electronic syndromic surveillance system. Three-categories of usage emerged (Low, Mid, High). LHD financial, workforce, organization, governance, and leadership characteristics, and types of services provided were explored across categories. Low-informatics capacity LHDs had lower levels of use of each informatics functionality than high-informatics capacity LHDs. Mid-informatics capacity LHDs had usage levels equivalent to high-capacity LHDs for the three most common functionalities and equivalent to low-capacity LHDs for the three least common functionalities. Informatics capacity was positively associated with service provision, especially for population-focused services. Informatics capacity is clustered within LHDs. Increasing LHD informatics capacity may require LHDs with low levels of informatics capacity to expand capacity across a range of functionalities, taking into account their narrower service portfolio. LHDs with mid-level informatics capacity may need specialized support in enhancing capacity for less common technologies.

  9. Health Departments' Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity.

    Science.gov (United States)

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

    2016-04-30

    Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs' informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection.

  10. Role of the Health Department in Tuberculosis Prevention and Control-Legal and Public Health Considerations.

    Science.gov (United States)

    Jeffries, Carla; Lobue, Phil; Chorba, Terence; Metchock, Beverly; Kashef, Ijaz

    2017-03-01

    Because tuberculosis is caused by an infectious organism that is spread from person to person through the air, public health measures are essential to control the disease. There are three priority strategies for tuberculosis prevention and control in the United States: (i) identifying and treating persons who have tuberculosis disease; (ii) finding persons exposed to infectious tuberculosis patients, evaluating them for Mycobacterium tuberculosis infection and disease, and providing subsequent treatment, if appropriate; and (iii) testing populations at high risk for latent tuberculosis infection (LTBI) and treating those persons who are infected to prevent progression to disease. These strategies for prevention and control of tuberculosis are discussed in a framework containing the following important topics: historical and epidemiological context of tuberculosis control, organization of public health tuberculosis control programs, legal basis for public health authority, conducting overall planning and development of policy, identifying persons who have clinically active tuberculosis, evaluation of immigrants, managing persons who have or who are suspected of having disease, medical consultation, interjurisdictional referrals, identifying and managing persons infected with Mycobacterium tuberculosis, providing laboratory and diagnostic services, collecting and analyzing data, and providing training and education. This chapter describes the role of the health department in the context of these components. This discussion is primarily applicable to tuberculosis prevention and control programs in the United States.

  11. State and Local Health Department Activities Related to Abortion: A Web Site Content Analysis.

    Science.gov (United States)

    Berglas, Nancy F; Johns, Nicole E; Rosenzweig, Caroline; Hunter, Lauren A; Roberts, Sarah C M

    2017-08-29

    Recent legislation in states across the United States has required governmental health agencies to take on new and different roles in relation to abortion. While there has been media attention to health department roles in regulating abortion providers, there has been no systematic investigation of the range of activities in which state and local health departments are engaged. To systematically investigate health department activities related to abortion. We searched state health department Web sites of the 50 states and District of Columbia using key words such as "abortion" and "pregnancy termination". Two trained coders categorized 6093 documents using the 10 Essential Public Health Services (EPHS) framework. We then applied these methods to 671 local health department documents. State and local health department Web sites. N/A. On average, states engaged in 5.1 of 10 Essential Services related to abortion. Most (76%-98%) state health departments engaged in activities to Monitor Health Status (EPHS1), Enforce Laws (EPHS6), and Evaluate Effectiveness, Accessibility, and Quality (EPHS9). Many (47%-69%) engaged in activities to Inform and Educate (EPHS3), Develop Policies (EPHS5), and Link to Services (EPHS7). A minority (4%-29%) engaged in activities to Diagnose and Investigate Health Problems (EPHS2), Mobilize Community Partnerships (EPHS4), and Assure Competent Workforce (EPHS8). No state engaged in Innovative Research (EPHS10). Few local health departments engaged in abortion-related activities. While most state health departments engage in abortion-related activities, they appear to reflect what the law requires rather than the range of core public health activities. Additional research is needed to assess whether these services meet quality standards for public health services and determine how best to support governmental health agencies in their growing tasks. These findings raise important questions about the role of public health agencies and

  12. Violence in the emergency department: a survey of health care workers

    OpenAIRE

    Fernandes, C M; Bouthillette, F; Raboud, J M; Bullock, L; Moore, C.F.; Christenson, J M; Grafstein, E; Rae, S.; Ouellet, L; Gillrie, C; Way, M

    1999-01-01

    BACKGROUND: Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. METHODS: A retrospective written survey of all 163 emergency department employees working in 1996 at...

  13. Government size, market-orientation and regional corruption: Evidence from the provincial level panel data

    OpenAIRE

    ZHOU Li¡¯an; Tao, Jing

    2009-01-01

    Using a panel data at the provincial level during the period of 1989–2004, this paper examines the effects of social and economic factors such as government scale, privatization, openness, and education on regional corruption. Applying a fixed-effect model and IV estimation, we find that government size positively affects the incidence rate of corruption, and the effect becomes larger with the increase in the size of the core department of the government. 1% increase in the core department of...

  14. Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

    Energy Technology Data Exchange (ETDEWEB)

    Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)

    1990-12-31

    The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

  15. Bridging the health security divide: department of defense support for the global health security agenda.

    Science.gov (United States)

    Moudy, Robin M; Ingerson-Mahar, Michael; Kanter, Jordan; Grant, Ashley M; Fisher, Dara R; Jones, Franca R

    2014-01-01

    In 2011, President Obama addressed the United Nations General Assembly and urged the global community to come together to prevent, detect, and fight every kind of biological danger, whether a pandemic, terrorist threat, or treatable disease. Over the past decade, the United States and key international partners have addressed these dangers through a variety of programs and strategies aimed at developing and enhancing countries' capacity to rapidly detect, assess, report, and respond to acute biological threats. Despite our collective efforts, however, an increasingly interconnected world presents heightened opportunities for human, animal, and zoonotic diseases to emerge and spread globally. Further, the technical capabilities required to develop biological agents into a weapon are relatively low. The launch of the Global Health Security Agenda (GHSA) provides an opportunity for the international community to enhance the linkages between the health and security sectors, accelerating global efforts to prevent avoidable epidemics and bioterrorism, detect threats early, and respond rapidly and effectively to biological threats. The US Department of Defense (DoD) plays a key role in achieving GHSA objectives through its force health protection, threat reduction, and biodefense efforts at home and abroad. This article focuses on GHSA activities conducted in the DoD Office of the Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense.

  16. Organizational scope of practice: assessing the primary care and public health activities of health centers and health departments in Iowa.

    Science.gov (United States)

    Wright, Brad; Ugwi, Patience; Nice, Andrew J

    2015-04-01

    The objective was to understand how Federally Qualified Health Centers (FQHCs) and local health departments (LHDs) address their shared mission of improving population health by determining the scope of primary care and public health activities each provides in their community. A brief mail survey was designed and fielded among executive directors at all 14 FQHCs in Iowa, and 13 LHDs in Iowa representing counties with and without an FQHC. This survey contained a mixture of questions adapted from previously validated primary care and public health survey instruments. Using survey responses, each FQHC and LHD was given 2 scores (each ranging from 0-100) measuring the extent of their primary care and public health activities, respectively. The overall response rate was 85.2%; the response rate was 78.6% within FQHCs and 91.7% within LHDs. Overall, FQHCs had higher scores (73.8%) compared to LHDs (27.3%) on total primary care services, while both LHDs (79.3%) and FQHCs (70.9%) performed particularly well on public health services. FQHCs and LHDs in Iowa address a variety of public health and primary care issues, including but not limited to screening for chronic diseases, nutrition counseling, immunizations, and behavioral health. However, FQHCs provide a higher amount of primary care services and nearly as many public health services when compared to LHDs. In a value-based health care delivery system, integrating to improve population health is a wise strategy to maximize efficiency, but this will require maximizing coordination and minimizing duplication of services across different types of safety net providers.

  17. Institutionalizing the academic health department within the context of the 3-fold academic mission.

    Science.gov (United States)

    Livingood, William C; Goldhagen, Jeffrey; Bryant, Thomas; Harmon, Robert G; Wood, David L

    2014-01-01

    A mature model of an academic health department (AHD) that has been institutionalized over 2 decades is described within the context of the 3-fold traditional mission of academics (teaching, research, and service/practice). This adaptive model for AHDs, based on mutual benefits that can be viewed through the lenses of both the academic health center mission and the public health functions and services, has important implications for AHD sustainability. Continued collaboration in any academic-public health partnership will depend in part on the commitments of the changing leadership. However, institutionalizing support for the academic mission enables this collaboration to transcend changing leadership styles and priorities. The collaboration of Duval County Health Department and University of Florida College of Medicine-Jacksonville is an example of a model of AHD that has endured major changes in leadership within both the academic center and the Duval County Health Department.

  18. Mental health services use and management of eating disorders in an Italian Department of Mental Health.

    Science.gov (United States)

    Calugi, Simona; Avaldi, Vera Maria; Dalle Grave, Riccardo; Rucci, Paola; Fantini, Maria Pia

    2014-06-01

    To investigate the clinical characteristics of patients with eating disorders referred to Community Mental Health Centers (CMHCs) in the Department of Mental Health of Bologna, Italy, and to evaluate the number and type of interventions delivered. Adult patients with eating disorders who had a first contact with CMHCs between January 1, 2007 and December 31, 2012 were extracted from Bologna Local Health Authority database. Moreover, the hospital discharge records of patients were linked to the mental health information system of Bologna. Among the 276 patients with eating disorders identified, 59 (21.4%) were diagnosed as anorexia nervosa, 77 (27.9%) as bulimia nervosa and 140 (50.7%) as eating disorders not otherwise specified. The mean age of the sample was 37.3 (SD = 13.4), with no significant differences among the three diagnostic groups. The number of CMHCs outpatients increased each year from 2007 to 2011 and decreased in 2012. The proportion of new patients by year comprised about 50% of the total of patients. Psychotherapy accounted for about 10% of the interventions. Day-hospital and hospital admissions concerned 6.1 and 11.6% of the sample. CMHCs are part of the system of care outlined by the Regional policies for eating disorders and are responsible for providing the first level of outpatient care to adults. To date, there is the need to extend our monitoring across the whole system of care, to assess the implementation of specific and effective strategies to decrease the age of access of patients and to improve the quality of care delivered with the inclusion of evidence-based treatments in the process of care.

  19. Climate change and local public health in the United States: preparedness, programs and perceptions of local public health department directors.

    Directory of Open Access Journals (Sweden)

    Edward W Maibach

    Full Text Available While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their

  20. Emergency Health Care Professionals' Understanding of the Costs of Care in the Emergency Department.

    Science.gov (United States)

    Hoffman, Kevin A; Mancini, Michelino

    2017-06-01

    Efficiency and fiscal responsibility are important to the equal, safe, and effective delivery of care in the emergency department, where all presenting patients must be evaluated for emergent conditions. Health care professionals' understanding of the costs of care is a first step to developing rational approaches for the efficient distribution of the finite resources hospitals and emergency departments have at their disposal to reduce costs to patients and health care systems. To determine emergency department health care professionals' knowledge of the costs to patients of routine care delivered in the emergency department. An internet-based survey of currently practicing emergency medicine health care professionals with various levels of training (physicians, residents, physician assistants, and nurse practitioners) was conducted to evaluate their ability to identify the cost of care for 3 common presentations to the emergency department: abdominal pain, dyspnea, and sore throat. Four hundred forty-one emergency medicine health care professionals participated. In the 3 cases presented, correct costs were determined by 43.0%, 32.0%, and 40.1% of participants, respectively. Geographic region was not related to cost determination. Larger institution size was related to greater cost chosen (P=.01). Higher level of training was significantly correlated with perceived understanding of cost (P<.001); however, it was not related to accurate cost assessment in this study. Emergency medicine health care professionals have an inadequate understanding of the costs associated with care routinely provided in the emergency department.

  1. Developing an academic health department in Northeast Tennessee: a sustainable approach through student leadership.

    Science.gov (United States)

    Brooks, Billy; Blackley, David; Masters, Paula; May, Andrew Stephen; Mayes, Gary; Williams, Christian; Pack, Robert

    2014-01-01

    In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration-funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

  2. Primer Concilio Provincial del Nuevo Reino

    Directory of Open Access Journals (Sweden)

    Manuel Lucena Salmoral

    1963-01-01

    Full Text Available El acontecimiento más sobresaliente del patriarcado de don Fernando Arias de Ugarte, en el que hubo muchos notables, fue el Primer Concilio Provincial del Nuevo Reino de Granada, celebrado en el año 1623. Cumplió así una vieja aspiración de los arzobispos santafereños y la obligación impuesta en el Concilio de Trento, por lo que resulta incomprensible lo historiado por don José Antonio Plaza quien, al referirse a este hecho, dice lo siguiente...

  3. Provincial geology and the Industrial Revolution.

    Science.gov (United States)

    Veneer, Leucha

    2006-06-01

    In the early nineteenth century, geology was a new but rapidly growing science, in the provinces and among the gentlemen scientists of London, Oxford and Cambridge. Industry, particularly mining, often motivated local practical geologists, and the construction of canals and railways exposed the strata for all to see. The most notable of the early practical men of geology was the mineral surveyor William Smith; his geological map of England and Wales, published in 1815, was the first of its kind. He was not alone. The contributions of professional men, and the provincial societies with which they were connected, are sometimes underestimated in the history of geology.

  4. The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action.

    Science.gov (United States)

    Carman, Angela L

    2015-01-01

    Local health department directors' intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

  5. A critical discussion of the concept of recovery for mental health consumers in the Emergency Department.

    Science.gov (United States)

    Marynowski-Traczyk, Donna; Moxham, Lorna; Broadbent, Marc

    2013-08-01

    The Emergency Department has increasingly become the initial point of contact for mental health crisis assessment and intervention, and is the interface between community and inpatient care. Questions regarding the appropriateness of the Emergency Department in providing a suitable environment for people who have a mental health issue abound with commentary regarding the confidence and competence of general Registered Nurses to provide mental health care. Emergency Departments are busy noisy places where rapid assessments and response is the norm and is counterintuitive to contemporary mental health care. The model of care currently considered best practice in mental health is the Recovery-oriented model; a long term individualised approach to collaborative care. The notion of Recovery as understood and practised in contemporary mental health care is almost polarised to that which is embedded in generalist Emergency Registered Nurses' practice. As Emergency Departments play an integral role in the assessment of people experiencing mental illness, close collaboration and support is required between emergency and mental health specialities to achieve optimal client outcomes in an environment that is nested within the medical model. Furthermore, Emergency Department staff must be supported in acquiring the knowledge and skills required to care for and manage people with a mental health issue. This includes cognisance and understanding of the Recovery-oriented model of care which is the model of care considered best practice for this client group. This paper offers a critical discussion of the concept of recovery for mental health consumers in the Emergency Department. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  6. The Mokihana Program: The effectiveness of an integrated department of education and department of health school-based behavioral health approach.

    Science.gov (United States)

    Klontz, Bradley T; Bivens, Alex; Michels, Stanton; DeLeon, Patrick H; Tom, Lyndsey

    2015-05-01

    As a result of difficulties with access to care and resulting low levels of service utilization, the mental health problems of children often go undiagnosed and untreated. One of the most promising approaches to increasing access to care is the delivery of mental health services in school settings, where almost all of the children in a community can be accessed. However, as a result of competing needs, cultures, and objectives, integrating mental health services into schools can be challenging. In the wake of a devastating hurricane in 1992 and efforts to identify and treat children with posttraumatic stress, many of these barriers were overcome on the island of Kauai, Hawaii and led to the development of the Mokihana Program, an integrated Department of Education and Hawaii Department of Health initiative for providing school-based behavioral health services. This study examined the effectiveness of the Mokihana Program in the treatment of 123 elementary age children and 56 adolescents by comparing teacher ratings of behavior problems and adaptive skills at intake and at 1-year follow-up. It was hypothesized that symptom severity would decrease from pretreatment to follow-up. Findings showed statistically significant improvements across a wide spectrum of behavioral problems and adaptive functioning. The authors explore the challenges and opportunities in sustaining and replicating this type of departmental integration in the service of children and youth. (c) 2015 APA, all rights reserved).

  7. Use of Local Health Department Websites: A Study of E-Government Adoption and Diffusion

    Science.gov (United States)

    Aaltonen, Pamela Massie

    2013-01-01

    Two distinct but converging activities have the potential to alter the way local public health departments conduct business. These activities are the emergence of e-government and the addition of preparedness as a basic function of the public health system. Preparedness implies timely collaboration with government entities, community partners and…

  8. Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

    Science.gov (United States)

    Gustavsson, Maria; Ekberg, Kerstin

    2015-01-01

    This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

  9. The Mental Health Care Act No 17 – South Africa. Trials and triumphs

    African Journals Online (AJOL)

    Psychiatrists and the results of a national survey conducted among Heads of Departments of Psychiatry, Mental Health Review. Boards and Provincial Directors of Mental Health was reviewed. ... towards mental health and a lack of teamwork, integration and co-ordination. The need for active political support, managerial ...

  10. Analysis of the purpose of state health departments' tweets: information sharing, engagement, and action.

    Science.gov (United States)

    Thackeray, Rosemary; Neiger, Brad L; Burton, Scott H; Thackeray, Callie R

    2013-11-11

    Public health agencies are actively using social media, including Twitter. In the public health and nonprofit sectors, Twitter has been limited to one-way communication. Two-way, interactive communication on Twitter has the potential to enhance organizational relationships with followers and help organizations achieve their goals by increasing communication and dialog between the organization and its followers. Research shows that nonprofit organizations use Twitter for three main functions: information sharing, community building, and action. It is not known whether state health departments are using Twitter primarily for one-way information sharing or if they are trying to engage followers to build relationships and promote action. The purpose of this research was to discover what the primary function of Twitter use is among state health departments in the United States and whether this is similar to or different from nonprofit organizations. A complete list of "tweets" made by each state health department account was obtained using the Twitter application programming interface. We randomly sampled 10% of each state health department's tweets. Four research assistants hand-coded the tweets' primary focus (organization centric or personal health information centric) and then the subcategories of information dissemination, engagement, or action. Research assistants coded each tweet for interactivity, sophistication, and redirects to another website. Data were analyzed using SPSS version 20. There were 4221 tweets from 39 state health departments. There was no statistically significant difference in the number of tweets made by a state health department and the state population density (P=.25). The majority of tweets focused on personal health topics (69.37%, 2928/4221) while one-third were tweets about the organization (29.14% , 1230/4221). The main function of organization-based tweets was engagement through conversations to build community (65.77%, 809

  11. [Implementation of strategies and tools of sociosanitary coordination in a health department].

    Science.gov (United States)

    Botija, Pilar; Botija, Mercedes; Navarro, Jorge

    2017-09-25

    The objective of this article is to show an experience of new practice as implemented by the management of a Department of Health. An organisational model is shown of sociosanitary coordination between the different levels of care and sectors, establishing synergies of the common social and health resources of the Clínico-Malvarrosa Department of Health (Valencia, Spain). After one year, five basic health councils have been set up in Primary Care and a Sociosanitary Coordination Commission composed of three subcommittees: 1) socio and health care, 2) associationism and hospital volunteering, and 3) community action and citizen participation. The proposed organisational structure has been consolidated, the actions carried out have been valued positively by the different agents involved. It has generated a network of social and health communication: interdepartmental, extra-departmental and out-of-hospital. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. A review of health leadership and management capacity in the Solomon Islands.

    Science.gov (United States)

    Asante, Augustine; Roberts, Graham; Hall, John

    2012-04-01

    and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively

  13. Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma

    Science.gov (United States)

    When facing mental health problems, many service members choose not to seek needed help because of the stigma associated with mental health disorders...functioning of affected service members. The stigma of seeking mental health treatment in the military persists despite the efforts of both the U.S. Department...developing policies, programs, and campaigns to reduce stigma and increase service members help-seeking behavior.

  14. Emergency department and inpatient health care utilization among patients who require interpreter services.

    Science.gov (United States)

    Njeru, Jane W; St Sauver, Jennifer L; Jacobson, Debra J; Ebbert, Jon O; Takahashi, Paul Y; Fan, Chun; Wieland, Mark L

    2015-05-29

    Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P ≤ .001) and hospitalizations (408 vs 343; P ≤ .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60% higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95% confidence interval (CI), 1.4-1.9; P interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.

  15. 14 CFR 1204.508 - Delegation of authority of certain civil rights functions to Department of Health, Education, and...

    Science.gov (United States)

    2010-01-01

    ... rights functions to Department of Health, Education, and Welfare. 1204.508 Section 1204.508 Aeronautics... Department of Health, Education, and Welfare. (a) Pursuant to the authority of § 1250.111(c) of this chapter..., Department of Health, Education, and Welfare, on March 15, 1966: (1) Responsibilities with respect to...

  16. Ensuring a broad and inclusive approach: a provincial perspective on pandemic preparedness.

    Science.gov (United States)

    Kort, Rodney; Stuart, Allison J; Bontovics, Erika

    2005-01-01

    The SARS crisis revealed critical gaps in Ontario's health emergency response capacity, and identified, in the starkest terms possible, the need for improved emergency response planning. This article reviews the development of the Ontario Health Plan for an Influenza Pandemic (OHPIP), released in June 2005. Some key points arising from the provincial planning process include the necessity to: ensure a broad and inclusive development process; ensure the pandemic plan identifies: 1) clear roles and responsibilities of federal, provincial/territorial and municipal levels of government, 2) the approach to occupational health and safety issues and ethical decision-making, 3) a communications strategy linking all affected sectors and levels of government and health sector; 4) any commitments to antiviral stockpiling, vaccine and antiviral allocation and use, and an approach for drug delivery from provincial stockpiles to local public health units; 5) health human resource management and supplementation; and 6) key programs/services to be scaled back to maximize surge capacity; address best practices (e.g., involve all sectors of the health care system at the outset, acquire strategic expertise, coordinate/advocate with broader emergency response system, etc); and, outline future stages that include strengthening the delivery of clinical care to influenza cases; clarifying the role of primary care practitioners during a pandemic; leveraging Ontario's significant e-Health investments.

  17. Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

    OpenAIRE

    Emmanuel D Jadhav; James W. Holsinger; Anderson, Billie W.; Nicholas Homant

    2017-01-01

    Background The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main charact...

  18. Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review.

    Science.gov (United States)

    Gossip, Kate; Gouda, Hebe; Lee, Yong Yi; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez Soto, Eliana

    2017-06-29

    Local health departments are often at the forefront of a disaster response, attending to the immediate trauma inflicted by the disaster and also the long term health consequences. As the frequency and severity of disasters are projected to rise, monitoring and evaluation (M&E) efforts are critical to help local health departments consolidate past experiences and improve future response efforts. Local health departments often conduct M&E work post disaster, however, many of these efforts fail to improve response procedures. We undertook a rapid realist review (RRR) to examine why M&E efforts undertaken by local health departments do not always result in improved disaster response efforts. We aimed to complement existing frameworks by focusing on the most basic and pragmatic steps of a M&E cycle targeted towards continuous system improvements. For these purposes, we developed a theoretical framework that draws on the quality improvement literature to 'frame' the steps in the M&E cycle. This framework encompassed a M&E cycle involving three stages (i.e., document and assess, disseminate and implement) that must be sequentially completed to learn from past experiences and improve future disaster response efforts. We used this framework to guide our examination of the literature and to identify any context-mechanism-outcome (CMO) configurations which describe how M&E may be constrained or enabled at each stage of the M&E cycle. This RRR found a number of explanatory CMO configurations that provide valuable insights into some of the considerations that should be made when using M&E to improve future disaster response efforts. Firstly, to support the accurate documentation and assessment of a disaster response, local health departments should consider how they can: establish a culture of learning within health departments; use embedded training methods; or facilitate external partnerships. Secondly, to enhance the widespread dissemination of lessons learned and facilitate

  19. Health Departments With A Commitment To Health Equity: A More Skilled Workforce And Higher-Quality Collaborations.

    Science.gov (United States)

    Furtado, Karishma S; Brownson, Carol; Fershteyn, Zarina; Macchi, Marti; Eyler, Amy; Valko, Cheryl; Brownson, Ross C

    2018-01-01

    Health equity is a public health priority, yet little is known about commitment to health equity in health departments, especially among practitioners whose work addresses chronic disease prevention. Their work places them at the forefront of battling the top contributors to disparities in morbidity and mortality. A random sample of 537 chronic disease practitioners working in state health departments was surveyed on health equity commitments, partnerships, and needed skills. A small percentage of respondents (2 percent) worked primarily on health equity, and a larger group (9 percent) included health equity as one of their multiple work areas. People who rated their work unit's commitment to health equity as high were more likely to engage with sectors outside of health and rate their leaders as high quality, and less likely to identify skills gaps in their work unit. Opportunities exist to more fully address health equity in state public health practice through organizational, institutional, and governmental policies, including those regarding resource allocation and staff training.

  20. Provincial land use planning in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, W. [British Columbia Ministry of Finance, Victoria, BC (Canada). Land Use Coordination Office

    1998-12-31

    The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province.

  1. Forecasting residential electricity demand in provincial China.

    Science.gov (United States)

    Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

    2017-03-01

    In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.

  2. No More Provincialism: Art and Text

    Directory of Open Access Journals (Sweden)

    Heather Barker

    2010-11-01

    Full Text Available This essay discusses the writing and personalities surrounding the 1981 establishment of the Australian art magazine, Art & Text, and traces its progression under Paul Taylor’s editorship up to his relocation to New York. During this period, Art & Text published Taylor’s own essays and, more importantly, those of other writers and artists — Meaghan Morris, Paul Foss, Philip Brophy, Imants Tillers, Rex Butler, Edward Colless — all articulating a consistent and complex postmodern position. The magazine’s founder and editor, Paul Taylor, personified the shattering impact of postmodernism upon the Australian art world as well as postmodernism’s limitations. Taylor facilitated a new theoretical framework for the discussion of Australian art, one that continues to dominate the internationalist aspirations of Australian art writers. He produced temporarily convincing solutions to problems that earlier critics had wrestled with unsuccessfully, in particular the twin problems of provincialism, and the relationship of Australian to international art.

  3. Building a regional health equity movement: the grantmaking model of a local health department.

    Science.gov (United States)

    Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy

    2011-01-01

    The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

  4. Programa provincial de lectura del Chubut

    Directory of Open Access Journals (Sweden)

    Natalia Alejandra Alaniz

    2014-10-01

    Full Text Available En el marco del proyecto “Dispositivos pedagógicos en las dinámicas de lavida escolar en contexto de pobreza urbana” lo que se propuso investigar es la forma de implementación del Programa de Lectura de la provincia de Chubut. El mismo fue creado por Resolución Ministerial N° 1044/ 08, a partir de diversos trabajos que comenzaron en el año 2003 a través de la Ley de Educación 26. 026, y que posteriormente se incorporaron a nivel provincial mediante la Resolución N ° 174/12 para revalorizar las trayectorias escolares de cada niño/a. El programa consiste en poner el énfasis en el vínculo pedagógico mediante la adecuación de los espacios curriculares, de tal modo que se pueda lograr una articulación entre los diferentes niveles educativos, desde el nivel inicial al secundario. Articulando para ello recursos materiales y humanos que posibiliten el acompañamiento del proceso de enseñanza y aprendizaje de lectura.A partir de esto, el objetivo de este trabajo fue indagar cómo perciben los docentes de una escuela pública la implementación del Programa Provincial de Lectura, lo que implico utilizar metodologías y técnicas de investigación apropiadas para obtener las experiencias actuales en el territorio y en la cotidianidad de los propios actores escolares. Teniendo en consideración que el dispositivo pedagógico es una construcción histórica, que produce subjetividades, y por consiguiente formas de ver y entender el mundo.

  5. 77 FR 40565 - Northwest Forest Plan Provincial Advisory Committees

    Science.gov (United States)

    2012-07-10

    ...: Notice of Administrative Meetings for the Northwest Forest Plan Provincial Advisory Committees. SUMMARY... up under the Northwest Forest Plan. The PIECs facilitate the successful implementation of the Record... administrative meetings will be to inform the current Provincial Advisory Committee membership of the following...

  6. Growing up and being young in an Indonesian provincial town

    NARCIS (Netherlands)

    Minza, W.M.

    2014-01-01

    This study explores the experiences of youth in the provincial town of Pontianak, West Kalimantan, done in Pontianak, the provincial capital of West Kalimantan during the years 2008-2009. It tries to understand the various patterns of relations between growing up and being young, how social

  7. Review of Paediatric Admissions In Mongomo Provincial Hospital ...

    African Journals Online (AJOL)

    Review of Paediatric Admissions In Mongomo Provincial Hospital, Wele Nzas, Equatorial Guinea. Nnamdi B Onyire. Abstract. Background: The author was part of the Technical Aid Corps team of the Nigerian Government to Mongomo Provincial Hospital, Wele Nzas province of Equatorial Guinea, between May 1997 and ...

  8. Benefits of a department of corrections partnership with a health sciences university: New Jersey's experience.

    Science.gov (United States)

    Reeves, Rusty; Brewer, Arthur; Debilio, Lisa; Kosseff, Christopher; Dickert, Jeff

    2014-04-01

    More than half of the state prisons in the United States outsource health care. While most states contract with private companies, a small number of states have reached out to their health science universities to meet their needs for health care of prisoners. New Jersey is the most recent state to form such an agreement. This article discusses the benefits of such a model for New Jersey's Department of Corrections and for New Jersey's health sciences university, the Rutgers University, formerly the University of Medicine and Dentistry of New Jersey. The benefits for both institutions should encourage other states to participate in such affiliations.

  9. Migrant Health Program: New Jersey State Department of Health, 1971 Annual Report.

    Science.gov (United States)

    New Jersey State Dept. of Health, Trenton.

    Project objectives and descriptions of 6 county migrant health projects are summarized and evaluated. The project services provided the migrant worker and his family included hospital, dental health, eye examination, nutrition, school health, maternal and child health, sanitation, and social services. Clinical and outreach activities in the…

  10. Succession planning for local health department top executives: reducing risk to communities.

    Science.gov (United States)

    Schmalzried, Hans; Fallon, L Fleming

    2007-06-01

    This study assessed the degree to which local health departments (LHDs) are preparing to replace retiring top executives. Questionnaires were sent to all 134 local health departments in Ohio. It is typical of many states in terms of the organization of LHDs. Ninety-two LHD top executives responded. The questionnaire addressed aspects of departmental succession planning and demographic parameters of their departments. Approximately half (51.7%) of responding LHD top executives rated having succession plans as being important. Overall, local boards of health are not very concerned about actually having a succession plan. One in four (27.6%) local health departments reported that they have succession plans. Half of those were grooming a successor. Succession planning is not a high priority among the majority of LHDs, despite the fact that 43.7% of top executives reported planning to leave their current position within six years. Experienced and continuous LHD leadership is important for strong responses to public health crises like major disease outbreaks and natural disasters. Having a succession plan in place that identifies how leadership voids are filled can help minimize risks to populations in an emergency.

  11. Local health department translation processes: potential of machine translation technologies to help meet needs.

    Science.gov (United States)

    Turner, Anne M; Mandel, Hannah; Capurro, Daniel

    2013-01-01

    Limited English proficiency (LEP), defined as a limited ability to read, speak, write, or understand English, is associated with health disparities. Despite federal and state requirements to translate health information, the vast majority of health materials are solely available in English. This project investigates barriers to translation of health information and explores new technologies to improve access to multilingual public health materials. We surveyed all 77 local health departments (LHDs) in the Northwest about translation needs, practices, barriers and attitudes towards machine translation (MT). We received 67 responses from 45 LHDs. Translation of health materials is the principle strategy used by LHDs to reach LEP populations. Cost and access to qualified translators are principle barriers to producing multilingual materials. Thirteen LHDs have used online MT tools. Many respondents expressed concerns about the accuracy of MT. Overall, respondents were positive about its potential use, if low costs and quality could be assured.

  12. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City–County, Colorado

    Science.gov (United States)

    Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C.

    2015-01-01

    Background Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Community Context Administrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. Methods A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Outcome Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Interpretation Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments. PMID:26111156

  13. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City-County, Colorado.

    Science.gov (United States)

    Hardy, Anna K; Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C

    2015-06-25

    Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Administrative leaders at the Pueblo City-County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments.

  14. The Public Health Nurse Workforce in U.S. State and Local Health Departments, 2012

    National Research Council Canada - National Science Library

    Beck, Angela J; Boulton, Matthew L

    2016-01-01

    .... An advisory committee convened by the University of Michigan Center of Excellence in Public Health Workforce Studies developed the Public Health Nurse Workforce Survey and disseminated it in 2012...

  15. Psychiatric screening in the emergency department: validation of the General Health Questionnaire.

    Science.gov (United States)

    Gold, I; Haughey, L; Baraff, L J

    1985-09-01

    Both a 28-item psychiatric scale, the Goldberg General Health Questionnaire (GHQ), and the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) were administered to 25 emergency department patients to determine the validity of the GHQ as a screening instrument for psychopathology in the emergency department setting. There was a significant association (P = 0.0343) between GHQ scores and DIS assessment. The sensitivity of the GHQ in this series was 55.6% and the specificity was 87.5% when compared with the DIS. This suggests that the GHQ may prove to be a valuable screening tool for patients with somatic complaints to detect unsuspected psychiatric illness in the emergency department.

  16. 76 FR 44592 - Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses...

    Science.gov (United States)

    2011-07-26

    ... HUMAN SERVICES Food and Drug Administration Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses in Support of Strategies That Address Food Safety Problems That Align Domestically and Globally (U01); Correction AGENCY: Food and Drug Administration, HHS. ACTION: Notice...

  17. Main-streaming NFP into the Department of Health of the Philippines: opportunities and challenges.

    Science.gov (United States)

    Infantado, R B

    1997-01-01

    In 1994, the Department of Health (DOH) of the Philippines issued a circular which reaffirmed natural family planning (NFP) as one of the basic services to be offered in all government family planning service sites and urged family planning workers to develop competence in teaching NFP methods. Although the circular represented a major policy breakthrough for the main-streaming of NFP it found the department without the capability or experience to directly provide NFP services. The two approaches the department is taking to respond to this new policy initiative are described in this paper. The selection of these approaches was influenced by the devolution of central government authority to local government units. The approaches include developing department capability in NFP training, service provision and service installation and creating a supportive program and policy environment. DOH partnership with an NFP non-government organization (NGO) has been critical in developing NFP capability within the government sector, particularly in NFP training and service installation.

  18. Availability of Foodborne Illness Reporting Mechanisms for the Public on Local Health Department Web Sites.

    Science.gov (United States)

    Harris, Jenine K; Wong, Roger; Matthew, Megan G; Mansour, Raed

    2017-04-04

    Foodborne illness is a serious and preventable public health problem, with high health and economic tolls in the United States. Local governments play an important role in food safety, with local health departments (LHDs) responsible for licensing and inspecting restaurants. Foodborne illness complaints from the public result in identification of more serious and critical food safety violations than regularly scheduled inspections; however, few people report foodborne illness. Availability of existing methods for the public to report foodborne illness to LHDs across the United States was examined. In 2016, data were collected and analyzed from a nationally representative stratified sample of 816 LHDs. Each LHD Web site was examined to determine whether the Web site included a way for constituents to report a suspected foodborne illness. Just 27.6% of LHD Web sites included a way for constituents to report a suspected foodborne illness. LHDs with reporting mechanisms were serving significantly larger populations and had significantly more staff members, higher revenues, and higher expenditures. Health departments with reporting mechanisms were also significantly more likely to conduct environmental health surveillance activities, to regulate, inspect, and/or license food service establishments, and to be involved in food safety policy. Consumer reports of suspected foodborne illness help identify serious and critical food safety violations in food establishments; however, foodborne illness is vastly underreported by the US public. While more evidence is needed on how current systems are working, increasing the visibility and availability of Web-based reporting mechanisms through the following strategies is recommended: (1) test and modify search functions on LHD Web sites to ensure consumers find reporting mechanisms; (2) add a downloadable form as an option for reporting; (3) coordinate with state health departments to ensure clear instructions are available for

  19. Managerial barriers and challenges in Iran public health system: East Azerbaijan health managers' perspective.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Hasanzadeh, Alireza

    2017-03-01

    To investigate managerial barriers and challenges facing East Azerbaijan Province health system. This qualitative study was conducted in Tabriz, Iran, from August 2014 to August 2015, and comprised professionals, experts and informants working at the East Azerbaijan Health Centre. Data was collected through focus group discussions and semi-structured, face-to-face, individual and group interviews were conducted. Interviews and focus group discussions were taped, transcribed and analysed using content analysis method.. Of the 46 participants, 29(63%) were male and 17(37%) were female. Moreover, 15(33%) participants were head of their respective units and 8(17%) were district health managers. Managerial barriers witnessed during the study period differed between the three managerial levels of interest, i.e., district health centres, provincial health centre departments and top levels of provincial health centre and macro-management systems outside the health centre. Lack of management training, inadequate resources, unclear duties and responsibilities were considered to be the most common barriers facing district health centres. Unclear budgeting mechanisms, instability of management positions and shortage of trained staff on provincial and district levels were reported to be managerial barriers in provincial health centre departments. Political interference in technical decisions, treatment-based approaches, lack of clear career paths on all levels of health system management, unnecessary bureaucracy lying within inter-organisational relationships and ineffective employment legislation were identified as managerial barriers on top levels of the provincial health system and in macro-management systems independent of the health system. Diverse challenges influenced the performance of health managers.

  20. Investigating Informatics Activity, Control, and Training Needs in Large, Medium, and Small Health Departments.

    Science.gov (United States)

    Bakota, Eric; Arnold, Ryan; Yang, Biru

    2016-01-01

    A recent National Association of City & County Health Officials survey shed light on informatics workforce development needs. Local health departments (LHDs) of various jurisdictional sizes and control over informatics may differ on training needs and activity. Understanding the precise nature of this variation will allow stakeholders to appropriately develop workforce development tools to advance the field. To understand the informatics training needs for LHDs of different jurisdictional sizes. Survey responses were analyzed by comparing training needs and LHD population size. Larger health departments consistently reported having greater informatics-related capacity and informatics-related training needs. Quantitative data analysis was identified as a primary need for large LHDs. In addition, LHDs that report higher control of informatics/information technology were able to engage in more informatics activities. Smaller LHDs need additional resources to improve informatics-related capacity and engagement with the field.

  1. Internal Evaluation of the Department of Environmental Health Engineering of Qom University of Medical Sciences, 2010

    Directory of Open Access Journals (Sweden)

    Hassan Izanloo

    2013-07-01

    Full Text Available Background and Objectives: Improvement of education quality of a university depends on the quality improvement of its departments. Therefore, internal evaluation of the department is an effective step in the quality growth of higher education system. The present study was performed aiming at internal evaluation of the Department of Environmental Health Engineering of the Qom University of Medical Sciences in 2010 took place. Methods: This study was done using a descriptive cross-sectional method. Four questionnaires, including department manager, faculty members, students, and graduates were used to collect the data. In completing these questionnaires, interviews, observations and review of documents were also done, and they were interpreted and concluded by employing descriptive statistics in the form of frequency distributions and measures of central tendency and dispersion.Results: The scores obtained for the goals and mission, management, and development of the department were 2.2, 2.1, and 2.82, respectively; the ratio of the number of faculty members to students, faculty members’ research activities, and satisfaction of the department were 2.23, 2.1, and 1.12, respectively; the ratio of the number of the students to the existing facilities, and awareness of the goals and missions of the department were 2.1, 1.75, respectively; and the ratio of the courses to the need of the graduates, satisfaction of the educational programs, and satisfaction of the content of the department programs were 1.68, 1.84, and 2.1, respectively.Conclusion: According to the results of this research, there is necessary that university departments attempt to protect and promote the factors, which are in ideal conditions and plan to improve the adverse factors. University officials should provide necessary conditions and resources to improve the present situation and achieve the most desirable level.

