Medical rehabilitation in low and middle income countries for adult acquired disability: challenges posed by rapidity of health system change and position on the individualistic-collectivist axis

Directory of Open Access Journals (Sweden)

Karl Sandin

2015-01-01

Full Text Available Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions. While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid. As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values. While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism. The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.

Social Change and its Potential Impacts on Chinese Population Health

Directory of Open Access Journals (Sweden)

Wang, Hong

2004-12-01

Full Text Available Within the past 25 years, China has experienced transformation of its economic system from a highly centralized planned economy toward a market oriented economic system. This process has led to massive and rapid changes in all aspects of society with profound effects on the population’s health in the large parts of the country. Along with the material prosperity, the living conditions of Chinese people, such as food, shelter, and sanitation status, have been improving steadily. People have more capability to purchase health related merchandise as well as health services. Overall the health status of most Chinese has improved but there are significant exceptions to this overall conclusion. These exceptions arise from increasing inequity of income, increases in unemployment rates, the decline of health insurance coverage, changes in demography, changes in social value, culture, health related behaviors, and the changes of health care systems.

Smartphone Technology and Apps: Rapidly Changing Health Promotion

Science.gov (United States)

Kratzke, Cynthia; Cox, Carolyn

2012-01-01

Despite the increased availability of smartphones and health applications (apps), little is known about smartphone technology and apps for implementation in health promotion practice. Smartphones are mobile devices with capabilities for e-mail, text messaging, video viewing, and wireless Internet access. It is essential for health promotion…

Global environmental change: what can health care providers and the environmental health community do about it now?

Science.gov (United States)

Schwartz, Brian S; Parker, Cindy; Glass, Thomas A; Hu, Howard

2006-12-01

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.

Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?

Science.gov (United States)

Schwartz, Brian S.; Parker, Cindy; Glass, Thomas A.; Hu, Howard

2006-01-01

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations. PMID:17185267

Millennium Ecosystem Assessment: MA Rapid Land Cover Change

Data.gov (United States)

National Aeronautics and Space Administration — The Millennium Ecosystem Assessment: MA Rapid Land Cover Change provides data and information on global and regional land cover change in raster format for...

Climate Change and Developing-Country Cities: Implications For Environmental Health and Equity

OpenAIRE

Campbell-Lendrum, Diarmid; Corvalán, Carlos

2007-01-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilitie...

Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

Science.gov (United States)

Guha-Sapir, D

1991-01-01

The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the

Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

Science.gov (United States)

Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

2015-05-01

Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

Method for producing rapid pH changes

Science.gov (United States)

Clark, J.H.; Campillo, A.J.; Shapiro, S.L.; Winn, K.R.

A method of initiating a rapid pH change in a solution comprises irradiating the solution with an intense flux of electromagnetic radiation of a frequency which produces a substantial pK change to a compound in solution. To optimize the resulting pH change, the compound being irradiated in solution should have an excited state lifetime substantially longer than the time required to establish an excited state acid-base equilibrium in the solution. Desired pH changes can be accomplished in nanoseconds or less by means of picosecond pulses of laser radiation.

The role of employee assistance programs in the era of rapid change in the health care delivery system.

Science.gov (United States)

Sumerall, S W; Israel, A R; Brewer, R; Prew, R E

1999-01-01

With the rapid changes occurring in the American healthcare system, questions regarding various aspects of care have arisen. These changes have led to the need for individuals working within an Employee Assistance Program (EAP) to respond quickly and effectively to crisis situations. This article summarizes the different roles and responsibilities of EAP workers in the healthcare marketplace.

Long-term culture change related to rapid response system implementation.

Science.gov (United States)

Stevens, Jennifer; Johansson, Anna; Lennes, Inga; Hsu, Douglas; Tess, Anjala; Howell, Michael

2014-12-01

Increasing attention to patient safety in training hospitals may come at the expense of trainee autonomy and professional growth. This study sought to examine changes in medical trainees' self-reported behaviour after the institution-wide implementation of a rapid response system. We conducted a two-point cross-sectional survey of medical trainees in 2006, during the implementation of a rapid response system, and in 2010, in a single academic medical centre. A novel instrument was used to measure trainee likelihood of calling for supervisory assistance, perception of autonomy, and comfort in managing decompensating patients. Non-parametric tests to assess for change were used and year of training was evaluated as an effect modifier. Response rates were 38% in 2006 and 70% in 2010. After 5 years of the full implementation of the rapid response system, residents were significantly more likely to report calling their attending physicians for assistance (rising from 40% to 65% of relevant situations; p autonomy at 5 years after the implementation of the rapid response system. These changes were mirrored in the actual use of the rapid response system, which increased by 41% during the 5-year period after adjustment for patient volume (p < 0.0001). A primary team-focused implementation of a rapid response system was associated with durable changes in resident physicians' reported behaviour, including increased comfort with involving more experienced physicians and managing unstable patients. © 2014 John Wiley & Sons Ltd.

Rapid Health and Needs assessments after disasters: a systematic review

Directory of Open Access Journals (Sweden)

Yzermans CJ

2010-06-01

Full Text Available Abstract Background Publichealth care providers, stakeholders and policy makers request a rapid insight into health status and needs of the affected population after disasters. To our knowledge, there is no standardized rapid assessment tool for European countries. The aim of this article is to describe existing tools used internationally and analyze them for the development of a workable rapid assessment. Methods A review was conducted, including original studies concerning a rapid health and/or needs assessment. The studies used were published between 1980 and 2009. The electronic databasesof Medline, Embase, SciSearch and Psychinfo were used. Results Thirty-three studies were included for this review. The majority of the studies was of US origin and in most cases related to natural disasters, especially concerning the weather. In eighteen studies an assessment was conducted using a structured questionnaire, eleven studies used registries and four used both methods. Questionnaires were primarily used to asses the health needs, while data records were used to assess the health status of disaster victims. Conclusions Methods most commonly used were face to face interviews and data extracted from existing registries. Ideally, a rapid assessment tool is needed which does not add to the burden of disaster victims. In this perspective, the use of existing medical registries in combination with a brief questionnaire in the aftermath of disasters is the most promising. Since there is an increasing need for such a tool this approach needs further examination.

Behavioral Health Services in the Changing Landscape of Private Health Plans.

Science.gov (United States)

Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

2016-06-01

Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

Wage and Benefit Changes in Response to Rising Health Insurance Costs

OpenAIRE

Dana Goldman; Neeraj Sood; Arleen Leibowitz

2005-01-01

Many companies have defined-contribution benefit plans requiring employees to pay the full cost (before taxes) of more generous health insurance choices. Research has shown that employee decisions are quite responsive to these arrangements. What is less clear is how the total compensation package changes when health insurance premiums rise. This paper examines employee compensation decisions during a three-year period when health insurance premiums were rising rapidly. The data come from a si...

Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action.

Science.gov (United States)

Bennett, Hayley; Jones, Rhys; Keating, Gay; Woodward, Alistair; Hales, Simon; Metcalfe, Scott

2014-11-28

Human-caused climate change poses an increasingly serious and urgent threat to health and health equity. Under all the climate projections reported in the recent Intergovernmental Panel on Climate Change assessment, New Zealand will experience direct impacts, biologically mediated impacts, and socially mediated impacts on health. These will disproportionately affect populations that already experience disadvantage and poorer health. Without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world will breach its carbon budget and may experience high levels of warming (land temperatures on average 4-7 degrees Celsius higher by 2100). This level of climate change would threaten the habitability of some parts of the world because of extreme weather, limits on working outdoors, and severely reduced food production. However, well-planned action to reduce greenhouse gas emissions could bring about substantial benefits to health, and help New Zealand tackle its costly burden of health inequity and chronic disease.

Adaptation to climate change in the Ontario public health sector

Directory of Open Access Journals (Sweden)

Paterson Jaclyn A

2012-06-01

Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

Adaptation to climate change in the Ontario public health sector

Science.gov (United States)

2012-01-01

Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

Mental health in the island nations of the Western Pacific: a rapid review of the literature.

Science.gov (United States)

Hunter, Ernest; Thusanth, Sneha; McCalman, Janya; Gopalkrishnan, Narayan

2015-12-01

The aim of the study was to identify mental-health-relevant literature accessible to policy makers and healthcare workers in the island nations of the Western Pacific. Material collated to support the inaugural Leadership in Mental Health: Island Nations course held in Cairns in May 2015 was used as the basis of a "rapid review". The rapid review considered 303 documents identified by a search carried out using James Cook University's OneSearch, Google Scholar, and the authors' knowledge. Search terms included mental health and the like, and terms with Pacific and current Pacific island country names. Findings were classified by region/country, year of release/publication, mental health issue addressed, peer-reviewed or grey literature, and type of study. Almost half of the findings had been released in the previous five years. However, only 36% were peer-reviewed publications and only 3.6% of the findings were intervention studies. There is limited easily accessible documentation to confidently direct practice or policies regarding which strategies are likely to be effective in responding to the high rates of mental ill-health experienced in the Pacific island nations, or to plan for increases as a consequence of rapid social and demographic changes that are transforming Pacific island societies. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

Science.gov (United States)

Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

2018-03-01

Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

Health impact assessment as an agent of policy change: improving the health impacts of the mayor of London's draft transport strategy.

Science.gov (United States)

Mindell, J; Sheridan, L; Joffe, M; Samson-Barry, H; Atkinson, S

2004-03-01

To increase the positive and mitigate the negative health impacts of the mayor's draft transport strategy for London. A rapid prospective health impact assessment (HIA) of the penultimate draft of the strategy, using a review commissioned by the regional director of public health; an appraisal of congestion charging; and a participatory workshop. Two audits of changes were performed to assess the impact on policy of the HIA process. Regional government policy development. Recommendations from the rapid HIA were fed back into the drafting process. Changes (a) between the penultimate draft and the draft for public consultation and (b) between that and the final mayoral strategy. The draft transport strategy published for consultation differed in a number of respects from the previous version. Almost all the recommendations from the HIA were incorporated into the final strategy. Significant changes included promoting sustainable travel plans for workplaces and schools; giving priority to infrastructure and services that benefit London's deprived communities; increased emphasis on promoting walking and cycling and reducing reliance on private cars; and a commitment to track the health impacts of the final strategy and its implementation. Specific additions included re-allocating road space. HIA was successful in influencing the transport strategy for London, resulting in several improvements from a health viewpoint. HIA is an effective method both for bringing about significant change in policy proposals and in increasing policy makers' understanding of determinants of health and hence in changing attitudes of policy makers.

Rapid Communication: seniority changing transitions in yrast states ...

Indian Academy of Sciences (India)

Bhoomika Maheshwari

2017-10-26

Oct 26, 2017 ... Rapid Communication: v = 2 seniority changing ... has been extensively used to understand various system- .... states. This understanding supports the previous inter- ..... Financial support from the Ministry of Human Resource.

Changes in male reproductive health and effects of endocrine disruptors in Scandinavian countries

Directory of Open Access Journals (Sweden)

Toppari Jorma

2002-01-01

Full Text Available Male reproductive health has deteriorated in many ways during the last decades. The incidence of testicular cancer has rapidly increased in Europe and European-derived populations. Sperm concentrations have declined and sperm motility and morphology have worsened in many areas. Both adverse trends have been shown to be associated with year of birth. Older birth cohorts have better reproductive health than the younger generations. Incidences of cryptorchidism and hypospadias have also increased according to several studies. The reasons for secular trends are unknown, but the rapid pace of the change points to environmental causes. Endocrine disrupting chemicals have been hypothesized to influence male reproductive health.

Earth as Humans’ Habitat: Global Climate Change and the Health of Populations

Directory of Open Access Journals (Sweden)

Anthony J McMichael

2014-01-01

Full Text Available Human-induced climate change, with such rapid and continuing global-scale warming, is historically unprecedented and signifies that human pressures on Earth’s life-supporting natural systems now exceed the planet’s bio-geo-capacity. The risks from climate change to health and survival in populations are diverse, as are the social and political ramifications. Although attributing observed health changes in a population to the recent climatic change is difficult, a coherent pattern of climate- and weather-associated changes is now evident in many regions of the world. The risks impinge unevenly, especially on poorer and vulnerable regions, and are amplified by pre-existing high rates of climate-sensitive diseases and conditions. If, as now appears likely, the world warms by 3-5oC by 2100, the health consequences, directly and via massive social and economic disruption, will be severe. The health sector has an important message to convey, comparing the health risks and benefits of enlightened action to avert climate change and to achieve sustainable ways of living versus the self-interested or complacent inaction.

Earth as humans’ habitat: global climate change and the health of populations

Science.gov (United States)

McMichael, Anthony J

2014-01-01

Human-induced climate change, with such rapid and continuing global-scale warming, is historically unprecedented and signifies that human pressures on Earth’s life-supporting natural systems now exceed the planet’s bio-geo-capacity. The risks from climate change to health and survival in populations are diverse, as are the social and political ramifications. Although attributing observed health changes in a population to the recent climatic change is difficult, a coherent pattern of climate- and weather-associated changes is now evident in many regions of the world. The risks impinge unevenly, especially on poorer and vulnerable regions, and are amplified by pre-existing high rates of climate-sensitive diseases and conditions. If, as now appears likely, the world warms by 3-5oC by 2100, the health consequences, directly and via massive social and economic disruption, will be severe. The health sector has an important message to convey, comparing the health risks and benefits of enlightened action to avert climate change and to achieve sustainable ways of living versus the self-interested or complacent inaction. PMID:24596901

'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

Science.gov (United States)

Harper, S L; Edge, V L; Cunsolo Willox, A

2012-03-01

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

Climate change, human health, and epidemiological transition.

Science.gov (United States)

Barrett, Bruce; Charles, Joel W; Temte, Jonathan L

2015-01-01

The health of populations depends on the availability of clean air, water, food, and sanitation, exposure to pathogens, toxins and environmental hazards, and numerous genetic, behavioral and social factors. For many thousands of years, human life expectancy was low, and population growth was slow. The development of technology-based civilizations facilitated what Abdel Omran called "epidemiological transition," with increasing life expectancy and rapid population growth. To a large extent, the spectacular growth of human populations during the past two centuries was made possible by the energy extracted from fossil fuels. We have now learned, however, that greenhouse gases from fossil fuel combustion are warming the planet's surface, causing changes in oceanic and atmospheric systems, and disrupting weather and hydrological patterns. Climate change poses unprecedented threats to human health by impacts on food and water security, heat waves and droughts, violent storms, infectious disease, and rising sea levels. Whether or not humanity can reduce greenhouse gas emissions quickly enough to slow climate change to a rate that will allow societies to successfully adapt is not yet known. This essay reviews the current state of relevant knowledge, and points in a few directions that those interested in human health may wish to consider. Copyright © 2014 Elsevier Inc. All rights reserved.