  2. [Conditions/Restrictions Applicable to All Open Burning : North Dakota Department of Health : Arrowwood National Wildlife Refuge : 2006

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A memorandum from the North Dakota Department of Health, to Arrowwood National Wildlife Refuge, responds to the refuge's request concerning the proper procedures...

  3. A prevalence study of methicillin-resistant Staphylococcus aureus colonization in emergency department health care workers.

    Science.gov (United States)

    Bisaga, April; Paquette, Katherine; Sabatini, Linda; Lovell, Elise O

    2008-11-01

    Few studies of the prevalence of nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) in emergency department (ED) health care workers have been conducted. To better understand the epidemiology of this pathogen, we seek to determine the MRSA nasal colonization rates in the ED health care workers in our hospital. We conducted a prospective cohort study on a convenience sample of ED health care workers, including nurses, physicians, and technicians. Nasal swabs from subjects were analyzed with a polymerase chain reaction assay for the presence of MRSA. Of the 105 ED health care workers enrolled, a total of 16 (15%, 95% confidence interval 9.6% to 23%) were MRSA positive. No significant difference was observed in colonization rates between nurses, physicians, and technicians. Our ED health care workers demonstrated a high prevalence of nasal MRSA colonization compared with individuals in recent community surveillance and other studies involving ED staff.

  4. 42 CFR 59.7 - What criteria will the Department of Health and Human Services use to decide which family...

    Science.gov (United States)

    2010-10-01

    ... Department of Health and Human Services use to decide which family planning services projects to fund and in... 42 Public Health 1 2010-10-01 2010-10-01 false What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and in what amount? 59.7...

  5. Analysis of National Institutes of Health Funding to Departments of Urology.

    Science.gov (United States)

    Silvestre, Jason; Agarwal, Divyansh; Lee, David I

    2016-05-01

    To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area. Fiscal totals were calculated for 2005-2014 and compared with other surgical departments during 2014. One hundred one investigators at 36 urology departments received $55,564,952 in NIH funding during 2014. NIH-funded investigators were predominately male (79%) and PhD scientists (52%). Funding totals did not vary by terminal degree or sex, but increased with higher academic rank (P urologic research. The R01 grant accounted for 41.0% of all costs. The top 3 NIH-funded clinical areas were urologic oncology (62.1%), urinary tract infection (8.8%), and neurourology (7.6%). A minority of costs supported clinical research (12.9%). In 2014, urology had the least number of NIH grants relative to general surgery, ophthalmology, obstetrics & gynecology, otolaryngology, and orthopedic surgery. NIH funding to urology departments lags behind awards to departments of other surgical disciplines. Future interventions may be warranted to increase NIH grant procurement in urology. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Academic-health department collaborative relationships are reciprocal and strengthen public health practice: results from a study of academic research centers.

    Science.gov (United States)

    Neri, Elizabeth M; Ballman, Marie R; Lu, Hua; Greenlund, Kurt J; Grunbaum, Jo Anne

    2014-01-01

    Collaborations between academic institutions and state and local health departments have been shown to enhance the public health core functions of Assurance by improving the public health workforce's knowledge and skills. Few studies have analyzed how academic-health department collaborations enhance Assessment and Policy Development core functions. This qualitative study explores types of collaborations between health departments and Prevention Research Centers (PRCs) and how they align with the core functions. Prevention Research Centers are academic institutions funded by the Centers for Disease Control and Prevention to conduct public health research and translate research results for policies and practices. We reviewed each PRC's annual report from fiscal year 2011 and abstracted descriptions of PRC-health department collaborations. We identified 14 themes of PRC-health department collaborations and conducted a qualitative analysis to describe the dimensions and distribution of themes. Of the 37 PRCs, 36 reported 215 collaborations with 19 city, 97 county, 31 state, and 46 tribal health departments. Themes of research, survey, and surveillance aligned with the Assessment core function and evaluation, strategic planning, technical assistance, and program implementation supported the Policy Development and Assurance core functions. Overall, health departments provided on-the-ground expertise to inform PRC research, ensuring its applicability to public health practice. Reciprocally, PRCs improved data quality, increased the scientific rigor of health department processes and programs, and filled knowledge gaps within health departments. Both PRCs and health departments enhanced the relevance of public health programs and practices by grounding implementation and evaluation in community needs and views. Findings from this study demonstrate that PRC-health department collaborations often enhanced multiple core functions that could lead to implementation of evidence

  7. Curtailment of well child services by a local health department: impact on rural 2-year-olds.

    OpenAIRE

    Alexander, C S; Klassen, A C

    1986-01-01

    The impact of changes in the delivery of well child health services by a rural health department on the reported health status, immunization status, and patterns of health care use is evaluated for poor children born in 1981, when well child clinic services were reduced. Using birth certificate records, all 1981 resident births were enumerated for the case county in Maryland and for a demographically similar comparison county that had continued to operate health department well child clinics....

  8. The Components of Dengue Haemorrhagic Fever (DHF Surveillance System in Health Department of Kediri City

    Directory of Open Access Journals (Sweden)

    Binti Mahfudhoh

    2015-01-01

    Full Text Available The Dengue Haemorrhagic Fever (DHF was the dangerous infectious disease because it could cause fatality. Kediri City was the DHF endemic area. The Incident Rate in 2013 was about 99,28 per 100.000 population and CFR 0,73%. Effort to overcome DHF in Kediri City was implementing the better epidemiology surveillance system that able to monitor the desease regularly and continuously. The purpose of this research was to evaluate the implementation of DHF surveillance in Health Department of Kediri City. This research used the descriptive method with cross sectional design. Respondent was the functionary of DHF surveillance programme in Health Departement. Data resources consist of primer data and secondary data. The result of the research shown that data collection of DHF surveillance were routine and non-routine data, manpower and tools were sufficient, data collection method were active and passive, the frequency of data collection were monthly, quarterly, and incidentally. Punctuality was uncountable, the completeness of data were 47,9%, and the DHF form were sufficient. Data compilation based on people, time, place, and endemic area. Data analysis based on morbidity, mortality, and area stratification. Data interpretation consist of comparative analysis, coverage analysis, and kecenderungan analysis. The epidemiology information were the general information of DHF. Information dissemination were reporting of the DHF data to Health Department of East Java province and feedback to the public health center. Keywords: DHF, evaluation, surveillance, Kediri City

  9. Public health response systems in-action: learning from local health departments' experiences with acute and emergency incidents.

    Directory of Open Access Journals (Sweden)

    Jennifer C Hunter

    Full Text Available As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems.

  10. An integrative review of information systems and terminologies used in local health departments.

    Science.gov (United States)

    Olsen, Jeanette; Baisch, Mary Jo

    2014-02-01

    The purpose of this integrative review based on the published literature was to identify information systems currently being used by local health departments and to determine the extent to which standard terminology was used to communicate data, interventions, and outcomes to improve public health informatics at the local health department (LHD) level and better inform research, policy, and programs. Whittemore and Knafl's integrative review methodology was used. Data were obtained through key word searches of three publication databases and reference lists of retrieved articles and consulting with experts to identify landmark works. The final sample included 45 articles analyzed and synthesized using the matrix method. The results indicated a wide array of information systems were used by LHDs and supported diverse functions aligned with five categories: administration; surveillance; health records; registries; and consumer resources. Detail regarding specific programs being used, location or extent of use, or effectiveness was lacking. The synthesis indicated evidence of growing interest in health information exchange groups, yet few studies described use of data standards or standard terminology in LHDs. Research to address these gaps is needed to provide current, meaningful data that inform public health informatics research, policy, and initiatives at and across the LHD level. Coordination at a state or national level is recommended to collect information efficiently about LHD information systems that will inform improvements while minimizing duplication of efforts and financial burden. Until this happens, efforts to strengthen LHD information systems and policies may be significantly challenged.

  11. Implementation and evaluation of health passport communication tools in emergency departments.

    Science.gov (United States)

    Heifetz, Marina; Lunsky, Yona

    2018-01-01

    People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Health department use of social media to identify foodborne illness - Chicago, Illinois, 2013-2014.

    Science.gov (United States)

    Harris, Jenine K; Mansour, Raed; Choucair, Bechara; Olson, Joe; Nissen, Cory; Bhatt, Jay

    2014-08-15

    An estimated 55 million to 105 million persons in the United States experience acute gastroenteritis caused by foodborne illness each year, resulting in costs of $2-$4 billion annually. Many persons do not seek treatment, resulting in underreporting of the actual number of cases and cost of the illnesses. To prevent foodborne illness, local health departments nationwide license and inspect restaurants and track and respond to foodborne illness complaints. New technology might allow health departments to engage with the public to improve foodborne illness surveillance. For example, the New York City Department of Health and Mental Hygiene examined restaurant reviews from an online review website to identify foodborne illness complaints. On March 23, 2013, the Chicago Department of Public Health (CDPH) and its civic partners launched FoodBorne Chicago, a website (https://www.foodbornechicago.org) aimed at improving food safety in Chicago by identifying and responding to complaints on Twitter about possible foodborne illnesses. In 10 months, project staff members responded to 270 Twitter messages (tweets) and provided links to the FoodBorne Chicago complaint form. A total of 193 complaints of possible foodborne illness were submitted through FoodBorne Chicago, and 133 restaurants in the city were inspected. Inspection reports indicated 21 (15.8%) restaurants failed inspection, and 33 (24.8%) passed with conditions indicating critical or serious violations. Eight tweets and 19 complaint forms to FoodBorne Chicago described seeking medical treatment. Collaboration between public health professionals and the public via social media might improve foodborne illness surveillance and response. CDPH is working to disseminate FoodBorne Chicago via freely available open source software.

  13. Standards for the mental health care of people with severe ...

    African Journals Online (AJOL)

    Adele

    Standards for the mental health care of people with severe psychiatric disorders in South Africa: Part 1. Conceptual issues. National and provincial departments must publish standards for the level and quality of services they will provide, including the introduction of new services to those who have previously been denied ...

  14. Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services.

    Science.gov (United States)

    Nieuwsma, Jason A; Jackson, George L; DeKraai, Mark B; Bulling, Denise J; Cantrell, William C; Rhodes, Jeffrey E; Bates, Mark J; Ethridge, Keith; Lane, Marian E; Tenhula, Wendy N; Batten, Sonja V; Meador, Keith G

    2014-12-01

    Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

  15. The Search for Stability: Provincial Reconstruction Teams in Afghanistan

    National Research Council Canada - National Science Library

    Wardle, Russel

    2004-01-01

    ... and international bodies as well as the military. Provincial Reconstruction Teams (PRTs), as employed in Afghanistan, are used as a vehicle to examine the wide range of activities necessary for Nation Building...

  16. Is low health literacy associated with increased emergency department utilization and recidivism?

    Science.gov (United States)

    Griffey, Richard T; Kennedy, Sarah K; D'Agostino McGowan, Lucy; McGownan, Lucy; Goodman, Melody; Kaphingst, Kimberly A

    2014-10-01

    The objective was to determine whether patients with low health literacy have higher emergency department (ED) utilization and higher ED recidivism than patients with adequate health literacy. The study was conducted at an urban academic ED with more than 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross-sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (S-TOFHLA) and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis and retaining those significant at an alpha of 0.05 in the final model. Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score

  17. Meeting at the crossroads: collaboration between information technology departments and health sciences libraries.

    Science.gov (United States)

    King, Samuel; Cataldi-Roberts, Erica; Wentz, Erin

    2017-01-01

    The purposes of this survey were to determine the nature and extent of collaboration between health sciences libraries and their information technology (IT) departments, to identify strengths and issues connected to this relationship, and to provide examples demonstrating exceptional collaborative success. A fourteen-question survey was sent to a broad selection of health care and academic libraries through a variety of email discussion lists and was limited to one response per institution. Convenience sampling was used to collect the responses. An overwhelming majority of libraries described the relationship with their IT departments as good or excellent, and there were a variety of creative joint initiatives underway. Opportunities exist for continued and expanded library/IT collaboration. Good quality relationships between libraries and their IT departments are essential due to the interconnected nature of their services, and fortunately, this appears to be the norm at a variety of institutions. Mutual respect, open communication, realization of each department's mission, and responsiveness to each other's needs are part of what makes these relationships successful, which in turn leads to successful collaborative ventures that bode well for the future of both services.

  18. How to Embrace Change: Provincial Unemployment After the 2008 Recession

    OpenAIRE

    Karpenko, Yevgeniya

    2014-01-01

    Five years after the 2008 recession, provincial unemployment rates in Canada remain higher than pre-recession levels. In some provinces, initial declines in unemployment have plateaued. When structural changes occur, a higher unemployment rate can persist even after a full economic recovery. This study undertakes an empirical analysis of provincial panel data to uncover potential causes of persistent unemployment across Canada. The results indicate that, after the recession, the structural co...

  19. What predicts recovery orientation in county departments of mental health? A pilot study.

    Science.gov (United States)

    Brown, Timothy T; Mahoney, Christine B; Adams, Neal; Felton, Mistique; Pareja, Candy

    2010-09-01

    In this pilot study we examined the determinants of recovery orientation among employees and influential stakeholders in a sample of 12 county departments of mental health in California. A two-level hierarchical linear model with random intercepts was estimated. Analyses show that recovery orientation has a U-shaped relationship with the age of staff/influential stakeholders and is negatively related to the difference between the desired level of adhocracy and the current level of adhocracy. Recovery orientation is positively related to the education level of staff/influential stakeholders, satisfying transformational leadership outcomes, and larger mental health budgets per capita. Policy implications are discussed.

  20. Asian tsunami relief: Department of Defense public health response: policy and strategic coordination considerations.

    Science.gov (United States)

    Tarantino, Dave

    2006-10-01

    The Asian tsunami of December 26, 2004, was one of the most devastating natural disasters in modern history. In particular, this disaster created massive, unique, public health threats, necessitating equally massive public health response efforts. The U.S. government (USG), including the Department of Defense (DoD), played a pivotal role in the response. This article examines some of the central policy issues and strategic coordination and planning measures involved in the public health response. The nearly unanimous consensus of international public health experts has been that the potential public health crisis in the aftermath of the Asian tsunami was averted largely because of the coordinated efforts of host nation officials and professionals, international and nongovernmental health organizations, and bilateral donors, especially the USG, including the DoD. The DoD played a central role in public health efforts through coordination and communication assistance, logistical and materiel support, disease surveillance activities, health needs assessments, and the contributions of the USS Mercy hospital ship. The core lessons involve the importance of an early, dedicated, public health response as a component of the overall disaster relief effort, as well as seamless coordination of health sector stakeholders in the USG and with those of the international community and affected host nations, which allows each organization to play to its strengths and to avoid duplication. The Asian tsunami relief effort highlighted the value of civil-military cooperation in disaster relief, particularly in the area of public health. The prominent role of the DoD in tsunami relief efforts, including public health efforts, also yielded beneficial secondary effects by bolstering security cooperation and winning "hearts and minds" in the region.

  1. Health, emergency department use, and early identification of young children exposed to trauma.

    Science.gov (United States)

    Roberts, Yvonne Humenay; Huang, Cindy Y; Crusto, Cindy A; Kaufman, Joy S

    2014-05-01

    Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency departments (EDs) are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters). Describe the prevalence of physical health symptoms, ED use, and health-related problems in young children (birth through 5 years) affected by trauma, and to predict whether or not children experiencing trauma are more likely to be affected by health-related problems. Community-based, cross-sectional survey of 208 young children. Traumatic events were assessed by the Traumatic Events Screening Inventory - Parent Report Revised. Child health symptoms and health-related problems were measured using the Caregiver Information Questionnaire, developed by ORC Macro (Atlanta, GA). Seventy-two percent of children had experienced at least one type of traumatic event. Children exposed to trauma were also experiencing recent health-related events, including visits to the ED (32.2%) and the doctor (76.9%) for physical health symptoms, and recurring physical health problems (40.4%). Children previously exposed to high levels of trauma (four or more types of events) were 2.9 times more likely to report having had recently visited the ED for health purposes. Preventing recurrent trauma or recognizing early trauma exposure is difficult, but essential if long-term negative consequences are to be mitigated or prevented. Within EDs, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury, and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Perspectives of Community- and Faith-Based Organizations about Partnering with Local Health Departments for Disasters

    Directory of Open Access Journals (Sweden)

    Michael Stajura

    2012-06-01

    Full Text Available Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way “push” model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

  3. Improving Immunization Rates of Underserved Children: A Historical Study of 10 Health Departments

    Directory of Open Access Journals (Sweden)

    Donald Robert Haley

    2014-05-01

    Full Text Available Background Despite high immunization rates, hundreds of thousands of poor and underserved children continue to lack their necessary immunizations and are at risk of acquiring a vaccine-preventable disease. Local Health Departments (LHDs and public health clinicians figure prominently in efforts to address this problem. Methods This exploratory research compared ten (10 North Carolina LHDs with respect to immunization delivery factors. The study sample was identified based on urban designation as well as county demographic and socio-economic indicators that identified predicted “pockets” of underimmunization. Survey instruments were used to identify specific LHD immunization delivery factors. Results It was found that hours of operation, appointment policies, use and type of tracking systems, and wait times influence a health department’s ability to immunize underserved children. This exploratory research is of particular importance, because it suggests that the implementation of specific policy interventions may reduce the morbidity and mortality related to vaccine-preventable diseases in poor and underserved children. This research also highlights the significance of the nurses’ role in the policy making process in this important area of community health assurance. Conclusion To improve childhood immunization rates, policy-makers should encourage adequate and appropriate funding for LHDs to adopt service delivery factors that are associated with higher-performing local health departments. LHDs should study the population they serve to further refine service delivery factors to meet the population’s needs.

  4. Perspectives of community- and faith-based organizations about partnering with local health departments for disasters.

    Science.gov (United States)

    Stajura, Michael; Glik, Deborah; Eisenman, David; Prelip, Michael; Martel, Andrea; Sammartinova, Jitka

    2012-07-01

    Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way "push" model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

  5. New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department.

    Science.gov (United States)

    Richardson, Sandra; Ardagh, Michael; Hider, Philip

    2006-04-21

    Emergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of ED patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. There are significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the ED. While there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.

  6. High-Performing Local Health Departments Relate Their Experiences at Community Engagement in Emergency Preparedness.

    Science.gov (United States)

    Schoch-Spana, Monica; Ravi, Sanjana; Meyer, Diane; Biesiadecki, Laura; Mwaungulu, Geoffrey

    2017-10-27

    Local health departments (LHDs) are implementing a national mandate to engage community partners, including individuals, businesses, and community- and faith-based organizations in the larger public health emergency preparedness (PHEP) enterprise. Investigate how LHDs of varying size and resource levels successfully engage the community in PHEP to help uncover "best practices" that aspiring agencies can replicate, particularly in low-resource environments. In-depth, semistructured qualitative interviews with practitioners from 9 highly performing LHDs. Participating agencies comprised equal amounts of small (serving 500 000 residents) LHDs and were diverse in terms of geographic region, rural-urban environment, and governance structure. A cross section of LHD staff (n = 34) including agency leaders, preparedness coordinators, public information officers, and health educators/promoters. Local health department performance at community engagement as determined by top scores in 2 national LHD surveys (2012, 2015) regarding community engagement in PHEP. Based on key informant accounts, high-performing LHDs show a holistic, organization-wide commitment to, rather than discrete focus on, community engagement. Best practices clustered around 5 domains: administration (eg, top executive who models collaborative behavior), organizational culture (eg, solicitous rather than prescriptive posture regarding community needs), social capital (eg, mining preexisting community connections held by other LHD programs), workforce skills (eg, cultural competence), and methods/tactics (eg, visibility in community events unrelated to PHEP). For LHDs that wish to enhance their performance at community engagement in PHEP, change will entail adoption of evidence-based interventions (the technical "what") as well as evidence-based administrative approaches (the managerial "how"). Smaller, rural LHDs should be encouraged that, in the case of PHEP community engagement, they have unique social

  7. Abuse experiences, substance use, and reproductive health in women seeking care at an emergency department.

    Science.gov (United States)

    Sutherland, Melissa A; Fantasia, Heidi Collins; McClain, Natalie

    2013-07-01

    Abuse experiences can have negative health consequences for women. Many women present to the emergency department for episodic, nonemergent care and may have unique needs as survivors of abuse. The purpose of this study was to describe child sexual abuse experiences, intimate partner violence, substance use, and reproductive health outcomes in a sample of adult women who were seeking care from a rural emergency department to better understand the health care needs of this unique population. One hundred forty-five adult women (18-45 years old) were recruited at an emergency department in the southeastern United States. Questionnaires were used to assess for demographic characteristics, history of child sexual abuse (CSA), intimate partner violence, reproductive health, and substance use. In the sample, 42.8% of women (n = 62) reported a positive history of CSA and 34.7% of women (n = 49) experienced intimate partner physical violence during the past year. More than 46% of the women (n = 65) had harmful drinking patterns in the past year and more than 50% reported some type of substance use in the past 3 months. Women who experienced CSA had a significantly greater number of lifetime sexual partners, were more likely to report pain with sexual intercourse, and were more likely to report a medical history of an abnormal Papanicolaou smear. The women in this sample had high rates of abuse, harmful drinking patterns, and substance use and were at risk for sexually transmitted infections. Through screening for lifetime violence, including sexual violence, emergency nurses can be an important liaison between women who have experienced CSA and appropriate referrals within the health care system. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  8. Extent and patterns of community collaboration in local health departments: An exploratory survey.

    Science.gov (United States)

    Studnicki, James; Platonova, Elena A; Eiechelberger, Chris N; Fisher, John W

    2011-10-07

    Local public health departments (LHDs) in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1) determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2) characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities. Local health department officials in North Carolina (n = 53) responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM) were used to characterize their collaboration. Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high), officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved. The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

  9. Extent and patterns of community collaboration in local health departments: An exploratory survey

    Directory of Open Access Journals (Sweden)

    Fisher John W

    2011-10-01

    Full Text Available Abstract Background Local public health departments (LHDs in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1 determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2 characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities. Methods Local health department officials in North Carolina (n = 53 responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM were used to characterize their collaboration. Results Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high, officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved. Conclusion The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

  10. The proof's in the partnerships: Are Affordable Care Act and Local Health Department accreditation practices influencing collaborative partnerships in community health assessment and improvement planning?

    Science.gov (United States)

    Laymon, Barbara; Shah, Gulzar; Leep, Carolyn J; Elligers, Julia Joh; Kumar, Vibha

    2015-01-01

    The strengthened requirement for nonprofit hospitals to complete a community health needs assessment and implementation plan in the Affordable Care Act, concurrent with a new voluntary accreditation process for local health departments that requires collaborative community health assessments and community health improvement plans, have led to a resurgence of interest in assessment and improvement planning. This study provides baseline data that will help determine whether the Affordable Care Act and public health accreditation will result in more collaborative community assessment and community health improvement activity by describing trends in collaborative community health assessment and community health improvement plan activities. Data sources include the National Profile of Local Health Departments studies and a database of community health assessment, community health needs assessment, community health improvement plan, and other implementation planning reports from across the country. The study finds that collaborative community assessment activity is positively associated with population size, governance type, and local health department and coalition-led efforts.

  11. Department of Energy Environment, Safety and Health Management Plan. Fiscal year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    This report describes efforts by the Department of Energy (DOE) to effectively plan for environment, safety and health activities that protect the environment, workers and the public from harm. This document, which covers fiscal year 1996, reflects planning by operating contractors and Program Offices in early 1994, updated to be consistent with the President`s FY 1996 budget submittal to Congress, and subsequent Department of Energy Program refinements. Prior to 1992, only a small number of facilities had a structured process for identifying environment, safety and health (ES and H) needs, reporting the costs (in both direct and indirect budgets) of ES and H requirements, prioritizing and allocating available resources, and efficiently communicating this information to DOE. Planned costs for ES and H activities were usually developed as an afterthought to program budgets. There was no visible, consistently applied mechanism for determining the appropriate amount of resources that should be allocated to ES and H, or for assuring that significant ES and H vulnerabilities were planned to be funded. To address this issue, the Secretary (in November 1991) directed DOE to develop a Safety and Health Five-Year Plan to serve as a line management tool to delineate DOE-wide programs to reduce and manage safety and health risks, and to establish a consistent framework for risk-based resource planning and allocation.

  12. Does numeracy correlate with measures of health literacy in the emergency department?

    Science.gov (United States)

    Griffey, Richard T; Melson, Andrew T; Lin, Margaret J; Carpenter, Christopher R; Goodman, Melody S; Kaphingst, Kimberly A

    2014-02-01

    The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. This was a prospective cross-sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S-TOFHLA], Rapid Estimate of Adult Literacy in Medicine-Revised [REALM-R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) versus adequate health literacy, and the proportion of patients answering all numeracy questions correctly was calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. A total of 446 patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (interquartile range [IQR] = 1 to 2). Among patients with limited health literacy (LHL) by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% versus >50% of numeracy questions correctly, there was a significant difference between those with LHL and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S-TOFHLA rs  = 0.428 (p

  13. Adapting to Health Impacts of Climate Change in the Department of Defense.

    Science.gov (United States)

    Chrétien, Jean-Paul

    2016-01-01

    The Department of Defense (DoD) recognizes climate change as a threat to its mission and recently issued policy to implement climate change adaptation measures. However, the DoD has not conducted a comprehensive assessment of health-related climate change effects. To catalyze the needed assessment--a first step toward a comprehensive DoD climate change adaptation plan for health--this article discusses the DoD relevance of 3 selected climate change impacts: heat injuries, vector-borne diseases, and extreme weather that could lead to natural disasters. The author uses these examples to propose a comprehensive approach to planning for health-related climate change impacts in the DoD.

  14. 32 CFR 644.336 - Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing...

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development (HUD). 644.336 Section 644.336... Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development...

  15. Health insurance, neighborhood income, and emergency department usage by Utah children 1996–1998

    Directory of Open Access Journals (Sweden)

    Knight Stacey

    2005-04-01

    Full Text Available Abstract Background It is estimated that approximately half of emergency department (ED usage in the U.S. and other developed countries is for non-urgent conditions and that this usage is related to availability, social, and economic factors. We examined pediatric ED usage in a U.S. state with respect to income, health insurance status, types of medical conditions, and whether introduction of managed care affected utilization by Medicaid children. Methods Emergency department usage rates were calculated from 1996 through 1998 using Utah ED data for children with commercial health insurance, Medicaid, for uninsured children, and by income group estimating neighborhood household income from Zip code of residence. We analyzed usage following the July 1996 transition of Utah Medicaid to managed care. Results Children with Medicaid had approximately 50% greater ED utilization rates than children with commercial health insurance or uninsured children. The majority of usage for Medicaid and uninsured children was for non-traumatic conditions. Only 35% of total ED usage was for non-emergent or non-urgent conditions and this was related to both Medicaid and low household income. Children lacking health insurance were more likely to be discharged against medical advice (OR = 2.36, 95% C.I. 1.88–2.96. There was no reduction in Medicaid ED usage following the transition to managed care. Conclusion Usage of ED services is related to both health insurance status and income. Children lacking health insurance and Medicaid children have excessive usage for conditions which could be treated in a primary care setting. That managed care does not reduce Medicaid ED usage is consistent with findings of other studies.

  16. The acceptability of mental health screening in a pediatric emergency department.

    Science.gov (United States)

    Williams, Jennifer R; Ho, Mona L; Grupp-Phelan, Jacqueline

    2011-07-01

    The purposes of the study were (1) to assess the acceptability of mental health screening in the pediatric emergency department (ED) for children and their parents; (2) to measure providers' perceptions on whether screening has an impact on patient care; and (3) to determine the impact of screening status on acceptability. A validated pediatric mental health screening instrument was administered to 384 parent-child dyads. A 6-item satisfaction questionnaire was administered by a trained research coordinator to assess parent-child reactions to the screen. Emergency department providers rated how difficult the screening made it for them to care for the patient. Research staff reported the difficulty of conducting screening during the ED visit and the amount of time parents/children spent completing the screen. Most parents (82%) and children (75%) felt the screening was acceptable. Parent reports of pediatric mental health problems were not associated with lower acceptability scores. The number of mental health problems reported by a child was associated with an increased likelihood that the screening made the child upset (P = 0.02). Parents who reported pediatric mental health problems were more likely to find the screening helpful (odds ratio,1.84 [95% confidence interval, 1.15-2.93]), with black parents more likely to report that the screen was helpful (odds ratio, 2.5 [95% confidence interval, 1.43-4.33]). Nearly all doctors (99%) and nurses (97%) reported that the screening did not make it difficult for them to care for the patient. Overall, mental health screening appears to be acceptable in the pediatric ED.

  17. Attitudes of Students Studying In Health Related Departments towards the Elderly

    Directory of Open Access Journals (Sweden)

    Sercan Özbek YAZICI

    2016-12-01

    Full Text Available Negative attitudes towards the elderly may cause decreases in quality health service provided to the elderly. In the study, the aim was to determine attitudes of students studying in health related departments towards the elderly and relationships between the attitudes and various variables were analyzed. In a descriptive study, the sample included nursing, physiotherapy, and elderly care students. Kogan’s attitude towards old people scale (KAOP was used to measure attitudes towards the elderly and Stanley Coopersmith Self Esteem Inventory (SEI was used to assess the level of students’ self-esteem. The KOAP mean attitude score of the students was 125.6 ± 14.38 and the students had slightly positive attitudes towards the elderly. Students who were at the age of 20 or over and who were living in the city showed more positive attitudes. The students of the Elderly Care Department had the lowest mean score and there was a significant difference between mean KAOP scores of students at Nursing and Elderly Care Department. Also, weak positive correlation was found between the KAOP and SEI mean scores of students. The results implies that the students are required to enhance their positive attitudes towards the elderly. Therefore, students should be provided a training program that improves the positive attitudes

  18. Informatics as a Strategic Priority and Collaborative Processes to Build a Smarter, Forward-Looking Health Department

    OpenAIRE

    Lovelace, Kay; Shah, Gulzar H.

    2016-01-01

    Health information is critical to surveillance and assessment of public health threats, population and disease trends, management of clinical services, completion of immunizations, identification of disease trends, and communication with community partners. This article explores how a medium-sized local health department using best practices in informatics could implement and use informatics to improve the practice of public health.

  19. A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru

    OpenAIRE

    M. Shashi Kumar; B. Ramakrishna Goud; Bobby Joseph

    2014-01-01

    Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH) measures in the Laundry Department and to assess the use of personal protective equipments (PPEs) among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teachin...

  20. The Use of Social Media by State Health Departments in the US: Analyzing Health Communication Through Facebook.

    Science.gov (United States)

    Jha, Ayan; Lin, Leesa; Savoia, Elena

    2016-02-01

    The use of social media as a powerful health communication tool is an area of current research interest. Our objective was to describe use of Facebook by State Health Departments (SHDs) in US, and their relationship with CDC's Behavioral Risk Factor Surveillance System (BRFSS) data. Facebook pages of 34 SHDs were studied over a 200 day period, coding 2597 posts into 19 broad health communication categories. Mean number of Facebook posts per SHD was 76.4 (range 34-133); most frequent topic areas included healthy living (12%), communicable diseases (9%), vaccines and immunization (7%), emergency preparedness and response (7%), infant and child health (5%), smoking and tobacco use (5%), and miscellaneous (32%). Through web-based interactive graphics (Google motion charts), we contrasted Facebook posts with CDC's BRFSS data on adult nutrition and physical activity, vaccination, smoking, adolescent health and road traffic accidents. Our research finds an apparent disconnect between content provided on Facebook by SHDs and the health conditions that affect their populations. Acknowledging the severe limitations in funding and human resources faced by the SHDs, our research attempts to present the factual situation in embracing a vastly popular social media platform for health communication. We believe there is a need for research exploring methods to balance the demands and resources.

  1. Perceptions of Health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012.

    Directory of Open Access Journals (Sweden)

    Holly Ann Williams

    Full Text Available The international response to Haiti's ongoing cholera outbreak has been multifaceted, including health education efforts by community health workers and the distribution of free water treatment products. Artibonite Department was the first region affected by the outbreak. Numerous organizations have been involved in cholera response efforts in Haiti with many focusing on efforts to improve water, sanitation, and hygiene (WASH. Multiple types of water treatment products have been distributed, creating the potential for confusion over correct dosage and water treatment methods. We utilized qualitative methods in Artibonite to determine the population's response to WASH messages, use and acceptability of water treatment products, and water treatment and sanitation knowledge, attitudes and practices at the household level. We conducted eighteen focus group discussions (FGDs: 17 FGDs were held with community members (nine among females, eight among males; one FGD was held with community health workers. Health messages related to WASH were well-retained, with reported improvements in hand-washing. Community health workers were identified as valued sources of health information. Most participants noted a paucity of water-treatment products. Sanitation, specifically the construction of latrines, was the most commonly identified need. Lack of funds was the primary reason given for not constructing a latrine. The construction and maintenance of potable water and sanitation services is needed to ensure a sustainable change.

  2. Augmented Fish Health Monitoring for Washington Department of Wildlife, 1989 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Kerwin, John L.; Roberts, Steve; Oman, Leni; Bolding, Bruce

    1991-04-01

    The augmented fish health monitoring project is funded by the Bonneville Power Administration (BPA) with the mandate to collect fish health data on anadromous fish stocks of the BPA Columbia River Basin in a standardized manner. The project began in 1986 and the data reported here was collected in the fourth year. This segment of the project was carried out by the Washington Department of Wildlife and summarizes fish health findings at anadromous game fish hatcheries in Washington State operated by the BPA. Information gathered to data has provided impetus to alter facility design and management practices for improved fish health through prevention. Treatment efficacy can be better assessed due to the monthly monitoring of fish stocks and insight is being gained into disease prevention and control. The ultimate goal, of course, is to improve fish health for better survival in the wild. Tagged returns at index hatcheries within this project area will provide some indication of the impact of improving fish health on providing greater adult returns as well as an improved product for the fishery. 3 refs., 2 figs., 16 tabs.

  3. Augmented Fish Health Monitoring for Washington Department of Wildlife, 1988 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Gearheard, Jim

    1988-10-01

    The augmented fish health monitoring project is funded by the Bonneville Power Administration with the mandate to collect fish health data on anadromous fish stocks of the Columbia River Basin in a standardized manner. The project began in 1986 and the data reported here was collected in the third year. This segment of the project was carried out by the Washington Department of Wildlife and summarizes fish health findings at anadromous game hatcheries in Washington State operated by the BPA. Information gathered to date has provided impetus to alter facility design and management practices for improved fish health through prevention. Treatment efficacy can be better assessed due to the monthly monitoring of fish stocks and insight is being gained into disease prevention and control. The ultimate goal, of course, is to improve fish health for better survival in the wild. Tagged returns at index hatcheries within this project area will indicate the impact of improving fish health on providing greater adult returns as well as an improved product for the fishery. 2 refs., 3 figs., 15 tabs.

  4. Electronic Health Records and Meaningful Use in Local Health Departments: Updates From the 2015 NACCHO Informatics Assessment Survey.

    Science.gov (United States)

    Williams, Karmen S; Shah, Gulzar H

    2016-01-01

    Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data. The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs. Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling design of LHD populations. Oversampling of larger LHDs was conducted and sampling weights were applied. Data were analyzed using descriptive statistics and logistic regression in SPSS. Forty-two percent of LHDs indicated the use of an EHR system compared with 58% that use a non-EHR system for the storage of primary health data. Seventy-one percent of LHDs had reviewed some or all of the current systems to determine whether they needed to be improved or replaced, whereas only 6% formally conducted a readiness assessment for health information exchange. Twenty-seven percent of the LHDs had conducted informatics training within the past 12 months. LHD characteristics statistically associated with having an EHR system were having state or centralized governance, not having created a strategic plan related to informatics within the past 2 years throughout LHDs, provided informatics training in the past 12 months, and various levels of control over decisions regarding hardware allocation or acquisition, software selection, software support, and information technology budget allocation. A focus on EHR implementation in public health is pertinent to examining the impact of public health programming and interventions for the positive change in population health.

  5. Building Geographic Information System Capacity in Local Health Departments: Lessons From a North Carolina Project

    Science.gov (United States)

    Miranda, Marie Lynn; Silva, Jennifer M.; Overstreet Galeano, M. Alicia; Brown, Jeffrey P.; Campbell, Douglas S.; Coley, Evelyn; Cowan, Christopher S.; Harvell, Dianne; Lassiter, Jenny; Parks, Jerry L.; Sandelé, Wanda

    2005-01-01

    State government, university, and local health department (LHD) partners collaborated to build the geographic information system (GIS) capacity of 5 LHDs in North Carolina. Project elements included procuring hardware and software, conducting individualized and group training, developing data layers, guiding the project development process, coordinating participation in technical conferences, providing ongoing project consultation, and evaluating project milestones. The project provided health department personnel with the skills and resources required to use sophisticated information management systems, particularly those that address spatial dimensions of public health practice. This capacity-building project helped LHDs incorporate GIS technology into daily operations, resulting in improved time and cost efficiency. Keys to success included (1) methods training rooted in problems specific to the LHD, (2) required project identification by LHD staff with associated timelines for development, (3) ongoing technical support as staff returned to home offices after training, (4) subgrants to LHDs to ease hardware and software resource constraints, (5) networks of relationships among LHDs and other professional GIS users, and (6) senior LHD leadership who supported the professional development activities being undertaken by staff. PMID:16257950

  6. Should they stay or should they go? Leader duration and financial performance in local health departments.

    Science.gov (United States)

    Jadhav, Emmanuel D; Holsinger, James W; Mays, Glen; Fardo, David

    2015-01-01

    The delivery of programs by local health departments (LHDs) has shifted from "if we do not have the money we don't do it" to LHD directors should "identify and fund public health priorities." This shift has subsequently increased performance expectations of LHD leaders. In the for-profit sector the leaders' failure to perform has resulted in a shortening tenure trend. Tenure is a proxy for human capital accumulation. In LHDs, the nature of association, if any, between leader tenure and agency performance is unknown. Examine association between financial performance of LHDs with short-, average-, and long-tenured LHD leaders. Variation in leader characteristics and percent change in expenditure were examined using a longitudinal cohort design and positive deviance methodology. Bivariate analysis of LHD financial performance and leader characteristics was conducted, and a logistic regression model was developed to test association between leader tenure and LHDs that experienced a positive percentage expenditure change. From a total of 2523 LHDs, 1453 were examined. The cross-sectional surveys of US public health agencies conducted by the National Association of County and City Health Officials in 2008 and 2010 contain the leader and LHD variables. Approximately 44% of LHDs experienced a positive percentage expenditure change. Leader tenure, age, gender, and education status were significantly associated with a positive percentage expenditure change using a chi-square test of independence. From the logistic regression analysis tenure, educational status, employment status, area population, governance, classification, and jurisdiction were statistically significant. Local health departments with leaders whose tenure was less than 2 years were less likely than those with average tenure to experience a positive percentage expenditure change. The odds ratios for tenure suggest that tenure is positively associated up to a threshold level and then declines. Implying that

  7. Substance abuse and mental health visits among adolescents presenting to US emergency departments.

    Science.gov (United States)

    Fahimi, Jahan; Aurrecoechea, Adrian; Anderson, Erik; Herring, Andrew; Alter, Harrison

    2015-05-01

    The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. We performed a secondary analysis of ED visits by adolescents (age, 11-24) using the National Hospital Ambulatory Medical Care Survey (1997-2010) to identify visits for mental health, substance use, and dual diagnosis. Univariate and multivariate statistics were used to analyze demographic and visit-level factors, factors associated with substance use and dual diagnosis visits, as well as the effects of substance use and mental health conditions on ED LOS and disposition. Substance use and mental health accounted for 2.1% and 4.3% of all adolescent visits, respectively, with 20.9% (95% confidence interval [CI], 18.3%-23.5%) of substance abuse visits complicated by mental health. The factors significantly associated with substance use include the following: male sex, urban location, West region, ambulance arrival, night and weekend shift, anxiety disorders, mood disorders, and psychotic disorders. Additional LOS was 89.77 minutes for mental health, 71.33 minutes for substance use, and 139.97 minutes for dual diagnosis visits, as compared with visits where these conditions were not present. Both mental health and substance use were associated with admission/transfer as compared with other dispositions as follows: mental health odds ratio (OR), 5.93 (95% CI, 5.14-6.84); illicit drug use OR, 3.56 (95% CI 2.72-4.64); and dual diagnosis OR, 6.86 (95% CI, 4.67-10.09). Substance abuse and dual diagnosis are common among adolescent ED visits and are strongly associated with increased use of prehospital resources, ED LOS, and need for hospitalization.

  8. Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders.

    Science.gov (United States)

    Jadhav, Emmanuel D; Holsinger, James W; Fardo, David W

    2015-01-01

    During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders' demographic and organizational characteristics and to characterize the underlying relationships. The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ) and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal-Wallis non-parametric tests were used, and to adjust for potential confounding, linear regression analysis was performed. Local health department leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data were utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders' observable attributes relating to age, gender, race, educational background, leadership experience, and openness to change. Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-2013 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply that there are underlying relationships between leader and LHD characteristics based on leader openness to change.

  9. Florida Department of Health workers' response to 2004 hurricanes: a qualitative analysis.

    Science.gov (United States)

    Herberman Mash, Holly B; Fullerton, Carol S; Kowalski-Trakofler, Kathleen; Reissman, Dori B; Scharf, Ted; Shultz, James M; Ursano, Robert J

    2013-04-01

    Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family's safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness.

  10. Florida Department of Health Workers’ Response to 2004 Hurricanes: A Qualitative Analysis

    Science.gov (United States)

    Herberman Mash, Holly B.; Fullerton, Carol S.; Kowalski-Trakofler, Kathleen; Reissman, Dori B.; Scharf, Ted; Shultz, James M.; Ursano, Robert J.

    2015-01-01

    Objective Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family’s safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Methods Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. Results A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Conclusions Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness. PMID:24618166

  11. Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

    Directory of Open Access Journals (Sweden)

    Chun Nok Lam

    2016-09-01

    Full Text Available Introduction: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This study assessed the impact of homelessness on 30-day ED revisits and hospital readmissions among patients presenting with mental health conditions in an urban, safety-net hospital. Methods: We conducted a secondary analysis of administrative data on all adult ED visits in 2012 in an urban safety-net hospital. Patient demographics, mental health status, homelessness, insurance coverage, level of acuity, and ED disposition per ED visit were analyzed using multilevel modeling to control for multiple visits nested within patients. We performed multivariate logistic regressions to evaluate if homelessness moderated the likelihood of mental health patients’ 30-day ED revisits and hospital readmissions. Results: Study included 139,414 adult ED visits from 92,307 unique patients (43.5±15.1 years, 51.3% male, 68.2% Hispanic/Latino. Nearly 8% of patients presented with mental health conditions, while 4.6% were homeless at any time during the study period. Among patients with mental health conditions, being homeless contributed to an additional 28.0% increase in likelihood (4.28 to 5.48 odds of 30-day ED revisits and 38.2% increase in likelihood (2.04 to 2.82 odds of hospital readmission, compared to non-homeless, non-mental health (NHNM patients as the base category. Adjusted predicted probabilities showed that homeless patients presenting with mental health conditions have a 31.1% chance of returning to the ED within 30-day post discharge and a 3

  12. An Evaluation of Provincial Infectious Disease Surveillance Reports in Ontario.

    Science.gov (United States)

    Chan, Ellen; Barnes, Morgan E; Sharif, Omar

    2017-01-30

    Public Health Ontario (PHO) publishes various infectious disease surveillance reports, but none have yet been formally evaluated. PHO evaluated its monthly and annual infectious disease surveillance reports to assess public health stakeholders' current perception of the products and to develop recommendations for improving future products. An evaluation consisting of an online survey and a review of public Web sites of other jurisdictions with similar annual reports. For the online survey, stakeholder organizations targeted were the 36 local public health units and the Health health ministry in Ontario, Canada. Survey participants included epidemiologists, managers, directors, and other public health practitioners from participating organizations. Online survey respondents' awareness and access to the reports, their rated usefulness of reports and subsections, and suggestions for improving usefulness; timeliness of select annual reports from other jurisdictions based on the period from data described to report publication. Among 57 survey respondents, between 74% and 97% rated each report as useful; the most common use was for situational awareness. Respondents ranked timeliness as the most important attribute of surveillance reports, followed by data completeness. Among 6 annual reports reviewed, the median time to publication was 11.5 months compared with 23.2 months for PHO. Recommendations based on this evaluation have already been applied to the monthly report (eg, focusing on the most useful sections) and have become key considerations when developing future annual reports and other surveillance reporting tools (eg, need to provide more timely reports). Other public health organizations may also use this evaluation to inform aspects of their surveillance report development and evaluation. The evaluation results have provided PHO with direction on how to improve its provincial infectious disease surveillance reporting moving forward, and formed a basis for

  13. The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight

    Science.gov (United States)

    2013-09-18

    E M B E R 1 8 , 2 0 1 3 The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More...Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight 5a. CONTRACT NUMBER...Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight Objective Our audit objective was to determine whether the

  14. US Department of Energy Environment, Safety and Health Progress Assessment of the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety, and Health (ES&H) Progress Assessment of the Nevada Test Site (NTS), Nye County, Nevada. The assessment, which was conducted from July 20 through August 4, 1992, included a selective review of the ES&H management systems and progress of the responsible DOE Headquarters Program Offices; the DOE Nevada Field Office (NV); and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. This report presents a summary of issues and progress in the areas of environment, safety and health, and management.

  15. [Satisfaction according to health care insurance systems in an emergency department].

    Science.gov (United States)

    Dávila, F A; Herrera, J S; Yasnó, D A; Forero, L C; Alvarado, M V

    Health satisfaction is a fundamental measure of the quality of health services. This study aims to validate and analyse the results of a quality of care questionnaire to assess the level of satisfaction of patients attended in the emergency department of a high complexity hospital. Observational, cross-sectional study, with a questionnaire designed to assess the quality of service and satisfaction at the end of care in the emergency department. Descriptive statistics of scale were established and presented, as well as determining the construct validity, overall reliability, internal and concurrent validity of an overall against a uni-dimensional scale. A total of 5,961 records were reviewed, most of them (77.3%) reported by patients in the Mandatory Health Plan. High levels of satisfaction overall and by subgroups were found. There were no significant differences between subgroups, with 86.8 for those with Pre-paid Medical Care Plan and 84.4 for mandatory health plan. Cronbach's alpha for the questionnaire was 0.90. The questionnaire proved to be reliable and valid in determining the quality and satisfaction with care. The results showed high levels of satisfaction overall and in the domains. A low consistency between the results of the multidimensional and unidimensional satisfaction scales suggests that there were aspects of satisfaction not investigated on the multidimensional scale. Ecologically-designed before and after studies are required to evaluate the effectiveness of interventions in satisfaction. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Tweeting for and against public health policy: response to the Chicago Department of Public Health's electronic cigarette Twitter campaign.

    Science.gov (United States)

    Harris, Jenine K; Moreland-Russell, Sarah; Choucair, Bechara; Mansour, Raed; Staub, Mackenzie; Simmons, Kendall

    2014-10-16

    In January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department's Twitter account became the target of a "Twitter bomb" by Twitter users sending more than 600 tweets in one week against the proposed regulation. The purpose of our study was to examine the messages and tweet patterns in the social media response to the CDPH e-cigarette campaign. We collected all tweets mentioning the CDPH in the week between the e-cigarette campaign and the vote on the new local e-cigarette policy. We conducted a content analysis of the tweets, used descriptive statistics to examine characteristics of involved Twitter users, and used network visualization and descriptive statistics to identify Twitter users prominent in the conversation. Of the 683 tweets mentioning CDPH during the week, 609 (89.2%) were anti-policy. More than half of anti-policy tweets were about use of electronic cigarettes for cessation as a healthier alternative to combustible cigarettes (358/609, 58.8%). Just over one-third of anti-policy tweets asserted that the health department was lying or disseminating propaganda (224/609, 36.8%). Approximately 14% (96/683, 14.1%) of the tweets used an account or included elements consistent with "astroturfing"-a strategy employed to promote a false sense of consensus around an idea. Few Twitter users were from the Chicago area; Twitter users from Chicago were significantly more likely than expected to tweet in support of the policy. Our findings may assist public health organizations to anticipate, recognize, and respond to coordinated social media campaigns.

  17. Support and services provided by public health regional surveillance teams to Local Health Departments in North Carolina.

    Science.gov (United States)

    Horney, Jennifer A; Markiewicz, Milissa; Meyer, Anne Marie; Macdonald, Pia D M

    2011-01-01

    Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.

  18. Violence in the emergency department: a survey of health care workers.

    Science.gov (United States)

    Fernandes, C M; Bouthillette, F; Raboud, J M; Bullock, L; Moore, C F; Christenson, J M; Grafstein, E; Rae, S; Ouellet, L; Gillrie, C; Way, M

    1999-11-16

    Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. Of the 163 staff, 106 (65%) completed the survey. A total of 68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. Physical exercise, sleep and the company of

  19. Measuring Low-carbon Development Level of provincial construction Industry

    Science.gov (United States)

    Shang, Mei; Fu, Yujie; Zhang, Liping

    2017-11-01

    In the 13th Five-Year plan, promoting Low-carbon cycle development is proposed. Low-carbon economy has become the key direction. As the pillar industry of national economy, the construction industry contributes obviously to the economic development. And the consumption of energy and the pollution of the environment can not be ignored. Accurately grasping the carbon emission level of the provincial construction industry is critical to making the future development strategy. In the paper, carbon emissions, energy consumption and economic growth of the provincial construction industry are analyzed firstly., then low carbon evaluation index is built to measure low-carbon level of provincial construction industry, at last relevant policy suggestions are put forward accordingly.

  20. Local health department responses during the 2004-2005 influenza vaccine shortage.

    Science.gov (United States)

    Ransom, James; Bashir, Zarnaaz; Phillips, Cynthia

    2007-08-01

    During the 2004-2005 influenza vaccine shortage, the Centers for Disease Control and Prevention (CDC) coordinated distribution of post-October 5th 2004 doses of influenza vaccine to state and local health departments (LHDs), who subsequently distributed vaccine to community providers. The National Association of County and City Health Officials (NACCHO) conducted three Web-based surveys throughout the 2004-2005 influenza season to assess in real-time how LHDs were 1) dealing with the vaccine shortage, 2) implementing the interim recommendations from the Advisory Committee on Immunization Practices (ACIP), and 3) making efforts to reallocate and redistribute doses of influenza vaccine toward high-priority populations within their communities. This paper highlights LHD responses that alleviated adverse impacts during this public health emergency. The first survey asked LHDs to quantify their community's vaccine supply; the second survey asked them to describe their specific responses to the crisis; and the third survey asked them to reflect and evaluate the effectiveness of their efforts to vaccinate high-priority groups during the crisis. Six hundred five (605) of 717 (84%) LHDs in 44 states responded to the three surveys. Results show that LHDs leveraged preparedness plans, formed strategic community partnerships, and practiced vaccination drills to address the problems of vaccinating high-priority and hard-to-reach populations that arose out of the vaccine shortage. The practices used by LHDs during this shortage may provide valuable response lessons to minimize the impact of future influenza vaccine shortages and other public health emergencies.

  1. Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

    Science.gov (United States)

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2015-09-01

    The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, phealthcare services is associated with lower per capita expenditures. LHDs, especially those serving healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  2. Are the public health workforce competencies predictive of essential service performance? A test at a large metropolitan local health department.

    Science.gov (United States)

    Mayer, Jeffrey P

    2003-01-01

    Since many training initiatives employ the core public health workforce competencies as objectives, it is important to demonstrate an association between competency and essential service job performance. A cross-sectional survey of 420 employees of a local health department was conducted in 1999, with a response rate of 76 percent. Each of ten essential service performance measures was regressed on four core competency measures, controlling for employee experience and education. The competencies explained 2 percent to 20 percent of the variance in essential service performance. While offering support for the core competencies as a foundation for training program content, the results also make clear the large role that other individual, organizational, and community influences may have. Explaining additional variance in performance will require incorporating these variables into future studies.

  3. Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders.

    Science.gov (United States)

    Jadhav, Emmanuel D; Holsinger, James W; Anderson, Billie W; Homant, Nicholas

    2017-01-01

    The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public's Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1-10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. The competency of most relevance to the highest executive function category was that of "interaction with interrelated systems." For sub-agency level officers the competency of most relevance was "advocating for the role of public health." The competency of most relevance to Program Directors/Managers or Administrators was "ensuring continuous quality improvement." The variation between competencies by job category suggests there are

  4. Competence of general practice nurses caring for patients with mental health problems in the somatic departments.

    Science.gov (United States)

    Svediene, Ligija; Jankauskiene, Lina; Kusleikaite, Marija; Razbadauskas, Artūras

    2009-01-01

    OBJECTIVE. To investigate competence of general practice nurses caring for patients with mental health problems in the somatic departments. MATERIAL AND METHODS. A quantitive study on competence of general practice nurses using an anonymous questionnaire was carried out in Klaipeda secondary health care institution in January-February of 2007. The respondents (128 general practice nurses) were selected from seven departments, in which psychiatric consultation was more frequently recommended. In the working places of nurses, 140 questionnaires were distributed; 135 questionnaires were completed (response rate was 96.4%), among them 7 questionnaires were acknowledged as not valid. RESULTS. About 45.0% of general practice nurses had knowledge how to care for the patients with mental health problems, from 1.6 to 21.9% did not have knowledge, and the rest reported having only moderate knowledge (28.1-64.1%). These findings provided a statistically significant link between the duration of employment and education (r from 0.292 to 0.76; P from <0.05 to <0.01). However, only 30.5% of respondents were able to manage conflicts. Most common undesirable events (60.3%) were runaway from inpatient clinic care, injury followed by runaway (29.4%), and suicide (10.3%). From 18.8% to 28.9% of respondents believed that undesirable events were influenced by an unsuitable environment of the department, the shortage of time and personnel, difficulty in getting a psychiatrist's consultation. Only 3.1% of respondents thought that these undesirable events might be affected by the lack of competence of personnel. Most of the nurses (form 75.0% to 84.4%) had a positive attitude toward the patients; however, the nursing principles were recognized only by (6.3% to 24.2%) of respondents. CONCLUSIONS. Competence of the nurses caring for the patients with mental health problems is not at the level required. This may be associated with insufficient professional skills, conflict situations with the

  5. the south african hiv epidemic, reflected by nine provincial ...

    African Journals Online (AJOL)

    A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection. Directorate: Health Systems Research, Department ofHealth, Pretoria. J P Swanevelder, BComm, BSc Hons, MSc. H G V Kiistner ...

  6. Knowledge and perceptions of national and provincial tuberculosis control programme managers in Pakistan about the WHO Stop TB strategy: a qualitative study.

    Science.gov (United States)

    Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus

    2016-01-01

    To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall

  7. Illinois department of public health H1N1/A pandemic communications evaluation survey.

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, D.; Decision and Information Sciences

    2010-09-16

    Because of heightened media coverage, a 24-hour news cycle and the potential miscommunication of health messages across all levels of government during the onset of the H1N1 influenza outbreak in spring 2009, the Illinois Department of Public Health (IDPH) decided to evaluate its H1N1 influenza A communications system. IDPH wanted to confirm its disease information and instructions were helping stakeholders prepare for and respond to a novel influenza outbreak. In addition, the time commitment involved in preparing, issuing, monitoring, updating, and responding to H1N1 federal guidelines/updates and media stories became a heavy burden for IDPH staff. The process and results of the H1N1 messaging survey represent a best practice that other health departments and emergency management agencies can replicate to improve coordination efforts with stakeholder groups during both emergency preparedness and response phases. Importantly, the H1N1 survey confirmed IDPH's messages were influencing stakeholders decisions to activate their pandemic plans and initiate response operations. While there was some dissatisfaction with IDPH's delivery of information and communication tools, such as the fax system, this report should demonstrate to IDPH that its core partners believe it has the ability and expertise to issue timely and accurate instructions that can help them respond to a large-scale disease outbreak in Illinois. The conclusion will focus on three main areas: (1) the survey development process, (2) survey results: best practices and areas for improvement and (3) recommendations: next steps.

  8. Mental Health Screening Among Adolescents and Young Adults in the Emergency Department.

    Science.gov (United States)

    Nager, Alan L; Pham, Phung K; Grajower, Daniel N; Gold, Jeffrey I

    2017-01-01

    To determine if a new, non-validated mental health screener can detect the prevalence of alcohol/drug abuse, traumatic exposure, and behavioral symptoms in adolescents and young adults seeking care in a pediatric emergency department (ED) for medical complaints. An 11-item mental health screener (Emergency Department Distress Response Screener [ED-DRS] investigator developed) was created. Patients 12 years or older seen for medical complaints were assessed by physicians using the ED-DRS. Data were analyzed using the Kuder-Richardson Formula 20, χ test, Mann-Whitney U test, and Spearman correlation. Among 992 ED patients, mean age was 15.11 ± 2.10 years (46.2% boys; 53.8% girls). Approximately 77.9% were Hispanic/Latino. Symptomatic patients (S) answered "yes" to at least 1 ED-DRS item; asymptomatic patients answered "no" to all items. The S patients comprised 47.5% of the sample; asymptomatic patients comprised 52.5%. Among S patients, alcohol/drug abuse frequency was 14%. The traumatic exposure frequencies included: 33.5% physically or emotionally traumatized, 29.3% bullied, 21.2% physically abused, 8.1% touched inappropriately and 7.0% exposed to domestic violence. Behavioral symptom frequencies included: 33.8% depressed mood, 30.4% anxiety, 23.8% high energy behavior, 6.6% hallucinations, and 6.2% suicidal/homicidal ideation. Although patients present to the ED with medical complaints, they may be at risk for concomitant mental health problems potentially discoverable using the ED-DRS.

  9. Health-hazard-evaluation report HETA 87-042-1869, Florida Department of Health and Rehabilitative Services, Jacksonville, Florida

    Energy Technology Data Exchange (ETDEWEB)

    Ornella, G.A.; Mathias, C.G.T.

    1988-02-01

    In response to a request from the State of Florida Department of Health and Rehabilitative Services, Jacksonville, Florida, an evaluation was made of working conditions at public health laboratories to investigate outbreaks of red rashes, dryness, and chapping of skin among employees. Exposure to the oxidase reagents used in the preliminary identification of Neisseria-gonorrhoeae cultures was reported by 54 of 99 workers completing a questionnaire. In skin-patch tests using oxidase reagents, seven of 27 individuals tested positive for allergic contact dermatitis to oxidase reagents. A relationship was also noted between those who were nonsensitized victims of dermatitis and the degree of exposure they had to the oxidase reagents. There is a health hazard from exposure to oxidase compounds at these public health laboratories. The authors recommend that more extensive patch testing be carried out and those workers testing positive be transferred to other areas of the facility. Those workers who are not sensitive should wear disposable vinyl gloves when working with oxidase reagents. Work practices should be changed to minimize accidental spillage.

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-01-01

    Objectives. To assess how health department contextual factors influence perceptions of the 15 Public Health Preparedness Capabilities, developed by the Centers for Disease Control and Prevention (CDC) to provide guidance on organizing preparedness activities. Methods. We conducted an online survey and focus group between September 2015 and May 2016 with directors of preparedness programs in state, metropolitan, and territorial jurisdictions funded by CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement. The survey collected demographic information and data on contextual factors including leadership, partnerships, organizational structure, resources and structural capacity, and data and evaluation. Results. Seventy-seven percent (48 of 62) of PHEP directors completed the survey and 8 participated in the focus group. Respondents were experienced directors (mean = 10.6 years), and 58% led 7 or more emergency responses. Leadership, partnerships, and access to fiscal and human resources were associated with perception and use of the capabilities. Conclusions. Despite some deficiencies, PHEP awardees believe the capabilities provide useful guidance and a flexible framework for organizing their work. Contextual factors affect perceptions of the capabilities and possibly the effectiveness of their use. Public Health Implications. The capabilities can be used to address challenges in preparedness, including identifying evidence-based practices, developing performance measures, and improving responses. PMID:28892447

  12. Health Care Utilization before and after an Outpatient Emergency Department Visit in Older People

    Science.gov (United States)

    Horney, Carolyn; Schmader, Kenneth; Sanders, Linda L.; Heflin, Mitchell; Ragsdale, Luna; McConnell, Eleanor; Hocker, Michael; Hastings, S. Nicole

    2010-01-01

    Background Older adults in the U.S. receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization has not been adequately studied in this population. Objectives The goal of this study were to examine the relationships between health care use before and after an ED visit among older adults. Methods This retrospective cohort study examined health care use among 308 patients ≥ 65 years old discharged from a university-affiliated ED. Proportional-hazards models were used to assess the relationship between pre-ED health care use (primary care physician (PCP), specialist, ED and hospital) and risk of return ED visits. Results Older ED patients in this study had visited other types of providers frequently in the previous year (median number of primary care physician (PCP) and specialist visits = 4). Patients who used the ED on 2 or more occasions in the previous year were found to have visited their PCP more often than those without frequent ED use (median number of visits 7.0 vs 4.0, p<.001). Despite more PCP use in this population, frequent ED use was associated with increased risk of a repeat ED visit (HR 2.20, 95% CI 1.15–4.21), in models adjusted for demographics and health status. Conclusion Older adults who use the ED are also receiving significant amounts of care from other sources; simply providing additional access to care may not improve outcomes for these vulnerable individuals. PMID:21216555

  13. Exploring patterns of health service use in older emergency department patients.

    Science.gov (United States)

    Hastings, S Nicole; Horney, Carolyn; Landerman, Lawrence R; Sanders, Linda L; Hocker, Michael B; Schmader, Kenneth E

    2010-10-01

    Study objectives were to identify groups of older patients with similar patterns of health care use in the 12 months preceding an index outpatient emergency department (ED) visit and to identify patient-level predictors of group membership.   Subjects were adults ≥ 65 years of age treated and released from an academic medical center ED. Latent cluster analysis (LCA) models were estimated to identify groups with similar numbers of primary care (PC), specialist, and outpatient ED visits and hospital days within 12 months preceding the index ED visit.   In this sample (n = 308), five groups with distinct patterns of health service use emerged. Low Users (35%) had fewer visits of all types and fewer hospital days compared to sample means. Low Users were more likely to be female and had fewer chronic health conditions relative to the overall sample (p < 0.05). The ED to Supplement Primary Care Provider (PCP) (23%) group had more PCP visits, but also significantly more ED visits. Specialist Heavy (22%) group members had twice as many specialist visits, but no difference in PCP visits. Members of this class were more likely to be white and male (p < 0.05). High Users (15%) received more care in all categories and had more chronic baseline health conditions (p < 0.05) but no differences in demographic characteristics relative to the whole sample. The ED and Hospital as Substitution Care (6%) group had fewer PC and specialist visits, but more ED visits and hospital days.   In this sample of older ED patients, five groups with distinct patterns of health service use were identified. Further study is needed to determine whether identification of these patient groups can add important information to existing risk-assessment methods. © 2010 by the Society for Academic Emergency Medicine.

  14. Evaluation of physical and mental health of sexual assault cases applied to forensic medicine department

    Directory of Open Access Journals (Sweden)

    Mustafa Korkmaz

    2014-12-01

    Full Text Available Objective: In the present study, to assess the sexual assault victims considering sociodemographic and forensic psychiatry who were examined by our Board of Physical and Mental Health was aimed. Methods: The cases who were examined in Board of Physical and Mental Health in Forensic medicine Department of Dicle University, Faculty of Medicine were assessed retrospectively in terms of age, gender, marital status, education level, relation of the victim with the accused, presence of penetration and disruption of physical and mental health. Results: Among 258 cases, who referred to our board, 196 were female and 62 were male. The age range of the victims was 2 to 50 and average age was detected as 13.1 ± 5.9 years. It was determined that 227 (88% cases were under 18 years and 31 cases (12% were above 18 years. Vaginal and anal penetration was claimed in 48 and 61 cases, respectively; oral + anal penetration was claimed in 11 cases; both vaginal and oral penetration was claimed in two cases. Among 258 cases, 144 cases had no physical and mental disruption; 49 cases were diagnosed with mental and physical health disruption and 65 cases were followed by issuing a preliminary report. Conclusion: As a result of our study any significant relation is not found between impairment in psychological health and sex, marital status, educational level of the victim, age groups, the age difference between the victim and the defendant. Therefore, it is understood that either men or women, married or single, educated or uneducated people are affected emotionally as bad as from sexual assault. This supports the idea that, especially in cases that any findings cannot be obtained with genital and physical examination, psychological evaluation may be important.

  15. Global Health Engagement and The Department of Defense as a Vehicle for Security and Sustainable Global Health.

    Science.gov (United States)

    Moten, Asad; Schafer, Daniel; Burkett, Edwin K

    2018-01-01

    The Unites States Department of Defense (DoD) is viewed by many in the general public as a monolithic government entity whose primary purpose is to coordinate this country's ability to make war and maintain a military presence around the world. However, the DoD is in fact a multidimensional organization whose global impact is as expansive as it is varying and is responsible for far-reaching global health interventions. The United States has worked toward providing long-term care among host nation populations by providing training in several areas related to medicine, with positive results. These efforts can be built upon with substantial positive effects. Building health infrastructure and capacity around the world is essential. The DoD is the most generously funded agency in the world, and the resources at its disposal provide the opportunity to make great gains in the long term in terms of both health and security worldwide. With efficient and careful use of DoD resources, and partnerships with key non-governmental organizations with specialized knowledge and great passion, partnerships can be forged with communities around the world to ensure that public health is achieved in even the most underserved communities. A move toward creating sustainable health systems with long-term goals and measurable outcomes is an essential complement to the already successful disaster and emergency relief that the United States military already provides. By ensuring that communities around the world are both provided with access to the sustainable health care they need and that emergency situations can be responded to in an efficient way, the United States can serve its duty as a leader in sharing expertise and resources for the betterment and security of all humankind. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  16. Healthy Canada by Design CLASP: Lessons learned from the first phase of an intersectoral, cross-provincial, built environment initiative.

    Science.gov (United States)

    Miro, Alice; Kishchuk, Natalie A; Perrotta, Kim; Swinkels, Helena M

    2014-09-12

    The Healthy Canada by Design (HCBD) CLASP (Coalitions Linking Action and Science for Prevention) Initiative promotes the building of communities that support health by 1) facilitating the integration of health evidence into built environment decision-making; 2) developing new, cross-sector collaboration models and tools; and 3) fostering a national community of practice. A coalition of public health professionals, researchers, professional planners and non-governmental organization (NGO) staff from across Canada developed, implemented and participated in the Initiative. In the first phase, HCBD interventions took place for the most part in large urban and suburban settings in Quebec, Ontario and British Columbia. National knowledge transfer and exchange (KTE) activities were delivered both locally and nationally. Project participants developed tools or processes for collaboration between the health and the community planning sectors. These were designed to increase the capacity of the health sector to influence decisions about land use and transportation planning. Tool or process development was accompanied by pilot testing, evaluation, and dissemination of findings and lessons learned. On a parallel track, NGOs involved with HCBD led national KTE interventions. The first phase of HCBD demonstrated the potential for public health organizations to influence the built environment determinants of cancer and chronic diseases. Public health authorities forged relationships with several organizations with a stake in built environment decisions, including municipal and regional planning departments, provincial governments, federal government agencies, researchers, community groups and NGOs. The Initiative accomplished the following: 1) created new relationships across sectors and across health authorities; 2) improved the knowledge and skills for influencing land use planning processes among public health professionals; 3) increased awareness of health evidence and intent

  17. Conducting Community Health Needs Assessments in the Local Public Health Department: A Comparison of Random Digit Dialing and the Community Assessment for Public Health Emergency Response.

    Science.gov (United States)

    Stone, Kahler; Sierocki, Allison; Shah, Vaidehi; Ylitalo, Kelly R; Horney, Jennifer A

    2017-01-30

    Community health needs assessments (CHNAs) are now required by the Affordable Care Act (ACA) for nonprofit hospitals and the Public Health Accreditation Board (PHAB) for local health departments that seek accreditation. Currently, various primary data collection methods exist that meet the ACA and PHAB requirements. To compare 2 CHNA data collection methods implemented in the same geographical area from a local health department perspective. Two community surveys, one door-to-door and one telephone, in the 76706 zip code area of McLennan County, Texas. Adult survey respondents (Community Assessment for Public Health Emergency Response [CASPER]: N = 184; random digit dialing [RDD]: N = 133) of the 76706 zip code in McLennan County, Texas. Survey response rates, sociodemographic characteristics of survey respondents, and self-reported health behaviors from both community survey types. The CASPER survey had a contact rate of 36.0% and a cooperation rate of 60.5%, compared with a 10.1% response rate for the RDD survey. CASPER respondents were younger (26.6% aged 18-24 years), had lower education attainment (17.4% less than high school), and had a higher proportion of Hispanics (24.5%) than RDD respondents (4.6%, 10.5%, and 17.3%, respectively). CASPER respondents were less likely to report being overweight or obese (56.5%), to report days where no fruit or vegetables were consumed (7.1%), and to report days where no walking activity was conducted (9.8%) than RDD respondents (70.2%, 27.8%, and 21.8%, respectively). The CASPER survey cost less to conduct ($13 500) than the RDD survey ($100 000) and was logistically easier for the local health department to conduct using internally available resources. Local health departments use various data collection methods to conduct CHNAs for their populations and require varying levels of commitment and resources. RDD and CASPER can be used to meet ACA and PHAB requirements, collecting valuable health needs estimates and offer

  18. Openness to change: experiential and demographic components of change in in Local Health Department leaders

    Directory of Open Access Journals (Sweden)

    Emmanuel D Jadhav

    2015-09-01

    Full Text Available Background: During the 2008-10 economic recession, Kentucky local health department (LHD leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders’ demographic and organizational characteristics and to characterize the underlying relationships. Material and Methods: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal Wallis non-parametric tests were used, and to adjust for potential confounding linear regression analysis was performed.Data: LHD leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data was utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders’ observable attributes relating to age, gender, race, educational background, leadership experience and openness to change. Results: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-13 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply there are underlying relationships between leader and LHD characteristics

  19. Sustaining a quality improvement culture in local health departments applying for accreditation.

    Science.gov (United States)

    Verma, Pooja; Moran, John W

    2014-01-01

    This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

  20. Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

    Science.gov (United States)

    Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

    2016-06-01

    This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

  1. Pediatric Burns at The Rift Valley Provincial General Hospital ...

    African Journals Online (AJOL)

    Aim To determine the etiology and outcome of pediatric burns (0-12 years). Design A retrospective study of burn victims hospitalized at the Rift Valley Provincial General Hospital, Nakuru, Kenya from April 2004 to March 2007. Method Charts of all children hospitalized for burn injury were reviewed for patient demographics, ...

  2. Pediatric Burns at The Rift Valley Provincial General Hospital ...

    African Journals Online (AJOL)

    surgical/female burn ward were eligible. On average the ward admits 680 patients a year out of which 170 pa- tients (25.7 %) are due to pediatric burns. The Hospital attracts patients mostly from low socioeconomic status. Pediatric Burns at The Rift Valley. Provincial General Hospital, Nakuru,. Kenya. Author: Oduor P.R. ...

  3. Psychological skills of provincial netball players in different playing ...

    African Journals Online (AJOL)

    Psychological skills of provincial netball players in different playing positions. ... South African Journal for Research in Sport, Physical Education and Recreation ... Differences regarding the psychological skill levels of soccer, basketball, rugby union and American football players in different playing positions have been ...

  4. Provincial road condition and round wood timber transport in South ...

    African Journals Online (AJOL)

    The context of the study is the concern over declining provincial road conditions due to insufficient government funding for road maintenance. The roads are used by a ... There is a 20% reduction in the road condition during wet periods, which would indicate poor drainage and/or use of poor quality road building materials.

  5. The South African HIV epidemic, reflected by nine provincial ...

    African Journals Online (AJOL)

    A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection. The exponential model significantly explains the HIV epidemics in the provinces. The combination of these provincial epidemics ...

  6. Functional classification of the Gauteng provincial road network ...

    African Journals Online (AJOL)

    At link level it was possible to synchronise the upgraded network with the financial asset registry in order to gauge the current state of the provincial roads within Gauteng, and to identify those that are in need of attention and/or rehabilitation to optimise efficiency and safety. This approach can be standardised throughout the ...

  7. Motorcycle Accident injuries seen at Kakamega Provincial Hospital ...

    African Journals Online (AJOL)

    Background: Injuries related to motorcycles contribute significantly to the number of road traffic injuries This study was aimed at determining the pattern of injuries caused by motorcycle crash among patients seen at Kakamega provincial hospital in Kenya... Methods: This was a cross sectional study which was conducted in ...

  8. The identification of possible future provincial boundaries for South ...

    African Journals Online (AJOL)

    Results compare favourably with those from a principal component and cluster analysis, which has previously been used to demarcate the South African space economy into a hierarchy of development regions. Keywords: Journey-to-work flows, provincial boundaries, intramax method, principal component analysis, ...

  9. 76 FR 28414 - Provincial Advisory Committees Charter Re-Establishment

    Science.gov (United States)

    2011-05-17

    ..., intends to re-establish the Provincial Advisory Committees (PACs) for the provinces in California, Oregon, and Washington. This re-establishment is in response to the continued need for the PACs to provide... Northern Spotted Owl. The PACs also provide advice and recommendations to promote integration and...

  10. In search of middle Indonesia: middle classes in provincial towns

    NARCIS (Netherlands)

    van Klinken, G.; Berenschot, W.

    2014-01-01

    The post-1998 surge in local politics has moved the provincial town back to centre stage. This book examines the Indonesian middle class (now 43%!) up close in the place where its members are most at home: the town. Middle Indonesia generates national political forces, yet it is neither particularly

  11. [The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

    Science.gov (United States)

    Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

    2016-11-11

    Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems

  12. Impact of health care system interventions on emergency department utilization and overcrowding in Singapore.

    Science.gov (United States)

    Anantharaman, V

    2008-04-01

    Public emergency departments (EDs) in Singapore were facing increasing attendances (visits) with frequent overcrowding in the 10 years from 1975 to 1985. Over the next 12 years a series of social interventions were carried out to minimize "unnecessary" attendances at these EDs. This paper reviews the various interventions carried out on ED utilization to determine their impact and usefulness. Emergency and non-emergency attendances at the six main public EDs were analysed over the 32 years of the review and especially just before and soon after the application of four major interventions relating to use of EDs, including: (1) public education campaigns, (2) financial disincentives, (3) redirection to primary health care centres and (4) use of alternative clinics. The 12-year period of social interventions resulted in a fall in the proportion of non-emergency patients using the EDs from 57% to 18%. Public education campaigns each resulted in a fall in inappropriate attendances of 27% to 67%. Financial disincentives were able to demonstrate an impact if they were significant and resulted in a heavier fiscal cost to the patient than if available primary health clinics were used. Redirection of non-emergencies away from EDs resulted in significant public relations issues with only mild decreases in non-emergency attendances. Alternative clinics may provide some respite if actively promoted by ED staff, but are able to generate their own separate patient clientele. Public education and financial measures that seek to change the pattern of ED utilization in a community must go hand in hand with an easily accessible primary health care system for best effect. Co-ordination of such efforts requires active support from all levels of the health service and political leadership. An active feedback loop is needed for better outcomes management.

  13. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

    Science.gov (United States)

    Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

    2016-01-01

    Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

  14. Governance's role in local health departments' information system and technology usage.

    Science.gov (United States)

    Vest, Joshua R; Menachemi, Nir; Ford, Eric W

    2012-01-01

    The purpose of this article is to explore the relationship between local health departments' (LHDs') governance structures and their use of information systems (IS) and information technologies (IT). As the US health system moves toward more integrated models of delivering care, LHDs have been identified as key nexus for information exchange. Therefore, understanding how LHDs' governance facilitates or inhibits the adoption and use of such IS and IT tools is critical. The 2008 survey of the National Association of County and City Health Officials' members included a set of questions dedicated to the use of IS/IT and its relationship to governance structures. Ordinal logistic and Poisson regressions are used to identify significant relationships among the variables. The survey sample's results (n = 473) are extended to the national sample (N = 2794) using the variable weightings included in the study design. The 2 dependent variables examined are IS and IT use. The IS variable captures the software and analytic tools used in LHDs. The IT measure primarily captures hardware and infrastructure capabilities. Overall, the use of IS/IT by LHDs is low. Generally, LHDs that have shared governance structures with other state and community bodies tended to have greater IS/IT use. Similarly, larger LHDs with leaders that have higher educational levels used IS/IT in greater amounts. With their current IS/IT capability levels, LHDs will struggle to play a meaningful role in the integration and exchange of health information. Given that LHD also serve at-risk populations in disproportionate numbers, this digital divide may become a real divide in the access to high quality care for some communities.

  15. Use of twitter among local health departments: an analysis of information sharing, engagement, and action.

    Science.gov (United States)

    Neiger, Brad L; Thackeray, Rosemary; Burton, Scott H; Thackeray, Callie R; Reese, Jennifer H

    2013-08-19

    Social media offers unprecedented opportunities for public health to engage audiences in conversations and collaboration that could potentially lead to improved health conditions. While there is some evidence that local health departments (LHDs) are using social media and Twitter in particular, little is known about how Twitter is used by LHDs and how they use it to engage followers versus disseminating one-way information. To examine how LHDs use Twitter to share information, engage with followers, and promote action, as well as to discover differences in Twitter use among LHDs by size of population served. The Twitter accounts for 210 LHDs were stratified into three groups based on size of population served (n=69 for less than 100,000; n=89 for 100,000-499,999; n=52 for 500,000 or greater). A sample of 1000 tweets was obtained for each stratum and coded as being either about the organization or about personal-health topics. Subcategories for organization included information, engagement, and action. Subcategories for personal health included information and action. Of all LHD tweets (n=3000), 56.1% (1682/3000) related to personal health compared with 39.5% (1186/3000) that were about the organization. Of the personal-health tweets, 58.5% (984/1682) involved factual information and 41.4% (697/1682) encouraged action. Of the organization-related tweets, 51.9% (615/1186) represented one-way communication about the organization and its events and services, 35.0% (416/1186) tried to engage followers in conversation, and 13.3% (158/1186) encouraged action to benefit the organization (eg, attend events). Compared with large LHDs, small LHDs were more likely to post tweets about their organization (Cramer's V=0.06) but were less likely to acknowledge events and accomplishments of other organizations (χ²=12.83, P=.02, Cramer's V=0.18). Small LHDs were also less likely to post personal health-related tweets (Cramer's V=0.08) and were less likely to post tweets containing

  16. Increased use of the emergency department after health care reform in Massachusetts.

    Science.gov (United States)

    Smulowitz, Peter B; O'Malley, James; Yang, Xiaowen; Landon, Bruce E

    2014-08-01

    With implementation of the Patient Protection and Affordable Care Act, 30 million individuals are predicted to gain access to health insurance. The experience in Massachusetts, which implemented a similar reform beginning in 2006, should provide important lessons about the effect of health care reform on emergency department (ED) utilization. Our objective is to understand the extent to which Massachusetts health care reform was associated with changes in ED utilization. We compared changes in ED utilization at the population level for individuals from areas of the state that were affected minimally by health care reform with those from areas that were affected the most, as well as for those younger than 65 years and aged 65 years or older. We used a difference-in-differences identification strategy to compare rates of ED visits in the prereform period, during the reform, and in the postreform period. Because we did not have population-level data on insurance status, we estimated area-level insurance rates by using the percentage of actual visits made during each period by individuals with insurance. We studied 13.3 million ED visits during 2004 to 2009. Increasing insurance coverage in Massachusetts was associated with increasing use of the ED; these results were consistent across all specifications, including the younger than 65 years versus aged 65 years or older comparison. Depending on the model used, the implementation of health care reform was estimated to result in an increase in ED visits per year of between 0.2% and 1.2% within reform and 0.2% and 2.2% postreform compared with the prereform period. The implementation of health care reform in Massachusetts was associated with a small but consistent increase in the use of the ED across the state. Whether this was due to the elimination of financial barriers to seeking care in the ED, a persistent shortage in access to primary care for those with insurance, or some other cause is not entirely clear and will

  17. The Department of Energy`s interagency agreement with the National Institute of Environmental Health Sciences: Audit report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    The Department of Energy (Department) and the National Institute of Environmental Health Sciences (NIEHS) entered into an interagency agreement in September 1992 to develop model safety and health training programs for workers involved in waste cleanup activities at Departmental facilities. Under the terms of the agreement, recipients of NIEHS training grants were to provide Hazardous Waste Operations and Emergency Response (HAZWOPER) training to Departmental sites. By June 1997, the Department had obligated over $40 million to the agreement. The objective of this audit was to determine whether the interagency agreement with NIEHS was the most cost-effective method of acquiring the training.