Major rapid weight loss induces changes in cardiac repolarization

DEFF Research Database (Denmark)

Vedel-Larsen, Esben; Iepsen, Eva Winning; Lundgren, Julie

2016-01-01

INTRODUCTION: Obesity is associated with increased all-cause mortality, but weight loss may not decrease cardiovascular events. In fact, very low calorie diets have been linked to arrhythmias and sudden death. The QT interval is the standard marker for cardiac repolarization, but T-wave morphology...... analysis has been suggested as a more sensitive method to identify changes in cardiac repolarization. We examined the effect of a major and rapid weight loss on T-wave morphology. METHODS AND RESULTS: Twenty-six individuals had electrocardiograms (ECG) taken before and after eight weeks of weight loss......A1c (pweight loss induces changes in cardiac repolarization. Monitoring of MCS during calorie restriction makes it possible to detect repolarization changes with higher discriminative power than the QT-interval during major rapid weight...

The Rapid Ice Sheet Change Observatory (RISCO)

Science.gov (United States)

Morin, P.; Howat, I. M.; Ahn, Y.; Porter, C.; McFadden, E. M.

2010-12-01

The recent expansion of observational capacity from space has revealed dramatic, rapid changes in the Earth’s ice cover. These discoveries have fundamentally altered how scientists view ice-sheet change. Instead of just slow changes in snow accumulation and melting over centuries or millennia, important changes can occur in sudden events lasting only months, weeks, or even a single day. Our understanding of these short time- and space-scale processes, which hold important implications for future global sea level rise, has been impeded by the low temporal and spatial resolution, delayed sensor tasking, incomplete coverage, inaccessibility and/or high cost of data available to investigators. New cross-agency partnerships and data access policies provide the opportunity to dramatically improve the resolution of ice sheet observations by an order of magnitude, from timescales of months and distances of 10’s of meters, to days and meters or less. Advances in image processing technology also enable application of currently under-utilized datasets. The infrastructure for systematically gathering, processing, analyzing and distributing these data does not currently exist. Here we present the development of a multi-institutional, multi-platform observatory for rapid ice change with the ultimate objective of helping to elucidate the relevant timescales and processes of ice sheet dynamics and response to climate change. The Rapid Ice Sheet Observatory (RISCO) gathers observations of short time- and space-scale Cryosphere events and makes them easily accessible to investigators, media and general public. As opposed to existing data centers, which are structured to archive and distribute diverse types of raw data to end users with the specialized software and skills to analyze them, RISCO focuses on three types of geo-referenced raster (image) data products in a format immediately viewable with commonly available software. These three products are (1) sequences of images

Scoping the proximal and distal dimensions of climate change on health and wellbeing.

Science.gov (United States)

Morris, George Paterson; Reis, Stefan; Beck, Sheila Anne; Fleming, Lora Elderkin; Adger, William Neil; Benton, Timothy Guy; Depledge, Michael Harold

2017-12-05

The impacts of climate on health and wellbeing occur in time and space and through a range of indirect, complicated mechanisms. This diversity of pathways has major implications for national public health planning and influence on interventions that might help to mitigate and adapt to rapidly changing environmental conditions, nationally and internationally. This paper draws upon evidence from public health and adverse impact studies across climate science, hydrology, agriculture, public health, and the social sciences. It presents a conceptual model to support decision-making by recognizing both the proximal and distal pathways from climate-induced environmental change to national health and wellbeing. The proximal and distal pathways associated with food security, migration and mobility illustrate the diverse climate change influences in different geographic locations over different timescales. We argue that greater realization and articulation of proximal and distal pathways should radically alter how climate change is addressed as a national and international public health challenge.

Ecosystem stewardship: sustainability strategies for a rapidly changing planet

Science.gov (United States)

F. Stuart Chapin; Stephen R. Carpenter; Gary P. Kofinas; Carl Folke; Nick Abel; William C. Clark; Per Olsson; D. Mark Stafford Smith; Brian Walker; Oran R. Young; Fikret Berkes; Reinette Biggs; J. Morgan Grove; Rosamond L. Naylor; Evelyn Pinkerton; Will Steffen; Frederick J. Swanson

2010-01-01

Ecosystem stewardship is an action-oriented framework intended to foster the social-ecological sustainability of a rapidly changing planet. Recent developments identify three strategies that make optimal use of current understanding in an environment of inevitable uncertainty and abrupt change: reducing the magnitude of, and exposure and sensitivity to, known stresses...

How well does climate change and human health research match the demands of policymakers? A scoping review.

Science.gov (United States)

Hosking, Jamie; Campbell-Lendrum, Diarmid

2012-08-01

In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help

Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy.

Science.gov (United States)

Moulton, Anthony Drummond; Schramm, Paul John

Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.

Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy

Science.gov (United States)

Moulton, Anthony Drummond; Schramm, Paul John

2017-01-01

Context Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Objective Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Methods Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Findings Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. Conclusions A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic

Forest health in a changing world.

Science.gov (United States)

Pautasso, Marco; Schlegel, Markus; Holdenrieder, Ottmar

2015-05-01

Forest pathology, the science of forest health and tree diseases, is operating in a rapidly developing environment. Most importantly, global trade and climate change are increasing the threat to forest ecosystems posed by new diseases. Various studies relevant to forest pathology in a changing world are accumulating, thus making it necessary to provide an update of recent literature. In this contribution, we summarize research at the interface between forest pathology and landscape ecology, biogeography, global change science and research on tree endophytes. Regional outbreaks of tree diseases are requiring interdisciplinary collaboration, e.g. between forest pathologists and landscape ecologists. When tree pathogens are widely distributed, the factors determining their broad-scale distribution can be studied using a biogeographic approach. Global change, the combination of climate and land use change, increased pollution, trade and urbanization, as well as invasive species, will influence the effects of forest disturbances such as wildfires, droughts, storms, diseases and insect outbreaks, thus affecting the health and resilience of forest ecosystems worldwide. Tree endophytes can contribute to biological control of infectious diseases, enhance tolerance to environmental stress or behave as opportunistic weak pathogens potentially competing with more harmful ones. New molecular techniques are available for studying the complete tree endobiome under the influence of global change stressors from the landscape to the intercontinental level. Given that exotic tree diseases have both ecologic and economic consequences, we call for increased interdisciplinary collaboration in the coming decades between forest pathologists and researchers studying endophytes with tree geneticists, evolutionary and landscape ecologists, biogeographers, conservation biologists and global change scientists and outline interdisciplinary research gaps.

Perceptual classification in a rapidly-changing environment

OpenAIRE

Summerfield, Christopher; Behrens, Timothy E.; Koechlin, Etienne

2011-01-01

Humans and monkeys can learn to classify perceptual information in a statistically optimal fashion if the functional groupings remain stable over many hundreds of trials, but little is known about categorisation when the environment changes rapidly. Here, we used a combination of computational modelling and functional neuroimaging to understand how humans classify visual stimuli drawn from categories whose mean and variance jumped unpredictably. Models based on optimal learning (Bayesian mode...

Rethinking species’ ability to cope with rapid climate change

DEFF Research Database (Denmark)

Hof, Christian; Levinsky, Irina; Bastos Araujo, Miguel

2011-01-01

Ongoing climate change is assumed to be exceptional because of its unprecedented velocity. However, new geophysical research suggests that dramatic climatic changes during the Late Pleistocene occurred extremely rapid, over just a few years. These abrupt climatic changes may have been even faster...... than contemporary ones, but relatively few continent-wide extinctions of species have been documented for these periods. This raises questions about the ability of extant species to adapt to ongoing climate change. We propose that the advances in geophysical research challenge current views about...... species' ability to cope with climate change, and that lessons must be learned for modelling future impacts of climate change on species....

Rapidly changing treatment options adding burden to the management of typhoid fever

Directory of Open Access Journals (Sweden)

Jaspal Kaur

2015-01-01

Full Text Available Typhoid fever continues to be a global public health problem. It is caused by the facultative intracellular organisms Salmonella enteric serotype Typhi and Salmonella paratyphi. Antimicrobial therapy is the mainstay for treatment of typhoid fever. Chloramphenicol, ampicillin, and cotrimoxazole had been in use for decades for treating enteric fever. But the emergence and rapid spread of drug resistance has resulted in rapid shift of treatment options from chloramphenicol to fluoroquinolones to third generation cephalosporins to azithromycin with tigecycline and carbapenems in line, thus adding burden to the health-care sector in developing countries. Rational and judicious antibiotic prescribing practices by health professionals are necessary to prevent further development of drug resistance and help in re-emergence of sensitive strains.

On being a scientist in a rapidly changing world.

Science.gov (United States)

Mandel, I D

1996-02-01

The practice of biological science has changed dramatically since mid-century, reshaped not only by a rapid series of landmark discoveries, but also by governmental directives, institutional policies, and public attitudes. Until 1964, the major influences were the mentor, who provided direction and indoctrination into the culture of science, and in dentistry, the newly established NIDR, which fueled the research engine with an expanding research and training program. The 1965-74 period witnessed the advent of the Institutional Review Board, an increased social involvement of biological scientists, and a recognition of the need for biological and physical safeguards in the conduct of research. The most turbulent years were 1975-89, when there was a confluence of animal rights activism and regulation, growing concerns with scientific fraud and publication malpractice, and the stresses and strains (and opportunities) resulting from the rapid expansion of the academic-industrial complex. The current period is characterized by rapid pace, high volume, and an increased depth and breadth of knowledge-a major change in scale in the conduct of science. It is an exciting time but one in which ethical issues are multiplying. Attention must be paid.

Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements.

Science.gov (United States)

Moyad, Mark A

2011-08-01

Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.

Rapid gene expression changes in peripheral blood lymphocytes upon practice of a comprehensive yoga program.

Directory of Open Access Journals (Sweden)

Su Qu

Full Text Available One of the most common integrative medicine (IM modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices--SK&P compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.

Designing serious video games for health behavior change: current status and future directions.

Science.gov (United States)

Thompson, Debbe

2012-07-01

Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player's knowledge and skill, ways in which personal mastery experiences can be incorporated into a video game environment, using game characters and avatars to promote observational learning, creating personalized experiences through tailoring, and the importance of achieving a balance between "fun-ness" and "seriousness." The article concludes with suggestions for future research needed to inform this rapidly growing field. © 2012 Diabetes Technology Society.

Miles to go before we sleep: education, technology, and the changing paradigms in health information.

Science.gov (United States)

Cleveland, Ana D

2011-01-01

This lecture discusses a philosophy of educating health information professionals in a rapidly changing health care and information environment. Education for health information professionals must be based upon a solid foundation of the changing paradigms and trends in health care and health information, as well as technological advances, to produce a well-prepared information workforce to meet the demands of health-related environments. Educational programs should begin with the core principles of library and information sciences and expand in interdisciplinary collaborations. A model of the health care environment is presented to serve as a framework for developing educational programs for health information professionals. Interdisciplinary and collaborative relationships-which merge health care, library and information sciences, and other information-related disciplines-should form the basis of education for health information professionals.

The Relation of Rapid Changes in Obesity Measures to Lipid Profile - Insights from a Nationwide Metabolic Health Survey in 444 Polish Cities

Science.gov (United States)

Kaess, Bernhard M.; Jóźwiak, Jacek; Nelson, Christopher P.; Lukas, Witold; Mastej, Mirosław; Windak, Adam; Tomasik, Tomasz; Grzeszczak, Władysław; Tykarski, Andrzej; Gąsowski, Jerzy; Ślęzak-Prochazka, Izabella; Ślęzak, Andrzej; Charchar, Fadi J.; Sattar, Naveed; Thompson, John R.; Samani, Nilesh J.; Tomaszewski, Maciej

2014-01-01

Objective The impact of fast changes in obesity indices on other measures of metabolic health is poorly defined in the general population. Using the Polish accession to the European Union as a model of political and social transformation we examined how an expected rapid increase in body mass index (BMI) and waist circumference relates to changes in lipid profile, both at the population and personal level. Methods Through primary care centres in 444 Polish cities, two cross-sectional nationwide population-based surveys (LIPIDOGRAM 2004 and LIPIDOGRAM 2006) examined 15,404 and 15,453 adult individuals in 2004 and 2006, respectively. A separate prospective sample of 1,840 individuals recruited in 2004 had a follow-up in 2006 (LIPIDOGRAM PLUS). Results Two years after Polish accession to European Union, mean population BMI and waist circumference increased by 0.6% and 0.9%, respectively. This tracked with a 7.6% drop in HDL-cholesterol and a 2.1% increase in triglycerides (all p<0.001) nationwide. The direction and magnitude of the population changes were replicated at the personal level in LIPIDOGRAM PLUS (0.7%, 0.3%, 8.6% and 1.8%, respectively). However, increases in BMI and waist circumference were both only weakly associated with HDL-cholesterol and triglycerides changes prospectively. The relation of BMI to the magnitude of change in both lipid fractions was comparable to that of waist circumference. Conclusions Moderate changes in obesity measures tracked with a significant deterioration in measures of pro-atherogenic dyslipidaemia at both personal and population level. These associations were predominantly driven by factors not measureable directly through either BMI or waist circumference. PMID:24497983

Strengthening health professions regulation in Cambodia: a rapid assessment.

Science.gov (United States)

Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

2016-03-10

This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

Equity in health in unequal societies: meeting health needs in contexts of social change.

Science.gov (United States)

Bloom, G

2001-09-01

The paper explores the implications for health policy of the segmentation of society into social groups with very different levels of income and wealth. Discourses on equity in health are presently dominated by a debate between 'European' and 'American' models of health delivery. This has led to a focus on ideal outcomes rather than practical options for organising and financing health services in poor countries undergoing rapid change. The paper argues for a more explicit acknowledgement of the dynamic character of health development and the political nature of the negotiations regarding the use of government powers. Unregulated markets for health care are neither equitable nor efficient. Government must play a role in supporting the organisation of health services used by different social groups. Countries with low levels of inequality may be able to provide universal access to relatively sophisticated health services. Otherwise, governments need to operate within a segmented system. This means the negotiation of strategies to reduce the burden of sickness and premature death, whilst meeting the needs of different social groups. The discussion is organised in terms of the powers of government to require individuals and institutions to transfer resources for social uses, enforce regulations and generate and disseminate information. The paper concludes that governments committed to equity-enhancing health development need to increase their capacity to facilitate coalition building and manage change. It proposes an international public health legal framework that might include a definition of minimum standards for certain health services, to be underwritten by national and international financial commitments.

Rapid changes in the range limits of Scots pine 4000 years ago

International Nuclear Information System (INIS)

Gear, A.J.; Huntley, B.

1991-01-01

Paleoecological data provide estimates of response rates to past climate changes. Fossil Pinus sylvestris stumps in far northern Scotland demonstrate former presence of pine trees where conventional pollen evidence of pine forests is lacking. Radiocarbon, dendrochronological, and fine temporal-resolution palynological data show that pine forest were present for about four centuries some 4,000 years ago; the forests expanded and then retreated rapidly some 70 to 80 kilometers. Despite the rapidity of this response to climate change, it occurred at rates slower by an order of magnitude than those necessary to maintain equilibrium with forecast climate changes attributed to the greenhouse effect

Ambient air pollution, climate change, and population health in China.

Science.gov (United States)

Kan, Haidong; Chen, Renjie; Tong, Shilu

2012-07-01

As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency. Copyright © 2011 Elsevier Ltd. All rights reserved.

Health Effects of Climate Change (Environmental Health Student Portal)

Science.gov (United States)

... change can affect your health. Read About It Climate Change and Human Health (Public Broadcasting Services (including their teacher resources)) - Web ... Health Sciences) - Overview of the potential effects of climate change on human health. Climate and Health Program: Health Effects (Centers for ...

Rapid Change Detection Algorithm for Disaster Management

Science.gov (United States)

Michel, U.; Thunig, H.; Ehlers, M.; Reinartz, P.

2012-07-01

This paper focuses on change detection applications in areas where catastrophic events took place which resulted in rapid destruction especially of manmade objects. Standard methods for automated change detection prove not to be sufficient; therefore a new method was developed and tested. The presented method allows a fast detection and visualization of change in areas of crisis or catastrophes. While often new methods of remote sensing are developed without user oriented aspects, organizations and authorities are not able to use these methods because of absence of remote sensing know how. Therefore a semi-automated procedure was developed. Within a transferable framework, the developed algorithm can be implemented for a set of remote sensing data among different investigation areas. Several case studies are the base for the retrieved results. Within a coarse dividing into statistical parts and the segmentation in meaningful objects, the framework is able to deal with different types of change. By means of an elaborated Temporal Change Index (TCI) only panchromatic datasets are used to extract areas which are destroyed, areas which were not affected and in addition areas where rebuilding has already started.

Applying social marketing in health care: communicating evidence to change consumer behavior.

Science.gov (United States)

Evans, W Douglas; McCormack, Lauren

2008-01-01

Social marketing uses commercial marketing strategies to change individual and organizational behavior and policies. It has been effective on a population level across a wide range of public health and health care domains. There is limited evidence of the effectiveness of social marketing in changing health care consumer behavior through its impact on patient-provider interaction or provider behavior. Social marketers need to identify translatable strategies (e.g., competition analysis, branding, and tailored messages) that can be applied to health care provider and consumer behavior. Three case studies from social marketing illustrate potential strategies to change provider and consumer behavior. Countermarketing is a rapidly growing social marketing strategy that has been effective in tobacco control and may be effective in countering pharmaceutical marketing using specific message strategies. Informed decision making is a useful strategy when there is medical uncertainty, such as in prostate cancer screening and treatment. Pharmaceutical industry marketing practices offer valuable lessons for developing competing messages to reach providers and consumers. Social marketing is an effective population-based behavior change strategy that can be applied in individual clinical settings and as a complement to reinforce messages communicated on a population level. There is a need for more research on message strategies that work in health care and population-level effectiveness studies.

Public Health Adaptation to Climate Change in Large Cities: A Global Baseline.

Science.gov (United States)

Araos, Malcolm; Austin, Stephanie E; Berrang-Ford, Lea; Ford, James D

2016-01-01

Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation. © The Author(s) 2015.

Rapid change of field line connectivity and reconnection in stochastic magnetic fields

International Nuclear Information System (INIS)

Huang, Yi-Min; Bhattacharjee, A.; Boozer, Allen H.

2014-01-01

Magnetic fields without a direction of continuous symmetry have the generic feature that neighboring field lines exponentiate away from each other and become stochastic, and hence the ideal constraint of preserving magnetic field line connectivity becomes exponentially sensitive to small deviations from ideal Ohm's law. The idea of breaking field line connectivity by stochasticity as a mechanism for fast reconnection is tested with numerical simulations based on reduced magnetohydrodynamics equations with a strong guide field line-tied to two perfectly conducting end plates. Starting from an ideally stable force-free equilibrium, the system is allowed to undergo resistive relaxation. Two distinct phases are found in the process of resistive relaxation. During the quasi-static phase, rapid change of field line connectivity and strong induced flow are found in regions of high field line exponentiation. However, although the field line connectivity of individual field lines can change rapidly, the overall pattern of field line mapping appears to deform gradually. From this perspective, field line exponentiation appears to cause enhanced diffusion rather than reconnection. In some cases, resistive quasi-static evolution can cause the ideally stable initial equilibrium to cross a stability threshold, leading to formation of intense current filaments and rapid change of field line mapping into a qualitatively different pattern. It is in this onset phase that the change of field line connectivity is more appropriately designated as magnetic reconnection. Our results show that rapid change of field line connectivity appears to be a necessary, but not a sufficient condition for fast reconnection.

Preferred ecosystem characteristics: their food and health relevance to China's rapid urbanisation.

Science.gov (United States)

Gibson, Valerie; Zhu, Yong-Guan; Ge, Rubing; Wahlqvist, Mark L

2015-01-01

For most of its history, China has supported a growing population through food systems which have been mutually inclusive of people and their locality. This trajectory has required adequate ecosystem maintenance or humanised reformulation and a high degree of recyclable nutrient flow. The 'tipping point' in habitat sustainability has come with the size and demographic structure of China's population to one that is ageing, with modernisation of its infrastructure and increased expectations of better livelihoods, standards of living and health. In order to meet these expectations, China has embarked on rapid urbanisation for upwards of 300 million people over the next 15-20 years and to do so taking account of the environmental limitations. The process will radically change rural as well as urban China and the systems which connect them. Chief among these will be ecosystems in number and type along with the food and health systems integral to them. To minimise ecological damage and optimise the benefits to people and place, describing, monitoring and managing the process will be paramount. The present paper is a situational analysis of health as it may be ecologically favoured or disordered (Ecosystem Health Disorders) and of the food systems on which the environment and health depend. An effort is made to enumerate the current situation in China in a way that might enable the optimisation of humanised ecosystems.

Indigenous people's detection of rapid ecological change.

Science.gov (United States)

Aswani, Shankar; Lauer, Matthew

2014-06-01

When sudden catastrophic events occur, it becomes critical for coastal communities to detect and respond to environmental transformations because failure to do so may undermine overall ecosystem resilience and threaten people's livelihoods. We therefore asked how capable of detecting rapid ecological change following massive environmental disruptions local, indigenous people are. We assessed the direction and periodicity of experimental learning of people in the Western Solomon Islands after a tsunami in 2007. We compared the results of marine science surveys with local ecological knowledge of the benthos across 3 affected villages and 3 periods before and after the tsunami. We sought to determine how people recognize biophysical changes in the environment before and after catastrophic events such as earthquakes and tsunamis and whether people have the ability to detect ecological changes over short time scales or need longer time scales to recognize changes. Indigenous people were able to detect changes in the benthos over time. Detection levels differed between marine science surveys and local ecological knowledge sources over time, but overall patterns of statistically significant detection of change were evident for various habitats. Our findings have implications for marine conservation, coastal management policies, and disaster-relief efforts because when people are able to detect ecological changes, this, in turn, affects how they exploit and manage their marine resources. © 2014 Society for Conservation Biology.

Middle Holocene rapid environmental changes and human adaptation in Greece

Science.gov (United States)

Lespez, Laurent; Glais, Arthur; Lopez-Saez, José-Antonio; Le Drezen, Yann; Tsirtsoni, Zoï; Davidson, Robert; Biree, Laetitia; Malamidou, Dimitra

2016-03-01

Numerous researchers discuss of the collapse of civilizations in response to abrupt climate change in the Mediterranean region. The period between 6500 and 5000 cal yr BP is one of the least studied episodes of rapid climate change at the end of the Late Neolithic. This period is characterized by a dramatic decline in settlement and a cultural break in the Balkans. High-resolution paleoenvironmental proxy data obtained in the Lower Angitis Valley enables an examination of the societal responses to rapid climatic change in Greece. Development of a lasting fluvio-lacustrine environment followed by enhanced fluvial activity is evident from 6000 cal yr BP. Paleoecological data show a succession of dry events at 5800-5700, 5450 and 5000-4900 cal yr BP. These events correspond to incursion of cold air masses to the eastern Mediterranean, confirming the climatic instability of the middle Holocene climate transition. Two periods with farming and pastural activities (6300-5600 and 5100-4700 cal BP) are evident. The intervening period is marked by environmental changes, but the continuous occurrence of anthropogenic taxa suggests the persistence of human activities despite the absence of archaeological evidence. The environmental factors alone were not sufficient to trigger the observed societal changes.

Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

Science.gov (United States)

Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

2018-01-01

Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

The Chinese experience of rapid modernization: sociocultural changes, psychological consequences?

Directory of Open Access Journals (Sweden)

Jiahong eSun

2016-04-01

Full Text Available Mainland China has undergone profound changes dating back to the nineteenth century, including a contemporary period of rapid modernization that began in the 1980s. The result has been dramatic social, cultural, and economic shifts impacting the daily lives of Chinese people. In this paper, we explore the psychological implications of sociocultural transformation in China, emphasizing two central themes. First, rising individualism: findings from social and developmental psychology suggest that China’s rapid development has been accompanied by ever-increasing adherence to individualistic values. Second, rising rates of depression: findings from psychiatric epidemiology point to increasing prevalence of depression over this same time period, particularly in rural settings. We argue that links between sociocultural and psychological shifts in China can be usefully studied through a cultural psychology lens, emphasizing the mutual constitution of culture, mind, and brain. In particular, we note that the link between social change, individualism, and rising mental illness deserves careful attention. Our review suggests that shifting values and socialization practices shape emotion norms of concealment and display, with implications for depressive symptom presentation. The challenge comes with interpretation. Increasing prevalence rates of depression may indeed be a general response to the rapidity of sociocultural change, or a specific consequence of rising individualism—but may also result from increasingly ‘Western’ patterns of symptom presentation, or improvements in diagnostic practice. We conclude by considering the challenges posed to standard universal models of psychological phenomena.

The Chinese Experience of Rapid Modernization: Sociocultural Changes, Psychological Consequences?

Science.gov (United States)

Sun, Jiahong; Ryder, Andrew G.

2016-01-01

Mainland China has undergone profound changes dating back to the nineteenth century, including a contemporary period of rapid modernization that began in the 1980s. The result has been dramatic social, cultural, and economic shifts impacting the daily lives of Chinese people. In this paper, we explore the psychological implications of sociocultural transformation in China, emphasizing two central themes. First, rising individualism: findings from social and developmental psychology suggest that China’s rapid development has been accompanied by ever-increasing adherence to individualistic values. Second, rising rates of depression: findings from psychiatric epidemiology point to increasing prevalence of depression over this same time period, particularly in rural settings. We argue that links between sociocultural and psychological shifts in China can be usefully studied through a cultural psychology lens, emphasizing the mutual constitution of culture, mind, and brain. In particular, we note that the link between social change, individualism, and rising mental illness deserves careful attention. Our review suggests that shifting values and socialization practices shape emotion norms of concealment and display, with implications for depressive symptom presentation. The challenge comes with interpretation. Increasing prevalence rates of depression may indeed be a general response to the rapidity of sociocultural change, or a specific consequence of rising individualism—but may also result from increasingly ‘Western’ patterns of symptom presentation, or improvements in diagnostic practice. We conclude by considering the challenges posed to standard universal models of psychological phenomena. PMID:27092093

The role of the public health nurse in a changing society.

Science.gov (United States)

Nic Philibin, Caitriona Aine; Griffiths, Colin; Byrne, Gobnait; Horan, Paul; Brady, Anne-Marie; Begley, Cecily

2010-04-01

This study is a report of a study to clarify the role of the public health nurse in one Irish community care area in the light of acknowledged problems in defining boundaries of the role. Demographic developments and planned reorientation towards primary care of the health service in Ireland have changed the workload of public health nurses, which is unique compared with other countries. However, there is a lack of clarity and consequent problems in defining the role of the Irish public health nurse. A descriptive qualitative study was conducted with 25 representatives of community nursing from one county in Ireland with a population of 209,077 and a complement of 65 full-time equivalent public health nurses. Purposive sampling was used and 21 public health nurses, two registered general nurses, one assistant director and one school nurse participated. Tape-recorded, individual semi-structured interviews were conducted over a 15-month period from 2002 to 2004. The constant comparative method was used for analysis. Four themes emerged: 'Jack of all trades: the role of the public health nurse defined and described', 'the essence of the role', 'challenges to the role of the public health nurse' and 'communication'. The first theme is discussed in this paper. Public health nurses need to define and redesign their role so that they no longer think that they are the catch-all service in the community. This will enable them to deal with the rapid demographic, sociological and cultural changes in the population, a change that has international resonance.

Rapid ecosystem change challenges the adaptive capacity of Local Environmental Knowledge.