  18. Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

    Directory of Open Access Journals (Sweden)

    Emmanuel D. Jadhav

    2017-10-01

    Full Text Available BackgroundThe foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs. The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health.Materials and methodsThe study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person.DataData were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS.ResultsThe competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement

  19. Department of Energy ALARA implementation guide. Response to the Health Physics Society

    Energy Technology Data Exchange (ETDEWEB)

    Connelly, J.M. [Dept. of Energy, Washington, DC (United States)

    1995-03-01

    In the August 1993 Health Physics Society (HPS) newsletter, the HPS Scientific and Public Issues Committee published a Position Statement entitled {open_quotes}Radiation Protection of the Public and the Environment.{close_quotes}. In this article, this HPS committee made the statement that they were deeply concerned by the trend for agencies to incorporate the ALARA concept as a regulatory requirements, without providing specific guidance as to what it means and how to implement it consistently. The HPS position paper was in response to the DOE notice on proposed rulemaking for Title 10 Code of Federal Regulations Part 834, {open_quotes}Radiation Protection of the Public and the Environment{close_quotes} (10 CFR 834). In the notice of proposed rulemaking for 10 CFR 834, the Department of Energy (DOE) defined ALARA as follows: {open_quotes}As used in this part, ALARA is not a dose limit, but rather a process which has the objective of attaining doses as far below the applicable limit of this part as is reasonably achievable{close_quotes} (10 CFR 834.2, p. 16283 of the Federal Register). The HPS position paper continues, {open_quotes}The section goes on to elaborate on what is meant by a process without providing sufficient guidance to assure uniform applicability of the process.{close_quotes}. Although this concern is directed towards the ALARA process as it relates to the environment, the Office of Health, which is responsible for occupational workers, shares the same definition for ALARA.

  20. Where health and welfare meet: social deprivation among patients in the emergency department.

    Science.gov (United States)

    Gordon, J A; Chudnofsky, C R; Hayward, R A

    2001-03-01

    As a safety net provider for many disadvantaged Americans, the emergency department (ED) may be an efficient site not only for providing acute medical care, but also for addressing serious social needs. To characterize the social needs of ED patients, and to evaluate whether the most disadvantaged patients have connections with the health and welfare system outside the ED. Cross-sectional survey conducted over 24 hours in the fall of 1997. Three EDs: an urban public teaching hospital, a suburban university hospital, and a semirural community hospital. Consecutive patients presenting for care, including those transported by ambulance. The survey response rate was 91% (N = 300; urban = 115, suburban = 102, rural = 83). Index of socioeconomic deprivation described by the US Census Bureau (based on food, housing, and utilities). Of all ED patients, 31% reported one or more serious social deprivations. For example, 13% of urban patients reported not having enough food to eat, and 9% of rural patients reported disconnection of their gas or electricity (US population averages both less than 3%). While 40% of all patients had no consistent health care outside the ED (networks. Community efforts to address serious social deprivation should include partnerships with the local ED.

  1. Medical stability operations--one approach to transforming the Department of Defense Military Health System.

    Science.gov (United States)

    Licina, Derek

    2012-10-01

    The Department of Defense Instruction (DoDI) 6000.16 entitled Military Health Support for Stability Operations was published in 2010 and established policy that Medical Stability Operations (MSOs) would be a core military mission. The instruction set out to institutionalize how the Military Health Support (MHS) would effectively support MSOs and assist in bridging the gap with other actors operating in the same space. What is less clear is the current status of the MHS in accomplishing the responsibilities outlined in the DoDI. Even more concerning is how these efforts will support the "new" strategic guidance for the DoD published in January 2012 that states U.S. forces will no longer be sized to conduct large-scale, prolonged stability operations. In the absence of a publicly available DoDI 6000.16 implementation strategy, this article proposes the use of an organizational transformation process developed by internationally acclaimed leadership and organizational change expert Dr. John Kotter. The eight-step process is used as a framework to explore ways to effectively transform the DoD in meeting the intent of the MSOs DoDI. The past decade has transformed how service members think about MSOs. Now is the time to transform the MHS with urgency to institutionalize these thoughts.

  2. Effect of a Targeted Women's Health Intervention in an Inner-City Emergency Department

    Directory of Open Access Journals (Sweden)

    Debra Houry

    2011-01-01

    Full Text Available Objective. To evaluate the effect of an Emergency Department (ED based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21–55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence were randomized to standard information about community resources (control or to targeted educational handouts based upon their screening results (intervention. Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse. 157 women were randomized to intervention and 169 to control. Among women who completed follow-up (=71, women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, =0.04 and were more likely to have taken risk-reducing action (97% versus 79%, =0.04. Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations.

  3. Association between Intimate Partner Violence and Health Behaviors of Female Emergency Department Patients

    Directory of Open Access Journals (Sweden)

    Anitha Elizabeth Mathew

    2012-08-01

    Full Text Available Introduction: We assessed the correlation between intimate partner violence (IPV and health behaviors, including seat belt use, smoke alarm in home, handgun access, body mass index, diet, and exercise. We hypothesized that IPV victims would be less likely to have healthy behaviors as compared to women with similar demographics.Methods: All adult female patients who presented to 3 Atlanta-area emergency department waiting rooms on weekdays from 11AM to 7PM were asked to participate in a computer-based survey by trained research assistants. The Universal Violence Prevention Screen was used for IPV identification. The survey also assessed seatbelt use, smoke alarm presence, handgun access, height, weight, exercise, and diet. We used chi-square tests of association, odds ratios, and independent t-tests tomeasure associations between variables.Results: Participants ranged from 18 to 68 years, with a mean of 38 years. Out of 1,452 respondents, 155 patients self-identified as white (10.7%, and 1,218 as black (83.9%; 153 out of 832 women who were in a relationship in the prior year (18.4% screened positive for IPV. We found significant relationships between IPV and not wearing a seatbelt (p,0.01, handgun access (p,0.01, and eating unhealthy foods (p,0.01.Conclusion: Women experiencing IPV are more likely to exhibit risky health behaviors than women who are not IPV victims. [West J Emerg Med. 2012;13(3:278–282.

  4. Racial Disparities in Emergency Department Utilization for Dental/Oral Health-Related Conditions in Maryland.

    Science.gov (United States)

    Chalmers, Natalia I

    2017-01-01

    Hospital emergency departments (EDs) are a place where many Americans seek treatment of dental conditions. Racial and ethnic minorities consistently have higher rates of ED utilization than whites for dental conditions. The reasons for these disparities and significant public health concerns are investigated less often. In this paper, we measure trends in racial disparities in ED discharges for dental conditions in Maryland from 2010 to 2013. To understand these disparities, we also describe differences between racial groups in age, gender, income, location, payer, comorbidities, and the availability of dental care. 2010-2013 State Emergency Department Data for Maryland were used in the analysis. Rates per 100,000 of the population are calculated using information from census population estimates. Cost-to-charge ratios are used to estimate the costs of ED discharges. Dental/oral health-related conditions (DOHRC) are defined as discharge diagnoses of ICD-9-CM codes 520.0 through 529.9. Descriptive statistics and fixed effects logistic regression models with a rare event correction are used to analyze the data. Blacks, especially females aged 25-34, have larger proportions of total ED discharges due to DOHRC, and higher population rates of DOHRC, than any other racial or ethnic group. In 2013, Blacks represented 30% of Maryland's population and accounted for 52% of ED costs for DOHRC. Hispanics and those of other races have much lower rates of DOHRC discharges. The regression results show that the high proportion of DOHRC discharges among Blacks may be explained by the concentration of Blacks in low-income central cities with less access to dental care. There are significant racial disparities in the ED utilization for DOHRC in Maryland. These disparities reflect the lack of access to dental care due to both cost and geographic limitations. This results in high healthcare costs and ineffective solutions for patients. Addressing oral health disparities will require

  5. Racial Disparities in Emergency Department Utilization for Dental/Oral Health-Related Conditions in Maryland

    Directory of Open Access Journals (Sweden)

    Natalia I. Chalmers

    2017-07-01

    Full Text Available ObjectivesHospital emergency departments (EDs are a place where many Americans seek treatment of dental conditions. Racial and ethnic minorities consistently have higher rates of ED utilization than whites for dental conditions. The reasons for these disparities and significant public health concerns are investigated less often. In this paper, we measure trends in racial disparities in ED discharges for dental conditions in Maryland from 2010 to 2013. To understand these disparities, we also describe differences between racial groups in age, gender, income, location, payer, comorbidities, and the availability of dental care.Methods2010–2013 State Emergency Department Data for Maryland were used in the analysis. Rates per 100,000 of the population are calculated using information from census population estimates. Cost-to-charge ratios are used to estimate the costs of ED discharges. Dental/oral health-related conditions (DOHRC are defined as discharge diagnoses of ICD-9-CM codes 520.0 through 529.9. Descriptive statistics and fixed effects logistic regression models with a rare event correction are used to analyze the data.ResultsBlacks, especially females aged 25–34, have larger proportions of total ED discharges due to DOHRC, and higher population rates of DOHRC, than any other racial or ethnic group. In 2013, Blacks represented 30% of Maryland’s population and accounted for 52% of ED costs for DOHRC. Hispanics and those of other races have much lower rates of DOHRC discharges. The regression results show that the high proportion of DOHRC discharges among Blacks may be explained by the concentration of Blacks in low-income central cities with less access to dental care.ConclusionThere are significant racial disparities in the ED utilization for DOHRC in Maryland. These disparities reflect the lack of access to dental care due to both cost and geographic limitations. This results in high healthcare costs and ineffective solutions for

  6. Clinical Data Systems to Support Public Health Practice: A National Survey of Software and Storage Systems Among Local Health Departments.

    Science.gov (United States)

    McCullough, J Mac; Goodin, Kate

    2016-01-01

    Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs. To analyze clinical and nonclinical data storage and software types by LHDs. Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Outcome measures included LHD's primary clinical service data system, nonclinical data system(s) used, and plans to adopt electronic clinical data system (if not already in use). Predictors of interest included jurisdiction size and governance type, and other informatics capacities within the LHD. Bivariate analyses were performed using χ and t tests. Up to 38.4% of LHDs reported using an electronic health record (EHR). Usage was common especially among LHDs that provide primary care and/or dental services. LHDs serving smaller populations and those with state-level governance were both less likely to use an EHR. Paper records were a common data storage approach for both clinical data (28.9%) and nonclinical data (59.4%). Among LHDs without an EHR, 84.7% reported implementation plans. Our findings suggest that LHDs are increasingly using EHRs as a clinical data storage solution and that more LHDs are likely to adopt EHRs in the foreseeable future. Yet use of paper records remains common. Correlates of electronic system usage emerged across a range of factors. Program- or system-specific needs may be barriers or facilitators to EHR adoption. Policy makers can tailor resources to address barriers specific to LHD size, governance, service portfolio, existing informatics capabilities, and other pertinent characteristics.

  7. Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies.

    Science.gov (United States)

    Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

    2015-01-01

    To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a "user-centered design approach." A survey was completed to assess functionality and user satisfaction. IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. IMATS satisfies the need for a system for monitoring and reporting health departments' countermeasure quantities so that decision makers are better informed. The "user-centered design approach" was successful, as evident by the many public health departments that adopted IMATS.

  8. Estimating the frequency and characteristics of respiratory disease outbreaks at mass gatherings in the United States: Findings from a state and local health department assessment

    National Research Council Canada - National Science Library

    Argelia Figueroa; Reena K Gulati; Jeanette J Rainey

    2017-01-01

    .... We administered an online assessment to the 50 state health departments and 31 large local health departments in the United States to gather information about mass gathering-related respiratory...

  9. Pre and post hoc analysis of electronic health record implementation on emergency department metrics.

    Science.gov (United States)

    Rupp, Kyle J; Ham, Nathan J; Blankenship, Dennis E; Payton, Mark E; Murray, Kelly A

    2017-04-01

    Longitudinal time-based emergency department (ED) performance measures were quantified 12 months before and 12 months after (March 2012-February 2014) implementation of a Meditech 6.0® electronic health record (EHR) at a single urban academic ED. Data assessed were length of stay from door to door, door to admission, door to bed, bed to provider, provider to disposition, and disposition to admission, as well as number of patients leaving against medical advice and number of patients leaving without being seen. Analysis of variance was used to compare levels before and after EHR implementation for each variable, with adjustments made for the number of admissions, transfers, and month. No difference was seen in monthly volume, admissions, or transfers. Implementation of an EHR resulted in a sustained increase in ED time metrics for mean length of stay and times from door to door, door to admission, door to bed, and provider to disposition. Decreased ED time metrics were seen in bed-to-provider and disposition-to-admit times. The number of patients who left against medical advice increased after implementation, but the number of patients who left without being seen was not significantly different. Thus, EHR implementation was associated with an increase in time with most performance metrics. Although general times trended back to near preimplementation baselines, most ED time metrics remained elevated beyond the study length of 12 months. Understanding the impact of EHR system implementation on the overall performance of an ED can help departments prepare for potential adverse effects of such systems on overall efficiency.

  10. The value from investments in health information technology at the U.S. Department of Veterans Affairs.

    Science.gov (United States)

    Byrne, Colene M; Mercincavage, Lauren M; Pan, Eric C; Vincent, Adam G; Johnston, Douglas S; Middleton, Blackford

    2010-04-01

    We compare health information technology (IT) in the Department of Veterans Affairs (VA) to norms in the private sector, and we estimate the costs and benefits of selected VA health IT systems. The VA spent proportionately more on IT than the private health care sector spent, but it achieved higher levels of IT adoption and quality of care. The potential value of the VA's health IT investments is estimated at $3.09 billion in cumulative benefits net of investment costs. This study serves as a framework to inform efforts to measure and calculate the benefits of federal health IT stimulus programs.

  11. Development of a Sexual Health Screening Tool for Adolescent Emergency Department Patients.

    Science.gov (United States)

    Goyal, Monika K; Shea, Judy A; Hayes, Katie L; Badolato, Gia; Chamberlain, James M; Zaoutis, Theoklis; Fein, Joel

    2016-07-01

    The objective was to develop a content-valid audio computer-assisted self-interview (ACASI) sexual health survey (SHS) that is understandable and acceptable to adolescents and can be feasibly implemented in a pediatric emergency department (ED) for sexually transmitted infection (STI) risk assessment. Multistep iterative qualitative study utilizing a Delphi panel of key informants for survey development and content validity, cognitive interviews with end-users to evaluate understanding, and pilot testing with end-users to evaluate acceptability and feasibility. We developed a 20-item questionnaire through an iterative modified Delphi process with experts in adolescent and pediatric emergency medicine. All items were assessed as understandable by >90% of adolescents during the cognitive interviews. All respondents found the SHS easy to use. A total of 76.5% preferred answering questions related to sexual health through the SHS compared to face-to-face interviews. Mean (±SD) length of survey completion was 17.5 (±6.7) minutes and 88.6% of participants found survey length to be "just right." With respect to feasibility testing, there was no statistically significant difference in median ED LOS between those who piloted the SHS and those who did not (230.0 minutes vs. 219.0 minutes; p = 0.7). We developed a content-valid ACASI for the identification of adolescents at risk for STIs that was understandable, acceptable, and easy to use by adolescent patients and feasible for implementation in the pediatric ED. Future planned steps include the evaluation of the SHS in providing clinical decision support for targeted STI screening in the ED. © 2016 by the Society for Academic Emergency Medicine.

  12. Health care utilization among adenosine-sensitive supraventricular tachycardia patients presenting to the emergency department.

    Science.gov (United States)

    Dewland, Thomas A; Oesterle, Adam; Stein, John; Marcus, Gregory M

    2017-08-01

    Although adenosine-sensitive supraventricular tachycardia (SVT) is generally curable, it remains an important cause of healthcare utilization. We sought to determine predictors of health care utilization among SVT patients presenting to the emergency department (ED). We studied consecutive patients evaluated in an urban, academic ED for adenosine-sensitive SVT. The primary study outcomes were (1) ambulance transportation to the index ED visit, (2) hospital admission from the index ED encounter, and (3) recurrent SVT-associated ED encounters. Among 100 patients with adenosine-sensitive SVT, 35 were transported to the ED by ambulance. Prior electrophysiologist evaluation was associated with a significant 87% reduced odds of ambulance utilization (OR 0.13, 95% CI 0.03-0.67, p = 0.015). A total of 62 patients were subsequently admitted to the hospital. All patients with coronary artery disease, diabetes, syncope, and wide complex SVT were admitted. Similarly, individuals with an elevated troponin had a significantly greater odds of hospital admission (OR 16.8, 95% CI 1.9-148.4, p = 0.011). After the index ED visit, 60 patients were seen by an electrophysiologist, and 47 underwent catheter ablation. Individuals treated with catheter ablation had a significant 75% reduction in the risk of a recurrent ED visit for SVT (HR 0.25, 95% CI 0.10-0.62, p = 0.003). Readily modifiable clinical factors, including a previous visit to an electrophysiologist and treatment with catheter ablation, are associated with reduced health care utilization among patients presenting to the ED with SVT.

  13. Health Risks to Ecological Workers on Contaminated Sites - the Department of Energy as a Case Study.

    Science.gov (United States)

    Burger, Joanna; Gochfeld, Michael

    At most contaminated sites the risk to workers focuses on those 'hazardous waste workers' directly exposed to chemicals or radionuclides, and to the elaborate approaches implemented to protecting their health and safety. Ecological workers generally are not considered. To explore the risks to the health and safety of ecological workers on sites with potential chemical and radiological exposures before, during or after remediation of contamination. To use the U.S. Department of Energy as a case study, and to develop concepts that apply generally to sites contaminated with hazardous or nuclear wastes. Develop categories of ecological workers, describe their usual jobs, and provide information on the kinds of risks they face. Ecological activities include continued surveillance and monitoring work on any sites with residual contamination, subject to institutional controls and engineered barriers following closure as well as the restoration. The categories of ecological workers and their tasks include 1) Ecological characterization, mapping and monitoring, 2) biodiversity studies, 2) Contaminant fate and transport, 3) On-going industrial activities 4) Remediation activities (environmental management), 5) Environmental restoration, 6) Post-cleanup surveillance and monitoring, and 7) Post-closure future site activities. There are a set of functional activities that can occur with different frequencies and intensities, including visual inspection, collecting biological samples, collecting media physical samples, collecting biological debris, restoration planting, and maintaining ecosystems. Ecological workers face different exposures and risks than other environmental cleanup workers. Many of their tasks mimic shift work with long hours leading to fatigue, and they are exposed to biological as well as chemical/radiological hazards. DOE and other entities need to examine the risks to ecological workers on site with an eye to risk reduction.

  14. Analysis of Leadership Flexibility Capability of District/City Public Health Department in North Sumatra

    Directory of Open Access Journals (Sweden)

    Achmad Rifai

    2016-02-01

    Full Text Available Leadership has an important role in the organization as leader is in charge of supervising and controlling the course of an organization. Ability to lead in mobilizing and empowering employees will affect the performance of the organization. This behavior has a significant impact on the attitudes, behavior and performance of employees. The results of the study showed there is a significant relationship between characteristics such as age (p = 0.004, education(p = 0.034, work experience (p = 0.000, the experience of the organization (p = 0.000, and educational hierarchy (p =0.000 for leadership flexibility. Sex variable is not significant to the leadership flexibility (p = 0.801. There is a relationship with the flexibility of directive leadership style (p = 0.027, supportive leadership style (p = 0.046, and participative leadership style (p = 0.009 with the flexibility of leadership. There is aso a relationship between achievement-oriented leadership style and leadership flexibility (p = 0.000. There is a relationship between the individual characteristics of leadership style and versatility with variable: educational level of leadership (p = 0.021; OR = 19.265. The result suggests that we need more organized seminars / work shop / scientific studies that stimulate the realization of learning about leadership flexibility in improving the performance of the District/City Health Office and it is necessary to study theperformance of the head of the Department of Health assessment intensively and periodically

  15. The air quality health index and emergency department visits for urticaria in Windsor, Canada.

    Science.gov (United States)

    Kousha, Termeh; Valacchi, Giuseppe

    2015-01-01

    Ambient air pollution exposure has been associated with several health conditions, limited not only to respiratory and cardiovascular systems but also to cutaneous tissues. However, few epidemiological studies examined pollution exposure on skin problems. Basically, the common mechanism by which pollution may affect skin physiology is by induction of oxidative stress and inflammation. Urticaria is among the skin pathologies that have been associated with pollution. Based on the combined effects of three ambient air pollutants, ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM) with a median aerodynamic diameter of less than 2.5 μm (PM(2.5)), on mortality, the Air Quality Health Index (AQHI) in Canada was developed. The aim of this study was to examine the associations of short-term changes in AQHI with emergency department (ED) visits for urticaria in Windsor-area hospitals in Canada. Diagnosed ED visits were retrieved from the National Ambulatory Care Reporting System (NACRS). A time-stratified case-crossover design was applied to 2905 ED visits (males = 1215; females = 1690) for urticaria from April 2004 through December 2010. Odds ratios (OR) and their corresponding 95% confidence intervals (95%CI) for ED visits associated with increase by one unit of risk index were calculated employing conditional logistic regression. Positive and significant results were observed between AQHI levels and OR for ED visits for urticaria in Windsor for lags 2 and 3 days. A distributed lag nonlinear model technique was applied to daily counts of ED visits for lags 0 to 10 and significant results were obtained from lag 2 to lag 5 and for lag 9. These findings demonstrated associations between ambient air pollution and urticarial confirming that air pollution affects skin conditions.

  16. A Description of the Forensic Monitoring System of the Missouri Department of Mental Health.

    Science.gov (United States)

    Reynolds, James B

    2016-03-01

    The Forensic Monitoring System (FMS) of the Missouri Department of Mental Health considers and approves consumers committed under not guilty by reason of insanity (NGRI) status for release. The system extends to the outpatient sector to ensure that such persons maintain their mental stability and do not pose a danger to the community. The process of conditional release and the organization of the FMS are outlined, reasons for the low recidivism rate are discussed, and paternalism in requiring treatment compliance as a condition of individual liberty is explored. Case examples illustrate the success, in terms of revocation and rearrest rates, of the Missouri system, which typically sees an annual return to inpatient custody of only 7%, and a still lower rate of criminal recidivism. Cost-effectiveness is discussed in terms of resources spent so that recovered persons with dangerous mental illnesses may live in safety outside of an institution. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Benchmarking as a tool for the improvement of health services' supply departments.

    Science.gov (United States)

    Dacosta-Claro, Ivan; Lapierre, Sophie D

    2003-11-01

    This paper presents a benchmarking study carried out on the supply departments of Quebec's health services. The paper begins with the definition of a methodology to collect the information needed, both environmental (to enable institutions to be sorted into homogenous groups) and performance related. The analysis of indicators and the data envelopment analysis (DEA) models allowed classification of each hospital's performance and explained the operational approaches used, either at a general level or for each subprocess of the supply chain. It was observed that important economies of scale may be achieved with better co-ordination and with the regrouping of the supplying activities, both for purchasing management and central store management. The study showed that the best performance of central store services comes with flexible administrative structures, by receiving packages as small as possible and by using employees from the lowest range of the hierarchy. Purchasing services should employ highly qualified and well-paid staff. Although such services are relatively small with respect to their purchase volume, they show a higher activity rate. As a result of the discovered performing strategies, the possible economies range from 20% to 30% of the actual supply-chain management cost.

  18. Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

    Science.gov (United States)

    Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin

    2016-12-01

    This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

  19. Analysis of the Chinese provincial air transportation network

    Science.gov (United States)

    Du, Wen-Bo; Liang, Bo-Yuan; Hong, Chen; Lordan, Oriol

    2017-01-01

    The air transportation system is of a great impact on the economy and globalization of a country. In this paper, we analyze the Chinese air transportation network (ATN) from a provincial perspective via the complex network framework, where all airports located in one province are abstracted as a single node and flights between two provinces are denoted by a link. The results show that the network exhibits small-world property, homogeneous structure and disassortative mixing. The variation of the flight flow within 24 h is investigated and an obvious tide phenomenon is found in the dynamics of Chinese provincial ATN for high output level of tertiary industry. Our work will offer a novel approach for understanding the characteristic of the Chinese air transportation network.

  20. Investor sentiment and stock returns: Evidence from provincial TV audience rating in China

    Science.gov (United States)

    Zhang, Yongjie; Zhang, Yuzhao; Shen, Dehua; Zhang, Wei

    2017-01-01

    In this paper, we advocate the provincial TV audience rating as the novel proxy for the provincial investor sentiment (PIS) and investigate its relation with stock returns. The empirical results firstly show that the PIS is positively related to stock returns. Secondly, we provide direct evidence on the existence of home bias in China by observing that the provincial correlation coefficient is significantly larger than the cross-provincial correlation coefficient. Finally, the PIS can explain a large proportion of provincial comovement. To sum up, all these findings support the role of the non-traditional information sources in understanding the "anomalies" in stock market.

  1. Insights from the evaluation of a provincial healthy eating strategy in Nova Scotia, Canada.

    Science.gov (United States)

    Sim, S Meaghan; Kirk, Sara F L

    2013-10-01

    Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.

  2. Laying the groundwork for evidence-based public health: why some local health departments use more evidence-based decision-making practices than others.

    Science.gov (United States)

    Lovelace, Kay A; Aronson, Robert E; Rulison, Kelly L; Labban, Jeffrey D; Shah, Gulzar H; Smith, Mark

    2015-04-01

    We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs' use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important.

  3. Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...

    African Journals Online (AJOL)

    Cette étude prospective a été menée pour évaluer l'utilisation des services de soins prénatals à l'Hôpital Spécialisé Provincial à Mongomo en Guinée Equatoriale, en mettant l'accent sur les facteurs déconcertant qui affectent les prestations des soins prénatals (SP) efficaces. Nous avons recueilli des renseignements à ...

  4. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    Directory of Open Access Journals (Sweden)

    Derek Mohammed

    2014-04-01

    Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

  5. Harm reduction in name, but not substance: a comparative analysis of current Canadian provincial and territorial policy frameworks.

    Science.gov (United States)

    Hyshka, Elaine; Anderson-Baron, Jalene; Karekezi, Kamagaju; Belle-Isle, Lynne; Elliott, Richard; Pauly, Bernie; Strike, Carol; Asbridge, Mark; Dell, Colleen; McBride, Keely; Hathaway, Andrew; Wild, T Cameron

    2017-07-26

    In Canada, funding, administration, and delivery of health services-including those targeting people who use drugs-are primarily the responsibility of the provinces and territories. Access to harm reduction services varies across jurisdictions, possibly reflecting differences in provincial and territorial policy commitments. We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes of a harm reduction approach. We employed an iterative search and screening process to generate a corpus of 54 provincial and territorial harm reduction policy documents that were current to the end of 2015. Documents were content-analyzed using a deductive coding framework comprised of 17 indicators that assessed the quality of policies relative to how well they described key population and program aspects of a harm reduction approach. Only two jurisdictions had current provincial-level, stand-alone harm reduction policies; all other documents were focused on either substance use, addiction and/or mental health, or sexually transmitted and/or blood-borne infections. Policies rarely named specific harm reduction interventions and more frequently referred to generic harm reduction programs or services. Only one document met all 17 indicators. Very few documents acknowledged that stigma and discrimination are issues faced by people who use drugs, that not all substance use is problematic, or that people who use drugs are legitimate participants in policymaking. A minority of documents recognized that abstaining from substance use is not required to receive services. Just over a quarter addressed the risk of drug overdose, and even fewer acknowledged the need to apply harm reduction approaches to an array of drugs and modes of use. Current provincial and territorial policies offer few robust characterizations of harm reduction or go beyond rhetorical or

  6. Tuberculosis treatment managed by providers outside the Public Health Department: lessons for the Affordable Care Act.

    Directory of Open Access Journals (Sweden)

    Melissa Ehman

    Full Text Available INTRODUCTION: Tuberculosis (TB requires at least six months of multidrug treatment and necessitates monitoring for response to treatment. Historically, public health departments (HDs have cared for most TB patients in the United States. The Affordable Care Act (ACA provides coverage for uninsured persons and may increase the proportion of TB patients cared for by private medical providers and other providers outside HDs (PMPs. We sought to determine whether there were differences in care provided by HDs and PMPs to inform public health planning under the ACA. METHODS: We conducted a retrospective, cross-sectional analysis of California TB registry data. We included adult TB patients with culture-positive, pulmonary TB reported in California during 2007-2011. We examined trends, described case characteristics, and created multivariate models measuring two standards of TB care in PMP- and HD-managed patients: documented culture conversion within 60 days, and use of directly observed therapy (DOT. RESULTS: The proportion of PMP-managed TB patients increased during 2007-2011 (p = 0.002. On univariable analysis (N = 4,606, older age, white, black or Asian/Pacific Islander race, and birth in the United States were significantly associated with PMP care (p<0.05. Younger age, Hispanic ethnicity, homelessness, drug or alcohol use, and cavitary and/or smear-positive TB disease, were associated with HD care. Multivariable analysis showed PMP care was associated with lack of documented culture conversion (adjusted relative risk [aRR] = 1.37, confidence interval [CI] 1.25-1.51 and lack of DOT (aRR = 8.56, CI 6.59-11.1. CONCLUSION: While HDs cared for TB cases with more social and clinical complexities, patients under PMP care were less likely to receive DOT and have documented culture conversion. This indicates a need for close collaboration between PMPs and HDs to ensure that optimal care is provided to all TB patients and TB transmission is

  7. Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

    Science.gov (United States)

    Ryan, Timothy; Specht, Jessica; Smith, Sarah; DelGaudio, John M

    2016-09-01

    Analyze the correlation between online-based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department. Retrospective cross sectional. Tertiary academic institution. All available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero-order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores. There were no statistically significant correlations between time spent with the patient (r = 0.391, P = .208) and overall provider scores (r = 0.193, P = .508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items "probability of recommending the provider" (r = -0.122, P = .666) and "trust in provider" (r = -0.025, P = .929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P = .014), listening for Healthgrades.com (r = 0.981, P ≤ .001), and trust in the provider for the PGPSS (r = 0.971, P ≤ .001). This study suggests that online-based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better-informed decisions regarding their health care. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  8. Interoperability of Information Systems Managed and Used by the Local Health Departments.

    Science.gov (United States)

    Shah, Gulzar H; Leider, Jonathon P; Luo, Huabin; Kaur, Ravneet

    2016-01-01

    In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs). To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability. This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received (50% response rate). Qualitative data were used from a key informant interview study of LHD informatics staff from across the United States. Qualitative data were independently coded by 2 researchers and analyzed thematically. Survey data were cleaned, bivariate comparisons were conducted, and a multivariable logistic regression was run to characterize factors associated with interoperability. For 30% of LHDs, no systems were interoperable, and 38% of LHD respondents indicated some of the systems were interoperable. Significant determinants of interoperability included LHDs having leadership support (adjusted odds ratio [AOR] = 3.54), control of information technology budget allocation (AOR = 2.48), control of data systems (AOR = 2.31), having a strategic plan for information systems (AOR = 1.92), and existence of business process analysis and redesign (AOR = 1.49). Interoperability of all systems may be an informatics goal, but only a small proportion of LHDs reported having interoperable systems, pointing to a substantial need among LHDs nationwide.

  9. Geographical disparities in the health of iranian women: Health outcomes, behaviors, and health-care access indicators

    Directory of Open Access Journals (Sweden)

    Mohsen Bayati

    2017-01-01

    Conclusions: We found large provincial disparities in determinants of women's health in Iran. Determinants such as lifestyle, health behavior, health knowledge, and health-care services availability should be considered by health policymakers in addressing the inequality in women's health at a provincial level.

  10. Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012.

    Science.gov (United States)

    Roser-Renouf, Connie; Maibach, Edward W; Li, Jennifer

    2016-01-01

    Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011-2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed.

  11. Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012

    Science.gov (United States)

    Roser-Renouf, Connie; Maibach, Edward W.; Li, Jennifer

    2016-01-01

    Background Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. Methods We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011–2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Results Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed. PMID:26991658

  12. A National Informatics Agenda for Nursing Education and Practice. Report to the Secretary of the Department of Health & Human Services.

    Science.gov (United States)

    National Advisory Council on Nurse Education and Practice, Rockville, MD.

    Nursing informatics is a specialty whose activities center around information management and processing for the nursing profession. The Division of Nursing of the U.S. Department of Health and Human Services and the National Advisory Council on Nurse Education and Practice (NACNEP) recognized a need to identify initiatives that would more…

  13. 78 FR 38343 - Notice of a Department of Health and Human Services Public Meeting and Request for Comments on...

    Science.gov (United States)

    2013-06-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... view the public meeting via live streaming technology. Information on that option is provided in... visitors must be escorted while in the building. D. Live Streaming Information For participants who cannot...

  14. Disparities in the Quality of HIV Care When Using US Department of Health and Human Services Indicators

    Science.gov (United States)

    Althoff, Keri N.; Rebeiro, Peter; Brooks, John T.; Buchacz, Kate; Gebo, Kelly; Martin, Jeffrey; Hogg, Robert; Thorne, Jennifer E.; Klein, Marina; Gill, M. John; Sterling, Timothy R.; Yehia, Baligh; Silverberg, Michael J.; Crane, Heidi; Justice, Amy C.; Gange, Stephen J.; Moore, Richard; Kitahata, Mari M.; Horberg, Michael A.; Kirk, Gregory D.; Benson, Constance A.; Bosch, Ronald J.; Collier, Ann C.; Boswell, Stephen; Grasso, Chris; Mayer, Kenneth H.; Hogg, Robert S.; Richard Harrigan, P.; Montaner, Julio SG; Cescon, Angela; Samji, Hasina; Brooks, John T.; Buchacz, Kate; Gebo, Kelly A.; Moore, Richard D.; Moore, Richard D.; Carey, John T.; Horberg, Michael A.; Silverberg, Michael J.; Thorne, Jennifer E.; Goedert, James J.; Jacobson, Lisa P.; Klein, Marina B.; Rourke, Sean B.; Burchell, Ann N.; Rachlis, Anita R.; Hunter-Mellado, Robert F.; Mayor, Angel M.; Gill, M.John; Deeks, Steven G.; Martin, Jeffrey N.; Saag, Michael S.; Mugavero, Michael J.; Willig, James; Eron, Joseph J.; Napravnik, Sonia; Kitahata, Mari M.; Crane, Heidi M.; Justice, Amy C.; Dubrow, Robert; Fiellin, David; Sterling, Timothy R.; Haas, David; Bebawy, Sally; Turner, Megan; Gange, Stephen J.; Anastos, Kathryn; Moore, Richard D.; Saag, Michael S.; Gange, Stephen J.; Kitahata, Mari M.; Althoff, Keri N.; McKaig, Rosemary G.; Justice, Amy C.; Freeman, Aimee M.; Moore, Richard D.; Freeman, Aimee M.; Lent, Carol; Kitahata, Mari M.; Van Rompaey, Stephen E.; Crane, Heidi M.; Morton, Liz; McReynolds, Justin; Lober, William B.; Gange, Stephen J.; Althoff, Keri N.; Abraham, Alison G.; Lau, Bryan; Zhang, Jinbing; Jing, Jerry; Golub, Elizabeth; Modur, Shari; Hanna, David B.; Rebeiro, Peter; Wong, Cherise; Mendes, Adell

    2014-01-01

    We estimated US Department of Health and Human Services (DHHS)–approved human immunodeficiency virus (HIV) indicators. Among patients, 71% were retained in care, 82% were prescribed treatment, and 78% had HIV RNA ≤200 copies/mL; younger adults, women, blacks, and injection drug users had poorer outcomes. Interventions are needed to reduce retention- and treatment-related disparities. PMID:24463281

  15. Impact of Mental Health and Substance Use Disorders on Emergency Department Visit Outcomes for HIV Patients

    Directory of Open Access Journals (Sweden)

    Brian Y. Choi, MD, MPH

    2016-03-01

    Full Text Available Introduction: A disproportionate number of individuals with human immunodeficiency virus (HIV have mental health and substance-use disorders (MHSUDs, and MHSUDs are significantly associated with their emergency department (ED visits. With an increasing share of older adults among HIV patients, this study investigated the associations of MHSUDs with ED outcomes of HIV patients in four age groups: 21-34, 35-49, 50-64, and 65+ years. Methods: We used the 2012 Nationwide Emergency Department Sample (NEDS dataset (unweighted n=23,244,819 ED events by patients aged 21+, including 115,656 visits by patients with HIV. Multinomial and binary logistic regression analyses, with “treat-and-release” as the base outcome, were used to examine associations between ED outcomes and MHSUDs among visits that included a HIV diagnosis in each age group. Results: Mood and “other” mental disorders had small effects on ED-to-hospital admissions, as opposed to treat-and-release, in age groups younger than 65+ years, while suicide attempts had medium effects (RRR=3.56, CI [2.69-4.70]; RRR=4.44, CI [3.72-5.30]; and RRR=5.64, CI [4.38- 7.26] in the 21-34, 35-49, and 50-64 age groups, respectively. Cognitive disorders had mediumto-large effects on hospital admissions in all age groups and large effects on death in the 35-49 (RRR=7.29, CI [3.90-13.62] and 50-64 (RRR=5.38, CI [3.39-8.55] age groups. Alcohol use disorders (AUDs had small effects on hospital admission in all age groups (RRR=2.35, 95% CI [1.92-2.87]; RRR=2.15, 95% CI [1.95-2.37]; RRR=1.92, 95% CI [1.73-2.12]; and OR=1.93, 95% CI [1.20-3.10] in the 21-34, 35-49, 50-64, and 65+ age groups, respectively. Drug use disorders (DUDs had small-to-medium effects on hospital admission (RRR=4.40, 95% CI [3.87-5.0]; RRR=4.07, 95% CI [3.77-4.40]; RRR=4.17, 95% CI [3.83-4.55]; and OR=2.53, 95% CI [2.70- 3.78] in the 21-34, 35-49, 50-64, and 65+ age groups, respectively. AUDs and DUDs were also significantly related to

  16. Focus on: University Hospital & Health Sciences Center SUNY at Stony Brook Biomedical Engineering Department.

    Science.gov (United States)

    Dyro, J F

    1993-01-01

    Clinical Engineering is practiced within the Biomedical Engineering Department (BME) at University Hospital, a modern, 536-bed, tertiary care teaching hospital. The 30-member department delivers a full range of clinical engineering services within the Stony Brook academic medical center. Major clinical engineering advances have been made in the areas of technology management, productivity and cost effectiveness, medical device safety, education, and research. University Hospital provides care for 2.5 million people in Suffolk County and other parts of Long Island.