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Fernández-Llamazares, Álvaro; Díaz-Reviriego, Isabel; Luz, Ana C; Cabeza, Mar; Pyhälä, Aili; Reyes-García, Victoria

2015-03-01

The use of Local Environmental Knowledge has been considered as an important strategy for adaptive management in the face of Global Environmental Change. However, the unprecedented rates at which global change occurs may pose a challenge to the adaptive capacity of local knowledge systems. In this paper, we use the concept of the shifting baseline syndrome to examine the limits in the adaptive capacity of the local knowledge of an indigenous society facing rapid ecosystem change. We conducted semi-structured interviews regarding perceptions of change in wildlife populations and in intergenerational transmission of knowledge amongst the Tsimane', a group of hunter-gatherers of Bolivian Amazonia ( n = 300 adults in 13 villages). We found that the natural baseline against which the Tsimane' measure ecosystem changes might be shifting with every generation as a result of (a) age-related differences in the perception of change and (b) a decrease in the intergenerational sharing of environmental knowledge. Such findings suggest that local knowledge systems might not change at a rate quick enough to adapt to conditions of rapid ecosystem change, hence potentially compromising the adaptive success of the entire social-ecological system. With the current pace of Global Environmental Change, widening the gap between the temporal rates of on-going ecosystem change and the timescale needed for local knowledge systems to adjust to change, efforts to tackle the shifting baseline syndrome are urgent and critical for those who aim to use Local Environmental Knowledge as a tool for adaptive management.

Climate Change and Health

Science.gov (United States)

... Home / News / Fact sheets / Detail WHO /A. Craggs Climate change and health 1 February 2018 ","datePublished":"2018-02- ... in improved health, particularly through reduced air pollution. Climate change Over the last 50 years, human activities – particularly ...

Using Rapid Ethnography to Support the Design and Implementation of Health Information Technologies.

Science.gov (United States)

Ackerman, Sara; Gleason, Nathaniel; Gonzales, Ralph

2015-01-01

Ethnography is the defining practice - and art - of anthropology. Among health information technology (IT) developers, however, ethnography remains a little used and undervalued mode of inquiry and representation. In this chapter we demonstrate that ethnography can make important contributions to the design and implementation of more user-oriented health IT devices and systems. In particular, we propose 'rapid ethnography' as a pragmatic strategy that draws on classic ethnographic methods, but emphasizes shorter periods of fieldwork and quick turnaround of findings to inform (re)design, programming and implementation efforts. Rapid ethnography is theoretically and empirically situated in science and technology studies' explorations of a) the entanglement of social and technical dimensions of technology use; b) how getting tools to 'work' requires aligning interests across a wide range of human and non-human actors; and c) the ways in which humans and technology transform each other as they interact. We provide two detailed case studies to illustrate the evolution and uses of rapid ethnography at a U.S. academic medical center. By providing deeper insights into the experiences of users, and the contexts and communities in which new tools are introduced, rapid ethnography can serve as a valuable component of Techno-Anthropology and health IT innovation.

Climate change, air pollution and human health in Sydney, Australia: A review of the literature

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Dean, Annika; Green, Donna

2018-05-01

Sydney is Australia’s largest city and is growing rapidly. Although Sydney’s air quality is relatively good compared to the major cities in many industrialised countries, particulate matter (PM) and ozone (O3) occasionally exceed the national health standards and are the cause of premature mortalities and hospital admissions. Numerous studies from overseas (e.g. North America and continental Europe) suggest that climate change may impact air quality to the detriment of human health. There is limited knowledge about how climate change may impact air quality in Sydney. This study reviews the available literature on the impacts of climate change on air quality related health impacts in Sydney to identify knowledge and research gaps. Where no studies are available for Sydney, it draws on relevant studies from other Australian cities and overseas. Our findings summarise what is known about how climate change may impact air quality in Sydney and where research gaps exist. This approach can facilitate research agendas, policies and planning strategies that mitigate public health impacts and tackle climate change and air pollution in a coordinated way.

Changes in access to health care in China, 1989-1997.

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Akin, John S; Dow, William H; Lance, Peter M; Loh, Chung-Ping A

2005-03-01

The post-1979 period in China has seen the implementation of reforms that dismantled much of the Maoist era social welfare system and permitted a significant reallocation of society's resources. The result has been rapid but uneven economic development that has profoundly altered the environment within which consumers make health investment decisions. Many studies report significant and apparently non-random reductions in health care utilization during this period. Scholars have tended to focus on the loss of insurance coverage and the growth of fees for services in explaining such reductions. An alternative explanation is growing inequality in access to care. This possibility has not received much research attention. As a result, our understanding of the patterns of changes in health care access, and of the types of populations that have been most adversely affected, has been rather limited. This research examines the distribution of the changes in several indicators of access to health care across communities during the period 1989 to 1997. We find evidence of relatively uneven changes to these indicators. Money charges for routine services increased consistently, though this trend was less pronounced in lower-income communities. Most communities experienced reductions in travel distance to clinics but increases in distance to hospitals. There were major improvements to the quality of care in wealthier rural areas, but not in poorer villages. Wealthier villages experienced less improvement in waiting time and drug availability. These trends appear to be closely associated with changing economic circumstances during the reform era.

Does rapid urbanization aggravate health disparities? Reflections on the epidemiological transition in Pune, India

Directory of Open Access Journals (Sweden)

Mareike Kroll

2014-09-01

Full Text Available Background: Rapid urbanization in low- and middle-income countries reinforces risk and epidemiological transition in urban societies, which are characterized by high socioeconomic gradients. Limited availability of disaggregated morbidity data in these settings impedes research on epidemiological profiles of different population subgroups. Objective: The study aimed to analyze the epidemiological transition in the emerging megacity of Pune with respect to changing morbidity and mortality patterns, also taking into consideration health disparities among different socioeconomic groups. Design: A mixed-methods approach was used, comprising secondary analysis of mortality data, a survey among 900 households in six neighborhoods with different socioeconomic profiles, 46 in-depth interviews with laypeople, and expert interviews with 37 health care providers and 22 other health care workers. Results: The mortality data account for an epidemiological transition with an increasing number of deaths due to non-communicable diseases (NCDs in Pune. The share of deaths due to infectious and parasitic diseases remained nearly constant, though the cause of deaths changed considerably within this group. The survey data and expert interviews indicated a slightly higher prevalence of diabetes and hypertension among higher socioeconomic groups, but a higher incidence and more frequent complications and comorbidities in lower socioeconomic groups. Although the self-reported morbidity for malaria, gastroenteritis, and tuberculosis did not show a socioeconomic pattern, experts estimated the prevalence in lower socioeconomic groups to be higher, though all groups in Pune would be affected. Conclusions: The rising burden of NCDs among all socioeconomic groups and the concurrent persistence of communicable diseases pose a major challenge for public health. Improvement of urban health requires a stronger focus on health promotion and disease prevention for all

Climate change, conflict and health.

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Bowles, Devin C; Butler, Colin D; Morisetti, Neil

2015-10-01

Future climate change is predicted to diminish essential natural resource availability in many regions and perhaps globally. The resulting scarcity of water, food and livelihoods could lead to increasingly desperate populations that challenge governments, enhancing the risk of intra- and interstate conflict. Defence establishments and some political scientists view climate change as a potential threat to peace. While the medical literature increasingly recognises climate change as a fundamental health risk, the dimension of climate change-associated conflict has so far received little attention, despite its profound health implications. Many analysts link climate change with a heightened risk of conflict via causal pathways which involve diminishing or changing resource availability. Plausible consequences include: increased frequency of civil conflict in developing countries; terrorism, asymmetric warfare, state failure; and major regional conflicts. The medical understanding of these threats is inadequate, given the scale of health implications. The medical and public health communities have often been reluctant to interpret conflict as a health issue. However, at times, medical workers have proven powerful and effective peace advocates, most notably with regard to nuclear disarmament. The public is more motivated to mitigate climate change when it is framed as a health issue. Improved medical understanding of the association between climate change and conflict could strengthen mitigation efforts and increase cooperation to cope with the climate change that is now inevitable. © The Royal Society of Medicine.

Climate change and human health: a One Health approach.

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Patz, Jonathan A; Hahn, Micah B

2013-01-01

Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

Understanding rapid theoretical change in particle physics: a month-by-month co-citation analysis

International Nuclear Information System (INIS)

Sullivan, D.; Koester, D.; White, D.H.; Kern, R.

1979-01-01

While co-citation analysis has proved a powerful tool in the study of changes in intellectual foci in science, no one has ever used the technique to study very rapid changes in the theoretical structure of a scientific field. This paper presents month-by-month co-citation analyses of key phases in the weak-electromagnetic unification research program within particle physics, and shows that these analyses capture and illuminate very rapid intellectual changes. These data provide yet another illustration of the utility of co-citation analysis for understanding the history of science. 8 figures

Rapid area change in pitch-up manoeuvres of small perching birds.

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Polet, D T; Rival, D E

2015-10-26

Rapid pitch-up has been highlighted as a mechanism to generate large lift and drag during landing manoeuvres. However, pitching rates had not been measured previously in perching birds, and so the direct applicability of computations and experiments to observed behaviour was not known. We measure pitch rates in a small, wild bird (the black-capped chickadee; Poecile atricapillus), and show that these rates are within the parameter range used in experiments. Pitching rates were characterized by the shape change number, a metric comparing the rate of frontal area increase to acceleration. Black-capped chickadees increase the shape change number during perching in direct proportion to their total kinetic and potential energy at the start of the manoeuvre. The linear relationship between dissipated energy and shape change number is in accordance with a simple analytical model developed for two-dimensional pitching and decelerating airfoils. Black-capped chickadees use a wing pitch-up manoeuvre during perching to dissipate energy quickly while maintaining lift and drag through rapid area change. It is suggested that similar pitch-and-decelerate manoeuvres could be used to aid in the controlled, precise landings of small manoeuvrable air vehicles.

Climate change and One Health.

Science.gov (United States)

Zinsstag, Jakob; Crump, Lisa; Schelling, Esther; Hattendorf, Jan; Maidane, Yahya Osman; Ali, Kadra Osman; Muhummed, Abdifatah; Umer, Abdurezak Adem; Aliyi, Ferzua; Nooh, Faisal; Abdikadir, Mohammed Ibrahim; Ali, Seid Mohammed; Hartinger, Stella; Mäusezahl, Daniel; de White, Monica Berger Gonzalez; Cordon-Rosales, Celia; Castillo, Danilo Alvarez; McCracken, John; Abakar, Fayiz; Cercamondi, Colin; Emmenegger, Sandro; Maier, Edith; Karanja, Simon; Bolon, Isabelle; de Castañeda, Rafael Ruiz; Bonfoh, Bassirou; Tschopp, Rea; Probst-Hensch, Nicole; Cissé, Guéladio

2018-06-01

The journal The Lancet recently published a countdown on health and climate change. Attention was focused solely on humans. However, animals, including wildlife, livestock and pets, may also be impacted by climate change. Complementary to the high relevance of awareness rising for protecting humans against climate change, here we present a One Health approach, which aims at the simultaneous protection of humans, animals and the environment from climate change impacts (climate change adaptation). We postulate that integrated approaches save human and animal lives and reduce costs when compared to public and animal health sectors working separately. A One Health approach to climate change adaptation may significantly contribute to food security with emphasis on animal source foods, extensive livestock systems, particularly ruminant livestock, environmental sanitation, and steps towards regional and global integrated syndromic surveillance and response systems. The cost of outbreaks of emerging vector-borne zoonotic pathogens may be much lower if they are detected early in the vector or in livestock rather than later in humans. Therefore, integrated community-based surveillance of zoonoses is a promising avenue to reduce health effects of climate change.

Climate change and respiratory health.

Science.gov (United States)

Gerardi, Daniel A; Kellerman, Roy A

2014-10-01

To discuss the nature of climate change and both its immediate and long-term effects on human respiratory health. This review is based on information from a presentation of the American College of Chest Physicians course on Occupational and Environmental Lung Disease held in Toronto, Canada, June 2013. It is supplemented by a PubMed search for climate change, global warming, respiratory tract diseases, and respiratory health. It is also supplemented by a search of Web sites including the Environmental Protection Agency, National Oceanic and Atmospheric Administration, World Meteorological Association, National Snow and Ice Data Center, Carbon Dioxide Information Analysis Center, Inter-Governmental Panel on Climate Change, and the World Health Organization. Health effects of climate change include an increase in the prevalence of certain respiratory diseases, exacerbations of chronic lung disease, premature mortality, allergic responses, and declines in lung function. Climate change, mediated by greenhouse gases, causes adverse health effects to the most vulnerable patient populations-the elderly, children, and those in distressed socioeconomic strata.

Rapid Communication: v= 2 seniority changing transitions in yrast 3 ...

Indian Academy of Sciences (India)

Home; Journals; Pramana – Journal of Physics; Volume 89; Issue 5. Rapid Communication: Δ υ = 2 seniority changing transitions in yrast 3 − states and B ( E 3 ) systematics of Sn isotopes. BHOOMIKA MAHESHWARI SWATI GARG ASHOK KUMAR JAIN. Research Article Volume 89 Issue 5 November 2017 Article ID 75 ...

Climate change and ecological public health.

Science.gov (United States)

Goodman, Benny

2015-02-17

Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.

San Francisco Bay Area Rapid Transit District (BART) climate change adaptation assessment pilot.

Science.gov (United States)

2013-12-01

The objective of this pilot study was to evaluate the impacts of climate change on the San Francisco Bay Area Rapid Transit District : (BART) infrastructure and to develop and implement adaptation strategies against those impacts. Climate change haza...

Changing work, changing health: can real work-time flexibility promote health behaviors and well-being?

Science.gov (United States)

Moen, Phyllis; Kelly, Erin L; Tranby, Eric; Huang, Qinlei

2011-12-01

This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees' schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees' health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors.

Applying Lean principles and Kaizen rapid improvement events in public health practice.

Science.gov (United States)

Smith, Gene; Poteat-Godwin, Annah; Harrison, Lisa Macon; Randolph, Greg D

2012-01-01

This case study describes a local home health and hospice agency's effort to implement Lean principles and Kaizen methodology as a rapid improvement approach to quality improvement. The agency created a cross-functional team, followed Lean Kaizen methodology, and made significant improvements in scheduling time for home health nurses that resulted in reduced operational costs, improved working conditions, and multiple organizational efficiencies.

Neurogenomics and the role of a large mutational target on rapid behavioral change.