  17. Governance typology: a consensus classification of state-local health department relationships.

    Science.gov (United States)

    Meit, Michael; Sellers, Katie; Kronstadt, Jessica; Lawhorn, Nikki; Brown, Alexa; Liss-Levinson, Rivka; Pearsol, Jim; Jarris, Paul E

    2012-11-01

    Public health practitioners and researchers often refer to state public health systems as being centralized, decentralized, shared, or mixed. These categories refer to governance of the local public health units within the state and whether they operate under the authority of the state government, local government, shared state and local governance, or a mix of governance structures within the state. This article describes the development of an objective method of classifying states as centralized, decentralized, shared, or mixed. We also discuss some initial analyses that have been conducted to identify how public health resources and activities vary across states with different classifications. Cross-sectional study. State health agencies. Survey respondents were organizational leaders from all 50 state health agencies. Total full-time equivalent employees, total health agency expenditures, expenditures on clinical services, and provision of clinical services. Centralized state health agencies employ more full-time equivalent employees, have higher total expenditures, and provide more clinical services than decentralized state health agencies. Although higher expenditures on clinical services were observed, these differences were not statistically significant. It is important to take governance classification into account when investigating variation in services, resources, or performance of governmental public health systems. As public health systems and services researchers seek to identify best practices in the organization of public health systems, consistent definition of different types of organization is critical. This system provides an objective and reliable system for classifying governance relationships that allows for comparisons that are meaningful to both practitioners and researchers.

  18. State of Hawaii, Department of Health, Clean Water Branch Special Surveys for Bellow Beach, Oahu, Hawaii 1992-1999 (NODC Accession 0014264)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality samples at six sites near the mouth of streams and...

  19. State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1999-2006 (NODC Accession 0013723)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

  20. Water quality data from the State of Hawaii, Department of Health, from the Coastal Waters of Hawaii from 05 November 2005 to 15 November 2006 (NODC Accession 0020391)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality data at 8 sites centered on Hanalei Bay on the north...

  1. State of Hawaii, Department of Health, Clean Water Branch Hanalei, Kauai Water Quality Sampling Dataset October 2005 - November 2006 (NODC Accession 0020391)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality data at 8 sites centered on Hanalei Bay on the north...

  2. Water sample data set from the State of Hawaii, Department of Health, 1999-2006 in Hawaiian waters (NODC Accession 0013723)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Water quality data from were collected by the Monitoring Section of the State of Hawaii, Department of Health. Data were obtained from 373 state-wide coastal...

  3. State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1973-1998 (NODC Accession 0013724)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

  4. Water sample data set from the State of Hawaii, Department of Health, 1973-1998 in Hawaiian waters (NODC Accession 0013724)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Water quality data from were collected by the Monitoring Section of the State of Hawaii, Department of Health. Data were obtained from 373 state-wide coastal...

  5. Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

    Science.gov (United States)

    Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

    2011-02-01

    To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

  6. The Impact of Emotional Intelligence on Conditions of Trust Among Leaders at the Kentucky Department for Public Health

    Directory of Open Access Journals (Sweden)

    Jennifer Redmond Knight

    2015-03-01

    Full Text Available There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health. The Kentucky Department for Public Health (KDPH serves as Kentucky’s state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation coefficients and corresponding p-values are presented to provide the association between emotional intelligence scales and the conditions of trust. Significant positive correlations were observed between supervisors' stress management and the staff members' trust or perception of supervisors' loyalty(r=0.6, p=0.01, integrity(r=0.5, p=0.03, receptivity(r=0.6, p=0.02, promise fulfillment(r=0.6, p=0.02 and availability (r=0.5, p=0.07. This research lays the foundation for emotional intelligence and trust research and leadership training in other governmental public health settings, such as local, other state, national or international organizations. This original research provides metrics to assess the public health workforce with attention to organizational management and leadership constructs. The survey tools could be used in other governmental public health settings in order to develop tailored training opportunities related to emotional intelligence and trust organizations.

  7. New Approaches for Moving Upstream: How State and Local Health Departments Can Transform Practice to Reduce Health Inequalities

    Science.gov (United States)

    Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

    2015-01-01

    Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream"…

  8. Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos.

    Science.gov (United States)

    Schmidt, S; Bounnack, S; Hoehn, T

    2018-01-01

    Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. Institution-to-institution mentoring to build capacity in 24 local US health departments: best practices and lessons learned.

    Science.gov (United States)

    Veatch, Maggie; Goldstein, Gail P; Sacks, Rachel; Lent, Megan; Van Wye, Gretchen

    2014-10-02

    Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented for 24 Communities Putting Prevention to Work grantee communities nationwide. We conducted semi-structured telephone interviews to assess grantees' perspectives on the effectiveness of the mentoring program in supporting their work. Two interviews were conducted with key informants from each participating community. Three evaluators coded and analyzed data using ATLAS.ti software and using grounded theory to identify emerging themes. We completed 90 interviews with 44 mentees. We identified 7 key program strengths: learning from the New York City health department's experience, adapting resources to local needs, incorporating new approaches and sharing strategies, developing the mentor-mentee relationship, creating momentum for action, establishing regular communication, and encouraging peer interaction. Participants overwhelmingly indicated that the mentoring program's key strengths improved their capacity to address chronic disease prevention in their communities. We recommend dissemination of the results achieved, emphasizing the need to adapt the institutional mentoring model to local needs to achieve successful outcomes. We also recommend future research to consider whether a hybrid programmatic model that includes regular one-on-one communication and in-person conferences could be used as a standard framework for institutional mentoring.

  10. 2002 Department of Defense Survey of Health Related Behaviors Among Military Personnel

    Science.gov (United States)

    2003-10-01

    Disease and Stroke 16. Cancer 17. Diabetes 18. Chronic Kidney Disease 19. Disability and Secondary Conditions 20. HIV Infection 21. Sexually...disease, and diabetes (Pi-Sunyer, 1993). Fortunately, behavioral measures can positively impact these types of conditions. For example, the health...attitude, reported behavior, and perceptions of their own gingival health (Tan, Ruiter, & Verhey, 1981). To encourage better oral health care, military

  11. HIGHLIGHTS: 1998 Department of Defense Survey of Health Related Behaviors Among Military Personnel

    National Research Council Canada - National Science Library

    Bray, Robert

    1999-01-01

    .... It also provides estimates for health behaviors pertaining to fitness and cardiovascular disease risk reduction, injuries and injury prevention, sexually transmitted disease risk reduction, cervical...

  12. Department of medicine of catastrophes, medical care and mobilization training of health the stages of development

    OpenAIRE

    Akhmerov, F.; Petrov, G.; Shigapov, B.

    2010-01-01

    The article presents the stages of organization and development of the department of medicine of catastrophes, the formation of the service providing emergency medical care and specialized rehabilitation center in the Republic of Tatarstan. Keywords: medicine of catastrophes, emergency medical care.

  13. The determinants of discrimination against daughters in China: evidence from a provincial-level analysis.

    Science.gov (United States)

    Attané, Isabelle

    2009-03-01

    This paper reports a provincial-level analysis of the way in which various socio-economic and socio-demographic determinants influence the decision to discriminate against daughters in China. While most existing studies use the infant or child sex ratio as the only variable to be explained, this study analyses separately the two main discriminatory practices: sex-selective abortion (with sex ratio at birth as a proxy) and neglect of girls' health care (with excess infant mortality among females as a proxy). The analysis helps to illuminate the circumstances that encourage sex-selective behaviours, which appear to be dictated mainly by extreme poverty, family support to the elderly, and father's education, together with the social pressure on couples to adhere to traditional values and roles and the constraints on family size. While sex-selective abortion appears to result from long-term strategies to optimize family composition, lethal neglect is the immediate result of economic constraints.

  14. Methicillin-Resistant Staphylococcus aureus Colonization among Health Care Workers in a Downtown Emergency Department in Toronto, Ontario

    OpenAIRE

    Gregory Saito; Jessica Thom; Yanliang Wei; Piraveina Gnanasuntharam; Pirasanya Gnanasuntharam; Nathan Kreiswirth; Barbara Willey; Michelle Loftus; Catherine Varner; Vanessa Porter; Allison McGeer; Bjug Borgundvaag

    2013-01-01

    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) acquired in the community, otherwise known as community-acquired MRSA, has emerged rapidly in recent years. Colonization with MRSA has been associated with an increased risk of symptomatic and serious infections and, in some settings, health care workers (HCWs) exhibit a higher prevalence of MRSA colonization.OBJECTIVE: To determine MRSA colonization in emergency department (ED) HCWs in the setting of a moderate prevalence of MRSA...

  15. . . . Sending out an SMS: an impact and outcome evaluation of the Western Australian Department of Health's 2005 chlamydia campaign.

    Science.gov (United States)

    Wilkins, Alexa; Mak, Donna B

    2007-08-01

    Evaluation of the Western Australian (WA) Department of Health 2005 chlamydia campaign. Twenty-nine people aged 17-25 years were focus tested and 122 people aged 14-29 years were surveyed to investigate awareness and opinions of a multimedia chlamydia campaign targeting young people and to seek their recommendations on how to communicate sexual health information to young people. Forty-three general practice (GP) waiting rooms in the Perth metropolitan area were visited to examine type, availability and standard of display of sexual health resources. The majority of participants surveyed (63.2%) were aware of the chlamydia campaign. Campaign recall ranged from 27% for the website to 48.4% for the posters and print advertisements. Participants predominantly nominated television, radio, posters and magazines as preferred media for receiving sexual health messages. Participants preferred to obtain sexual health information through the Internet or a health professional. The majority of participants (58.2%) rated Short Message Service (SMS) as a very good or good communication method. Chlamydia testing increased during the campaign period by 21% in females and 29% in males, and notifications increased by 12% in females and 4% in males. The study demonstrated a high level of awareness of the chlamydia campaign among the target audience. Television, radio, posters, magazines, the Internet and health professionals were the preferred media for receiving and obtaining sexual health information. SMS was identified as a useful marketing strategy. There was a low level of uptake of the campaign resources in GP waiting rooms.

  16. Is there an association between local health department organizational and administrative factors and childhood immunization coverage rates?

    Science.gov (United States)

    Ransom, James; Schaff, Katherine; Kan, Lilly

    2012-01-01

    Vaccines are valuable, cost-effective tools for preventing disease and improving community health. Despite the importance and ubiquity of vaccinations, childhood immunization coverage rates vary widely by geography, race, and ethnicity. These differences have been documented for nearly two decades, but their sources are poorly understood. Between 2005 and 2008, immunization staff of the National Association of County & City Health Officials (NACCHO) visited 17 local health department (LHD) immunization programs in 10 states to assess their immunization service delivery (ISD) practices and their impact on community childhood immunization coverage rates. To qualitatively characterize LHD immunization programs and specific organizational factors underlying ISD performance challenges and successes related to community childhood immunization coverage rates. Case studies were conducted in a convenience sample of 17 geographically and demographically diverse LHDs, predicated on each LHD's childhood immunization coverage rates per data from the National Immunization Survey and/or Kindergarten Retrospective Survey. NACCHO staff selected LHDs with high (> or = 80% up to date [UTD]), moderate (> or = 75% UTD but management related to aligning ISD with other child-focused services within the LHD; 2) resources: organizational efforts focused on aligning federal and state ISD financing with local ISD needs; 3) politics: political advocacy and partnering with local community stakeholders, including local political entities and boards of health to better organize ISD; 4) community engagement/coalitions and partnerships: partnerships, coalitions, and community engagement to support local immunization-related decision-making and prioritization; 5) credibility: agency credibility and its ability to influence community attitudes and perspectives on the health department's value in terms of child health; and 6) cultural competency of LHD staff: LHD staff members' perceptions and

  17. Connecting the Dots: State Health Department Approaches to Addressing Shared Risk and Protective Factors Across Multiple Forms of Violence

    Science.gov (United States)

    Wilkins, Natalie; Myers, Lindsey; Kuehl, Tomei; Bauman, Alice; Hertz, Marci

    2018-01-01

    Violence takes many forms, including intimate partner violence, sexual violence, child abuse and neglect, bullying, suicidal behavior, and elder abuse and neglect. These forms of violence are interconnected and often share the same root causes. They can also co-occur together in families and communities and can happen at the same time or at different stages of life. Often, due to a variety of factors, separate, “siloed” approaches are used to address each form of violence. However, understanding and implementing approaches that prevent and address the overlapping root causes of violence (risk factors) and promote factors that increase the resilience of people and communities (protective factors) can help practitioners more effectively and efficiently use limited resources to prevent multiple forms of violence and save lives. This article presents approaches used by 2 state health departments, the Maryland Department of Health and Mental Hygiene and the Colorado Department of Public Health and Environment, to integrate a shared risk and protective factor approach into their violence prevention work and identifies key lessons learned that may serve to inform crosscutting violence prevention efforts in other states. PMID:29189502

  18. 2005 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel

    National Research Council Canada - National Science Library

    Bray, Robert M; Hourani, Laurel L; Rae Olmsted, Kristine L; Witt, Michael; Brown, Janice M; Pemberton, Michael R; Marsden, Mary Ellen; Marriott, Bernadette; Scheffler, Scott; Vandermaas-Peeler, Russ

    2006-01-01

    ... Secretary of Defense (Health Affairs). All of the surveys investigated the prevalence of alcohol use, illicit drug use, and tobacco use, as well as negative consequences associated with substance use...

  19. Los orígenes del Instituto provincial de higiene de las Canarias orientales y la sanidad municipal (1926-1927: cambios estructurales y asistenciales

    Directory of Open Access Journals (Sweden)

    Martín del Castillo, Juan Francisco

    2005-12-01

    Full Text Available The «Instituto Provincial de Higiene de las Canarias Orientales» is an example of Estatuto Provincial of José Calvo Sotelo (1925. Involved in administrative affaires and economical distributions between the Townhall of Las Palmas de Gran Canaria and Insular Council, its beginning is labour of Doctor Antonio Ortiz de Landázuri, in that moment Health Inspector. In this paper, be described the structure and functions of Hygiene Institute, so the change of technical members of laboratories and stations of previous town health services.

    El Instituto Provincial de Higiene de las Canarias Orientales es un ejemplo de la puesta en marcha del Estatuto Provincial de José Calvo Sotelo (1925. Envuelto en medidas administrativas y repartos financieros entre el Ayuntamiento de Las Palmas de Gran Canaria y el Cabildo Insular, su inicio es obra directa del doctor Antonio Ortiz de Landázuri, en aquellos momentos al cargo de la Inspección de Sanidad. En el presente, quedan descritos la estructura y funciones del Instituto de Higiene, además del pase de los miembros facultativos de los laboratorios y estaciones de anteriores servicios municipales del ramo.

  20. Marihuana and Health: A Report to Congress from the Secretary, U. S. Department of Health Education and Welfare.

    Science.gov (United States)

    National Inst. of Mental Health (DHEW), Bethesda, MD.

    This report to congress is designed to summarize the current status of our knowledge of the health consequences of the use of marijuana, that is, not only the effects of the drug on the individual's physical and psychological health, but also the effects of marijuana use on the society as a whole. Certainly, our knowledge of marijuana and health…

  1. Cross-Sectional Study of the Relation of Health Literacy to Primary Language and Emergency Department Length of Stay.

    Science.gov (United States)

    Sarangarm, Dusadee; Ernst, Amy; Horner, Rachel; Crum, Ashley; Weiss, Steven J; Zemkova, Yana; King, Kisa

    2017-12-01

    The primary aim of this study was to determine whether emergency department (ED) length of stay (LOS) or primary language was related to the degree of health literacy of patients. Adult English-speaking and Spanish-speaking patients were recruited for the study. Participants completed the Newest Vital Sign (NVS) tool (English and Spanish versions), a 6-question validated scale. Patients with NVS scores of 0 to 3 were considered to be at risk for limited health literacy, whereas those with adequate health literacy were defined as scoring a 4 to 6. After completion of their ED visit, a retrospective chart review was performed to identify the patient's ED LOS (time from registration to time of disposition) and ED disposition. In addition, 2 single-item questions were compared with the NVS for validity. Participants included 250 English-speaking and 257 Spanish-speaking subjects. Per the NVS, 71% (359 of 507) of all patients had limited health literacy. By language group, significantly more Spanish-speaking than English-speaking patients had limited health literacy (93% vs 48%, diff 45%, 95% confidence interval 37-51). There was no significant difference in LOS between the limited health literacy group and adequate health literacy group (medians 440 vs 461 min). The 2 single-item questions had fair validity in comparison to the NVS scale (κ 0.2-0.3). There was a significant difference in health literacy based on language, with 93% of all Spanish-speaking patients in our sample having limited health literacy. We found no significant difference in ED LOS between patients with limited health and adequate health literacy in an academic urban ED setting.

  2. Decision-making and radiological protection at Three Mile Island: response of the Department of Health, Education and Welfare

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I.

    1982-02-01

    Decision-making by decision-makers during the nuclear accident at Three Mile Island all had to do in some way, and impacted on the public health and safety, the health and safety of the workers, and emergency preparedness and health care. This paper reviews the activities of only one federal agency during the accident, the Department of Health, Education, and Welfare (HEW), and its effectiveness in its role as the leading institution responsible for protecting the public health during the first accident in a nuclear power plant designed for the commerical generation of electricity in the United States. My comments are limited to only three acts dealing with radiological health and protection: the struggle for power and assertion of leadership in response to possible health consequences of the accident; the decisions to evacuate the area during the radiological emergency; and the use of potassium iodide as a means of protecting the public and the workers from the hazards of exposure to radioactive iodine released to the environment.

  3. Acute health problems in African refugees: ten years' experience in a Swiss emergency department.

    Science.gov (United States)

    Pfortmueller, Carmen A; Graf, Fabienne; Tabbara, Malek; Tabarra, Malek; Lindner, Gregor; Zimmermann, Heinz; Exadaktylos, Aristomenis K

    2012-09-01

    Over the last two decades, the total number of applications from Africans for asylum in the countries of the European Union has increased from 578,000 to more than 2.9 million. About 20 % (7,196/36,100) of the asylum seekers in Switzerland originate from Africa. The disease profile of African asylum seekers is remarkably different from that of the native population in the country of application. We have therefore conducted an analysis of African asylum seekers presenting themselves to our emergency department. In a retrospective analysis, the central patient registry database was searched for patients originating from Africa admitted from 1 January 2000 to 30 November 2011 and labelled as "Asylbewerber" (asylum seeker) or "Flüchtling" (refugee). Three thousand six hundred and seventy-five African asylum seekers were admitted to our emergency department between 2000 and 2010. Thirty-four percent (n = 1,247) were female and 66 % (n = 2,426) male. Eighty percent (n = 1,940) of the men and 70 % (n = 823) of the women were younger than 40 years. Most of our patients originated from Algeria (n = 612). Forty-five percent (n = 1,628) of all patients presented with internal medical problems, 40 % (n = 1,487) with injuries. 3.5 % (n = 130) of all patients presented with psychiatric problems. Admission for psychiatric problems increased steadily from 2 % (n = 4) in 2001 to 10 % (n = 35) in 2011. The causes of presentation are manifold, including internal medical problems and injuries. Admissions for psychiatric problems are increasing. Establishing simple screening scores for somatization should be a key priority in providing more focused treatment in emergency departments.

  4. A Guide for State Government Agencies: Establishing Cost Allocation Plans and Indirect Cost Rates for Grants and Contracts with the Department of Health, Education, and Welfare.

    Science.gov (United States)

    Department of Health, Education, and Welfare, Washington, DC.

    This brochure provides guidelines for State governments seeking to recover the costs of services provided by central service-type activities to grantee State departments and the indirect cost of grantee State departments. As a prerequisite to such recovery, States must develop and submit to the Department of Health, Education, and Welfare a formal…

  5. The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments Study: Feasibility and Findings

    Directory of Open Access Journals (Sweden)

    Kerry Stephen Kuehl

    2014-05-01

    Full Text Available This randomized prospective trial aimed to assess the feasibility and efficacy of a team-based worksite health and safety intervention for law enforcement personnel. Four-hundred and eight subjects were enrolled and half were randomized to meet participants met for weekly, peer-led sessions delivered from a scripted team-based health and safety curriculum. Curriculum addressed: exercise, nutrition, stress, sleep, body weight, injury, and other unhealthy lifestyle behaviours such as smoking and heavy alcohol use. Health and safety questionnaires administered before and after the intervention found significant improvements for increased fruit and vegetable consumption, overall healthy eating, increased sleep quantity and sleep quality, and reduced personal stress.

  6. Building Community Disaster Resilience: Perspectives From a Large Urban County Department of Public Health

    Science.gov (United States)

    Fielding, Jonathan E.; Chandra, Anita; Williams, Malcolm; Eisenman, David; Wells, Kenneth B.; Law, Grace Y.; Fogleman, Stella; Magaña, Aizita

    2013-01-01

    An emerging approach to public health emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory—specifically, the focus on incorporating equity and social justice considerations in preparedness planning and response. We also examine the challenges of integrating community resilience with traditional public health practices and the importance of developing metrics for evaluation and strategic planning purposes. Using the example of the Los Angeles County Community Disaster Resilience Project, we discuss our experience and perspective from a large urban county to better understand how to implement a community resilience framework in public health practice. PMID:23678937

  7. Building community disaster resilience: perspectives from a large urban county department of public health.

    Science.gov (United States)

    Plough, Alonzo; Fielding, Jonathan E; Chandra, Anita; Williams, Malcolm; Eisenman, David; Wells, Kenneth B; Law, Grace Y; Fogleman, Stella; Magaña, Aizita

    2013-07-01

    An emerging approach to public health emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory-specifically, the focus on incorporating equity and social justice considerations in preparedness planning and response. We also examine the challenges of integrating community resilience with traditional public health practices and the importance of developing metrics for evaluation and strategic planning purposes. Using the example of the Los Angeles County Community Disaster Resilience Project, we discuss our experience and perspective from a large urban county to better understand how to implement a community resilience framework in public health practice.

  8. Evaluation Of Malaria Surveillance System In Department Of Health District Sumbawa Besar

    Directory of Open Access Journals (Sweden)

    Zainuddin Zainuddin

    2014-09-01

    Full Text Available ABSTRACT Malaria is a public health problem that can affect infant mortality, under five, pregnant women and can reduce productivity. The annual parasite incidence from 2008 antil 2011showed malaria morbidity in Sumbawa district remain high. The Purpose of this study was to describe the implementation of Malaria Surveillance System at the District Health Office Lombok Sumbawa Besar. This study used a descriptive survey method. Subjects were malaria surveillance officer in district Health office, health centers, and hospitals. Research object is a document epidemiological surveillance report of malaria in 2013. Variables of this study is the implementation of malaria surveillance system (input, process, output and surveillance system attributes. Data obtained from interviews and observations were analyzed descriptively. The results showed that the data type on input stage was not yet complete, the quantity of labor was complete but insufficient quality of human resources, facilities and sufficient funds were available. At stage of the data collection process employed W2 weekly report format and monthly report format, report formats and reporting lines were simple, completeness and monthly reports 100% W2, W2 reporting time liness was > 80% and monthly reports was > 90%, Analysis and interpretation of the data was done However the analysis of relationshif was conducted by 20% of primary health care. The resulting output is a description of endemicity areas, API and SPR are presented in tabular form, graph and maps. Dissemination of information is done in the form of reports, workshops and profiles. Feedback is done each month through coordination meeting, regular meetings and regular supervision. Surveillance evaluation system based on attributed surveillance showed its simplicity and acceptability, however sensitivity can not be assessed yet, low NPP 1.75%, report punctuality was > 80%. It is necessary the existence of expert epidemiologists (S2

  9. U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

  10. 'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief.

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2017-10-02

    How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing

  11. “Cabina de Aislamiento Acústico para operadores de calderos del departamento de mantenimiento del Hospital Provincial General Docente Riobamba”

    OpenAIRE

    Coral Tapia, César Alfredo

    2016-01-01

    Thirsted was conducted in the Maintenance Department of the Provincial General Teaching Hospital in Riobamba, aiming to determine the prevalence of hearing loss induced by noise (NIHL) by its acronym in English (Noise Induced Hearing Loss), the public servants who are exposed to noise in the roundhouse For this study were required measurements of noise in the workplace such as dosimeter measurements in broadband and octave band and audiometry The analysis of the measurements resulted ...

  12. Role of the physiotherapist in the orthopaedic trauma department in the context of National Health Fund funding of medical procedures.

    Science.gov (United States)

    Śliwiński, Zbigniew; Frączek, Ewa; Starczyńska, Małgorzata

    2013-01-01

    The present paper aims to demonstrate that physiotherapy in orthopaedic and trauma departments is part and parcel of a comprehensive treatment plan. Hospital records of 66 patients treated in three orthopaedic trauma departments in 2011 were analysed. Basing on the requirements of the National Health Fund (Narodowy Fundusz Zdrowia--NFZ), reports were generated on the number of physiotherapy procedures provided. The mean age of the patients was 70.26 (SD=12.08) years. Sixty-two of them (93.94%) had undergone hip replacement and the remaining 4 (6.06%) had undergone knee replacement procedures. The patients spent a mean of 13 days in hospital (SD=3.66, range 9-30 days). The following physiotherapy procedures were applied: mobilisation in 48 subjects (72.73%), seating in 47 (71.21%), gait training in 48 (72.73%), exercises of the affected leg in 46 (69.70%), upper limb exercises in 38 (57.58%) and breathing exercises in 28 (42.42%). According to the NFZ regulations, the maximum number of patients per one physiotherapist in an orthopaedic department is 10, which requirement was met in only one of the three hospitals involved. 1. Arthroplasty procedures along with long bone fracture fixation are the most common causes of hospitalisation in orthopaedic trauma departments. 2. The departments involved in this study do not provide pre-operative rehabilitation. Physiotherapy begins at 3 days post surgery. 3. Most of the departments involved do not comply with the NFZ's requirement regarding the therapist-to-patient ratio.

  13. U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

  14. New health and safety initiatives at the Department of Energy (DOE)

    Science.gov (United States)

    Ziemer, Paul L.

    1993-01-01

    This document touches on some of the more important lessons learned and the more noteworthy initiatives DOE has put into motion in the last three years to protect the health and safety of our contractor employees. What we have learned in the process should come as no surprise to those of you who have been working in the field: (1) that management commitment to safety and health is critical to a successful program; (2) that meaningful employee participation in all aspects of the program enhances its effectiveness at every level; and (3) that the dedication and expertise of medical and occupational safety and health professionals are needed if the challenging problems presented by the complex and technologically advanced environment at DOE facilities are to be overcome. I believe that we have made a good beginning in the long and arduous task of building an Occupational Safety and Health Program that will serve as a model for others, and I can assure you that we intend to continue our efforts to protect every worker within the complex from occupational injury and disease.

  15. ISLAM IN PROVINCIAL INDONESIA: Middle Class, Lifestyle, and Democracy

    Directory of Open Access Journals (Sweden)

    Noorhaidi Hasan

    2011-02-01

    Full Text Available Islamic symbols have flourished in the public spaces of Indonesian provincial towns after Suharto. This phenomenon has occurred in parallel with the  significant shifts in the social, economic and political fields, which is tied to the mounting impact of Islamization, social mobility, economic growth, and democratization occurring among town people. It is as if we see a parallel move between Islamization, modernization, globalization and democratization. Key concepts associated with these trends are appropriated with those rooted in tradition and local culture to inform the whole dynamics of Indonesian provincial towns today. The key player in this process is the new middle class, who look to Islam for inspiration both to claim distinction and social status and to legitimize their consumptive lifestyle. They are newly pious who act as active negotiators between the global and the local as well as the cosmopolitan centre and the hinterland. They also play a pivotal role as an agency that liberalizes religion from its traditionally subservient, passive and docile posture by turning it into a source of moral legitimacy and distinction to represent a modern form of life. Given its intimate relationship with locality, tradition, modernity as well as globalization, Islam has increasingly assumed a greater importance for local politics. Political elites have used Islamic symbols for the instrumental purpose of extending their political legitimacy and mobilizing constituency support, in a political environment of open competition and increased public participation in decision making. In this process religious symbols have irrefutably been distanced from their religious moorings and narrow, Islamist understandings, in favor of pragmatic political purposes. Keywords: Islamic symbols, middle class, globalization, lifestyle, local politics

  16. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all.

  17. Achieving focused infrastructure investment in South Africa: Technical advances in provincial spatial planning

    CSIR Research Space (South Africa)

    Meiklejohn, C

    2008-11-01

    Full Text Available This paper presents the CSIR’s contribution to technical advances in the approach to provincial spatial planning in South Africa. It demonstrates the CSIR’s involvement in conducting the national Provincial Growth and Development Strategy Assessment...

  18. Attitudes of Employees of Provincial Directorates of National Education and School Administrators towards Strategic Planning

    Science.gov (United States)

    Altinkurt, Yahya

    2010-01-01

    The aim of the study is to determine the attitudes of employees of Provincial Directorates of National Education and school administrators towards strategic planning. The research was designed as a survey model study. The population of the research consisted of employees of Provincial Directorate of National Education of Kutahya and school…

  19. The Impact of Emotional Intelligence on Conditions of Trust among Leaders at the Kentucky Department for Public Health.

    Science.gov (United States)

    Knight, Jennifer Redmond; Bush, Heather M; Mase, William A; Riddell, Martha Cornwell; Liu, Meng; Holsinger, James W

    2015-01-01

    There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health (KDPH). The KDPH serves as Kentucky's state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation coefficients and corresponding p-values are presented to provide the association between emotional intelligence scales and the conditions of trust. Significant positive correlations were observed between supervisors' stress management and the staff members' trust or perception of supervisors' loyalty (r = 0.6, p = 0.01), integrity (r = 0.5, p = 0.03), receptivity (r = 0.6, p = 0.02), promise fulfillment (r = 0.6, p = 0.02), and availability (r = 0.5, p = 0.07). This research lays the foundation for emotional intelligence and trust research and leadership training in other governmental public health settings, such as local, other state, national, or international organizations. This original research provides metrics to assess the public health workforce with attention to organizational management and leadership constructs. The survey tools could be used in other governmental public health settings in order to develop tailored training opportunities related to emotional intelligence and trust organizations.

  20. [ISO 9001 certification of innovation and clinical research departments: Extending the scope of health assessment].

    Science.gov (United States)

    Sambou, C; Guillemaut, S; Morelle, M; Achache, A; Le Corroller, A-G; Perol, D; Perrier, L

    2017-04-01

    The International organization for standardization (ISO) is the world leader in providing industrial and commercial standards and certifications. Beyond medical devices, four French clinical research and innovation departments have received an ISO 9001 certification (the standard for quality management). Simultaneously, medico-economic studies have become increasingly important in the public decision process. Using the clinical research and innovation department from the Léon-Bérard Cancer Center as an example, the purpose of this article is to show how the scope of the ISO 9001 certification has been extended to cover medico-economic studies. All of the processes, procedures, operating modes, documents, and indicators used by the clinical research and innovation department of the Léon-Bérard center were investigated. Literature searches were conducted using Medline keywords. The recommendations from the French national authority for health and other organizations, such as the International society for pharmacoeconomics and outcomes research (ISPOR), were also considered, as well as the recommendations of the General inspectorate of social affairs. In accordance with the national and international recommendations, two procedures were created and four procedures were revised at this center. Five indicators of quality and an evaluation chart were developed. By adopting the ISO 9001 certification into its medico-economic studies, the clinical research and innovation department of the Léon-Bérard center has used an innovative approach in the context of the growing importance of economic studies in decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Adolescent and parent attitudes toward screening for suicide risk and mental health problems in the pediatric emergency department.

    Science.gov (United States)

    O'Mara, Roisin M; Hill, Ryan M; Cunningham, Rebecca M; King, Cheryl A

    2012-07-01

    The objective of this study was to investigate adolescent and parent attitudes toward screening adolescents for suicide risk and other mental health problems in the emergency department (ED). Two hundred ninety-four adolescents and 300 parents completed questionnaires about the importance of screening for suicide risk and other mental health problems in the ED, what would be helpful if the screen was positive, their concerns about screening in the ED, whether they believe screening should be a routine part of an ED visit, and whether they would complete a screening during the current visit if offered the opportunity. Overall, parents and adolescents reported positive attitudes toward screening for suicide risk and other mental health problems in the ED, with the majority responding that it should be a routine part of ED care. Suicide risk and drug and alcohol misuse were rated as more important to screen for than any of the other mental health problems by both parents and adolescents. Adolescent females and mothers were more supportive of screening for suicide risk and mental health problems in the ED than male adolescents and fathers. Descriptive data regarding screening concerns and follow-up preferences are reported. Study results suggest overall positive support for screening for suicide risk and other mental health problems in the ED, with some important preferences, concerns, and parent versus adolescent and male versus female differences.

  2. Women and crisis pregnancy : a report presented to the Department of Health and Children

    OpenAIRE

    MAHON, EVELYN

    1998-01-01

    PUBLISHED Dublin In June 1995, the Minister for Health, Michael Noonan, commissioned this study on women and crisis pregnancy in Ireland. The study was commissioned to identify the factors which contributed to the incidence of unwanted pregnancy and those which resulted in abortion. In this report, the decision making processes and the factors which women consider when making decisions arising from crisis pregnancies are analysed. The purpose of the research is to assi...

  3. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

  4. Florida county health department, environmental health 2006 survey: do rural counties know "what to do' in a chemical or all-hazards event?

    Science.gov (United States)

    Becker, Alan; Suther, Sandra; Dutton, Matthew; Kearney, Gregory D; Xu, Xiaohui

    2015-01-01

    The objective of the study described here was to determine basic plans and collaboration with first responder stakeholders and to identify perceived roles and responsibilities in preparing for and responding to a chemical disaster. A survey was developed and provided to environmental health personnel at county health departments (CHDs) in Florida. Most of the counties had good collaborative relationships with first responder stakeholders. A little more than half of the respondents had access to a resource manual with contact information and had developed and maintained a chemical plan. Rural counties were less likely to know "what to do" or their responsibility in a chemical disaster; however, both rural and nonrural counties were equally likely not to have a written plan. Public health agencies at the local CHD must be the communicators of public health messages in coordination with the incident commander and the state communications office in a chemical disaster, so it is important to strengthen collaboration and cooperation with chemical response stakeholders.

  5. Information security concepts and practices: the case of a provincial multi-specialty hospital.

    Science.gov (United States)

    Cavalli, Enrico; Mattasoglio, Andrea; Pinciroli, Francesco; Spaggiari, Piergiorgio

    2004-03-31

    In recent years, major and widely accepted information security understandings and achievements confirm that the problem is complex. They clarify that technologies are fundamental tools, but management processes have even bigger relevance, as also prestigious international magazines dossier clearly explained recently. Such a magazine attention outlines the wide impact that the subject has on watchful decision makers. ISO17799 is an emerging standard in information security. In principle there are no reasons for considering it not applicable to the health care sector. In practice, because of both the just conceptual level of the standard and the peculiarities of the health care data and institutions, a lot of analysis and design work need to be invested any time a health care institution decides to deal with the subject. CEN/ENV 12924 is another emerging standard certainly more on the spot of the health care. Nevertheless, it also asks for evident further investigation. The practical case of information security design, implementation, management, and auditing inside a multi-specialty provincial Italian hospital will be described.

  6. Suicide Mortality Following Nursing Home Discharge in the Department of Veterans Affairs Health System

    Science.gov (United States)

    Szymanski, Benjamin R.; Karlin, Bradley E.; Katz, Ira R.

    2013-01-01

    Objectives. We assessed suicide rates up to 6 months following discharge from US Department of Veterans Affairs (VA) nursing homes. Methods. In VA Minimum Data Set (MDS) records, we identified 281 066 live discharges from the 137 VA nursing homes during fiscal years 2002 to 2008. We used MDS and administrative data to assess resident age, gender, behaviors, pain, and indications of psychoses, bipolar disorder, dementia, and depression. We identified vital status and suicide mortality within 6 months of discharge through National Death Index searches. Results. Suicide rates within 6 months of discharge were 88.0 per 100 000 person-years for men and 89.4 overall. Standardized mortality ratios relative to age- and gender-matched individuals in the VA patient population were 2.3 for men (95% confidence interval [CI] = 1.9, 2.8) and 2.4 overall (95% CI = 2.0, 2.9). In multivariable proportional hazards regression analyses, resident characteristics, diagnoses, behaviors, and pain were not significantly associated with suicide risk. Conclusions. Suicide risk was elevated following nursing home discharge. This underscores the importance of ongoing VA efforts to enhance discharge planning and timely postdischarge follow-up. PMID:24134359

  7. Provincial logistics costs in South Africa’s Western Cape province: Microcosm of national freight logistics challenges

    National Research Council Canada - National Science Library

    Jan H Havenga; Leila L Goedhals-Gerber; Anneke de Bod; Zane Simpson

    2015-01-01

    Background: Logistics costs are most commonly measured on a national level. An understanding of the provincial logistics landscape can add significant value both to provincial and national policy interventions...

  8. Health protection at the Savannah River Site: A guide to records series of the Department of Energy and its contractors

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    As part of the Department of Energy`s (DOE) Epidemiologic Records Inventory Project, History Associates Incorporated (HAI) prepared this guide to the records series pertaining to health protection activities at the DOE`s Savannah River Site (SRS). Since its inception in the early 1950s, the SRS, formerly known as the Savannah River Plant (SRP), has demonstrated significant interest in safeguarding facilities, protecting employees` health, and monitoring the environment. The guide describes records that concern health protection program administration, radiological monitoring of the plant and the environment, calibration and maintenance of monitoring instruments, internal and external dosimetry practices, medical surveillance of employees, occupational safety and training measures, site visitation, and electronic information systems. The introduction to the guide describes the Epidemiologic Records Inventory Project and HAI`s role in the project. It provides brief histories of the DOE, SRS, and the SRS organizational units responsible for health protection activities. This introduction also summarizes HAI`s methodology in developing criteria and conducting its verification of the SRS inventory of active and inactive SRS Health Protection records. Furthermore, it furnishes information on the production of the guide, the content of the records series descriptions, the location of the records, and the procedures for accessing records repositories.

  9. Disordered lives: Life circumstances and clinical characteristics of very frequent users of emergency departments for primary mental health complaints.

    Science.gov (United States)

    Meng, Xiangfei; Muggli, Tracy; Baetz, Marilyn; D'Arcy, Carl

    2017-06-01

    This study explored the life circumstances and clinical characteristics of very frequent users of emergency departments (EDs) presenting with a primary mental health complaint. Patients with 10 or more EDs visits in 2012 with a primary psychiatric diagnosis in a Canadian regional health authority were identified from electronic administrative files. The hospital charts for these patients were thoroughly reviewed for a three-year period, from 2011 to 2013. A retrospective thematic analysis was undertaken. Very frequent users of EDs were generally young to early middle aged, unemployed, living in transient accommodations, having substance abuse diagnoses, and self-referred to EDs for a variety of psychiatric and health symptoms and/or unmet needs. Four themes were identified: 1) substance abuse and associated health and social problems; 2) common mental disorders, which may include suicidality; 3) social and personal stressors with additional common mental disorders and somatic complaints; 4) cognitive impairment with concurrent psychiatric disorders. Traditional mental health services are ineffective in dealing with patients with complex psychiatric and social problems/needs. Efforts should focus on early detection, intervention, reducing mental and behavior problems, and developing appropriate case management and treatment options. Personalized care models are needed to meet their diverse needs. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Health and Human Services – ASPR

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Steve [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-06-01

    This report focuses on the Department of Health and Human Services, Assistant Secretary for Preparedness and Response fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agency’s fleet. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  11. Written information material and availability of sexual health care for men experiencing sexual dysfunction after prostate cancer treatment: An evaluation of Dutch urology and radiotherapy departments.

    Science.gov (United States)

    Grondhuis Palacios, L A; Krouwel, E M; Duijn, M; den Oudsten, B L; den Ouden, M E M; Putter, H; Pelger, R C M; Elzevier, H W

    2017-03-01

    Objective was to investigate content of written information material and availability of sexual health care for men experiencing sexual dysfunction (SD) after prostate cancer treatment. A cross-sectional survey was conducted among Dutch urology and radiotherapy departments to evaluate information materials and availability of sexual health care. Out of 71 eligible departments, 34 urology and 15 radiotherapy departments participated in the survey (response rate 69.0%). Fifty-nine brochures corresponding to 31 urology and 11 radiotherapy departments were analysed. In 88.1% of collected information material, sexual health was mentioned. Regarding extensiveness, 20.4% of the brochures contained extensive information, 50.8% moderate amount of information and 28.8% contained little or no information. Urology departments provided pre-treatment nurse consultations more often than radiotherapy departments. Sexual counselling was more frequently provided by urology departments. Urology departments were more aware of adequate referral possibilities. Information material provided by Dutch urology and radiotherapy departments does not address treatment-related SD routinely. Sexual health care is not available everywhere for men experiencing SD. Applying a standard regarding content of sexual health in information material is recommended as well as improved awareness of referral possibilities and enhanced provision of pre-treatment nurse consultations for men experiencing SD after prostate cancer treatment. © 2016 John Wiley & Sons Ltd.

  12. Variation in Formulary Management Practices Within the Department of Veterans Affairs Health Care System.

    Science.gov (United States)

    Radomski, Thomas R; Good, Chester B; Thorpe, Carolyn T; Zhao, Xinhua; Marcum, Zachary A; Glassman, Peter A; Lowe, John; Mor, Maria K; Fine, Michael J; Gellad, Walid F

    2016-02-01

    All Department of Veterans Affairs Medical Centers (VAMCs) operate under a single national drug formulary, yet substantial variation in prescribing and spending exists across facilities. Local management of the national formulary may differ across VAMCs and may be one cause of this variation. To characterize variation in the management of nonformulary medication requests and pharmacy and therapeutics (P&T) committee member perceptions of the formulary environment at VAMCs nationwide. We performed an online survey of the chief of pharmacy and an additional staff pharmacist and physician on the P&T committee at all VAMCs. Respondents were asked questions regarding criteria for use for nonformulary medications, specific procedures for ordering nonformulary medications in general and specific lipid-lowering and diabetes agents, the appeals process, and the formulary environment at their VAMCs. We compared responses across facilities and between chiefs of pharmacy, pharmacists, and physicians. A total of 212 chief pharmacists (n = 80), staff pharmacists (n = 78), and physicians (n = 54) responded, for an overall response rate of 49%. In total, 107/143 (75%) different VAMCs were represented. The majority of VAMCs reported adhering to national criteria for use, with 38 (36%) being very adherent and 69 (65%) being mostly adherent. There was substantial variation between VAMCs regarding how nonformulary drugs were ordered, evaluated, and appealed. The nonformulary lipid-lowering drugs ezetimibe, rosuvastatin, and atorvastatin were viewable to providers in the order entry screen at 67 (63%), 67 (63%), and 64 (60%) VAMCs, respectively. The nonformulary diabetes medication pioglitazone was only viewable at 58 (55%) VAMCs. In the remaining VAMCs, providers could not order these nonformulary drugs through the normal order-entry process. For questions about the formulary environment, physician respondent perceptions differed from those of staff pharmacists and chief pharmacists

  13. [Chronic neutropenia - experience from the Department of Immunology, Children's Memorial Health Institute].

    Science.gov (United States)

    Klaudel-Dreszler, Maja; Pietrucha, Barbara; Skopczynska, Hanna; Pac, Malgorzata; Kurenko-Deptuch, Magdalena; Heropolitanska-Pliszka, Edyta; Wolska-Kusnierz, Beata; Maslanka, Krystyna; Bernatowska, Ewa

    2007-01-01

    Chronic neutropenia (CN) is defined by an absolute neutrophil count (ANC) below 1500/ul, lasting at least 6 months. clinical course and treatment of children afflicted with CN was analysed. we present 60 children treated in our department due to CN. The diagnosis was based on: bone marrow smears, ANC, immunologic investigation. we established the diagnosis of: Kostmann disease (KD), cyclic neutropenia (CyN), hyperIgM syndrome (HIGM), Shwachman-Diamond syndrome (SDS), severe chronic neutropenia (SCN) and chronic benign neutropenia (CBN) in: 4, 2, 2, 1, 21 and 20 children respectively. Due to positive results of tests: MAIGA, GIFT or GAT autoimmune neutropenia of infancy (AIN) was confirmed in 7 children. In 3 infants neutropenia was connected with HCMV- infection and Gancyclovir therapy. RHuG-CSF treatment was implemented in 14 and effective in 13 patients. A girl, suffering from KD, during rHuG-CSF therapy, developed chronic myeloblasts leucaemia and died. A boy, with the same diagnosis, underwent bone marrow transplantation from related donor but died from invasive pulmonary aspergillosis. Antibacterial prophylaxis was necessary in 29 children. We used Amoxicillin or Trimethoprim/Sulfametoxazole, obtaining decrease of frequency and severity of infections. During observation period all children suffered from upper respiratory tract infections, 19 had chronic gingivitis. Severe infections- bacterial pneumonia, sepsis, severe varicella and measles were observed in 30, 5, 2 and 1 patient respectively. A teenager, affected with SCN, died due to fulminant Clostridium perfringens infection. 1. RHuG-CSF therapy is essential in children with KD and SCN (when accompanied by severe infections). 2. AIN proved to be a mild condition, although ANC decreased below 500. In this entity rHuG-CSF is recommended during severe infections and before surgery. 3. Antibiotic prophylaxis is recommended for children with: KD, CyN, GSD1b, CN in 1st year of life, HIGM; in other cases it is

  14. Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences.

    Science.gov (United States)

    Mallon, Timothy M; Grizzell, Tifani L; Hodgson, Michael J

    2015-03-01

    The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs. The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided. The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted. Cooperation between human resources workers' compensation personnel, safety and occupational health personnel is a must for successful management of the WC program. Information and data sharing are critical for root cause and injury prevention, case management, and cost containment efforts. Enhancing efforts in these areas will save an estimated $100 million through cost avoidance efforts.

  15. The characteristics of hospital emergency department visits made by people with mental health conditions who had dental problems.

    Science.gov (United States)

    Nalliah, Romesh P; Da Silva, John D; Allareddy, Veerasathpurush

    2013-06-01

    There is a paucity of knowledge regarding nationally representative estimates of hospital-based emergency department (ED) visits for dental problems made by people with mental health conditions. The authors conducted a study to provide nationwide estimates of hospital-based ED visits attributed to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess made by people with mental health conditions. The authors used the Nationwide Emergency Department Sample, which is a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. ED visits attributable to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess were identified by the emergency care provider by using diagnostic codes in International Classification of Diseases, Ninth Revision, Clinical Modification. The authors examined outcomes, including hospital charges. They used simple descriptive statistics to summarize the data. In 2008, people with mental health conditions made 15,635,253 visits to hospital-based ED in the United States. A diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess represented 63,164 of these ED visits. The breakdown of the ED visits was 34,574 with dental caries, 25,352 with pulpal and periapical lesions, 9,657 with gingival and periodontal lesions, and 2,776 with mouth cellulitis/abscess. The total charge for ED visits in the United States was $55.46 million in 2008. In 2008, people with mental health conditions made 63,164 visits to hospital-based EDs and received a diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions or mouth cellulitis/abscess. These ED visits incurred substantial hospital charges. Programs designed to reduce the number of ED visits made by this population for common dental problems could have a

  16. Pediatric suicide-related presentations: a systematic review of mental health care in the emergency department.

    Science.gov (United States)

    Newton, Amanda S; Hamm, Michele P; Bethell, Jennifer; Rhodes, Anne E; Bryan, Craig J; Tjosvold, Lisa; Ali, Samina; Logue, Erin; Manion, Ian G

    2010-12-01

    We evaluate the effectiveness of interventions for pediatric patients with suicide-related emergency department (ED) visits. We searched of MEDLINE, EMBASE, the Cochrane Library, other electronic databases, references, and key journals/conference proceedings. We included experimental or quasiexperimental studies that evaluated psychosocial interventions for pediatric suicide-related ED visits. Inclusion screening, study selection, and methodological quality were assessed by 2 independent reviewers. One reviewer extracted the data and a second checked for completeness and accuracy. Consensus was reached by conference; disagreements were adjudicated by a third reviewer. We calculated odds ratios, relative risks (RRs), or mean differences for each study's primary outcome, with 95% confidence intervals (CIs). Meta-analysis was deferred because of clinical heterogeneity in intervention, patient population, and outcome. We included 7 randomized controlled trials and 3 quasiexperimental studies, grouping and reviewing them according to intervention delivery: ED-based delivery (n=1), postdischarge delivery (n=6), and ED transition interventions (n=3). An ED-based discharge planning intervention increased the number of attended post-ED treatment sessions (mean difference=2.6 sessions; 95% CI 0.05 to 5.15 sessions). Of the 6 studies of postdischarge delivery interventions, 1 found increased adherence with service referral in patients who received community nurse home visits compared with simple placement referral at discharge (RR=1.28; 95% CI 1.06 to 1.56). The 3 ED transition intervention studies reported (1) reduced risk of subsequent suicide after brief ED intervention and postdischarge contact (RR=0.10; 95% CI 0.03 to 0.41); (2) reduced suicide-related hospitalizations when ED visits were followed up with interim, psychiatric care (RR=0.41; 95% CI 0.28 to 0.60); and (3) increased likelihood of treatment completion when psychiatric evaluation in the ED was followed by

  17. The Colombian conflict: a description of a mental health program in the Department of Tolima

    Directory of Open Access Journals (Sweden)

    Grais Rebecca F

    2009-12-01

    Full Text Available Abstract Colombia has been seriously affected by an internal armed conflict for more than 40 years affecting mainly the civilian population, who is forced to displace, suffers kidnapping, extortion, threats and assassinations. Between 2005 and 2008, Médecins Sans Frontières-France provided psychological care and treatment in the region of Tolima, a strategic place in the armed conflict. The mental health program was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here we describe the population attending during 2005-2008, in both urban and rural settings, as well as the psychological treatment provided during this period and its outcomes. We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict.

  18. Prevalence of hypertension and its risk factors among individuals attending outpatient department of rural health training centre, Haldwani

    Directory of Open Access Journals (Sweden)

    Janki Bartwal

    2014-03-01

    Full Text Available Introduction: Hypertension is one of the major health and development challenges of the 21st century, which, for most countries, has developed together with rapid cultural and social changes, ageing populations, increasing urbanization, dietary changes, reduced physical activity, and other unhealthy behaviours. Objectives: 1 To find out the prevalence of Hypertension in study subjects 2 To identify the risk factors associated with Hypertension. Materials and Methods: A Cross-sectional study was carried out among 369 individuals of 30 years and above attending Out Patient Department (OPD in Rural Health Training Centre (RHTC under the Department of Community Medicine, Government Medical College, Haldwani during June 2013-August 2013. A pretested predesigned questionnaire was used to collect demographic data by interview technique .The blood pressure was recorded and classified using JNC VII criteria to grade hypertension. Data was compiled, entered & analyzed using SPSS version 20. Results: Among 369 patients, the prevalence of hypertension was 41.7%; out of this, 28.7% were aware of their hypertensive status while 13% were newly diagnosed cases. The association between hypertension with increase in age, family history of hypertension, increase salt intake, consuming mixed diet, increase waist circumference, waist hip ratio and body mass index was found significant. Physical inactivity, gender, tobacco and alcohol consumption were not significantly associated with hypertension. Conclusions: The prevalence of hypertension in rural area is relatively high. Extensive efforts are required for raising the awareness level & regular screening of high-risk population is recommended for preventing the complications & disability.

  19. Evaluation of the timeliness and completeness of a Web-based notifiable disease reporting system by a local health department.

    Science.gov (United States)

    Vogt, Richard L; Spittle, Robyn; Cronquist, Alicia; Patnaik, Jennifer L

    2006-01-01

    To evaluate the completeness and timeliness of the Colorado statewide Web-based system for reporting notifiable diseases, called the Colorado Electronic Disease Reporting System. This project demonstrates how a local health department can conduct a surveillance evaluation to identify areas of improvement. Reports received by Colorado for 2004 were categorized as Tri-County Health Department (TCHD) reports and reports received for the rest of Colorado. Report completeness and timeliness were compared for all diseases routinely followed up by TCHD for both datasets. A data field was considered complete if there was data entry for that field. Timeliness in this study was defined as the interval between "specimen collection date" and "report date" for each record. Six of 12 selected data fields were 95% or more complete for both datasets. Twenty-four-hour notifiable diseases were reported a median of 2.0 days for reports in the TCHD dataset and a median of 3.0 days for reports in the dataset for the rest of Colorado. Seven-day notifiable diseases were reported a median of 4.0 days for both datasets. Both Colorado datasets were found to be relatively complete and timely. Improved data collection by interviewers will help better determine demographic information of reported cases and timeliness of reports.

  20. The Department of Energy`s Rocky Flats Plant: A guide to record series useful for health-related research. Volume VII. Employee occupational exposure and health

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This is the seventh in a series of seven volumes which constitute a guide to records of the Rocky Flats Plant useful for conducting health-related research. The primary purpose of Volume VII is to describe record series pertaining to employee occupational exposure and health at the Department of Energy`s (DOE) Rocky Flats Plant, now named the Rocky Flats Environmental Technology Site, near Denver, Colorado. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project and HAI`s role in the project, provides a history of occupational exposure monitoring and health practices at Rocky Flats, and identifies organizations contributing to occupational exposure monitoring and health policies and activities. Other topics include the scope and arrangement of the guide and the organization to contact for access to these records. Comprehensive introductory and background information is available in Volume 1. Other volumes in the guide pertain to administrative and general subjects, facilities and equipment, production and materials handling, environmental and workplace monitoring, and waste management. In addition, HAI has produced a subject-specific guide, titled The September 1957 Rocky Flats Fire: A Guide to Record Series of the Department of Energy and Its Contractors, which researchers should consult for further information about records related to this incident.

  1. Evaluating a new model of nurse-led emergency department mental health care in Australia; perspectives of key informants.

    Science.gov (United States)

    Wand, Timothy; D'Abrew, Natalie; Acret, Louise; White, Kathryn

    2016-01-01

    Mental health nurse services have existed in Emergency Departments (ED) for many years. However, there is considerable variation in the way these services operate, and no standardised model of care has been articulated. To evaluate an extended hours nurse practitioner-led mental health liaison nurse (MHLN) service based in an ED in Sydney Australia. As part of a larger mixed-methods study, semi-structured interviews were conducted with a sample of ED patients and nursing, medical and psychiatry staff (N = 46). Newly recruited MHLNs were interviewed at the commencement and conclusion of the study period. This paper presents the qualitative component from the evaluation. The new service was met with high levels of approval by patients and staff. MHLN team members were challenged by their new role but considered the service reduced waiting times, provided therapeutic benefits, and enhanced communication and support for emergency staff. A nurse practitioner-led extended hours MHLN service embedded within the ED team structure provides prompt and effective access to specialised mental health care for people with 'undifferentiated health problems' and removes a significant workload from nursing and medical staff. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department.

    Science.gov (United States)

    Wand, Timothy; D'Abrew, Natalie; Barnett, Catherine; Acret, Louise; White, Kathryn

    2015-02-01

    To evaluate a nurse practitioner (NP)-led extended hours mental health liaison nurse (MHLN) service based in the emergency department (ED) of an inner city teaching hospital in Sydney and to explicate a model of care that is transferable across a broad range of ED settings, both in metropolitan and rural contexts. This mixed-methods evaluation encompassed descriptive data on ED mental health presentations, quantifying waiting times for MHLN involvement and interviews with MHLN team members at the commencement of the evaluation and 12 months later. Interviews were also conducted with a snapshot of ED patients, and a sample of ED and psychiatry staff. The expanded MHLN service was rapidly incorporated into the ED structure, enthusiastically endorsed by ED patients and highly valued by staff and the organisation. The MHLN team saw 55% of referred patients within the first hour of arrival (frequently before medical assessment), thereby initiating and expediting co-ordination of care at an early stage of the ED process. An NP-led extended hours MHLN team based in the ED provides prompt and effective access to specialised mental health care for people with 'undifferentiated health problems', and removes a significant workload from nursing and medical staff. Embedding the NP-led MHLN service within the ED structure was pivotal to the success and sustainability of this model of care.

  3. Integrated care coordination by an interprofessional team reduces emergency department visits and hospitalisations at an academic health centre.

    Science.gov (United States)

    Gaglioti, Anne H; Barlow, Patrick; Thoma, Kate DuChene; Bergus, George R

    2017-09-01

    People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents. We then evaluated the clinical effectiveness of this programme by describing participants' healthcare utilisation patterns pre- and post-enrolment. Patients enrolled in the programme were approximately 60-70% less likely to utilise the emergency room and 50% less likely to be admitted to the hospital after enrolment in the programme compared to before enrolment. The odds of individual attendance at outpatient primary care and mental health visits improved after enrolment. In the context of the implementation of integrated behavioural and physical healthcare in primary care, this interprofessional care management programme reduced emergency department utilisation and hospitalisations while improving utilisation of primary care and psychiatry outpatient care. Further studies should focus on replication of this model to further discern the model's cost-savings and health promotion effects.

  4. The HEADS-ED: a rapid mental health screening tool for pediatric patients in the emergency department.

    Science.gov (United States)

    Cappelli, Mario; Gray, Clare; Zemek, Roger; Cloutier, Paula; Kennedy, Allison; Glennie, Elizabeth; Doucet, Guy; Lyons, John S

    2012-08-01

    The American Academy of Pediatrics called for action for improved screening of mental health issues in the emergency department (ED). We developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial history in adolescents. The reliability and validity of the tool and its potential for use as a screening measure are presented. ED patients presenting with mental health concerns from March 1 to May 30, 2011 were included. Crisis intervention workers completed the HEADS-ED and the Child and Adolescent Needs and Strengths-Mental Health tool (CANS MH) and patients completed the Children's Depression Inventory (CDI). Interrater reliability was assessed by using a second HEADS-ED rater for 20% of the sample. A total of 313 patients were included, mean age was 14.3 (SD 2.63), and there were 182 females (58.1%). Interrater reliability was 0.785 (P mental health concerns.

  5. [Hygiene during leisure time among third year students from the Department of Nursing and Health Sciences].

    Science.gov (United States)

    Czabak-Garbacz, Róza; Skibniewska, Agnieszka; Mazurkiewicz, Piotr; Wisowska, Anna

    2002-01-01

    The aim of the study was the assessment of hygiene of leisure time among third year students from Faculty of Nursing and Health Science of Lublin Medical Academy. It analysed passive and active ways of spending free time. The study involved 106 students (55 stationary and 51 extramural) and it was conducted by means of questionnaire. The study revealed that students prefer passive types of spending their leisure time. The most popular activity was listening to the radio, to which they devoted average 2.9 hours a day (listening to music mainly). Extramural students listened to the radio shorter than stationary ones (the difference was statistically significant). Students spent also a lot of their time watching television (average 1.5 hours a day), reading books and newspapers (average 1.85 hours a day) and doing housework, which is an active way of rest (average 2.7 hours a day), mainly preparing meals and shopping. Students devoted the least of their free time to sleep during the day in spite of the fact it is an excellent way of rest. The study found also that physical activity was not a favourite type of spending free time. Every third student did not do any sport. Stationary students did sport 4 times longer than extramural (the difference was statistically significant). Only 31% practiced taking a daily walk and only 44% of students made tourist trips. 81.9% of them went away during summer holidays, but only 31% of them during the winter break. Undoubtedly, the way of spending free time by the students under examination was not hygienic as it did not give them a sense of relaxation and rest; also the students themselves were not satisfied with it.

  6. Declining mortality following acute myocardial infarction in the Department of Veterans Affairs Health Care System

    Directory of Open Access Journals (Sweden)

    Piñeros Sandy

    2009-08-01

    Full Text Available Abstract Background Mortality from acute myocardial infarction (AMI is declining worldwide. We sought to determine if mortality in the Veterans Health Administration (VHA has also been declining. Methods We calculated 30-day mortality rates between 2004 and 2006 using data from the VHA External Peer Review Program (EPRP, which entails detailed abstraction of records of all patients with AMI. To compare trends within VHA with other systems of care, we estimated relative mortality rates between 2000 and 2005 for all males 65 years and older with a primary diagnosis of AMI using administrative data from the VHA Patient Treatment File and the Medicare Provider Analysis and Review (MedPAR files. Results Using EPRP data on 11,609 patients, we observed a statistically significant decline in adjusted 30-day mortality following AMI in VHA from 16.3% in 2004 to 13.9% in 2006, a relative decrease of 15% and a decrease in the odds of dying of 10% per year (p = .011. Similar declines were found for in-hospital and 90-day mortality. Based on administrative data on 27,494 VHA patients age 65 years and older and 789,400 Medicare patients, 30-day mortality following AMI declined from 16.0% during 2000-2001 to 15.7% during 2004-June 2005 in VHA and from 16.7% to 15.5% in private sector hospitals. After adjusting for patient characteristics and hospital effects, the overall relative odds of death were similar for VHA and Medicare (odds ratio 1.02, 95% C.I. 0.96-1.08. Conclusion Mortality following AMI within VHA has declined significantly since 2003 at a rate that parallels that in Medicare-funded hospitals.

  7. Mobile Health Technology to Communicate Discharge and Follow-Up Information to Adolescents From the Emergency Department.

    Science.gov (United States)

    Ray, Margaret; Dayan, Peter S; Pahalyants, Vartan; Chernick, Lauren S

    2016-12-01

    Adolescents are the largest users of mobile technology; yet, there are little data regarding their receptivity to the use of mobile health technology (mHealth) from the emergency department (ED). The objective of this study was to determine adolescents' preferences for receiving ED discharge and follow-up information via mHealth and factors associated with those preferences. We administered an anonymous self-reporting survey to patients aged 14 to 19 years discharged from an urban pediatric ED. We conducted exploratory bivariate analyses to evaluate differences in communication preferences based on patient characteristics. We used multivariable logistic regression to determine whether preference for health information via mHealth is associated with frequent information technology (IT) use, adjusting for age, sex, ethnicity, and insurance status. Four hundred thirty-nine adolescents completed the survey. Most were female (n = 279, 64%), 14 to 17 years old (n = 247, 57%), Hispanic (n = 359, 86%), and insured (n = 388, 88%). Adolescents used IT often, texting more than 30 times a day (58%) and emailing more than once a day (61%). Most (n = 335, 78%) were interested in electronic communication from the ED. Teens expressed particular interest in using email for discharge instructions (n = 196, 47%), physician referrals (n = 197, 48%), and test results (n = 201, 48%) and using texting for medication (n = 155, 38%) and appointment reminders (n = 170, 41%). Individuals tended to prefer communication with IT modes that they typically used, although only email was independently associated with preference for this mode (adjusted odds ratio, 2.8; 95% confidence interval, 1.5-5.3). Adolescent patients are interested in receiving health information from the ED, mainly via email and texting. Future ED interventions should evaluate the effectiveness of these modalities to communicate with patients after discharge.

  8. Using a positive deviance framework to identify Local Health Departments in Communities with exceptional maternal and child health outcomes: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Tamar Klaiman

    2016-07-01

    Full Text Available Abstract Background The United States spends more than most other countries per capita on maternal and child health (MCH, and yet lags behind other countries in MCH outcomes. Local health departments (LHDs are responsible for administering various maternal and child health programs and interventions, especially to vulnerable populations. The goal of this study was to identify local health department jurisdictions (LHDs that had exceptional maternal and child health outcomes compared to their in-state peers – positive deviants (PDs - in Washington, Florida and New York in order to support the identification of strategies that can improve community health outcomes. Methods We used MCH expenditure data for all LHDs in FL (n = 67, and WA (n = 35, and most LHDs in NY (n = 48 for 2009–2010 from the Public Health Activities and Services Tracking (PHAST database. We conducted our analysis in 2014–2015. Data were linked with variables depicting local context and LHD structure. We used a cross-sectional study design to identify communities with better than expected MCH outcomes and multiple regression analysis to control for factors outside of and within LHD control. Results We identified 50 positive deviant LHD jurisdictions across 3 states: WA = 10 (29 %; FL = 24 (36 %; NY = 16 (33 %. Overall, internal factor variables improved model fit for identifying PD LHD jurisdictions, but individual variables were not significant. Conclusions We empirically identified LHD jurisdictions with better MCH outcomes compared to their peers. Research is needed to assess what factors contributed to these exceptional MCH outcomes and over which LHDs have control. The positive deviance method we used to identify high performing local health jurisdictions in the area of maternal and child health outcomes can assist in better understanding what practices work to improve health outcomes. We found that funding may not be the only predictor of

  9. A Methodology to Institutionalise User Experience in Provincial Government

    Directory of Open Access Journals (Sweden)

    Marco Cobus Pretorius

    2014-12-01

    Full Text Available Problems experienced with website usability can prevent users from accessing and adopting technology, such as e-Government. At present, a number of guidelines exist for e-Government website user experience (UX design; however, the effectiveness of the implementation of these guidelines depends on the expertise of the website development team and on an organisation’s understanding of UX. Despite the highlighted importance of UX, guidelines are rarely applied in South African e-Government website designs. UX guidelines cannot be implemented if there is a lack of executive support, trained staff, budget and user-centred design processes. The goal of this research is to propose and evaluate a methodology (called the “Institutionalise UX in Government (IUXG methodology” to institutionalise UX in South African Provincial Governments (SAPGs. The Western Cape Government in South Africa was used as a case study to evaluate the proposed IUXG methodology. The results show that the IUXG methodology can assist SAPGs to establish UX as standard practice and improve the UX maturity levels.

  10. Who needs what from a national health research system:lessons from reforms to the English Department of Health's R&D system

    Directory of Open Access Journals (Sweden)

    Soper Bryony

    2010-05-01

    Full Text Available Abstract Health research systems consist of diverse groups who have some role in health research, but the boundaries around such a system are not clear-cut. To explore what various stakeholders need we reviewed the literature including that on the history of English health R&D reforms, and we also applied some relevant conceptual frameworks. We first describe the needs and capabilities of the main groups of stakeholders in health research systems, and explain key features of policymaking systems within which these stakeholders operate in the UK. The five groups are policymakers (and health care managers, health professionals, patients and the general public, industry, and researchers. As individuals and as organisations they have a range of needs from the health research system, but should also develop specific capabilities in order to contribute effectively to the system and benefit from it. Second, we discuss key phases of reform in the development of the English health research system over four decades - especially that of the English Department of Health's R&D system - and identify how far legitimate demands of key stakeholder interests were addressed. Third, in drawing lessons we highlight points emerging from contemporary reports, but also attempt to identify issues through application of relevant conceptual frameworks. The main lessons are: the importance of comprehensively addressing the diverse needs of various interacting institutions and stakeholders; the desirability of developing facilitating mechanisms at interfaces between the health research system and its various stakeholders; and the importance of additional money in being able to expand the scope of the health research system whilst maintaining support for basic science. We conclude that the latest health R&D strategy in England builds on recent progress and tackles acknowledged weaknesses. The strategy goes a considerable way to identifying and more effectively meeting the

  11. Geospatial Distribution of Local Health Department Tweets and Online Searches About Ebola During the 2014 Ebola Outbreak.

    Science.gov (United States)

    Wong, Roger; Harris, Jenine K

    2017-08-24

    This study compared the geospatial distribution of Ebola tweets from local health departments (LHDs) to online searches about Ebola across the United States during the 2014 Ebola outbreak. Between September and November 2014, we collected all tweets sent by 287 LHDs known to be using Twitter. Coordinates for each Ebola tweet were imported into ArcGIS 10.2.2 to display the distribution of tweets. Online searches with the search term "Ebola" were obtained from Google Trends. A Pearson's correlation test was performed to assess the relationship between online search activity and per capita number of LHD Ebola tweets by state. Ebola tweets from LHDs were concentrated in cities across the northeast states, including Philadelphia and New York City. In contrast, states with the highest online search queries for Ebola were primarily in the south, particularly Oklahoma and Texas. A weak, negative, non-significant correlation (r=-0.03, P=0.83, 95% CI: -0.30, 0.25) was observed between online search activity and per capita number of LHD Ebola tweets by state. We recommend that LHDs consider using social media to communicate possible disease outbreaks in a timely manner, and that they consider using online search data to tailor their messages to align with the public health interests of their constituents. (Disaster Med Public Health Preparedness. 2017;page 1 of 4).

  12. Local health department planning for a radiological emergency: an application of the AHP2 tool to emergency preparedness prioritization.

    Science.gov (United States)

    Dalnoki-Veress, F; McKallagat, Chris; Klebesadal, Amy

    2014-01-01

    We tested the Analytical Hierarchy Process tool for its use in public health to identify potential gaps in emergency preparedness by local health departments (LHDs) in California and Hawaii during a radiological emergency. We developed a dedicated tool called All-Hazards Preparedness Squared (AHP2) that can be used by those who are responsible for all-hazards preparedness planning and response to guide them while making strategic decisions both in preparing for and responding to a slow-moving incident while it is unfolding. The tool is an Internet-based survey that can be distributed among teams responsible for emergency preparedness and response. Twenty-eight participants from 16 LHDs in California and Hawaii responsible for coordinating preparedness and response in a radiological emergency participated in using the tool in 2013. We used the data to compare the perceived importance of different elements of preparedness among participants and identify gaps in preparedness of their organizations for meeting the challenges presented by a radiological incident. Clarity of information and transfer of information (to and from agency to public, state, and federal partners) were public health officials' dominant concerns while responding to an emergency. Participants also found that there were gaps in the adequacy of training and awareness of the chain of command during a radiological emergency. This preliminary study indicates that the AHP2 tool could be used for decision making in all-hazards preparedness planning and response.

  13. Ethical issues regarding caring for dermatology patients in the U.S. Department of Veterans Affairs Health Care System.

    Science.gov (United States)

    Reich, Reuben; Stevens, Emily; Dellavalle, Robert P

    2012-01-01

    The U.S. Department of Veterans Affairs (VA) operates the largest integrated health care system within the United States. VA budgets continue to escalate in an environment of heightened financial prudence and accountability. Despite having received many awards in areas from patient satisfaction and safety to product innovations, like any health care system, the VA is not immune to ethical conflict that requires exploration and evaluation. Several VA dermatologists, including section chiefs, were interviewed, and their responses to ethical complexities encountered or anticipated were analyzed in fictional case scenarios. Five morally concerning issues were highlighted. These include (1) providing care in a teaching setting with limited resources to a patient population with few other health care alternatives; (2) stereotyping patients, altogether an uncommon act, is possibly easier to do in the VA and has the potential to negatively affect patient care; (3) service-related disability claim cases often include medical opinion and findings documented in the medical record when judgments are made, thus the VA physician can have a significant effect on the outcome of these claims; (4) whether the VA provides a setting for apathetic physicians to thrive or instead allows for a more meaningful work experience and then how to manage the subpar performer; (5) except for the treatment of HIV lipodystrophy with injectables, primary cosmetic procedures are prohibited at the VA and can lead to difficulties for the VA dermatologist attempting to comply in a era where dermatology is being more closely associated with cosmesis. Published by Elsevier Inc.

  14. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

    Directory of Open Access Journals (Sweden)

    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  15. Social and organizational factors affecting implementation of evidence-informed practice in a public health department in Ontario: a network modelling approach

    OpenAIRE

    Yousefi-Nooraie, Reza; Dobbins, Maureen; Marin, Alexandra

    2014-01-01

    Objective The objective of this study is to develop a statistical model to assess factors associated with information seeking in a Canadian public health department. Methods Managers and professional consultants of a public health department serving a large urban population named whom they turned to for help, whom they considered experts in evidence-informed practice, and whom they considered friends. Multilevel regression analysis and exponential random graph modeling were used to predict th...

  16. Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

    Science.gov (United States)

    Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

    2017-12-07

    Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

  17. Radiological accidents potentially important to human health risk in the U.S. Department of Energy waste management program

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, C.; Roglans-Ribas, J.; Folga, S.; Nabelssi, B. [Argonne National Lab., IL (United States); Jackson, R. [Science Applications International Corp., Golden, CO (United States)

    1995-03-01

    Human health risks as a consequence of potential radiological releases resulting from plausible accident scenarios constitute an important consideration in the US Department of Energy (DOE) national program to manage the treatment, storage, and disposal of wastes. As part of this program, the Office of Environmental Management (EM) is currently preparing a Programmatic Environmental Impact Statement (PEIS) that evaluates the risks that could result from managing five different waste types. This paper (1) briefly reviews the overall approach used to assess process and facility accidents for the EM PEIS; (2) summarizes the key inventory, storage, and treatment characteristics of the various DOE waste types important to the selection of accidents; (3) discusses in detail the key assumptions in modeling risk-dominant accidents; and (4) relates comparative source term results and sensitivities.

  18. LBA-ECO LC-01 National, Provincial, and Park Boundaries, Ecuador

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set contains the national and provincial boundaries of Ecuador as well as the boundaries of two national parks: the Cuyabeno Wildlife Reserve and the...

  19. Provincial mortality in South Africa, 2000- priority-setting for now and ...

    African Journals Online (AJOL)

    Provincial mortality in South Africa, 2000- priority-setting for now and a benchmark for the future. Debbie Bradshaw, Nadine Nannan, Pam Groenewald, Jane Joubert, Ria Laubscher, Beatrice Nojilana, Rosana Norman, Desiree Pieterse, Michelle Schneider ...

  20. [Non-compliance with the systemic antibiotic treatment prescribed in Primary Health Care emergency departments (Study INCUMAT')].

    Science.gov (United States)

    Vega-Cubillo, E M; Andrés-Carreira, J M; Cirillo-Ibargüen, S; Manzanares-Arnaiz, C; Moreno-Moreno, G; Redondo-Figuero, C G

    Non-compliance with antibiotics treatment has severe consequences. Although antibiotics are commonly prescribed drugs, there are few studies that evaluate therapeutic compliance in acute diseases. The main objective of this study is to determine the percentage of non-compliance with the systemic antibiotics treatment prescribed in emergency departments. A prospective observational study was performed in the Emergency Department of 2 health centres of the Cantabria Health Service between the months of June and September 2014. The study included patients of any age, and those could be monitored, who were prescribed a systemic antibiotic for any infectious disease. Sociodemographic variables, diseases, and compliance were the variables studied. The Morinsky-Green test was used, plus 3 questions added by the authors. Of the 303 patients included, non-compliance, evaluated using the Morinsky-Green test, was 32.7% (95% CI 27.6-38.1), with this rising to the 44.9% (95% CI 39.4-50.5) when the 3 mentioned questions were added to the test. A downward trend is observed in non-compliance as the age increases. The risk of non-compliance is twice in men than in women: OR=2.02 (95% CI 1.27-3.24). Almost half (45%) of the patients who are prescribed antibiotics do not comply with the indications. Most of them attribute this fact to forgetfulness in compliance with the prescribed treatment. The elderly and women follow the treatment better, which should be taken into account when designing strategies to improve therapeutic compliance. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Harnessing Syndromic Surveillance Emergency Department Data to Monitor Health Impacts During the 2015 Special Olympics World Games.

    Science.gov (United States)

    Kajita, Emily; Luarca, Monica Z; Wu, Han; Hwang, Bessie; Mascola, Laurene

    Mass gatherings that attract a large international presence may cause or amplify point-source outbreaks of emerging infectious disease. The Los Angeles County Department of Public Health customized its syndromic surveillance system to detect increased syndrome-specific utilization of emergency departments (EDs) and other medical encounters coincident to the 2015 Special Olympics World Games. We queried live databases containing data on ED visits, California Poison Control System calls, and Los Angeles County coroner-investigated deaths for increases in daily counts from July 19 to August 6, 2015. We chose syndrome categories based on the potential for disease outbreaks common to international travel and dormitory settings, morbidity amplified by high temperatures, and bioterrorism threats inherent to mass gatherings. We performed line-list reviews and trend analyses of total, syndrome-specific, and region-specific daily counts, using cumulative sum-based signals. We also piloted a novel strategy of requesting that ED registrars proactively tag Special Olympics attendees in chief complaint data fields. The syndromic surveillance system showed that the 2015 Special Olympics did not generate large-scale acute morbidities leading to detectable stress on local EDs. We recruited 10 hospitals for proactive patient tagging, from which 16 Special Olympics attendees were detected; these patients reported various symptoms, such as injury, vomiting, and syncope. As an enhancement to traditional syndromic surveillance, proactive patient tagging can illuminate potential epidemiologic links among patients in challenging syndromic surveillance applications, such as mass gatherings. Syndromic surveillance has the potential to enhance ED patient polling and reporting of exposure, symptom, and other epidemiologic case definition criteria to public health agencies in near-real time.

  2. Bayesian versus frequentist statistical inference for investigating a one-off cancer cluster reported to a health department

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    Wills Rachael A

    2009-05-01

    Full Text Available Abstract Background The problem of silent multiple comparisons is one of the most difficult statistical problems faced by scientists. It is a particular problem for investigating a one-off cancer cluster reported to a health department because any one of hundreds, or possibly thousands, of neighbourhoods, schools, or workplaces could have reported a cluster, which could have been for any one of several types of cancer or any one of several time periods. Methods This paper contrasts the frequentist approach with a Bayesian approach for dealing with silent multiple comparisons in the context of a one-off cluster reported to a health department. Two published cluster investigations were re-analysed using the Dunn-Sidak method to adjust frequentist p-values and confidence intervals for silent multiple comparisons. Bayesian methods were based on the Gamma distribution. Results Bayesian analysis with non-informative priors produced results similar to the frequentist analysis, and suggested that both clusters represented a statistical excess. In the frequentist framework, the statistical significance of both clusters was extremely sensitive to the number of silent multiple comparisons, which can only ever be a subjective "guesstimate". The Bayesian approach is also subjective: whether there is an apparent statistical excess depends on the specified prior. Conclusion In cluster investigations, the frequentist approach is just as subjective as the Bayesian approach, but the Bayesian approach is less ambitious in that it treats the analysis as a synthesis of data and personal judgements (possibly poor ones, rather than objective reality. Bayesian analysis is (arguably a useful tool to support complicated decision-making, because it makes the uncertainty associated with silent multiple comparisons explicit.

  3. The influence of management and environment on local health department organizational structure and adaptation: a longitudinal network analysis.

    Science.gov (United States)

    Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A

    2013-01-01

    The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.