Science.gov (United States)

Stanley, Craig E; Kulathinal, Rob J

2016-11-08

Behavior, while complex and dynamic, is among the most diverse, derived, and rapidly evolving traits in animals. The highly labile nature of heritable behavioral change is observed in such evolutionary phenomena as the emergence of converged behaviors in domesticated animals, the rapid evolution of preferences, and the routine development of ethological isolation between diverging populations and species. In fact, it is believed that nervous system development and its potential to evolve a seemingly infinite array of behavioral innovations played a major role in the successful diversification of metazoans, including our own human lineage. However, unlike other rapidly evolving functional systems such as sperm-egg interactions and immune defense, the genetic basis of rapid behavioral change remains elusive. Here we propose that the rapid divergence and widespread novelty of innate and adaptive behavior is primarily a function of its genomic architecture. Specifically, we hypothesize that the broad diversity of behavioral phenotypes present at micro- and macroevolutionary scales is promoted by a disproportionately large mutational target of neurogenic genes. We present evidence that these large neuro-behavioral targets are significant and ubiquitous in animal genomes and suggest that behavior's novelty and rapid emergence are driven by a number of factors including more selection on a larger pool of variants, a greater role of phenotypic plasticity, and/or unique molecular features present in large genes. We briefly discuss the origins of these large neurogenic genes, as they relate to the remarkable diversity of metazoan behaviors, and highlight key consequences on both behavioral traits and neurogenic disease across, respectively, evolutionary and ontogenetic time scales. Current approaches to studying the genetic mechanisms underlying rapid phenotypic change primarily focus on identifying signatures of Darwinian selection in protein-coding regions. In contrast

Rapid changes in gene expression direct rapid shifts in intestinal form and function in the Burmese python after feeding.

Science.gov (United States)

Andrew, Audra L; Card, Daren C; Ruggiero, Robert P; Schield, Drew R; Adams, Richard H; Pollock, David D; Secor, Stephen M; Castoe, Todd A

2015-05-01

Snakes provide a unique and valuable model system for studying the extremes of physiological remodeling because of the ability of some species to rapidly upregulate organ form and function upon feeding. The predominant model species used to study such extreme responses has been the Burmese python because of the extreme nature of postfeeding response in this species. We analyzed the Burmese python intestine across a time series, before, during, and after feeding to understand the patterns and timing of changes in gene expression and their relationship to changes in intestinal form and function upon feeding. Our results indicate that >2,000 genes show significant changes in expression in the small intestine following feeding, including genes involved in intestinal morphology and function (e.g., hydrolases, microvillus proteins, trafficking and transport proteins), as well as genes involved in cell division and apoptosis. Extensive changes in gene expression occur surprisingly rapidly, within the first 6 h of feeding, coincide with changes in intestinal morphology, and effectively return to prefeeding levels within 10 days. Collectively, our results provide an unprecedented portrait of parallel changes in gene expression and intestinal morphology and physiology on a scale that is extreme both in the magnitude of changes, as well as in the incredibly short time frame of these changes, with up- and downregulation of expression and function occurring in the span of 10 days. Our results also identify conserved vertebrate signaling pathways that modulate these responses, which may suggest pathways for therapeutic modulation of intestinal function in humans. Copyright © 2015 the American Physiological Society.

THE ENVIRONMENTAL CHALLENGE AND HEALTH SECURITY IN CHINA

Directory of Open Access Journals (Sweden)

Wang Wuyi

2010-01-01

Full Text Available China has achieved impressive rapid development over the past 30 years. But China also faces the challenge of environmental change resulting from rapid economic growth and the attendant risks to human health. In this paper we described the environmental change and health risk in China from evident fluctuation of China’s climate, major changes in natural hydrological condition, raw materials and energy demand, changes of disease epidemic pattern related to climate change and ecosystem damage, new health risk raised by rapid urbanization and rural environmental quality degradation. The suggestion and countermeasures were discussed.

Climate Change Indicators: Health and Society

Science.gov (United States)

... chapter looks at some of the ways that climate change is affecting human health and society, including changes in Lyme disease, West ... health effects. Why does it matter? Changes in climate affect the ... to human health and welfare. Warmer average temperatures will likely lead ...

Changing Work, Changing Health: Can Real Work-Time Flexibility Promote Health Behaviors and Well-Being?

Science.gov (United States)

Moen, Phyllis; Kelly, Erin L.; Tranby, Eric; Huang, Qinlei

2012-01-01

This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees’ schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees’ health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors. PMID:22144731

New type of Piezoresistive Pressure Sensors for Environments with Rapidly Changing Temperature

Directory of Open Access Journals (Sweden)

Tykhan Myroslav

2017-03-01

Full Text Available The theoretical aspects of a new type of piezo-resistive pressure sensors for environments with rapidly changing temperatures are presented. The idea is that the sensor has two identical diaphragms which have different coefficients of linear thermal expansion. Therefore, when measuring pressure in environments with variable temperature, the diaphragms will have different deflection. This difference can be used to make appropriate correction of the sensor output signal and, thus, to increase accuracy of measurement. Since physical principles of sensors operation enable fast correction of the output signal, the sensor can be used in environments with rapidly changing temperature, which is its essential advantage. The paper presents practical implementation of the proposed theoretical aspects and the results of testing the developed sensor.

Curioser and Curioser: New Concepts in the Rapidly Changing Landscape of Educational Administration.

Science.gov (United States)

Fowler, Frances C.

1999-01-01

The new "Handbook" assumes that society is changing rapidly and educational administration must change with it. This article critiques chapters on four concepts: ideology, the new consumerism, social capital, and the new institutionalism. Consumerism is pure 19th-century liberalism/individualism; social capital theory and…

Rapid stress-induced transcriptomic changes in the brain depend on beta-adrenergic signaling.

Science.gov (United States)

Roszkowski, Martin; Manuella, Francesca; von Ziegler, Lukas; Durán-Pacheco, Gonzalo; Moreau, Jean-Luc; Mansuy, Isabelle M; Bohacek, Johannes

2016-08-01

Acute exposure to stressful experiences can rapidly increase anxiety and cause neuropsychiatric disorders. The effects of stress result in part from the release of neurotransmitters and hormones, which regulate gene expression in different brain regions. The fast neuroendocrine response to stress is largely mediated by norepinephrine (NE) and corticotropin releasing hormone (CRH), followed by a slower and more sustained release of corticosterone. While corticosterone is an important regulator of gene expression, it is not clear which stress-signals contribute to the rapid regulation of gene expression observed immediately after stress exposure. Here, we demonstrate in mice that 45 min after an acute swim stress challenge, large changes in gene expression occur across the transcriptome in the hippocampus, a region sensitive to the effects of stress. We identify multiple candidate genes that are rapidly and transiently altered in both males and females. Using a pharmacological approach, we show that most of these rapidly induced genes are regulated by NE through β-adrenergic receptor signaling. We find that CRH and corticosterone can also contribute to rapid changes in gene expression, although these effects appear to be restricted to fewer genes. These results newly reveal a widespread impact of NE on the transcriptome and identify novel genes associated with stress and adrenergic signaling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Climate Change, Health, and Communication: A Primer.

Science.gov (United States)

Chadwick, Amy E

2016-01-01

Climate change is one of the most serious and pervasive challenges facing us today. Our changing climate has implications not only for the ecosystems upon which we depend, but also for human health. Health communication scholars are well-positioned to aid in the mitigation of and response to climate change and its health effects. To help theorists, researchers, and practitioners engage in these efforts, this primer explains relevant issues and vocabulary associated with climate change and its impacts on health. First, this primer provides an overview of climate change, its causes and consequences, and its impacts on health. Then, the primer describes ways to decrease impacts and identifies roles for health communication scholars in efforts to address climate change and its health effects.

Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

Science.gov (United States)

Hembree, William E

2015-01-01

Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

Rapid Structural Design Change Evaluation with AN Experiment Based FEM

Science.gov (United States)

Chu, C.-H.; Trethewey, M. W.

1998-04-01

The work in this paper proposes a dynamic structural design model that can be developed in a rapid fashion. The approach endeavours to produce a simplified FEM developed in conjunction with an experimental modal database. The FEM is formulated directly from the geometry and connectivity used in an experimental modal test using beam/frame elements. The model sacrifices fine detail for a rapid development time. The FEM is updated at the element level so the dynamic response replicates the experimental results closely. The physical attributes of the model are retained, making it well suited to evaluate the effect of potential design changes. The capabilities are evaluated in a series of computational and laboratory tests. First, a study is performed with a simulated cantilever beam with a variable mass and stiffness distribution. The modal characteristics serve as the updating target with random noise added to simulate experimental uncertainty. A uniformly distributed FEM is developed and updated. The results show excellent results, all natural frequencies are within 0·001% with MAC values above 0·99. Next, the method is applied to predict the dynamic changes of a hardware portal frame structure for a radical design change. Natural frequency predictions from the original FEM differ by as much as almost 18% with reasonable MAC values. The results predicted from the updated model produce excellent results when compared to the actual hardware changes, the first five modal natural frequency difference is around 5% and the corresponding mode shapes producing MAC values above 0·98.

When activation changes, what else changes? the relationship between change in patient activation measure (PAM) and employees' health status and health behaviors.

Science.gov (United States)

Harvey, Lisa; Fowles, Jinnet Briggs; Xi, Min; Terry, Paul

2012-08-01

To test whether changes in the patient activation measure (PAM) are related to changes in health status and healthy behaviors. Data for this secondary analysis were taken from a group-randomized, controlled trial comparing a traditional health promotion program for employees with an activated consumer program and a control program. The study population included 320 employees (with and without chronic disease) from two U.S. companies: a large, integrated health care system and a national airline. Survey and biometric data were collected in Spring 2005 (baseline) and Spring 2007 (follow-up). Change in PAM was associated with changes in health behaviors at every level (1-4), especially at level 4. Changes related to overall risk score and many of its components: aerobic exercise, safety, cancer risk, stress and mental health. Other changes included frequency of eating breakfast and the likelihood of knowing about health plans and how they compare. Level 4 of patient activation is not an end-point. People are capable of continuing to make significant change within this level. Interventions should be designed to encourage movement from lower to higher levels of activation. Even people at the most activated level improve health behaviors. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Changes in the regulation and government of the health system. SESPAS report 2014].

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Repullo, José R

2014-06-01

The economic and fiscal crisis of 2008 has erupted into the debate on the sustainability of health systems; some countries, such as Spain, have implemented strong policies of fiscal consolidation and austerity. The institutional framework and governance model of the national health system (NHS) after its devolution to regions in 2002 had significant weaknesses, which were not apparent in the rapid growth stage but which have been clearly visible since 2010. In this article, we describe the changes in government regulation from the national and NHS perspective: both general changes (clearly prompted by the economic authorities), and those more specifically addressed to healthcare. The Royal Decree-Law 16/2012 represents the centerpiece of austerity policies in healthcare but also implies a rupture with existing political consensus and a return to social security models. Our characterization of austerity in healthcare explores impacts on savings, services, and on the healthcare model itself, although the available information only allows some indications. The conclusions highlight the need to change the path of linear, rapid and radical budget cuts, providing a time-frame for implementing key reforms in terms of internal sustainability; to do so, it is appropriate to restore political and institutional consensus, to emphasize "clinical management" and divestment of inappropriate services (approach to the medical profession and its role as micro-manager), and to create frameworks of good governance and organizational innovations that support these structural reforms. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Social change and women's health.

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McDonough, Peggy; Worts, Diana; McMunn, Anne; Sacker, Amanda

2013-01-01

Over the past five decades, the organization of women's lives has changed dramatically. Throughout the industrialized world, paid work and family biographies have been altered as the once-dominant role of homemaker has given way to the role of secondary, dual, or even primary wage-earner. The attendant changes represent a mix of gains and losses for women, in which not all women have benefited (or suffered) equally. But little is known about the health consequences. This article addresses that gap. It develops a "situated biographies" model to conceptualize how life course change may influence women's health. The model stresses the role of time, both as individual aging and as the anchoring of lives in particular historical periods. "Situating" biographies in this way highlights two key features of social change in women's lives: the ambiguous implications for the health of women as a group, and the probable connections to growing social and economic disparities in health among them. This approach lays the groundwork for more integrated and productive population-based research about how historical transformations may affect women's health.

Global Climate Change and Children's Health.

Science.gov (United States)

Ahdoot, Samantha; Pacheco, Susan E

2015-11-01

Rising global temperature is causing major physical, chemical, and ecological changes across the planet. There is wide consensus among scientific organizations and climatologists that these broad effects, known as climate change, are the result of contemporary human activity. Climate change poses threats to human health, safety, and security. Children are uniquely vulnerable to these threats. The effects of climate change on child health include physical and psychological sequelae of weather disasters, increased heat stress, decreased air quality, altered disease patterns of some climate-sensitive infections, and food, water, and nutrient insecurity in vulnerable regions. Prompt implementation of mitigation and adaptation strategies will protect children against worsening of the problem and its associated health effects. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health. Copyright © 2015 by the American Academy of Pediatrics.

Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

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Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

2013-06-13

China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

Climate change and developing-country cities: implications for environmental health and equity.

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Campbell-Lendrum, Diarmid; Corvalán, Carlos

2007-05-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity.

Effects of high latitude protected areas on bird communities under rapid climate change.

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Santangeli, Andrea; Rajasärkkä, Ari; Lehikoinen, Aleksi

2017-06-01

Anthropogenic climate change is rapidly becoming one of the main threats to biodiversity, along with other threats triggered by human-driven land-use change. Species are already responding to climate change by shifting their distributions polewards. This shift may create a spatial mismatch between dynamic species distributions and static protected areas (PAs). As protected areas represent one of the main pillars for preserving biodiversity today and in the future, it is important to assess their contribution in sheltering the biodiversity communities, they were designated to protect. A recent development to investigate climate-driven impacts on biological communities is represented by the community temperature index (CTI). CTI provides a measure of the relative temperature average of a community in a specific assemblage. CTI value will be higher for assemblages dominated by warm species compared with those dominated by cold-dwelling species. We here model changes in the CTI of Finnish bird assemblages, as well as changes in species densities, within and outside of PAs during the past four decades in a large boreal landscape under rapid change. We show that CTI has markedly increased over time across Finland, with this change being similar within and outside PAs and five to seven times slower than the temperature increase. Moreover, CTI has been constantly lower within than outside of PAs, and PAs still support communities, which show colder thermal index than those outside of PAs in the 1970s and 1980s. This result can be explained by the higher relative density of northern species within PAs than outside. Overall, our results provide some, albeit inconclusive, evidence that PAs may play a role in supporting the community of northern species. Results also suggest that communities are, however, shifting rapidly, both inside and outside of PAs, highlighting the need for adjusting conservation measures before it is too late. © 2016 John Wiley & Sons Ltd.