  4. Study On Spatial Organization Of Device Performance South Sulawesi Provincial Government

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    Andi Amin Akhiruddin

    2015-01-01

    Full Text Available Abstract This study aims to describe the identification of regional Organization Structuring South Sulawesi Provincial Government under Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007 knowing Planning Implications regional organization based on Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007 on Performance government of South Sulawesi and analyze models of regional Organization Structuring South Sulawesi Provincial Government ideal based on Government Regulation No. 38 of 2007 and Government Regulation No. 41 of 2007. The method used is descriptive to assess the condition of the South Sulawesi provincial government organizations as a result of the implementation of Government Regulation No. 38 of 2007 and Government Regulation No. 41 Year 2007 on Organizational Structure Model of the Region of South Sulawesi Provincial Government and the resulting impact on South Sulawesi Provincial Government Performance. Data collection techniques used were interviews questionnaires and study documents analyzed by descriptive qualitative and quantitative in percentage. The results showed that the arrangement of the South Sulawesi Provincial Government Organizations related mass organizations using maximal patterns based on Government Regulation No. 41 of 2007 has not kept pace even found no addition of several fields and sub-sub-fields in the affairs handled by the regional work units of South Sulawesi Province. But seen from the Organization Structuring implications arising on the performance of the Government of South Sulawesi showed quite good results this is in line with some of the responses of respondents who said it was very appropriate views of some of the indicators used by the author in a variable rate Accountability Responsibility and Innovation as a parameter in describing South Sulawesi provincial government performance. Structuring the ideal model of the regional organization of South

  5. THE SOCIOLOGICAL PORTRAIT OF PROVINCIAL UNIVERSITY ENTRANTS ON THE EXAMPLE OF UST-ILIMSK CITY

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    Filipp Rozanov

    2012-01-01

    Full Text Available The article presents the results of sociological study carried out to obtain a general model of ideas, expectations and preferences of provincial students in their attitude to higher education. The received results are presented in the form of diagrams. Provides a general interpretation of the data and on their basis are proposed recommendations for development marketing strategy and campaign to attract university entrants to the provincial university.

  6. Utilization of Information and Communication Technology in Coordination Between the National Library with the Provincial Library

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    Dimas Gammayani

    2018-01-01

    Full Text Available Changes are rapidly occur in this world, especially developments in the field of information and communication technology. Man must be able to adjust quickly to keep up. Developments in information and communication technology has made it easier for people in work. Utilization of information and communication technology are expected to make work performed by humans is more effective and efficient. National Library of Indonesia mandated by Law No. 43 of 2007 as an adviser to all types of libraries throughout Indonesia. In carrying out the task, the National Library should coordinate with local government including the provincial government, represented by the provincial library which can be said to represent the provincial government in the affairs of the library. National Library of Indonesia in coordination with the provincial library has been facilitated by information and communication technology such as telephone, fax and internet. In addition, coordination can also be done through conventional correspondency or direct face to face. This study tried to define which communication system that is commonly used by the National Library of Indonesia when coordinating with the provincial library and the reasons that lie behind them. The method used in this research is descriptive with a participatory approach, the researchers and respondents are equal and shared a mutual cooperation. This research indicates that face-to-face coordination is more preferred, because face-to-face coordination offers a social and economical benefit. Keywords: library, national library, provincial library, utilization technology

  7. Tot nut van 't algemeen? Een historische blik op de Vlaamse provincies als intermediair bestuursnuveau

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    P. Heyrman

    2008-01-01

    Full Text Available For the Benefit of the Common Good? A Historical View on the Flemish Provinces as an Intermediary at the Level of AdministrationThe nation state of Belgium saw its provinces chiefly as intermediary administrative entities from which political dispute had to be excluded. Nevertheless, they disposed of elected provincial councils and enjoyed fiscal autonomy. Although the provincial governments underwent a slow process of politicisation, the effects of the broad socio-political developments over the course of the last two centuries on this level remained far less tangible, due above all to the slow democratisation of the provincial suffrage. The provinces only had a modicum of public visibility and a very limited scope for policymaking. To argue their relevance, the provincial governments referred occasionally to the shared history of their respective inhabitants or to their cultural coherence(s. But this discourse was not powerful enough to shape a common provincial cultural identity. Moreover, it clashed on the artificial borders of the provinces and with the much stronger feelings of local and regional coherence. By clustering these expressions of (subregionalism, the provincial governments may have provided building stones for the creation of identity-structures on a higher level. However, this role too remained very modest and can hardly be used to substantiate the institutional tenacity of this level of government. 

  8. [Construction of Research-Oriented State Key Clinical Department by Highlighting the Characteris- tics and Advantages of Chinese Medicine].

    Science.gov (United States)

    Ma, Shi-yu; Guo, Li-heng; Han, Yun; Li, Jian; Zhang, Min-zhou

    2016-04-01

    As the largest research-oriented specialty department in national traditional Chinese medicine hospitals, the Department of Critical Care Medicine in Guangdong Provincial Hospital of Chinese Medicine insists on the development mode combined with clinical medicine and scientific research. By taking clinical and basic researches for integrative medicine preventing and treating acute myocardial in-farction and sepsis as a breakthrough, authors explored key problems of Chinese medicine in improving the prognosis related diseases and patients' quality of life. In recent 3 years our department has successively become the principal unit of the national key specialties cooperative group of critical care medicine (awarded by State Administration of Traditional Chinese Medicine), the key clinical specialties (awarded by National Health and Family Planning Commission), and Guangzhou key laboratory construction unit, and achieved overall lap in clinical medical treatment, personnel training, scientific research, and social service.

  9. Adaptation of immigrant psychiatrists from the former Soviet Union in the Department of Mental Health of the Israel Defense Forces.

    Science.gov (United States)

    Teitelbaum, A; Durst, R; Abramowitz, M; Knobler, H Y; Zislin, J; Fluk, A; Mark, M

    2000-06-01

    Psychiatrists from the former Soviet Union serve in the Department of Mental Health of the Israel Defense Forces. The new immigrant psychiatrists confront a wide range of difficulties during the process of integration to the military system and adaptation to the specifically military aspects of psychiatry. These include unfamiliarity with the military system, cultural clashes with the different groups of soldiers representing the various subgroups of the absorbing society, the psychopathology of soldiers, which is different from that seen in civil psychiatry, and the change in focus in the military mental health service, which emphasizes the importance of evaluating ego strength. Arbitrarily, one can describe four stages of adaptation that the immigrant psychiatrist has to pass through before recruitment and during service until adaptation and integration in the new role take place. Individual and group supervision are the main means by which the assimilation process is eased. The military service smooth the acculturation process and has an important role in helping the immigrant's adaptation to Israeli society and in building his or her professional identity.

  10. Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

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    Nghia Ho Dang Trung

    Full Text Available BACKGROUND: Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen. METHODS: We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology. RESULTS: We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children. CONCLUSIONS: Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

  11. Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination?

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    Smith? Robert J

    2008-04-01

    Full Text Available Abstract Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult

  12. Barcode Technology Acceptance and Utilization in Health Information Management Department at Academic Hospitals According to Technology Acceptance Model

    Science.gov (United States)

    Ehteshami, Asghar

    2017-01-01

    Nowdays, due to the increasing importance of quality care, organizations focuse on the improving provision, management and distribution of health. On one hand, incremental costs of the new technologies and on the other hand, increased knowledge of health care recipients and their expectations for high quality services have doubled the need to make changes in order to respond to resource constraints (financial, human, material). For this purpose, several technologies, such as barcode, have been used in hospitals to improve services and staff productivity; but various factors effect on the adoption of new technologies and despite good implementation of a technology and its benefits, sometimes personnel don’t accept and don’t use it. Methods: This is an applied descriptive cross-sectional study in which all the barcode users in health information management department of the three academic hospitals (Feiz, Al-Zahra, Ayatollah Kashani) affiliated to Isfahan University of Medical Sciences were surveyed by the barcode technology acceptance questionnaire, in six areas as following: barcode ease of learning, capabilities, perception of its usefulness and its ease of use, users attitudes towards its using, and users intention. Results: The finding showed that barcode technology total acceptance was relatively desirable (%76.9); the most compliance with TAM model was related to the user perceptions about the ease of use of barcode technology and the least compliance was related to the ease of learning barcode technology (respectively %83.7 and %71.5). Conclusion: Ease of learning and barcode capability effect of usefulness and perceived ease of barcode technology. Users perceptions effect their attitudes toward greater use of technology and their attitudes have an effect on their intention to use the technology and finally, their intention makes actual use of the technology (acceptance). Therefore, considering the six elements related to technology implementation can be

  13. Barcode Technology Acceptance and Utilization in Health Information Management Department at Academic Hospitals According to Technology Acceptance Model.

    Science.gov (United States)

    Ehteshami, Asghar

    2017-03-01

    Nowdays, due to the increasing importance of quality care, organizations focuse on the improving provision, management and distribution of health. On one hand, incremental costs of the new technologies and on the other hand, increased knowledge of health care recipients and their expectations for high quality services have doubled the need to make changes in order to respond to resource constraints (financial, human, material). For this purpose, several technologies, such as barcode, have been used in hospitals to improve services and staff productivity; but various factors effect on the adoption of new technologies and despite good implementation of a technology and its benefits, sometimes personnel don't accept and don't use it. This is an applied descriptive cross-sectional study in which all the barcode users in health information management department of the three academic hospitals (Feiz, Al-Zahra, Ayatollah Kashani) affiliated to Isfahan University of Medical Sciences were surveyed by the barcode technology acceptance questionnaire, in six areas as following: barcode ease of learning, capabilities, perception of its usefulness and its ease of use, users attitudes towards its using, and users intention. The finding showed that barcode technology total acceptance was relatively desirable (%76.9); the most compliance with TAM model was related to the user perceptions about the ease of use of barcode technology and the least compliance was related to the ease of learning barcode technology (respectively %83.7 and %71.5). Ease of learning and barcode capability effect of usefulness and perceived ease of barcode technology. Users perceptions effect their attitudes toward greater use of technology and their attitudes have an effect on their intention to use the technology and finally, their intention makes actual use of the technology (acceptance). Therefore, considering the six elements related to technology implementation can be important in the barcode

  14. Impact of the pan-Canadian Oncology Drug Review on provincial concordance with respect to cancer drug funding decisions and time to funding.

    Science.gov (United States)

    Srikanthan, A; Mai, H; Penner, N; Amir, E; Laupacis, A; Sabharwal, M; Chan, K K W

    2017-10-01

    The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding. In a retrospective review, Health Canada's Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics. Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr's implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada's noc date to the date of funding significantly declined (to 393 days from 522 days, p drug funding decisions between provinces and decreased time to funding decisions were observed.

  15. National Dissemination of Cognitive Behavioral Therapy for Depression in the Department of Veterans Affairs Health Care System: Therapist and Patient-Level Outcomes

    Science.gov (United States)

    Karlin, Bradley E.; Brown, Gregory K.; Trockel, Mickey; Cunning, Darby; Zeiss, Antonette M.; Taylor, C. Barr

    2012-01-01

    Objective: The Department of Veterans Affairs (VA) health care system is nationally disseminating and implementing cognitive behavioral therapy for depression (CBT-D). The current article evaluates therapist and patient-level outcomes associated with national training in and implementation of CBT-D in the VA health care system. Method: Therapist…

  16. Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.

    Science.gov (United States)

    Howard, Alex F; Bush, Heather M; Shapiro, Robert M; Dearinger, Angela

    2012-01-01

    The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009. This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study. Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant. Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists

  17. Individual and provincial characteristics associated with reproductive behavior of married women in Iran (2011

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    Serajeddin Mahmoudiani-Gilan

    2015-02-01

    Full Text Available Background: Fertility in the current situation is the most important determinant of a country's population increase rate. Iran's fertility rate has declined since the mid 1981’s, and has reached a relative stability below the replacement level in recent years. However, the fertility levels are different among provinces in the country. Methods: The present study investigated the reproductive behavior of women at both individual and provincial levels, so the two-level model was used. Data were adapted from the census in 2011 and Demographic and Health Surveys in 2010. The statistical population of the study was the 15-49 year-old married women in Iran and the study sample included 299,539 woman of the statistical population. Results: The results showed significant differences among the provinces in terms of the variance of the number of children born alive. Residence, employment status and educational status had significant effects on the number of children born. Moreover, the two-level variables (The mean age of women in the first marriage, contraception prevalence and development level by province had a significant effect on the slope of education and employment status. Conclusion: A convergence of fertility behavior has been initiated in the Iranian women, and the difference between some provinces is influenced by the development level of the given provinces. Other variables (such as education and employment status that affect women’s reproductive behavior are influenced by the development level of the province.

  18. Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons.

    Science.gov (United States)

    Poulin, Céline; Alary, Michel; Lambert, Gilles; Godin, Gaston; Landry, Suzanne; Gagnon, Hélène; Demers, Eric; Morarescu, Elena; Rochefort, Jean; Claessens, Christiane

    2007-07-31

    To determine the prevalence of HIV and hepatitis C virus (HCV) infections and examine risk factors for these infections among inmates in Quebec provincial prisons. Anonymous cross-sectional data were collected from January to June 2003 for men (n = 1357) and women (n = 250) who agreed to participate in the study and who completed a self-administrated questionnaire and provided saliva samples. The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%. HIV and HCV infections constitute an important public health problem in prison, where the prevalence is affected mainly by a high percentage of injection drug use among inmates.

  19. Factors associated with whole carcass condemnation rates in provincially-inspected abattoirs in Ontario 2001-2007: implications for food animal syndromic surveillance.

    Science.gov (United States)

    Alton, Gillian D; Pearl, David L; Bateman, Ken G; McNab, W Bruce; Berke, Olaf

    2010-08-12

    Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1) describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2) identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE) to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance involving these data. This study also demonstrated that

  20. Factors associated with whole carcass condemnation rates in provincially-inspected abattoirs in Ontario 2001-2007: implications for food animal syndromic surveillance

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    Alton Gillian D

    2010-08-01

    Full Text Available Abstract Background Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1 describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2 identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Results Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. Conclusions The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance

  1. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  2. World Trade Center-related physical and mental health burden among New York City Fire Department emergency medical service workers.

    Science.gov (United States)

    Yip, Jennifer; Zeig-Owens, Rachel; Webber, Mayris P; Kablanian, Andrea; Hall, Charles B; Vossbrinck, Madeline; Liu, Xiaoxue; Weakley, Jessica; Schwartz, Theresa; Kelly, Kerry J; Prezant, David J

    2016-01-01

    To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Evaluating the Meetings Output of Educational Council and Departments in School of Health Management and Information Sciences: Content Analysis of Minutes

    Directory of Open Access Journals (Sweden)

    Iman Tahamtan

    2013-10-01

    Full Text Available Introduction: This study analyzes the minutes of departments and educational council in Tehran University of Medical Sciences, School of Health Management and Information Sciences and evaluates the strengths and weaknesses of the departments meetings. Methods: This was a descriptive study. The study population was all minutes of departments in School of Health Management and Information Sciences in TUMS in 2004-2010. Minutes were transformed into digital format with a scanner. We used NVivo 8 software to codify and analyze the data. Results: Findings showed that in the meetings of both educational council and departments more attention was paid to the “thesis and proposal” and “educational issues”. Furthermore, each department had its own unique subjects which were not discussed in other departments. Conclusion: The chancellor at this school, deputy of dean and head of departments can use findings of current study to know the weaknesses of departments meetings and plan for better organization of weekly and monthly meetings in order to achieve the school goals and serve students better.

  4. Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.

    Science.gov (United States)

    Everson, Jordan; Kocher, Keith E; Adler-Milstein, Julia

    2017-04-01

    To assess whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. Our data included 2163 patients seen in the ED of a large academic medical center for whom clinicians requested and viewed outside information from February 14, 2014, to February 13, 2015. Outside information requests w.ere fulfilled via HIE (Epic's Care Everywhere) or fax/scan to the electronic health record (EHR). We used EHR audit data to capture the time between the information request and when a clinician accessed the data. We assessed whether the relationship between method of information return and ED outcomes (length of visit, odds of imaging [computed tomography (CT), magnetic resonance imaging (MRI), radiographs] and hospitalization, and total charges) was mediated by request-to-access time, controlling for patient demographics, case mix, and acuity. In multivariate analysis, there was no direct association between return of information via HIE vs fax/scan and ED outcomes. HIE was associated with faster outside information access (58.5 minutes on average), and faster access was associated with changes in ED care. For each 1-hour reduction in access time, visit length was 52.9 minutes shorter, the likelihood of imaging was lower (by 2.5, 1.6, and 2.4 percentage points for CT, MRI, and radiographs, respectively), the likelihood of admission was 2.4 percentage points lower, and average charges were $1187 lower ( P  ≤ .001 for all). The relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations.

  5. Establishing a nationwide emergency department-based syndromic surveillance system for better public health responses in Taiwan

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    Chiu Chan-Hsien

    2008-01-01

    Full Text Available Abstract Background With international concern over emerging infectious diseases (EID and bioterrorist attacks, public health is being required to have early outbreak detection systems. A disease surveillance team was organized to establish a hospital emergency department-based syndromic surveillance system (ED-SSS capable of automatically transmitting patient data electronically from the hospitals responsible for emergency care throughout the country to the Centers for Disease Control in Taiwan (Taiwan-CDC starting March, 2004. This report describes the challenges and steps involved in developing ED-SSS and the timely information it provides to improve in public health decision-making. Methods Between June 2003 and March 2004, after comparing various surveillance systems used around the world and consulting with ED physicians, pediatricians and internal medicine physicians involved in infectious disease control, the Syndromic Surveillance Research Team in Taiwan worked with the Real-time Outbreak and Disease Surveillance (RODS Laboratory at the University of Pittsburgh to create Taiwan's ED-SSS. The system was evaluated by analyzing daily electronic ED data received in real-time from the 189 hospitals participating in this system between April 1, 2004 and March 31, 2005. Results Taiwan's ED-SSS identified winter and summer spikes in two syndrome groups: influenza-like illnesses and respiratory syndrome illnesses, while total numbers of ED visits were significantly higher on weekends, national holidays and the days of Chinese lunar new year than weekdays (p Conclusion Taiwan's ED-SSS represents the first nationwide real-time syndromic surveillance system ever established in Asia. The experiences reported herein can encourage other countries to develop their own surveillance systems. The system can be adapted to other cultural and language environments for better global surveillance of infectious diseases and international collaboration.

  6. How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments.

    Science.gov (United States)

    Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming

    2017-05-01

    The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

  7. Attitudes toward technology-based health information among adult emergency department patients with drug or alcohol misuse.

    Science.gov (United States)

    Choo, Esther K; Ranney, Megan L; Wong, Zerlina; Mello, Michael J

    2012-12-01

    Technology-based screening and interventions are emerging solutions to the challenge of addressing substance use in the emergency department (ED). A standardized questionnaire of adult patients at a large-volume, urban, academic ED assessed interest in, and potential barriers to, technology-based substance use information. Questionnaire topics included substance use, access to technology, preferences for health information, and perceived barriers to technology interventions. Among the 430 participants, mean age was 39 years and 55% were female; 37% reported alcohol misuse and 52% drug misuse. Access to technology was high. Technology was preferred by 46% of alcohol misusers (vs. 43% non-misusers, p=0.65) but only 41.9% of drug misusers (vs. 56% non-drug misusers, p=0.005). In multivariate analyses, drug misuse was associated with decreased interest in receiving technology-based information. Cited barriers included confidentiality, complexity, and time. Our findings suggest that drug misusers in particular may wish to have reassurances about the confidentiality of technology-based interactions. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Reliability and validity of the Assessment for Disaster Engagement with Partners Tool (ADEPT) for local health departments.

    Science.gov (United States)

    Glik, Deborah C; Eisenman, David P; Donatello, Ian; Afifi, Abdelmonem; Stajura, Michael; Prelip, Michael L; Sammartinova, Jitka; Martel, Andrea

    2014-01-01

    This study presents reliability and validity findings for the Assessment for Disaster Engagement with Partners Tool (ADEPT), an instrument that can be used to monitor the frequency and nature of collaborative activities between local health departments (LHDs) and community-based organizations (CBOs) and faith-based organizations (FBOs) for disaster preparedness, response, and recovery. We used formative research to develop the instrument by ranking LHDs according to their disaster outreach and engagement activities. We validated the scale through a 2011 national survey of disaster preparedness coordinators (n=273) working in LHDs. We reduced the original measure of 25 items to a final measure comprising 15 items with four dimensions: (1) communication outreach and coordination, (2) resource mobilization, (3) organizational capacity building, and (4) partnership development and maintenance. We used internal consistency reliability m correlation and factor analysis to validate the measure. Using internal consistency reliability, we found reasonable inter-item reliability for the four hypothesized dimensions (Cronbach's alpha: 0.71-0.88). These four dimensions were confirmed through correlation and factor analysis (Varimax rotation). Higher scores on all four dimensions of ADEPT for organizational respondents suggest that more activities were conducted for inter-organizational preparedness in those organizations than in organizations whose respondents had lower scores. This finding implies that organizations with higher ADEPT scores have more active relationships with CBOs/FBOs in the realm of preparedness, a key element for creating community resilience for emergencies and disaster preparedness.

  9. Methicillin-resistant Staphylococcus aureus colonization among health care workers in a downtown emergency department in Toronto, Ontario.

    Science.gov (United States)

    Saito, Gregory; Thom, Jessica; Wei, Yanliang; Gnanasuntharam, Piraveina; Gnanasuntharam, Pirasanya; Kreiswirth, Nathan; Willey, Barbara; Loftus, Michelle; Varner, Catherine; Porter, Vanessa; McGeer, Allison; Borgundvaag, Bjug

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) acquired in the community, otherwise known as community-acquired MRSA, has emerged rapidly in recent years. Colonization with MRSA has been associated with an increased risk of symptomatic and serious infections and, in some settings, health care workers (HCWs) exhibit a higher prevalence of MRSA colonization. To determine MRSA colonization in emergency department (ED) HCWs in the setting of a moderate prevalence of MRSA in skin and soft tissue infections. The present study was conducted at a downtown ED in Toronto, Ontario. ED HCWs completed a brief questionnaire and swabs were taken from one anterior nare, one axilla and any open wounds (if present). Swabs were processed using standard laboratory techniques. None of the 89 staff (registered nurses [n=55], physicians [n=15], other [n=19]) were MRSA positive and 25 (28.1%) were colonized with methicillin-susceptible S aureus. Contrary to common belief among HCWs and previous studies documenting MRSA colonization of HCWs, MRSA colonization of this particular Canadian ED HCW cohort was very low and similar to that of the local population.

  10. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients' evaluations of the effectiveness of treatments.

    Science.gov (United States)

    Aazh, Hashir; Moore, Brian C J; Lammaing, Karen; Cropley, Mark

    2016-09-01

    To assess patients' judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT.

  11. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients’ evaluations of the effectiveness of treatments

    Science.gov (United States)

    Aazh, Hashir; Moore, Brian C. J.; Lammaing, Karen; Cropley, Mark

    2016-01-01

    Abstract Objective: To assess patients’ judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Design: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). Study sample: The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. Results : The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. Conclusion: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT. PMID:27195947

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

    Science.gov (United States)

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

    2014-05-28

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

  13. PLAYING RELATED HEALTH RISK´S AMONG STUDENTS AND TEACHERS OF MUSIC DEPARTMENT AT THE KOPER ART SCHOOL

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    Matej Plevnik

    2016-02-01

    Full Text Available The study of a musical instrument demands several hours of practicing on a daily basis as well as playing and performing. Consequently, the musician can be subjected to various health risks during his or her study process but also afterwards. Health problems depend on the individual physical and mental fitness, but also on the features and structure of the instrument as well as on the playing technique, which consists of repeated movements and mainly of static body position. Because of the possibility of chronic injuries, especially neuromuscular disorders but also others, it is important for the musician to regularly maintain his or her physical and mental fitness and movement performance by preventive and compensating activities and immediate action in case of pain or when noticing the first signs of medical problems or limitations. The study included 43 students (16.7 ± 1.5 year, 31 females and 12 males and 15 teachers (36.9 ± 8.8 years, 7 females and 8 males that attend and teach at the Music Department of The Koper Art School, which is a part of The Koper High School. The aim of the study was to recognize the risk factors in health status that occur as a consequence of playing a music instrument. A questionnaire consisting of 26 questions was used in the research. The results of the study showed that a half of the interviewed students practices every day but teachers practice less (p = 0.04. Therefore, teachers value the importance of physical (p = 0.013 and mental (p = 0.000 fitness more than students. Teachers also estimate their current physical and mental fitness to be higher (p = 0.003. 89.7 % of the respondents feel pain of discomfort during or after playing, out of these 95.3 % are students, and 73.3 % are teachers. These musicians state that they most frequently feel pain in the back and neck area and in the shoulders and wrists. 36.2 % of the musicians, 41.9 % of students and 20 % of teachers, affirmed to have had strains or pain

  14. Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India

    OpenAIRE

    Nagarajan Sripriya; Pushpanjali K

    2008-01-01

    Background: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. Materials and Methods: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administ...

  15. Equity and efficiency of medical service systems at the provincial level of China's mainland: a comparative study from 2009 to 2014.

    Science.gov (United States)

    Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang

    2018-02-05

    The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems

  16. Accounting and Accountability by Provincial Councils in Fiji: the Case of Namosi

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    Nacanieli Rika

    2008-03-01

    Full Text Available The aim of this paper is twofold: firstly to examine how the concepts of accounting andaccountability are understood by indigenous Fijians; and secondly to examine the role ofaccounting in the accountability of provincial councils.Provincial councils are part of the Fijian Administration, which runs alongside the centralgovernment but applies only to indigenous Fijians. The Fijian Administration was introducedby the British colonial administration in the late 1800s as a mechanism for controllingindigenous Fijians. It has undergone several reviews resulting from criticisms that it has failedto fulfill the aspirations of indigenous Fijians.There is evidence of implied and actual accountability by indigenous Fijians in Namosi. Thisis supported by monitoring mechanisms established by provincial offices. On the other hand,neither the Fijian Affairs Board nor the Namosi Provincial Council appears to take seriousresponsibility for accounting to indigenous Fijians in the province. Sadly, there is littleevidence to demonstrate an explicit accountability to indigenous Fijians. Significant scopeexists for improving the standard of accounting and accountability by provincial councils.This study contributes to understanding the role of accounting among indigenous peoples, inthe context of inherited colonial structures. It also represents accounting research conductedby indigenous academics, primarily in the Fijian language. This enables an examination ofhow language frames understanding of accounting concepts.

  17. A Systematic Review of Instruments to Identify Mental Health and Substance Use Problems Among Children in the Emergency Department.

    Science.gov (United States)

    Newton, Amanda S; Soleimani, Amir; Kirkland, Scott W; Gokiert, Rebecca J

    2017-05-01

    Specialized instruments to screen and diagnose mental health problems in children and adolescents are not yet standard components of clinical assessments in emergency departments (EDs). We conducted a systematic review to investigate the psychometric properties, accuracy, and performance metrics of instruments used in the ED to identify pediatric mental health and substance use problems. We searched seven electronic databases and the gray literature for psychometric validation studies, diagnostic studies, and cohort studies that assessed any instrument to screen for or diagnose mental illness, emotional or behavioral problems, or substance use disorders. Studies had to include children and adolescents with mental health presentations or positive screens for substance use. Two reviewers independently screened studies for relevance and quality. Diagnostic study quality was assessed with the four QUADAS-2 domains. Psychometric study quality was assessed with published criteria for instrument reliability, validity, and usability. We present a descriptive analysis of the reported psychometric properties and diagnostic performance of instruments for each study. Of the 4,832 references screened, 14 met inclusion criteria. Included studies evaluate 18 instruments for identifying suicide risk (six studies), alcohol use disorders (six studies), mood disorders (one study), and ED decision making (need for assessment, admission; one study). Nine studies include a psychometric focus but quality varies, with no studies fully meeting criteria for reliability, validity, and usability. Seven studies examine diagnostic performance of an instrument, but no study has a low risk of bias for all QUADAS-2 domains. The HEADS-ED instrument has good inter-rater reliability (r = 0.785) for identifying general mental health problems and modest evidence for ruling in patients requiring hospital admission (positive likelihood ratio [LR+] = 6.30). Internal consistency (reliability) varies

  18. Experiences of women who reported sexual assault at a provincial hospital, South Africa

    Directory of Open Access Journals (Sweden)

    Jeanette M. Sebaeng

    2016-02-01

    Full Text Available Background: Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital.Methods: A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher’s field notes and audiotape recordings.Results: Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support.Conclusion: Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene ‘clients’ from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.

  19. Harm reduction in name, but not substance: a comparative analysis of current Canadian provincial and territorial policy frameworks

    National Research Council Canada - National Science Library

    Elaine Hyshka; Jalene Anderson-Baron; Kamagaju Karekezi; Lynne Belle-Isle; Richard Elliott; Bernie Pauly; Carol Strike; Mark Asbridge; Colleen Dell; Keely McBride; Andrew Hathaway; T Cameron Wild

    2017-01-01

    .... We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes...

  20. Augmented Fish Health Monitoring for Washington Department of Wildlife; Five-year Project Report, 1986-1991 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Kerwin, John; Roberts, Steve; Oman, Leni; Bolding, Bruce

    1992-04-01

    The Augmented Fish Health Monitoring Project was funded by the Bonneville Power Administration (BPA) with the mandate to collect fish health data on the anadromous fish stocks of the Columbia River Basin in a standardized manner. The Washington Department of Wildlife began the project in 1986. Cumulative data and a final summary for this project are presented in this document. Fish stocks were examined monthly for length, weight, and health status at all Washington Department of Wildlife Columbia River Basin hatcheries. Assays for specific fish pathogens were conducted on all stocks of broodfish and smolts in the study area. Pathogens of interest were replicating viral agents, erythrocytic inclusion body syndrome virus (EIBSV), and Renibacterium salmoninarum. Sea-run cutthroat (SCT) were also sampled midway through the rearing cycle for R. salmoninarum. Juvenile fish were examined for the presence of any pathogen. Assays for Myxobolus cerebralis were conducted on fish stocks in several locations along the Columbia River. An organosomatic index analysis was made on each stock of smolts at the Cowlitz and Wells hatcheries. Results of the organosomatic index analysis were consistent between the years at each facility. However, the fish reared at Cowlitz displayed tissue changes associated with ceratomyxosis while those reared at Wells had a more desirable color and quality. Cell culture assays for viral agents in broodfish were positive for infectious hematopoeitic necrosis virus (IHNV) in all stocks at the Cowlitz Hatchery four out of five years in the study. Other stations were less consistent over the years. Only the sea-run cutthroat stock spawned at Beaver Creek was negative for any virus. Infectious pancreatic necrosis virus (IPNV) was isolated from summer-run steelhead (SS) broodfish at Wells in 1989 and 1991 and at Yakima in 1991. Inclusions that are characteristic of EIBSV were found in red blood cells of brood fish from the Wells Hatchery in 1990 and 1991

  1. Extending the reach: local health department collaboration with community pharmacies in Palm Beach County, Florida for H1N1 influenza pandemic response.

    Science.gov (United States)

    Rosenfeld, Lisa A; Etkind, Paul; Grasso, Alfred; Adams, Alex J; Rothholz, Mitchel C

    2011-01-01

    Palm Beach County Health Department (PBCHD) in Florida collaborated with pharmacists, community pharmacies, and pharmacy-based retail health clinics to increase access to influenza prevention through a widespread H1N1 influenza vaccination campaign and to disseminate timely and accurate public health recommendations and information using Flu Ready Cards. Selected pharmacy and store managers were surveyed, before and after distribution of H1N1 vaccine regarding issues facing pharmacists and the public in deciding whether or not to recommend or accept influenza vaccinations. Palm Beach County Health Department collaborated with Walgreens and CVS pharmacies, Publix and Winn-Dixie Super Market Pharmacies, and the Palm Beach County Pharmacy Association. More than 200000 Flu Ready Cards were distributed in 250 pharmacies between September 2009 and March 2010 as part the county-wide H1N1 influenza pandemic response. Approximately 40000 doses of H1N1 vaccine (12% of the PBCHD allocation) were shipped to local pharmacies and retail health clinics to immunize individuals and families, including those most at risk, vulnerable, or without a medical home. Eighty percent of surveyed store managers and 52% of pharmacists reported the Flu Ready Cards were useful and more than 60% of both groups felt partnership with the local health department was useful during the H1N1 pandemic. The collaborative relationship proved invaluable for distributing, transferring, and administering the H1N1 influenza vaccine, managing access to antivirals, and serving as a vital link to hospitals and other healthcare providers. Pharmacists can be an integral part of the nation's "first line resource" for health and wellness and can extend the reach for public health initiatives. The public-private collaboration between health departments and community pharmacists could improve individual and family readiness, increase access to trained and trusted professionals and strengthen overall preparedness and

  2. Acute cocaine-related health problems in patients presenting to an urban emergency department in Switzerland: a case series

    National Research Council Canada - National Science Library

    Bodmer, Michael; Enzler, Florian; Liakoni, Evangelia; Bruggisser, Marcel; Liechti, Matthias E

    2014-01-01

    .... We therefore conducted a retrospective analysis of 165 acute, laboratory-confirmed cocaine intoxications admitted to an urban emergency department in Switzerland between January 2007 and March 2011...

  3. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals.

    Science.gov (United States)

    Silva, Rosângela Marion da; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; Martino, Milva Maria Figueiredo de; Prestes, Francine Cassol

    2016-08-08

    to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. nurses had their health compromised due to their work in clinical surgery departments. analisar os efeitos do trabalho na saúde de enfermeiros que atuam em clínicas cirúrgicas de hospitais universitários, relacionando-os aos danos físicos, sociais e psicológicos. estudo quantitativo, transversal, realizado entre 2012 e 2013 em quatro instituições de um Estado da região sul do Brasil. A amostra foi composta por 65 enfermeiros que responderam questões sobre os hábitos de vida e dados sociodemográficos e a Escala de Avaliação de Danos Relacionados ao Trabalho. Associações foram verificadas pelo teste Qui-Quadrado e Exato de Fisher e as correlações pelo teste de Spearmann. prevaleceu o adoecimento físico, encontrando associação entre os fatores Danos Sociais e Psicológicos e as variáveis prática de atividade física, acidente de trabalho e opção pelo turno de trabalho. Evidenciou-se correlação entre Danos Sociais e Psicológicos. o trabalho realizado por enfermeiros que atuam

  4. Male marriage squeeze and inter-provincial marriage in central China: evidence from Anhui

    Science.gov (United States)

    Liu, Lige; Brown, Melissa J.; Feldman, Marcus W.

    2015-01-01

    Since the 1990s, inter-provincial female migration for marriage has become important in central and eastern rural China. Using survey data from X County in rural Anhui Province, we explore the arrangement of inter-provincial marriages, as well as the characteristics of husbands and wives, marital satisfaction, and marital stability for these marriages. We find that inter-provincial marriage is an important option for local men to respond to the marriage squeeze and the increasing expense of marriage. It helps to relieve the shortage of marriageable women in the local marriage market. Because this kind of marriage is based on economic exchange, but not affection, it is often subject to a higher risk of marriage instability, and can lead to such illegal behaviors as marriage fraud and mercenary marriage. PMID:26594102

  5. [Relationship between maternal body mass index, gestational weight gain and birth weight; prospective study in a health department].

    Science.gov (United States)

    Vila-Candel, Rafael; Soriano-Vidal, Francisco Javier; Navarro-Illana, Pedro; Murillo-Llorente, M Teresa; Martín-Moreno, José M

    2015-04-01

    To ascertain the relationship between maternal weight gain and birth weight, in every pre-gestational body mass index (BMI) category. A two-stage sampling observational and descriptive study was carried out in the health department of La Ribera (Valencia, Spain). The sample was divided into four groups according to pre-gestational BMI. 140 pregnant women were studied. We observed rising pre-gestational weight gain (PWG) and trimestral gradients. There was a higher increase from the first to the second trimester than from the second to the third trimester in every pre-gestational BMI category. According to the international recommendations of Institute of Medicine, 16.4% of women had an inferior gestational weight gain (GWG), 38.6% were within the recommendations and 45% were above them. The pre-gestational BMI, categorized by the WHO, is related to the birth weight, showing a statistical significance (F=6.636 and and pweight gain than the recommended have newborns with higher birth weight (4,353 ± 821.924 g) and, underweight mothers with a lower weight gain than the recommended, have newborns with lower birth weights (2,900 ± 381.83 g) than the rest of the groups. The absolute gestational weight gain did not show a statistical significance compared to the birthweight in any of the pre-gestational BMI categories and, as an isolated indicator, is not an added value to the prenatal quality control. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Effects of Common Data Errors in Electronic Health Records on Emergency Department Operational Performance Metrics: A Monte Carlo Simulation.

    Science.gov (United States)

    Ward, Michael J; Self, Wesley H; Froehle, Craig M

    2015-09-01

    The objective was to estimate how data errors in electronic health records (EHRs) can affect the accuracy of common emergency department (ED) operational performance metrics. Using a 3-month, 7,348-visit data set of electronic time stamps from a suburban academic ED as a baseline, Monte Carlo simulation was used to introduce four types of data errors (substitution, missing, random, and systematic bias) at three frequency levels (2, 4, and 7%). Three commonly used ED operational metrics (arrival to clinician evaluation, disposition decision to exit for admitted patients, and ED length of stay for admitted patients) were calculated and the proportion of ED visits that achieved each performance goal was determined. Even small data errors have measurable effects on a clinical organization's ability to accurately determine whether it is meeting its operational performance goals. Systematic substitution errors, increased frequency of errors, and the use of shorter-duration metrics resulted in a lower proportion of ED visits reported as meeting the associated performance objectives. However, the presence of other error types mitigated somewhat the effect of the systematic substitution error. Longer time-duration metrics were found to be less sensitive to data errors than shorter time-duration metrics. Infrequent and small-magnitude data errors in EHR time stamps can compromise a clinical organization's ability to determine accurately if it is meeting performance goals. By understanding the types and frequencies of data errors in an organization's EHR, organizational leaders can use data management best practices to better measure true performance and enhance operational decision-making. © 2015 by the Society for Academic Emergency Medicine.

  7. The Role of Social Work in Providing Mental Health Services and Care Coordination in an Urban Trauma Center Emergency Department.

    Science.gov (United States)

    Moore, Megan; Whiteside, Lauren K; Dotolo, Danae; Wang, Jin; Ho, Leyna; Conley, Bonnie; Forrester, Mollie; Fouts, Susan O; Vavilala, Monica S; Zatzick, Douglas F

    2016-12-01

    This study examined the role of emergency department (ED) social workers and identified predictors of receipt of social work services and length of ED stay. Comprehensive reviews were conducted of medical records of all patients (N=49,354) treated in a level 1 trauma center ED from January 1, 2012, to March 31, 2013. Content analysis of chart notes was used to categorize the types of social work services provided. Poisson regression was used to assess associations between demographic and clinical characteristics, receipt of social work services, and length of ED stay. Social work services were provided to 18,532 (38%) patients. Most were mental health services (54%), followed by care coordination (31%) and material support or other referrals (15%). Patients seen by social workers had complex presentations, involving mental disorder diagnoses (18%), substance use disorder diagnoses (29%), comorbid diagnoses (32%), and injuries (51%); a quarter of patients had multiple ED visits (26%). In adjusted regression analysis, females (relative risk [RR]=1.15), patients not discharged home (RR=1.44), and those with two or more comorbid diagnoses (RR=1.80), injuries due to assault (RR=1.37), and traumatic brain injury (RR=1.20) were more likely to receive social work services. Such services were associated with an increased length of ED stay (RR=1.34). Social workers provided services to patients with multifaceted needs resulting from complex presentations. Provision of social work services modestly increased length of ED stay. Triage algorithms are needed to target efficiencies, systematize provision of ED social work services, and improve access to services for all patients.

  8. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Canadian harm reduction policies: A comparative content analysis of provincial and territorial documents, 2000-2015.

    Science.gov (United States)

    Wild, T Cameron; Pauly, Bernie; Belle-Isle, Lynne; Cavalieri, Walter; Elliott, Richard; Strike, Carol; Tupper, Kenneth; Hathaway, Andrew; Dell, Colleen; MacPherson, Donald; Sinclair, Caitlin; Karekezi, Kamagaju; Tan, Benjamin; Hyshka, Elaine

    2017-07-01

    Access to harm reduction interventions among substance users across Canada is highly variable, and largely within the policy jurisdiction of the provinces and territories. This study systematically described variation in policy frameworks guiding harm reduction services among Canadian provinces and territories as part of the first national multimethod case study of harm reduction policy. Systematic and purposive searches identified publicly-accessible policy texts guiding planning and organization of one or more of seven targeted harm reduction services: needle distribution, naloxone, supervised injection/consumption, low-threshold opioid substitution (or maintenance) treatment, buprenorphine/naloxone (suboxone), drug checking, and safer inhalation kits. A corpus of 101 documents written or commissioned by provincial/territorial governments or their regional health authorities from 2000 to 2015 were identified and verified for relevance by a National Reference Committee. Texts were content analyzed using an a priori governance framework assessing managerial roles and functions, structures, interventions endorsed, client characteristics, and environmental variables. Nationally, few (12%) of the documents were written to expressly guide harm reduction services or resources as their primary named purpose; most documents included harm reduction as a component of broader addiction and/or mental health strategies (43%) or blood-borne pathogen strategies (43%). Most documents (72%) identified roles and responsibilities of health service providers, but fewer declared how services would be funded (56%), specified a policy timeline (38%), referenced supporting legislation (26%), or received endorsement from elected members of government (16%). Nonspecific references to 'harm reduction' appeared an average of 12.8 times per document-far more frequently than references to specific harm reduction interventions (needle distribution=4.6 times/document; supervised injection

  10. Provincial States and Bonaerense Town Councils, a troubled relation during the first Peronism

    Directory of Open Access Journals (Sweden)

    José Marcilese

    2009-11-01

    Full Text Available This study aims to analyze the relationship remained the state with the provincial towns of Buenos Aires during the first years of Peronism, which was introduced as a particular feature of progressive intervention of the provincial government on communal administrations. This trend helped the formation of a centralized state that was characterized, among other things, limit the autonomy of municipal governments. Also this method was accompanied by a devaluation of the growing political role of the mayors, to benefit other areas of the state apparatus and the party itself, and its conversion into a single functionary.

  11. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    Science.gov (United States)

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…

  12. A Declining Region: Provincial Renaissance Revisited (Case of Volgograd Region

    Directory of Open Access Journals (Sweden)

    Drozdova Yuliya

    2014-12-01

    context the author suggests changing the trajectory of development, building a positive image of the Volgograd region, enhancing the investment attractiveness of the region, improving the quality of life, building on the advantageous geographic and historical situation (the region’s past, natural and climatic conditions, natural resources, economic and geographic situation, agrarian conditions, prestigious universities, building trust in the authorities due to the efforts on the part of regional and municipal administration and improving the reputation of public servants, which would promote the strategy of adjusting inter-regional inequality and a renaissance of a provincial region.

  13. The Analysis Of Antibiotic Consumption And Bacterial Resistance As An Indicator Of Their Proper Use At The Urology Department In The Health Centre “Studenica” Kraljevo

    Directory of Open Access Journals (Sweden)

    Bukonjić Andriana

    2015-06-01

    Full Text Available The objective of the study was to analyze antibiotic consumption and determine bacterial resistance rates as an indicator of the rational utilization of this drug group at the urology department in the Health Centre “Studenica” Kraljevo.

  14. The Comparison of Self-Efficacy Belief Levels on Anatomy Education between the Undergraduate Students from Physical Therapy and Rehabilitation Department and the Associate Students from Vocational School of Health Services in Western Black Sea Region

    Science.gov (United States)

    Acar, Derya; Colak, Tuncay; Colak, Serap; Gungor, Tugba; Yener, Deniz M.; Aksu, Elif; Guzelordu, Dilsat; Sivri, Ismail; Colak, Enis; Ors, Abdullah

    2017-01-01

    Physical Therapy and Rehabilitation (PTR) undergraduate degree departments and Vocational School of Health Services (VSHS) associate degree departments train healthcare professionals, which is important for both continuance of human health and treatment of various illnesses. Anatomic structures underlie the illnesses that these departments treat…

  15. The Decline in Hydrocodone/Acetaminophen Prescriptions in Emergency Departments in the Veterans Health Administration Between 2009 to 2015

    Directory of Open Access Journals (Sweden)

    Michael A. Grasso

    2016-06-01

    Full Text Available Introduction: The purpose of the study was to measure national prescribing patterns for hydrocodone/acetaminophen among veterans seeking emergency medical care, and to see if patterns have changed since this medication became a Schedule II controlled substance. Methods: We conducted a retrospective cohort study of emergency department (ED visits within the Veterans Health Administration (VA between January 2009 and June 2015. We looked at demographics, comorbidities, utilization measures, diagnoses, and prescriptions. Results: During the study period, 1,709,545 individuals participated in 6,270,742 ED visits and received 471,221 prescriptions for hydrocodone/acetaminophen (7.5% of all visits. The most common diagnosis associated with a prescription was back pain. Prescriptions peaked at 80,776 in 2011 (8.7% of visits, and declined to 35,031 (5.6% during the first half of 2015 (r=‒0.99, p<0.001. The percentage of hydrocodone/acetaminophen prescriptions limited to 12 pills increased from 22% (13,949 in 2009 to 31% (11,026 in the first half of 2015. A prescription was more likely written for patients with a pain score≥7 (OR 3.199, CI [3.192‒3.205], a musculoskeletal (OR 1.622, CI [1.615‒1.630] or soft tissue (OR 1.656, CI [1.649‒1.664] diagnosis, and those below the first quartile for total ED visits (OR 1.282, CI [1.271‒1.293] and total outpatient ICD 9 codes (OR 1.843, CI [1.833‒1.853]. Conclusion: Hydrocodone/acetaminophen is the most frequently prescribed ED medication in the VA. The rate of prescribing has decreased since 2011, with the rate of decline remaining unchanged after it was classified as a Schedule II controlled substance. The proportion of prescriptions falling within designated guidelines has increased but is not at goal. [West J Emerg Med. 2016;17(4:396-403.

  16. Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy

    Directory of Open Access Journals (Sweden)

    Marinelli Paolo

    2010-02-01

    Full Text Available Abstract Background This survey assessed knowledge, attitudes, and compliance regarding standard precautions about health care-associated infections (HAIs and the associated determinants among healthcare workers (HCWs in emergency departments in Italy. Methods An anonymous questionnaire, self-administered by all HCWs in eight randomly selected non-academic acute general public hospitals, comprised questions on demographic and occupational characteristics; knowledge about the risks of acquiring and/or transmitting HAIs from/to a patient and standard precautions; attitudes toward guidelines and risk perceived of acquiring a HAI; practice of standard precautions; and sources of information. Results HCWs who know the risk of acquiring Hepatitis C (HCV and Human Immunodeficiency Virus (HIV from a patient were in practice from less years, worked fewer hours per week, knew that a HCW can transmit HCV and HIV to a patient, knew that HCV and HIV infections can be serious, and have received information from educational courses and scientific journals. Those who know that gloves, mask, protective eyewear, and hands hygiene after removing gloves are control measures were nurses, provided care to fewer patients, knew that HCWs' hands are vehicle for transmission of nosocomial pathogens, did not know that a HCW can transmit HCV and HIV to a patient, and have received information from educational courses and scientific journals. Being a nurse, knowing that HCWs' hands are vehicle for transmission of nosocomial pathogens, obtaining information from educational courses and scientific journals, and needing information were associated with a higher perceived risk of acquiring a HAI. HCWs who often or always used gloves and performed hands hygiene measures after removing gloves were nurses, provided care to fewer patients, and knew that hands hygiene after removing gloves was a control measure. Conclusions HCWs have high knowledge, positive attitudes, but low

  17. Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services.

    Directory of Open Access Journals (Sweden)

    Peter F Rebeiro

    Full Text Available We sought to quantify agreement between Institute of Medicine (IOM and Department of Health and Human Services (DHHS retention indicators, which have not been compared in the same population, and assess clinical retention within the largest HIV cohort collaboration in the U.S.Observational study from 2008-2010, using clinical cohort data in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD.Retention definitions used HIV primary care visits. The IOM retention indicator was: ≥2 visits, ≥90 days apart, each calendar year. This was extended to a 2-year period; retention required meeting the definition in both years. The DHHS retention indicator was: ≥1 visit each semester over 2 years, each ≥60 days apart. Kappa statistics detected agreement between indicators and C statistics (areas under Receiver-Operating Characteristic curves from logistic regression analyses summarized discrimination of the IOM indicator by the DHHS indicator.Among 36,769 patients in 2008-2009 and 34,017 in 2009-2010, there were higher percentages of participants retained in care under the IOM indicator than the DHHS indicator (80% vs. 75% in 2008-2009; 78% vs. 72% in 2009-2010, respectively (p<0.01, persisting across all demographic and clinical characteristics (p<0.01. There was high agreement between indicators overall (κ = 0.83 in 2008-2009; κ = 0.79 in 2009-2010, p<0.001, and C statistics revealed a very strong ability to predict retention according to the IOM indicator based on DHHS indicator status, even within characteristic strata.Although the IOM indicator consistently reported higher retention in care compared with the DHHS indicator, there was strong agreement between IOM and DHHS retention indicators in a cohort demographically similar to persons living with HIV/AIDS in the U.S. Persons with poorer retention represent subgroups of interest for retention improvement programs nationally, particularly in light of the

  18. Clinical experience and institutional in a Department of Mental Health: The multifamily groups for parents and children with psychiatric illness in the time of post-modernity

    Directory of Open Access Journals (Sweden)

    Luisella Ferraris

    2014-09-01

    Full Text Available The following work shows the beginning and development of a multifamily group, involving mental health professionals, parents and psychiatric patients, in a mental health center. The group goals and the main functions of this setting, will be described, observing also the social and community changes, occurring in recent years. Finally, starting from the analysis of the major psychoanalysis research findings, the concepts of inter-subjectivity, therapeutic alliance and institution's role regarding the psychiatric patients’ treatment, will be deepened. Keywords: Department of Mental Health; Multifamily group; Community changes; Therapeutic alliance; Psychiatric patients

  19. U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

    Energy Technology Data Exchange (ETDEWEB)

    Blaylock, B.P.; Legg, J.; Travis, C.C. [Oak Ridge National Lab., TN (United States). Center for Risk Management; Simek, M.A.; Sutherland, J. [Univ. of Tennessee, Knoxville, TN (United States); Scofield, P.A. [Office of Environmental Compliance and Documentation (United States)

    1995-06-01

    This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

  20. Incidence of social resistance in provincial mining legislation. The cases of Córdoba and Catamarca (2003-2008

    Directory of Open Access Journals (Sweden)

    Lucas Christel

    2013-11-01

    Full Text Available During the last decade in Argentina, the growth of open pit mining has faced strong social resistance and provincial laws prohibiting such activity. This work aims to analyse the ways in which the different subnational political regimes and economic systems impact upon the possibility of incidence of social resistance on provincial mining legislation, looking at the cases of Cordoba and Catamarca.

  1. 76 FR 21768 - Privacy Act of 1974; Department of Homeland Security/Office of Health Affairs-001 Contractor...

    Science.gov (United States)

    2011-04-18

    ... exercise oversight over all medical and public health activities of'' DHS. Section II, DHS Delegation 5001.... 321e by granting the Chief Medical Officer ``the authority to exercise oversight over all medical and..., in support of the Office of Health Affair's responsibilities for medical and health matters. This...

  2. Gebruik van informatie bij besluitvorming over verkeersveiligheidsmaatregelen : onderzoek in twaalf provincies.

    NARCIS (Netherlands)

    Bax, C.A. & Jagtman, H.M.

    2009-01-01

    This study investigates what information provinces use in decision-making about the construction of infrastructural road safety measures on provincial 80km/h roads. The following questions are answered in this study: ? Do provinces use general information about costs and effects, and specific

  3. Post-match recovery methods used by U19 and U21 provincial ...

    African Journals Online (AJOL)

    The aim of the study was to identify the most preferred post-match recovery methods utilized by U19 and U21 provincial rugby union players (n=97; Mean age: ± 20.2 years) in Gauteng Province of South Africa. Questionnaire-based data were collected from a purposive sample size of 97 rugby players. The findings ...

  4. Retail food environments, shopping experiences, First Nations and the provincial Norths.

    Science.gov (United States)

    Burnett, Kristin; Skinner, Kelly; Hay, Travis; LeBlanc, Joseph; Chambers, Lori

    2017-10-01

    This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.

  5. The Self-Identification of Provincial Young People in the Context of Social-Status Affiliation

    Science.gov (United States)

    Bukin, V. P.

    2011-01-01

    A survey conducted in two provincial areas of Russia provides the basis for an examination of the relation between the self-identification and the social status affiliation of young people. Self-assessments serve as the basis for a model of the social structure and a typology of the younger generation in these regions, in accordance with their…

  6. Physical activity opportunities in Canadian childcare facilities: a provincial/territorial review of legislation.

    Science.gov (United States)

    Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M

    2012-05-01

    Preschoolers spend a substantial portion of their day in childcare; therefore, these centers are an ideal venue to encourage healthy active behaviors. It is important that provinces'/territories' childcare legislation encourage physical activity (PA) opportunities. The purpose of this study was to review Canadian provincial/territorial childcare legislation regarding PA participation. Specifically, this review sought to 1) appraise each provincial/territorial childcare regulation for PA requirements, 2) compare such regulations with the NASPE PA guidelines, and 3) appraise these regulations regarding PA infrastructure. A review of all provincial/territorial childcare legislation was performed. Each document was reviewed separately by 2 researchers, and the PA regulations were coded and summarized. The specific provincial/territorial PA requirements (eg, type/frequency of activity) were compared with the NASPE guidelines. PA legislation for Canadian childcare facilities varies greatly. Eight of the thirteen provinces/territories provide PA recommendations; however, none provided specific time requirements for daily PA. All provinces/territories did require access to an outdoor play space. All Canadian provinces/territories lack specific PA guidelines for childcare facilities. The development, implementation, and enforcement of national PA legislation for childcare facilities may aid in tackling the childhood obesity epidemic and assist childcare staff in supporting and encouraging PA participation.

  7. A divided provincial town: the development from ethnic to class segmentation in Kupang, West Timor

    NARCIS (Netherlands)

    Tidey, S.

    2012-01-01

    This article focuses on the physical composition of the Eastern Indonesian provincial town of Kupang, a town thought to be characterized by interethnic tensions. I examine the assumption that social segmentation is explainable in terms of ethnicity. In order to show that ethnicity not the sole

  8. Recente vondsten van breedbladige fonteinkruiden (Groenlandia en Potamogeton spec.) in de provincie Noord-Brabant

    NARCIS (Netherlands)

    Linden, van der J.; Poelmans, W.

    1993-01-01

    Since 1987 the distribution of many plant species in the central and eastern parts of the province Noord-Brabant has been mapped for country use planning by the Provincial Authorities. Distribution maps (with a 5 x 5 km² grid) of the Potamogeton (broad-leaved pondweed) species, which are important

  9. Measuring triple-helix synergy in the Russian innovation systems at regional, provincial, and national levels

    NARCIS (Netherlands)

    Leydesdorff, L.; Perevodchikov, E.; Uvarov, A.

    2015-01-01

    We measure synergy for the Russian national, provincial, and regional innovation systems as reduction of uncertainty using mutual information among the 3 distributions of firm sizes, technological knowledge bases of firms, and geographical locations. Half a million units of data at firm level in

  10. Luis Albert and the first urban plans of the Provincial Council of Valencia

    Directory of Open Access Journals (Sweden)

    José Luis Merlo Fuertes

    2014-10-01

    Full Text Available This article will analyze the urban plans of those municipalities in the Province of Valencia that embraced the technical assistance given by the Provincial Council for the planning composition, at the time of Luis Albert Ballesteros, the provincial council architect. Those first urban plans of the Provincial Council make up a homogeneous set of documents since they respond to a unique style of urban planning that varies as much as the original core of the population does. The common element is the ground plan centrality that would be highlighted by an area or a protected green zone that will somehow link to the urban proposals connected to the city-garden model by Howard. Commencement of which began at a time characterized mainly by the co-existence of a great diversity of laws and percepts, making it so that the meaning of the term urban planning could be applied in a variety of ways. The urban plans of the Provincial Council represent the latest inheritance of the extension models and interior remodeling. In the transition to the Land Planning Act (Ley de Suelo of 1956, these plans have the interest in being, in addition to the last examples of the so-called urbanism in the municipal tradition, one of the ancestors of the current master plans of urban development (plan general de ordenación urbana.

  11. Business and politics in provincial Indonesia: The batik and construction sector in Pekalongan, Central Java

    NARCIS (Netherlands)

    Savirani, A.

    2015-01-01

    After the fall of Soeharto in 1998, and an increased connection to the global world, politics at the local level in Indonesia have changed significantly. This has contributed to a change in how business is conducted in provincial towns. This thesis explores the changing relationship between the

  12. Chemistry 300. Administration Manual for Supervising Teachers, Provincial Examination, Answer Key--Multiple-Choice and Written-Answer Questions, and Provincial Summary Report = Chimie 300. Guide d'administration a l'intention des surveillants d'examen, Examen provincial, Cle de correction--Questions choix multiple et Questions responses ouvertes, et Rapport sommaire provincial.

    Science.gov (United States)

    Manitoba Dept. of Education and Training, Winnipeg.

    This collection of manuals contains the Manitoba Provincial Chemistry Examination for students seeking credit in Senior 4 Chemistry (Chemistry 300) and instructions for its use and grading. The examination is based on the Core Topics of the Senior 4 Chemistry course and accounts for 30% of the student's final grade in the course. The examination…

  13. Retail food environments, shopping experiences, First Nations and the provincial Norths

    Directory of Open Access Journals (Sweden)

    Kristin Burnett

    2017-10-01

    Full Text Available Introduction: This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC and by reporting on the grocery shopping experiences of people living in northern Canada. Methods: We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Results: Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%, Saskatchewan (83% and Manitoba (72%. Respondents to the survey (n = 92 expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. Conclusion: There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.

  14. Provincial Reconstruction Teams : Symbool van NAVO-commitment in Afghanistan of meer?

    NARCIS (Netherlands)

    M. Grandia Mantas

    2010-01-01

    De Provincial Reconstruction Teams (PRT’s) zijn voor de NAVO het belangrijkste middel geweest om haar gebiedsuitbreiding naar geheel Afghanistan te realiseren. Daarnaast zijn PRT’S populair bij de media omdat ze veel met de lokale bevolking werken en projecten opzetten. De PRT’s zijn er in

  15. The contribution of health anxiety to retrospectively-recalled emergency department visits within a sample of patients in residential substance abuse treatment.

    Science.gov (United States)

    Fergus, Thomas A; Bardeen, Joseph R; Gratz, Kim L; Fulton, Jessica J; Tull, Matthew T

    2015-01-01

    With the burden of emergency department (ED) use increasing, research examining the factors associated with ED visits among individuals who use the ED most frequently is needed. Given that substance use is strongly linked to ED visits, this study sought to examine the factors associated with greater ED visits among patients with substance use disorders (SUD). More precisely, we examined whether health anxiety incrementally contributes to the prediction of ED visits for medical care among adult patients (N = 118) in a residential substance abuse disorder treatment facility. As predicted, health anxiety was significantly positively correlated with ED visits during the past year. Furthermore, health anxiety remained a significant predictor of ED visits after accounting for sociodemographic variables, frequency of substance use, and physical health status. These results suggest that health anxiety may contribute to increased ED visits for medical care among individuals with SUD.

  16. Impact of the ABCDE triage in primary care emergency department on the number of patient visits to different parts of the health care system in Espoo City

    Directory of Open Access Journals (Sweden)

    Kantonen Jarmo

    2012-01-01

    Full Text Available Abstract Background Many Finnish emergency departments (ED serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care doctors are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to secondary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for urgent patients. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the EDs of Espoo City, Finland. Methods The numbers of monthly visits to doctors were recorded before and after intervention in Espoo primary care EDs. To study if the implementation of the triage system redirects patients to other health services, the numbers of monthly visits to doctors were also scored in the private health care, the public sector health services of Espoo primary care during office hours and local secondary health care ED (Jorvi hospital. A face-to-face triage system was applied in the primary care EDs as an attempt to provide immediate treatment for the most acute patients. It is based on the letters A (patient sent directly to secondary care, B (to be examined within 10 min, C (to be examined within 1 h, D (to be examined within 2 h and E (no need for immediate treatment for assessing the urgency of patients' treatment needs. The first step was an initial patient assessment by a health care professional (triage nurse. The introduction of this triage system was combined with information to the public on the "correct" use of emergency services. Results After implementation of the ABCDE-triage system the number of patient visits to a primary care doctor decreased by up to 24% (962 visits/month as compared to the three previous years in the EDs

  17. Psychological and behavioral intervention improves the quality of life and mental health of patients suffering from differentiated thyroid cancer treated with postoperative radioactive iodine-131

    Directory of Open Access Journals (Sweden)

    Wu HX

    2016-05-01

    Full Text Available Hong-Xia Wu,1,* Hua Zhong,2,3,* Yue-Dong Xu,1 Cui-Ping Xu,4 Ying Zhang,5 Wei Zhang1 1Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, 2Department of Oncology, Shandong University of Traditional Chinese Medicine, 3Department of Traditional Chinese Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, 4Department of Nursing, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, 5Department of Nursing, Tianjin Chest Hospital, Tianjing, People’s Republic of China *These authors contributed equally to this work Background: We examined the effects of psychological and behavioral intervention on health-related quality of life and mental health among patients suffering from differentiated thyroid cancer (DTC treated with postoperative radioactive iodine-131 (RAI.Methods: Sixty patients with DTC, undergoing RAI, were randomly assigned to receive either conventional nursing (n=30 or a 1-year psychological and behavioral intervention based on conventional nursing (n=30. Health-related quality of life and mental health issues, depression, and anxiety were measured using the Quality of Life Core Questionnaire, Self-rating Depression Scale, and Self-rating Anxiety Score, respectively.Results: After RAI treatment, patients in both groups showed improved functional capacities (ie, physical, role, cognitive, emotional, and social and global quality of life, along with reduced depression and anxiety (P<0.05. At 1-year follow-up, compared with patients in the routine nursing group, those in the psychological and behavioral intervention group demonstrated greater improvements in functional capacities, global quality of life, and depression and anxiety symptoms (P<0.05.Conclusion: Psychological and behavioral interventions for patients with DTC undergoing RAI facilitated positive outcomes, suggesting that nursing care models that include psychological and behavioral interventions

  18. 78 FR 6112 - Request for Information (RFI): Opportunities To Apply a Department of Health and Human Services...

    Science.gov (United States)

    2013-01-29

    ... children, ages 1-5 years, and is available in both English and Spanish. Content for the messages was... individuals to be more engaged in managing their health. According to a Pew Charitable Trusts study conducted... innovative health education strategies. The intent is to build upon existing platforms and outreach models...

  19. Heterogeneity of Health Profiles of Older People Presenting to an Accident and Emergency Department With a Fall

    Directory of Open Access Journals (Sweden)

    Pui-Yee Yeung

    2009-09-01

    Conclusion: Older people presenting with falls at the A&E have multiple health problems and varying degrees of frailty. A homogeneous management pathway may not be appropriate, but rather, the approach should be in the context of management of the frailty syndrome, requiring an individualized approach and taking into account the heterogeneity of their health profile.

  20. Relationship Between Mental Health and Job Satisfaction Among Employees in a Medical Center Department of Laboratory Medicine

    Directory of Open Access Journals (Sweden)

    Mo Siu-Mei Lee

    2009-02-01

    Conclusion: The prevalence of psychiatric morbidity in the workplace is high. The severity of psychological distress is negatively associated with job satisfaction. Early detection of psychiatric morbidity through self-administered screening questionnaires, as well as implementation of organizational mental-health promotion programs, is recommended to improve employees' mental health and job satisfaction.

  1. Metallurgy Department

    DEFF Research Database (Denmark)

    Risø National Laboratory, Roskilde

    The activities of the Metallurgy Department at Risø during 1981 are described. The work is presented in three chapters: General Materials Research, Technology and Materials Development, Fuel Elements. Furthermore, a survey is given of the department's participation in international collaboration...

  2. A provincial adaptation of clinical practice guidelines for depression in primary care: a case illustration of the ADAPTE method.

    Science.gov (United States)

    Roberge, Pasquale; Fournier, Louise; Brouillet, Hélène; Delorme, André; Beaucage, Clément; Côté, Rodrigue; Demers, Pierre; Gervais, Michel; Laflamme, France; Latulippe, Louise; Marchand, André; Patry, Simon; Pelchat, Suzanne; Provencher, Martin D; Provost, Jean-Rémy; Robitaille, David; Cloutier, Anne-Marie

    2015-12-01

    Mental health services for patients with a major depressive disorder are commonly delivered by primary care. To support the uptake of clinical practice guidelines in primary care, we developed and disseminated a practice protocol for depression tailored for a multidisciplinary audience of primary mental health care providers with the ADAPTE methodology. The research questions addressed in this study aimed at examining the experience of the development process of a mental health practice protocol in terms of adaptation, facilitation and implementation. We present a descriptive case study of the development and implementation of a practice protocol for major depressive disorder for primary mental health care in the organizational and cultural context of the province of Québec (Canada), following the steps of the ADAPTE methodology. An expert committee composed of general practitioners, mental health specialists, health care administrators and decision makers at regional and provincial levels participated in the protocol development process. The practice protocol was based on two clinical practice guidelines: the NICE guideline on the treatment and management of depression in adults (2009, 2010) and the Canadian Network for Mood and Anxiety Treatments clinical guidelines for the management of major depressive disorder in adults (2009). A stepped care model was embedded in the protocol to facilitate the implementation of clinical recommendations in primary mental health care. A multifaceted dissemination strategy was used to support the uptake of the protocol recommendations in clinical practice. The ADAPTE methodology provided structure, rigour and efficiency to the trans-contextual adaptation of guideline recommendations. We will share the challenges associated with the adaptation of clinical recommendations and organizational strategies for a mental health guideline, and the dissemination of the practice protocol in primary care. © 2015 John Wiley & Sons, Ltd.

  3. The technique of lessons of health jogging and running at special educational department of students with vegetative-vascular dystonia complicated by sight pathology.

    Directory of Open Access Journals (Sweden)

    Gatsko O.V.

    2011-08-01

    Full Text Available The article deals with original methodology of health jogging and running. 175 students participated in experiment. Adaptive possibilities of cardiovascular system and changes in physical ability of students are assessed in the research. Index dynamics of physical state is determined in the paper. The research focuses on the fact that repetitive exercisers with aerobics alongside adjusted exercises caused the rise in health condition of students with vegetative-vascular dystonia. It is established that such use of running and jogging in the special sturdy department's program of physical exercisers can materially correct arterial pressure and improve students' feeling of feet.

  4. Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

    OpenAIRE

    Yousefi-Nooraie Reza; Dobbins Maureen; Brouwers Melissa; Wakefield Patricia

    2012-01-01

    Abstract Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The ...

  5. Using a community-based participatory research approach to improve the performance capacity of local health departments: the Kansas Immunization Technology Project.

    Science.gov (United States)

    Paschal, Angelia M; Oler-Manske, Julie; Kroupa, Kathy; Snethen, Edie

    2008-12-01

    Building the capacity of local health departments (LHDs) in the use of health data is critical. Unlike community-based health agencies or private healthcare providers, LHDs serve as public health officials for their communities. Thus, LHDs' ability to use technology, electronically access and distribute up-to-date health information, and to measure population-based health outcomes for their communities is crucial. Using feedback obtained from various sources, groundwork efforts in Kansas indicated that few LHDs had the skills to utilize and interpret immunization data in a way that would allow them to effectively assess, screen, treat, and monitor infectious diseases in their communities. In response to the need for a well-trained LHD workforce, and using a community-based participatory research (CBPR) approach, team members developed and delivered training to enhance immunization data skills among LHDs. The goal of the training was to improve LHDs' capacity to identify, obtain, analyze and present immunization data. Training was provided to LHD staff representing 46 counties. Satisfaction survey results indicated the overwhelming majority of participants found the training beneficial. Results indicated that approximately 93% acquired new knowledge and skills they could apply to their jobs. The project renders a model for providing ongoing trainings in stepwise fashion to a particular workforce. The willingness of the project partners to be innovative and inclusive in addressing the training needs of the state's public health professionals is noted. Similar training should be considered for other public health programmatic areas.

  6. HIV counselling and testing in Nova Scotia: the provincial strategy in the context of an international debate.

    Science.gov (United States)

    Gahagan, Jacqueline C; Fuller, Janice L; Delpech, Valerie C; Baxter, Larry N; Proctor-Simms, E Michelle

    2010-01-01

    Nova Scotia, as a small province in Atlantic Canada, provides health care professionals and policy analysts with unique challenges for developing and implementing a strategy for accessible and acceptable HIV counselling and testing. Despite universal health care in Canada, barriers and challenges persist in relation to HIV counselling and testing programs and services in Nova Scotia. It is therefore necessary to examine the unique circumstances in the provision of programs and services in Nova Scotia prior to the possibility of adopting international HIV counselling and testing standards and guidelines being implemented in other jurisdictions. Nova Scotia's provincial strategy on HIV/AIDS promotes a harm-reduction approach for different populations in various service settings, recognizing the diverse circumstances and experiences of people living in Nova Scotia. By contrast, the Centers for Disease Control (CDC) recommended strategy promotes opt-out testing and in some instances alters the requirement of informed consent. As the Public Health Agency of Canada (PHAC) revises the national HIV counselling and testing policies, it is imperative to address the unique characteristics of Nova Scotia's provision of services, and how divergent strategies have the potential to address or compound the barriers to access that exist in this province's communities.

  7. Plutonium working group report on environmental, safety and health vulnerabilities associated with the department`s plutonium storage. Volume II, Appendix B, Part 9: Oak Ridge site site team report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    This report provides the input to and results of the Department of Energy (DOE) - Oak Ridge Operations (ORO) DOE Plutonium Environment, Safety and Health (ES & H) Vulnerability Assessment (VA) self-assessment performed by the Site Assessment Team (SAT) for the Oak Ridge National Laboratory (ORNL or X-10) and the Oak Ridge Y-12 Plant (Y-12) sites that are managed by Martin Marietta Energy Systems, Inc. (MMES). As initiated (March 15, 1994) by the Secretary of Energy, the objective of the VA is to identify and rank-order DOE-ES&H vulnerabilities associated for the purpose of decision making on the interim safe management and ultimate disposition of fissile materials. This assessment is directed at plutonium and other co-located transuranics in various forms.

  8. Aplicación del mentoring para lograr una gestión eficiente en la Municipalidad Provincial del Callao

    OpenAIRE

    Huarcaya Godoy, Madison

    2015-01-01

    El presente trabajo de investigación: "Aplicación del Mentoring para lograr una gestión eficiente en la Municipalidad Provincial del Callao", es producto de un estudio y análisis de la gestión pública de la Municipalidad Provincial del Callao, con el objeto de determinar la eficiencia en el desempeño de los colaboradores, de niveles jerárquicos, órganos intermedios y órganos operativos de la Municipalidad Provincial del Callao a fin de mejorar la gestión de la provincia. El resultado, de la p...

  9. Provincial prenatal record revision: a multiple case study of evidence-based decision-making at the population-policy level

    Directory of Open Access Journals (Sweden)

    Olson Joanne

    2008-12-01

    Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review

  10. Provincial Comparison of Pharmacist Prescribing in Canada Using Alberta's Model as the Reference Point.

    Science.gov (United States)

    Bhatia, Surya; Simpson, Scot H; Bungard, Tammy

    2017-01-01

    In the past decade, pharmacist practice has evolved tremendously in Canada, but the scope of practice varies substantially from one province to another. To describe pharmacists' scopes of practice relevant to prescribing within various jurisdictions of Canada, using the prescribing model in Alberta (authors' province) as the reference point. This cross-sectional survey consisted of clinical scenarios for emergency prescribing, adapting or renewing a prescription, and initial-access prescribing for a chronic disease. Pharmacists were asked about their ability to administer injections and to order or access the results of laboratory tests, as well as certification and training requirements and reimbursement models. Thirteen pharmacists representing Canadian provinces other than Alberta were surveyed in late 2015, for comparison with Alberta. With specific reference to the scenarios presented, pharmacists were able to prescribe in an emergency in 9 of the 10 provinces, renew prescriptions in all provinces, and adapt prescriptions in 6 provinces. Three provinces required that pharmacists have collaborative practice agreements identifying a specific practice area in order to initiate a prescription for a chronic disease (with 6-12 pharmacists per province having such agreements). Alberta required pharmacists to have authorization, based on a detailed application, in order to initiate any provincially regulated drug (with about 1150 pharmacists having this authorization). Pharmacists were allowed to administer vaccines in 9 provinces, and 5 provinces allowed pharmacists to administer drugs by injection. Three provinces had systems in place for pharmacists to access laboratory test results, and 2 allowed pharmacists to order laboratory tests. Five provinces had government-reimbursed programs in place for select prescribing services; however, all 9 provinces with public vaccination programs reimbursed pharmacists for this service. Pharmacist prescribing differs among

  11. Health and productivity gains from better indoor environments and their implications for the U.S. Department of Energy

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J.

    2000-10-01

    A substantial portion of the US population suffers frequently from communicable respiratory illnesses, allergy and asthma symptoms, and sick building syndrome symptoms. We now have increasingly strong evidence that changes in building design, operation, and maintenance can significantly reduce these illnesses. Decreasing the prevalence or severity of these health effects would lead to lower health care costs, reduced sick leave, and shorter periods of illness-impaired work performance, resulting in annual economic benefits for the US in the tens of billions of dollars. Increasing the awareness of these potential health and economic gains, combined with other factors, could help bring about a shift in the way we design, construct, operate, and occupy buildings. The current goal of providing marginally adequate indoor environments could be replaced by the goal of providing indoor environments that maximize the health, satisfaction, and performance of building occupants. Through research and technology transfer, DOE and its contractors are well positioned to help stimulate this shift in practice and, consequently, improve the health and economic well-being of the US population. Additionally, DOE's energy-efficiency interests would be best served by a program that prepares for the potential shift, specifically by identifying and promoting the most energy-efficient methods of improving the indoor environment. The associated research and technology transfer topics of particular relevance to DOE are identified and discussed.

  12. A study of ambulatory care education in medical schools and U.S. Department of Veterans Affairs health care facilities.

    Science.gov (United States)

    Robbins, A S; Lussier, R R; Koser, K

    1989-10-01

    A study of ambulatory care and education was conducted by sending questionnaires to U.S. Department of Veterans Affairs hospitals (75) and medical schools (65) prior to the Conference on Ambulatory Care and Education. Responses from 48% of medical schools indicated that there was little required clinical time in ambulatory care (15-20%), as well as faculty resistance and lack of medical school commitment to ambulatory care education. VA respondents (35% sample) also documented relatively little training in ambulatory care at the undergraduate and graduate levels. Numerous barriers to ambulatory care education are mentioned and strategies for overcoming the problems found are discussed.

  13. La Comisión Provincial de Monumentos de Murcia : precedentes y actuaciones (1835-1865

    Directory of Open Access Journals (Sweden)

    Joaquín Martínez Pino

    2006-01-01

    Full Text Available Recoge este artículo la labor desarrollada por la Comisión Provincial de Monumentos de Murcia desde su creación en 1844 hasta su reorganización en 1865. Procura este estudio también plasmar las actividades llevadas a cabo por la Comisión Científico Artística de Murcia, como organismo precedente de las Comisiones de Monumentos.This article puts forward the work developed by the Provincial Commission on Monuments of Murcia (Spain since it was created in 1844 until its reorganization in 1865. This research also tries to capture the activities carried out by the Scientific Artistic Commission of Murcia (Spain, as the predecessor of the Commission on Monuments.

  14. Evaluation and Estimation of the Provincial Infant Mortality Rate in China's Sixth Census.

    Science.gov (United States)

    Hu, Song Bo; Wang, Fang; Yu, Chuan Hua

    2015-06-01

    To assess the data quality and estimate the provincial infant mortality rate (1q0) from China's sixth census. A log-quadratic model is applied to under-fifteen data. We analyze and compare the average relative errors (AREs) for 1q0 between the estimated and reported values using the leave-one-out cross-validation method. For the sixth census, the AREs are more than 100% for almost all provinces. The estimated average 1q0 level for 31 provinces is 12.3‰ for males and 10.7‰ for females. The data for the provincial 1q0 from China's sixth census have a serious data quality problem. The actual levels of 1q0 for each province are significantly higher than the reported values. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  15. A General Provincial Situation Visualization System Based on iPhone Operating System of Shandong Province

    Science.gov (United States)

    Ye, Z.; Xiang, H.

    2014-04-01

    The paper discusses the basic principles and the problem solutions during the design and implementation of the mobile GIS system, and base on the research result, we developed the General Provincial Situation Visualization System Based on iOS of Shandong Province. The system is developed in the Objective-C programming language, and use the ArcGIS Runtime SDK for IOS as the development tool to call the "World-map Shandong" services to implement the development of the General Provincial Situation Visualization System Based on iOS devices. The system is currently available for download in the Appstore and is chosen as the typical application case of ESRI China ArcGIS API for iOS.

  16. Voter Education: Provincial Autonomy and the Transformation of Chinese Election Law, 1920–1923

    Directory of Open Access Journals (Sweden)

    Joshua Hill

    2013-06-01

    Full Text Available Beginning in 1909, mainland Chinese governments routinely held elections, and lawmakers devoted considerable resources to writing and revising election laws. The earliest elections, held under the late Qing and the early Republic, utilized laws based on restricted electorates and indirect voting. By contrast, election laws designed during the provincial autonomy movement of the 1920s and the post-1927 Nationalist government featured direct voting in elections with (near-universal adult suffrage. Each of these two systems of electoral law incorporated different elements of foreign electoral practice with concerns and ideas that arose from the experiences and ideals of late imperial Chinese political thought. The transition between these two systems highlights the surprising influence of the short-lived provincial autonomy movement on the legal structures of the centralized one-party states that followed.

  17. Represión en Sevilla: el tribunal de responsabilidades políticas. Fondo del Archivo Histórico Provincial de Sevilla (Repression in Seville: the court of political responsibilities. Fund of the Historical Provincial Archive of Seville)

    National Research Council Canada - National Science Library

    Rosa Félix, Antonio

    2013-01-01

    ... situación anterior a la reforma agraria.Abstract: The Historical Provincial Archive of Seville keeps a collection of files record of Political Responsibilities, proceeding from the Court of The First Instance and Sanlúcar's Instruction...

  18. Lessons Learned from the Implementation of a Provincial Breastfeeding Policy in Nova Scotia, Canada and the Implications for Childhood Obesity Prevention

    Directory of Open Access Journals (Sweden)

    Sara F. L. Kirk

    2012-04-01

    Full Text Available Healthy public