A rapid evidence review on the effectiveness of institutional health partnerships.

Science.gov (United States)

Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

2015-12-14

Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

Protective factors for mental health and well-being in a changing climate: Perspectives from Inuit youth in Nunatsiavut, Labrador.

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Petrasek MacDonald, Joanna; Cunsolo Willox, Ashlee; Ford, James D; Shiwak, Inez; Wood, Michele

2015-09-01

The Canadian Arctic is experiencing rapid changes in climatic conditions, with implications for Inuit communities widely documented. Youth have been identified as an at-risk population, with likely impacts on mental health and well-being. This study identifies and characterizes youth-specific protective factors that enhance well-being in light of a rapidly changing climate, and examines how climatic and environmental change challenges these. In-depth conversational interviews were conducted with youth aged 15-25 from the five communities of the Nunatsiavut region of Labrador, Canada: Nain, Hopedale, Postville, Makkovik, and Rigolet. Five key protective factors were identified as enhancing their mental health and well-being: being on the land; connecting to Inuit culture; strong communities; relationships with family and friends; and staying busy. Changing sea ice and weather conditions were widely reported to be compromising these protective factors by reducing access to the land, and increasing the danger of land-based activities. This study contributes to existing work on Northern climate change adaptation by identifying factors that enhance youth resilience and, if incorporated into adaptation strategies, may contribute to creating successful and effective adaptation responses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rapid qualitative research methods during complex health emergencies: A systematic review of the literature.

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Johnson, Ginger A; Vindrola-Padros, Cecilia

2017-09-01

The 2013-2016 Ebola outbreak in West Africa highlighted both the successes and limitations of social science contributions to emergency response operations. An important limitation was the rapid and effective communication of study findings. A systematic review was carried out to explore how rapid qualitative methods have been used during global heath emergencies to understand which methods are commonly used, how they are applied, and the difficulties faced by social science researchers in the field. We also asses their value and benefit for health emergencies. The review findings are used to propose recommendations for qualitative research in this context. Peer-reviewed articles and grey literature were identified through six online databases. An initial search was carried out in July 2016 and updated in February 2017. The PRISMA checklist was used to guide the reporting of methods and findings. The articles were assessed for quality using the MMAT and AACODS checklist. From an initial search yielding 1444 articles, 22 articles met the criteria for inclusion. Thirteen of the articles were qualitative studies and nine used a mixed-methods design. The purpose of the rapid studies included: the identification of causes of the outbreak, and assessment of infrastructure, control strategies, health needs and health facility use. The studies varied in duration (from 4 days to 1 month). The main limitations identified by the authors were: the low quality of the collected data, small sample sizes, and little time for cross-checking facts with other data sources to reduce bias. Rapid qualitative methods were seen as beneficial in highlighting context-specific issues that need to be addressed locally, population-level behaviors influencing health service use, and organizational challenges in response planning and implementation. Recommendations for carrying out rapid qualitative research in this context included the early designation of community leaders as a point of

Rapid climate change did not cause population collapse at the end of the European Bronze Age.

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Armit, Ian; Swindles, Graeme T; Becker, Katharina; Plunkett, Gill; Blaauw, Maarten

2014-12-02

The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological (14)C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change.

The Changing Health Care Landscape and Implications of Organizational Ethics on Modern Medical Practice.

Science.gov (United States)

Castlen, Joseph P; Cote, David J; Moojen, Wouter A; Robe, Pierre A; Balak, Naci; Brennum, Jannick; Ammirati, Mario; Mathiesen, Tiit; Broekman, Marike L D

2017-06-01

Medicine is rapidly changing, both in the level of collective medical knowledge and in how it is being delivered. The increased presence of administrators in hospitals helps to facilitate these changes and ease administrative workloads on physicians; however, tensions sometimes form between physicians and administrators. This situation is based on perceptions from both sides that physicians obstruct cost-saving measures and administrators put profits before patients. In reality, increasing patient populations and changes in health care are necessitating action by hospitals to prevent excessive spending as health care systems become larger and more difficult to manage. Recognizing the cause of changes in health care, which do not always originate with physicians and administrators, along with implementing changes in hospitals such as increased physician leadership, could help to ease tensions and promote a more collaborative atmosphere. Ethically, there is a need to preserve physician autonomy, which is a tenet of medical professionalism, and a need to rein in spending costs and ensure that patients receive the best possible care. Physicians and administrators both need to have a well-developed personal ethic to achieve these goals. Physicians need be allowed to retain relative autonomy over their practices as they support and participate in administrator-led efforts toward distributive justice. Copyright © 2017 Elsevier Inc. All rights reserved.

Changing disease profile and preventive health care in India: Issues of economy, equity and effectiveness

Directory of Open Access Journals (Sweden)

Salma Kaneez

2015-01-01

Full Text Available The importance of preventive health care practices has increasingly been recognized in the wake of changing disease profile in India. The disease burden has been shifting from communicable to non-communicable diseases as a result of greater focus on achieving competitiveness in a fast globalizing economy. The rapid pace of social and technological changes has led to adverse life style choices resulting in higher incidence of heart diseases, diabetes, obesity, cancer, and deteriorating inter-personal relations and psychological well-being among individuals. Most of these health risks can considerably be reduced through disseminating science-based information on health promotion and disease prevention including exercise, nutrition, smoking and tobacco cessation, immunization, counseling, fostering good habits of health and hygiene, disease screening and preventive medicine. Prior evidences indicate that preventive health interventions can improve health outcomes in a great deal. In a regressive health delivery system of India where major health expenses on curative health is met by out-of-pocket money, preventive health services hold promise to be cost efficient, clinically effective and equity promoting. This article, therefore, examines in depth the issues and prospects of preventive and promotive health care services in realizing optimum health care needs of the people.

Climate engineering and the risk of rapid climate change

International Nuclear Information System (INIS)

Ross, Andrew; Damon Matthews, H

2009-01-01

Recent research has highlighted risks associated with the use of climate engineering as a method of stabilizing global temperatures, including the possibility of rapid climate warming in the case of abrupt removal of engineered radiative forcing. In this study, we have used a simple climate model to estimate the likely range of temperature changes associated with implementation and removal of climate engineering. In the absence of climate engineering, maximum annual rates of warming ranged from 0.015 to 0.07 deg. C/year, depending on the model's climate sensitivity. Climate engineering resulted in much higher rates of warming, with the temperature change in the year following the removal of climate engineering ranging from 0.13 to 0.76 deg. C. High rates of temperature change were sustained for two decades following the removal of climate engineering; rates of change of 0.5 (0.3,0.1) deg. C/decade were exceeded over a 20 year period with 15% (75%, 100%) likelihood. Many ecosystems could be negatively affected by these rates of temperature change; our results suggest that climate engineering in the absence of deep emissions cuts could arguably constitute increased risk of dangerous anthropogenic interference in the climate system under the criteria laid out in the United Nations Framework Convention on Climate Change.

The Pace of Technologic Change: Implications for Digital Health Behavior Intervention Research.

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Patrick, Kevin; Hekler, Eric B; Estrin, Deborah; Mohr, David C; Riper, Heleen; Crane, David; Godino, Job; Riley, William T

2016-11-01

This paper addresses the rapid pace of change in the technologies that support digital interventions; the complexity of the health problems they aim to address; and the adaptation of scientific methods to accommodate the volume, velocity, and variety of data and interventions possible from these technologies. Information, communication, and computing technologies are now part of every societal domain and support essentially every facet of human activity. Ubiquitous computing, a vision articulated fewer than 30 years ago, has now arrived. Simultaneously, there is a global crisis in health through the combination of lifestyle and age-related chronic disease and multiple comorbidities. Computationally intensive health behavior interventions may be one of the most powerful methods to reduce the consequences of this crisis, but new methods are needed for health research and practice, and evidence is needed to support their widespread use. The challenges are many, including a reluctance to abandon timeworn theories and models of health behavior-and health interventions more broadly-that emerged in an era of self-reported data; medical models of prevention, diagnosis, and treatment; and scientific methods grounded in sparse and expensive data. There are also many challenges inherent in demonstrating that newer approaches are, indeed, effective. Potential solutions may be found in leveraging methods of research that have been shown to be successful in other domains, particularly engineering. A more "agile science" may be needed that streamlines the methods through which elements of health interventions are shown to work or not, and to more rapidly deploy and iteratively improve those that do. There is much to do to advance the issues discussed in this paper, and the papers in this theme issue. It remains an open question whether interventions based in these new models and methods are, in fact, equally if not more efficacious as what is available currently. Economic

Using Ant Communities For Rapid Assessment Of Terrestrial Ecosystem Health

Energy Technology Data Exchange (ETDEWEB)

Wike, L

2005-06-01

relative health of the ecosystem. The IBI, though originally for Midwestern streams, has been successfully adapted to other ecoregions and taxa (macroinvertebrates, Lombard and Goldstein, 2004) and has become an important tool for scientists and regulatory agencies alike in determining health of stream ecosystems. The IBI is a specific type of a larger group of methods and procedures referred to as Rapid Bioassessment (RBA). These protocols have the advantage of directly measuring the organisms affected by system perturbations, thus providing an integrated evaluation of system health because the organisms themselves integrate all aspects of their environment and its condition. In addition to the IBI, the RBA concept has also been applied to seep wetlands (Paller et al. 2005) and terrestrial systems (O'Connell et al. 1998, Kremen et al. 1993, Rodriguez et al. 1998, Rosenberg et al. 1986). Terrestrial RBA methods have lagged somewhat behind those for aquatic systems because terrestrial systems are less distinctly defined and seem to have a less universal distribution of an all-inclusive taxon, such as fish in the IBI, upon which to base an RBA. In the last decade, primarily in Australia, extensive development of an RBA using ant communities has shown great promise. Ants have the same advantage for terrestrial RBAs that fish do for aquatic systems in that they are an essential and ubiquitous component of virtually all terrestrial ecosystems. They occupy a broad range of niches, functional groups, and trophic levels and they possess one very important characteristic that makes them ideal for RBA because, similar to the fishes, there is a wide range of tolerance to conditions within the larger taxa. Within ant communities there are certain groups, genera, or species that may be very robust and abundant under even the harshest impacts. There are also taxa that are very sensitive to disturbance and change and their presence or absence is also indicative of the local

Climate Change and Public Health.

Science.gov (United States)

Ciesielski, Timothy

2017-05-01

It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

Health in China and India: a cross-country comparison in a context of rapid globalisation.

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Dummer, Trevor J B; Cook, Ian G

2008-08-01

China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed.

Extreme Temperature Exceedances Change more Rapidly Under Future Warming in Regions of non-Gaussian Short Temperature Distribution Tails

Science.gov (United States)

Loikith, P. C.; Neelin, J. D.; Meyerson, J.

2017-12-01

Regions of shorter-than-Gaussian warm and cold side temperature distribution tails are shown to occur in spatially coherent patterns in the current climate. Under such conditions, warming may be manifested in more complex ways than if the underlying distribution were close to Gaussian. For example, under a uniform warm shift, the simplest prototype for future warming, a location with a short warm side tail would experience a greater increase in extreme warm exceedances compared to if the distribution were Gaussian. Similarly, for a location with a short cold side tail, a uniform warm shift would result in a rapid decrease in extreme cold exceedances. Both scenarios carry major societal and environmental implications including but not limited to negative impacts on human and ecosystem health, agriculture, and the economy. It is therefore important for climate models to be able to realistically reproduce short tails in simulations of historical climate in order to boost confidence in projections of future temperature extremes. Overall, climate models contributing to the fifth phase of the Coupled Model Intercomparison Project capture many of the principal observed regions of short tails. This suggests the underlying dynamics and physics occur on scales resolved by the models, and helps build confidence in model projections of extremes. Furthermore, most GCMs show more rapid changes in exceedances of extreme temperature thresholds in regions of short tails. Results therefore suggest that the shape of the tails of the underlying temperature distribution is an indicator of how rapidly a location will experience changes to extreme temperature occurrence under future warming.

Rural health service managers' perspectives on preparing rural health services for climate change.

Science.gov (United States)

Purcell, Rachael; McGirr, Joe

2018-02-01

To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

A bioinspired color-changing polystyrene microarray as a rapid qualitative sensor for methanol and ethanol

International Nuclear Information System (INIS)

Kuo, Wen-Kai; Weng, Hsueh-Ping; Hsu, Jyun-Jheng; Yu, Hsin Her

2016-01-01

Polystyrene (PS) microspheres were synthesized by emulsifier-free emulsion polymerization and arranged in an array of closely packed, opal-like photonic crystals by slow self-assembly through dip-coating. This periodic array of PS microspheres was then employed as a rapid qualitative sensor for methanol and ethanol. Both solvents could be detected rapidly based on the routes of their reflection coordinates in the chromaticity diagram or directly by the naked eye on the basis of the change in color within 1 min once a solvent sample had been placed on the PS photochromic sensor. This opal-like PS sensor can thus not only be employed as a rapid sensor for methanol and ethanol but can also be used as a powerful tool for the fast screening of illicit drugs and toxic chemicals during forensic investigations. - Highlights: • Opal-like array of polystyrene (PS) microspheres is synthesized by self-assembly. • This periodic PS array is used as a rapid sensor for methanol and ethanol. • Solvents are detected by routes of reflection coordinates in chromaticity diagram. • They are also detected directly by naked eye based on change in color of sensor. • The color change is irreversible for methanol but reversible for ethanol.

A bioinspired color-changing polystyrene microarray as a rapid qualitative sensor for methanol and ethanol

Energy Technology Data Exchange (ETDEWEB)

Kuo, Wen-Kai, E-mail: wkkuo@nfu.edu.tw [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Weng, Hsueh-Ping, E-mail: sherry.weng7949@gmail.com [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Hsu, Jyun-Jheng, E-mail: k88520x@gmail.com [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Yu, Hsin Her, E-mail: hhyu@nfu.edu.tw [Department of Biotechnology, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China)

2016-04-15

Polystyrene (PS) microspheres were synthesized by emulsifier-free emulsion polymerization and arranged in an array of closely packed, opal-like photonic crystals by slow self-assembly through dip-coating. This periodic array of PS microspheres was then employed as a rapid qualitative sensor for methanol and ethanol. Both solvents could be detected rapidly based on the routes of their reflection coordinates in the chromaticity diagram or directly by the naked eye on the basis of the change in color within 1 min once a solvent sample had been placed on the PS photochromic sensor. This opal-like PS sensor can thus not only be employed as a rapid sensor for methanol and ethanol but can also be used as a powerful tool for the fast screening of illicit drugs and toxic chemicals during forensic investigations. - Highlights: • Opal-like array of polystyrene (PS) microspheres is synthesized by self-assembly. • This periodic PS array is used as a rapid sensor for methanol and ethanol. • Solvents are detected by routes of reflection coordinates in chromaticity diagram. • They are also detected directly by naked eye based on change in color of sensor. • The color change is irreversible for methanol but reversible for ethanol.

Climate Change and Public Health Policy.

Science.gov (United States)

Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

2017-03-01

Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

Climate change and health in Earth's future

Science.gov (United States)

Bowles, Devin C.; Butler, Colin D.; Friel, Sharon

2014-02-01

Threats to health from climate change are increasingly recognized, yet little research into the effects upon health systems is published. However, additional demands on health systems are increasingly documented. Pathways include direct weather impacts, such as amplified heat stress, and altered ecological relationships, including alterations to the distribution and activity of pathogens and vectors. The greatest driver of demand on future health systems from climate change may be the alterations to socioeconomic systems; however, these "tertiary effects" have received less attention in the health literature. Increasing demands on health systems from climate change will impede health system capacity. Changing weather patterns and sea-level rise will reduce food production in many developing countries, thus fostering undernutrition and concomitant disease susceptibility. Associated poverty will impede people's ability to access and support health systems. Climate change will increase migration, potentially exposing migrants to endemic diseases for which they have limited resistance, transporting diseases and fostering conditions conducive to disease transmission. Specific predictions of timing and locations of migration remain elusive, hampering planning and misaligning needs and infrastructure. Food shortages, migration, falling economic activity, and failing government legitimacy following climate change are also "risk multipliers" for conflict. Injuries to combatants, undernutrition, and increased infectious disease will result. Modern conflict often sees health personnel and infrastructure deliberately targeted and disease surveillance and eradication programs obstructed. Climate change will substantially impede economic growth, reducing health system funding and limiting health system adaptation. Modern medical care may be snatched away from millions who recently obtained it.

Using rapid assessment and response to operationalise physical activity strategic health communication campaigns in Tonga.

Science.gov (United States)

Turk, Tahir; Latu, Netina; Cocker-Palu, Elizabeth; Liavaa, Villiami; Vivili, Paul; Gloede, Sara; Simons, Allison

2013-04-01

The aim of the present study was to identify stakeholder and program beneficiary needs and wants in relation to a netball communication strategy in Tonga. In addition, the study aimed to more clearly identify audience segments for targeting of communication campaigns and to identify any barriers or benefits to engaging in the physical activity program. A rapid assessment and response (RAR) methodology was used. The elicitation research encompassed qualitative fieldwork approaches, including semistructured interviews with key informants and focus group discussions with program beneficiaries. Desk research of secondary data sources supported in-field findings. A number of potential barriers to behavioural compliance existed, including cultural factors, gender discrimination, socioeconomic factors, stigmatising attitudes, the threat of domestic violence, infrastructure and training issues. Factors contributing to participation in physical activity included the fun and social aspects of the sport, incentives (including career opportunities, highlighting the health benefits of the activity and the provision of religious and cultural sanctions by local leaders towards the increased physical activity of women. The consultative approach of RAR provided a more in-depth understanding of the need for greater levels of physical activity and opportunities for engagement by all stakeholders. The approach facilitated opportunities for the proposed health behaviours to be realised through the communication strategy. Essential insights for the strategy design were identified from key informants, as well as ensuring future engagement of these stakeholders into the strategy. So what? The expanded use of RAR to inform the design of social marketing interventions is a practical approach to data collection for non-communicable diseases and other health issues in developing countries. The approach allows for the rapid mobilisation of scarce resources for the implementation of more

Changes in the etiology of valvular heart disease in the rapidly aging Korean population.

Science.gov (United States)

Jang, Shin Yi; Ju, Eun-Young; Seo, Su Ra; Choi, Ji Yeon; Park, Sung-Ji; Kim, Duk-Kyung; Park, Seung Woo

2014-06-15

The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65 years or older compared with groups aged 20-44 years or 45-64 years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65 years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

Science.gov (United States)

Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

2015-01-01

Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

Rapid treatment-induced brain changes in pediatric CRPS.

Science.gov (United States)

Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David

2016-03-01

To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation.

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

Science.gov (United States)

Paavola, Jouni

2017-12-05

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

Impact of organisational change on mental health

DEFF Research Database (Denmark)

Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia

2012-01-01

Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowle......Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web...

Climate change and health in British Columbia

International Nuclear Information System (INIS)

Ostry, A.; Ogborn, M.; British Columbia Univ., Vancouver, BC; Takaro, T.; Bassil, K.; Allen, D.

2008-11-01

This document described the models that scientists use to investigate the links between climate change and health. It then reviewed the evidence for possible impacts of climate change on human health. Most models conceptualize that climate change will affect the health of British Columbians directly through physical and biological pathways, and indirectly through complex socio-economic and environmental pathways. The direct physical and biological pathways will be the easiest to investigate, monitor and attribute to climate change, while the indirect socio-economic pathways will be more complex to investigate but will have the most impact. This document also provided guidance for a program of research and policy directions to better predict future impacts of climate change on health in BC and to enhance adaptation to these changes. The document suggested that basic research is needed to develop a made in BC model and infrastructure for climate change and health investigations. Currently, rural and remote forestry-dependent and Aboriginal communities in mountain pine infected zones are particularly vulnerable. However, it was concluded that although there is strong evidence for shifts in climate in BC, no direct evidence exists on the impact of climate change on human health in BC. refs., tabs., figs

[Health behavior change: motivational interviewing].

Science.gov (United States)

Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz

2017-08-01

Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.

How Rapid Change Affects Deltas in the Arctic Region

Science.gov (United States)

Overeem, I.; Bendixen, M.

2017-12-01

Deltas form where the river drains into the ocean. Consequently, delta depositional processes are impacted by either changes in the respective river drainage basin or by changes in the regional marine environment. In a warming Arctic region rapid change has occurred over the last few decades in both the terrestrial domain as well as in the marine domain. Important terrestrial controls include 1) change in permafrost possibly destabilizing river banks, 2) strong seasonality of river discharge due to a short melting season, 3) high sediment supply if basins are extensively glaciated, 4) lake outbursts and ice jams favoring river flooding. Whereas in the Arctic marine domain sea ice loss promotes wave and storm surge impact, and increased longshore transport. We here ask which of these factors dominate any morphological change in Arctic deltas. First, we analyze hydrological data to assess change in Arctic-wide river discharge characteristics and timing, and sea ice concentration data to map changes in sea ice regime. Based on this observational analysis we set up a number of scenarios of change. We then model hypothetical small-scale delta formation considering change in these primary controls by setting up a numerical delta model, and combining it dynamically with a permafrost model. We find that for typical Greenlandic deltas changes in river forcing due to ice sheet melt dominate the morphological change, which is corroborated by mapping of delta progradation from aerial photos and satellite imagery. Whereas in other areas, along the North Slope and the Canadian Arctic small deltas are more stable or experienced retreat. Our preliminary coupled model allows us to further disentangle the impact of major forcing factors on delta evolution in high-latitude systems.

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

Science.gov (United States)

Helfrich, Christian D; Kohn, Marlana J; Stapleton, Austin; Allen, Claire L; Hammerback, Kristen Elizabeth; Chan, K C Gary; Parrish, Amanda T; Ryan, Daron E; Weiner, Bryan J; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial

Directory of Open Access Journals (Sweden)

Christian D. Helfrich

2018-04-01

Full Text Available IntroductionOrganizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time.MethodsWe analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions; change valence (valuing health promotion; information assessment (demands and resources to implement health promotion; change commitment (an intention to implement health promotion; and change efficacy (a belief in shared ability to implement health promotion. We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time.ResultsOnly context and change commitment met reliability thresholds. Change commitment declined significantly for both control (−0.39 and interventions sites (−0.29 from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention. Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1 intervention sites exhibited significantly smaller change in

Focus on climate change and mental health

Science.gov (United States)

2018-04-01

The health impacts of climate change are being increasingly recognized, but mental health is often excluded from this discussion. In this issue we feature a collection of articles on climate change and mental health that highlight important directions for future research.

Roundtable on health and climate change : Strategic plan on health and climate change : a framework for collaborative action, final report

International Nuclear Information System (INIS)

2001-03-01

Climate change will have a significant impact on human health, arising from direct effects such as increased extreme weather events, and indirect effects resulting from changes in ecological systems on which humans depend. This paper is a compilation of discussions and input from the many stakeholders and representatives that contributed to the Roundtable on Health and Climate Change held in September 2000. The goal of the Roundtable was to raise the profile and inform policy makers of the health issues associated with climate change and to engage the health sector in the National Implementation Strategy on Climate Change. The strategic framework for collaborative action in addressing the health implications of climate change were presented. The strategic plan is based on the following key principles: (1) incorporating both mitigation and adaptation in all aspects of the plan, (2) maximizing co-benefits, associated with climate change and other key health priorities, (3) building on existing capacity within governments and non-governmental organizations, (4) forming multi-disciplinary alliances, (5) emphasizing collaboration and cooperation, and (6) recognizing the shared responsibility for action on climate change. The major recommendation from the Roundtable was to urge governments to place a high priority on the implementation of measures that will reduce greenhouse gas emissions in Canada, thereby improving health of Canadians. It was recommended that governments should insist that all analyses and modeling of climate change policy options include the assessment and consideration of health implications. 1 tab

Cosmic rays linked to rapid mid-latitude cloud changes

Directory of Open Access Journals (Sweden)

B. A. Laken

2010-11-01

Full Text Available The effect of the Galactic Cosmic Ray (GCR flux on Earth's climate is highly uncertain. Using a novel sampling approach based around observing periods of significant cloud changes, a statistically robust relationship is identified between short-term GCR flux changes and the most rapid mid-latitude (60°–30° N/S cloud decreases operating over daily timescales; this signal is verified in surface level air temperature (SLAT reanalysis data. A General Circulation Model (GCM experiment is used to test the causal relationship of the observed cloud changes to the detected SLAT anomalies. Results indicate that the anomalous cloud changes were responsible for producing the observed SLAT changes, implying that if there is a causal relationship between significant decreases in the rate of GCR flux (~0.79 GU, where GU denotes a change of 1% of the 11-year solar cycle amplitude in four days and decreases in cloud cover (~1.9 CU, where CU denotes a change of 1% cloud cover in four days, an increase in SLAT (~0.05 KU, where KU denotes a temperature change of 1 K in four days can be expected. The influence of GCRs is clearly distinguishable from changes in solar irradiance and the interplanetary magnetic field. However, the results of the GCM experiment are found to be somewhat limited by the ability of the model to successfully reproduce observed cloud cover. These results provide perhaps the most compelling evidence presented thus far of a GCR-climate relationship. From this analysis we conclude that a GCR-climate relationship is governed by both short-term GCR changes and internal atmospheric precursor conditions.

Engaging Chicago residents in climate change action: Results from Rapid Ethnographic Inquiry

Science.gov (United States)

Lynne M. Westphal; Jennifer. Hirsch

2010-01-01

Addressing climate change requires action at all levels of society, from neighborhood to international levels. Using Rapid Ethnography rooted in Asset Based Community Development theory, we investigated climate-friendly attitudes and behaviors in two Chicago neighborhoods in order to assist the City with implementation of its Climate Action Plan. Our research suggests...

Exposure science in an age of rapidly changing climate: challenges and opportunities

Science.gov (United States)

LaKind, Judy S; Overpeck, Jonathan; Breysse, Patrick N; Backer, Lorrie; Richardson, Susan D; Sobus, Jon; Sapkota, Amir; Upperman, Crystal R; Jiang, Chengsheng; Beard, C Ben; Brunkard, J M; Bell, Jesse E; Harris, Ryan; Chretien, Jean-Paul; Peltier, Richard E; Chew, Ginger L; Blount, Benjamin C

2016-01-01

Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science—Exposures in an Evolving Environment—brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct “consequential science”—doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health. PMID:27485992

Detecting and Attributing Health Burdens to Climate Change.

Science.gov (United States)

Ebi, Kristie L; Ogden, Nicholas H; Semenza, Jan C; Woodward, Alistair

2017-08-07

Detection and attribution of health impacts caused by climate change uses formal methods to determine a ) whether the occurrence of adverse health outcomes has changed, and b ) the extent to which that change could be attributed to climate change. There have been limited efforts to undertake detection and attribution analyses in health. Our goal was to show a range of approaches for conducting detection and attribution analyses. Case studies for heatwaves, Lyme disease in Canada, and Vibrio emergence in northern Europe highlight evidence that climate change is adversely affecting human health. Changes in rates and geographic distribution of adverse health outcomes were detected, and, in each instance, a proportion of the observed changes could, in our judgment, be attributed to changes in weather patterns associated with climate change. The results of detection and attribution studies can inform evidence-based risk management to reduce current, and plan for future, changes in health risks associated with climate change. Gaining a better understanding of the size, timing, and distribution of the climate change burden of disease and injury requires reliable long-term data sets, more knowledge about the factors that confound and modify the effects of climate on health, and refinement of analytic techniques for detection and attribution. At the same time, significant advances are possible in the absence of complete data and statistical certainty: there is a place for well-informed judgments, based on understanding of underlying processes and matching of patterns of health, climate, and other determinants of human well-being. https://doi.org/10.1289/EHP1509.

Changes in Employed People’s Health Satisfaction

Directory of Open Access Journals (Sweden)

Monika Jungbauer-Gans

2013-09-01

Full Text Available The article examines for Germany whether the subjective satisfaction with health has changed over the course of time. It is analysed whether a drop in health satisfaction can be observed and whether this can be explained by changing employment circumstances. Labour market research has documented a change in the employment situation in detail, which can be subsumed under the keyword of precarisation. In the theoretical section we will portray the current state of research concerning the development of the employment situation and emphasize the significance of gainful employment for health. The empirical analyses of the article are based on data of employed people in the German Socio-Economic Panel Study (SOEP of the years 1985, 1996 and 2009. The data show a significantly declining health satisfaction between 1985 and 2009 in Western Germany and no noteworthy change in Eastern Germany between 1996 and 2009. The Blinder/Oaxaca decomposition is used in the analyses to better differentiate the effect of the changed employment situation on the drop in health satisfaction. The analyses indeed reveal changing effects of the employment situation. In Western Germany, a significant percentage of the lesser health satisfaction can be attributed to an increasing number of workers in precarious employment situations. Workplace security is of primary significance for explaining the declining health satisfaction in Western Germany.

Changes in Body Composition According to Age and Sex among Young Non-Diabetic Korean Adults: The Kangbuk Samsung Health Study.

Science.gov (United States)

Kim, Seul Ki; Kwon, Yu Hyun; Cho, Jung Hwan; Lee, Da Young; Park, Se Eun; Oh, Hyung Geun; Park, Cheol Young; Lee, Won Young; Oh, Ki Won; Park, Sung Woo; Rhee, Eun Jung

2017-12-01

Age-related decreases in lean mass represent a serious health problem. We aimed to analyze the risks of rapid decreases in lean mass by age and sex in relatively young Korean adults during a 4-year follow-up study. A total of 65,856 non-diabetic participants (59.5% men, mean age 39.1 years) in a health screening program were subjected to bioimpedance body composition analyses and metabolic parameter analyses at baseline and after 4 years. The participants were sub-divided according to age, and additionally to six groups by age and the degree of body weight change over the 4-year period. The actual changes in body weight, lean mass, and fat mass and the percent changes over the 4-year period were assessed. The percent change in lean mass decreased and the percent change of fat mass increased with increasing age in every age and sex group. However, the annual percent decrease in lean mass and percent increase in fat mass were significantly higher among women than among men (-0.26% vs. -0.15% and 0.34% vs. 0.42%, respectively; P<0.01). Participants who were older than 50 years and had a weight loss <-5% during the 4 years had significantly greater decreases in lean mass and smaller decreases in fat mass, compared to those who were younger than 50 years. An odds ratio analysis to determine the lowest quartile of the percent change in lean mass according to age group revealed that participants older than 60 years had a significantly increased risk of a rapid decrease in the lean mass percentage (2.081; 95% confidence interval, 1.678 to 2.581). Even in this relatively young study population, the lean mass decreased significantly with age, and the risk of a rapid decrease in lean mass was higher among women than among men. Furthermore, the elderly exhibited a significantly more rapid decrease in lean mass, compared with younger participants. Copyright © 2017 Korean Endocrine Society

Changes in Body Composition According to Age and Sex among Young Non-Diabetic Korean Adults: The Kangbuk Samsung Health Study

Directory of Open Access Journals (Sweden)

Seul-Ki Kim

2017-11-01

Full Text Available BackgroundAge-related decreases in lean mass represent a serious health problem. We aimed to analyze the risks of rapid decreases in lean mass by age and sex in relatively young Korean adults during a 4-year follow-up study.MethodsA total of 65,856 non-diabetic participants (59.5% men, mean age 39.1 years in a health screening program were subjected to bioimpedance body composition analyses and metabolic parameter analyses at baseline and after 4 years. The participants were sub-divided according to age, and additionally to six groups by age and the degree of body weight change over the 4-year period. The actual changes in body weight, lean mass, and fat mass and the percent changes over the 4-year period were assessed.ResultsThe percent change in lean mass decreased and the percent change of fat mass increased with increasing age in every age and sex group. However, the annual percent decrease in lean mass and percent increase in fat mass were significantly higher among women than among men (−0.26% vs. −0.15% and 0.34% vs. 0.42%, respectively; P<0.01. Participants who were older than 50 years and had a weight loss <−5% during the 4 years had significantly greater decreases in lean mass and smaller decreases in fat mass, compared to those who were younger than 50 years. An odds ratio analysis to determine the lowest quartile of the percent change in lean mass according to age group revealed that participants older than 60 years had a significantly increased risk of a rapid decrease in the lean mass percentage (2.081; 95% confidence interval, 1.678 to 2.581.ConclusionEven in this relatively young study population, the lean mass decreased significantly with age, and the risk of a rapid decrease in lean mass was higher among women than among men. Furthermore, the elderly exhibited a significantly more rapid decrease in lean mass, compared with younger participants.

Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop.

Science.gov (United States)

Michie, Susan; Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

2017-06-29

Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom's Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop

Science.gov (United States)

Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

2017-01-01

Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom’s Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

Environmental impacts of rapid water level changes; Miljoekonsekvenser av raske vannstandsendringer

Energy Technology Data Exchange (ETDEWEB)

Arnekleiv, Jo Vegar; Bakken, Tor Haakon; Bogen, Jim; Boensnes, Truls Erik; Elster, Margrethe; Harby, Atle; Kutznetsova, Yulia; Saltveit, Svein Jakob; Sauterleute, Julian; Stickler, Morten; Sundt, Haakon; Tjomsland, Torulv; Ugedal, Ola

2012-07-01

This report summarizes the state of knowledge of the environmental impacts of power driving and rapid water level changes and describes possible mitigation measures. The report assesses the environmental effects of possible increased power installation in Mauranger and Tonstad power plants, based on existing data and knowledge. At Straumsmo plants in Barduelva there are collected some physical data and the environmental impact of existing power driving is considered. (eb)

Mobile work: Ergonomics in a rapidly changing work environment.

Science.gov (United States)

Honan, Meg

2015-01-01

Places of work have been completely transformed by innovations in mobile work tools and ever-present access to internet data. This article characterizes use patterns and provides preliminary considerations for productive and comfortable use of common mobile devices. Two surveys described trends in mobile work. In the first, ergonomics professionals who oversee programs reported common mobile devices, their users and what data is accessed. The second, an end user survey, explored common activities performed on mobile devices, duration of use and locations where mobile work is common. The survey results provide a baseline data point for the status of mobile work in early 2014. Research indicates that additional risks have been introduced to the neck, thumbs and hands when using mobile devices. Possible trends regarding device use and work locations emerge. Intervention studies provide some direction for the practitioner. Practical strategies are outlined to reduce exposure intensity and duration. Contemporary mobile work presents tremendous change and opportunity for ergonomists and researchers to keep pace with fitting the changing models of work to the person. Continued research is needed on current mobile device use patterns to better understand ergonomic risk exposure in this rapidly changing realm.

Rapid changes in protein phosphorylation associated with gravity perception in corn roots

International Nuclear Information System (INIS)

McFadden, J.J.; Poovaiah, B.W.

1987-01-01

A previous paper from this laboratory showed calcium- and calmodulin-dependent in vivo protein phosphorylation in corn root tips. The authors show that rapid changes in calcium-dependent protein phosphorylation are involved in light-dependent graviperception in corn root tips. Corn seedlings (Zea mays L, cv Merit) were grown in the dark for 3 d, then apical root segments were harvested in dim green light to measure in vivo protein phosphorylation. Segments were incubated with 0.5 mCi 32 P for 1 h, then immediately frozen in liquid N 2 or first treated with either 7 min light, or 7 min light plus 1 mM EGTA and 10 μM A23187. Labeled proteins were separated by 2D gel electrophoresis and detected by autoradiography. Light caused rapid and specific promotion of phosphorylation of 5 polypeptides. The increases in protein phosphorylation were reversed by treating with EGTA and A23187. The authors postulate that these changes in protein phosphorylation are an essential part of the light-dependent gravity response in Merit roots

Health Behavior Change Challenge: Understanding Stages of Change

Science.gov (United States)

Sullivan, Claire F.

2011-01-01

This semester-long activity requires students to reflect on their own strengths and weaknesses in attempting to take on a personally meaningful health behavior change challenge. This assignment affords them the opportunity to take a deeper look at theory and health concepts learned throughout the semester and to see how it has informed their own…

The development of a model of psychological first aid for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA.

Science.gov (United States)

Everly, George S; Lee McCabe, O; Semon, Natalie L; Thompson, Carol B; Links, Jonathan M

2014-01-01

The Johns Hopkins Center for Public Health Preparedness, which houses the Centers for Disease Control and Prevention-funded Preparedness and Emergency Response Learning Center, has been addressing the challenge of disaster-caused behavioral health surge by conducting training programs in psychological first aid (PFA) for public health professionals. This report describes our approach, named RAPID-PFA, and summarizes training evaluation data to determine if relevant knowledge, skills, and attitudes are imparted to trainees to support effective PFA delivery. In the wake of disasters, there is an increase in psychological distress and dysfunction among survivors and first responders. To meet the challenges posed by this surge, a professional workforce trained in PFA is imperative. More than 1500 participants received a 1-day RAPID-PFA training. Pre-/postassessments were conducted to measure (a) required knowledge to apply PFA; (b) perceived self-efficacy, that is, belief in one's own ability, to apply PFA techniques; and (c) confidence in one's own resilience in a crisis context. Statistical techniques were used to validate the extent to which the survey successfully measured individual PFA constructs, that is, unidimensionality, and to quantify the reliability of the assessment tool. Statistically significant pre-/postimprovements were observed in (a) knowledge items supportive of PFA delivery, (b) perceived self-efficacy to apply PFA interventions, and (c) confidence about being a resilient PFA provider. Cronbach alpha coefficients ranging from 0.87 to 0.90 suggested that the self-reported measures possessed sufficient internal consistency. Findings were consistent with our pilot work, and with our complementary research initiatives validating a variant of RAPID-PFA with faith communities. The RAPID-PFA model promises to be a broadly applicable approach to extending community behavioral health surge capacity. Relevant next steps include evaluating the effectiveness

Forecasted Impact of Climate Change on Infectious Disease and Health Security in Hawaii by 2050.

Science.gov (United States)

Canyon, Deon V; Speare, Rick; Burkle, Frederick M

2016-12-01

Climate change is expected to cause extensive shifts in the epidemiology of infectious and vector-borne diseases. Scenarios on the effects of climate change typically attribute altered distribution of communicable diseases to a rise in average temperature and altered incidence of infectious diseases to weather extremes. Recent evaluations of the effects of climate change on Hawaii have not explored this link. It may be expected that Hawaii's natural geography and robust water, sanitation, and health care infrastructure renders residents less vulnerable to many threats that are the focus on smaller, lesser developed, and more vulnerable Pacific islands. In addition, Hawaii's communicable disease surveillance and response system can act rapidly to counter increases in any disease above baseline and to redirect resources to deal with changes, particularly outbreaks due to exotic pathogens. The evidence base examined in this article consistently revealed very low climate sensitivity with respect to infectious and mosquito-borne diseases. A community resilience model is recommended to increase adaptive capacity for all possible climate change impacts rather an approach that focuses specifically on communicable diseases. (Disaster Med Public Health Preparedness. 2016;10:797-804).

Computed tomographic demonstration of rapid changes in fatty infiltration of the liver

International Nuclear Information System (INIS)

Bashist, B.; Hecht, H.L.; Harely, W.D.

1982-01-01

Two alcoholic patients in whom computed tomography (CT) demonstrated reversal of fatty infiltration of the liver are described. The rapid reversibility of fatty infiltration can be useful in monitoring alcoholics with fatty livers. Focal fatty infiltration can mimic focal hepatic lesions and repeat scans can be utilized to assess changes in CT attenuation values when this condition is suspected

Changing living conditions, life style and health

DEFF Research Database (Denmark)

Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

2005-01-01

. The aim of the paper is to illustrate the influence of environmental change on living conditions and life style and some of the mechanisms through which such changes affect physical and mental health. The interrelationship between environmental and societal change is illustrated by an example from a small......Human health is the result of the interaction of genetic, nutritional, socio-cultural, economic, physical infrastructure and ecosystem factors. All of the individual, social, cultural and socioeconomic factors are influenced by the environment they are embedded in and by changes in this environment...... community in Greenland, where changing environmental conditions have influenced fishing and employment opportunities to the extent that the size of the population has changed dramatically. The link between social change and health is shown with reference to studies on education, housing and occupation...

Monitoring changes in seismic velocity related to an ongoing rapid inflation event at Okmok volcano, Alaska

Science.gov (United States)

Bennington, Ninfa; Haney, Matt; De Angelis, Silvio; Thurber, Clifford; Freymueller, Jeff

2015-01-01

Okmok is one of the most active volcanoes in the Aleutian Arc. In an effort to improve our ability to detect precursory activity leading to eruption at Okmok, we monitor a recent, and possibly ongoing, GPS-inferred rapid inflation event at the volcano using ambient noise interferometry (ANI). Applying this method, we identify changes in seismic velocity outside of Okmok’s caldera, which are related to the hydrologic cycle. Within the caldera, we observe decreases in seismic velocity that are associated with the GPS-inferred rapid inflation event. We also determine temporal changes in waveform decorrelation and show a continual increase in decorrelation rate over the time associated with the rapid inflation event. Themagnitude of relative velocity decreases and decorrelation rate increases are comparable to previous studies at Piton de la Fournaise that associate such changes with increased production of volatiles and/ormagmatic intrusion within the magma reservoir and associated opening of fractures and/or fissures. Notably, the largest decrease in relative velocity occurs along the intrastation path passing nearest to the center of the caldera. This observation, along with equal amplitude relative velocity decreases revealed via analysis of intracaldera autocorrelations, suggests that the inflation sourcemay be located approximately within the center of the caldera and represent recharge of shallow magma storage in this location. Importantly, there is a relative absence of seismicity associated with this and previous rapid inflation events at Okmok. Thus, these ANI results are the first seismic evidence of such rapid inflation at the volcano.

Organizing and managing care in a changing health system.

Science.gov (United States)

Kohn, L T

2000-04-01

To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

Climate Change: Science, Health and the Environment

Centers for Disease Control (CDC) Podcasts

Climate Change: Science, Health and the Environment Howard Frumkin, MD, DrPH, Director of CDC's National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, discusses the science of climate change, the potential for shifts in the natural world to affect our wellbeing, and the challenges of emerging issues in environmental health.

Dental Education Required for the Changing Health Care Environment.

Science.gov (United States)

Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

2017-08-01

To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Climate change and health ? what?s the problem?

OpenAIRE

Anstey, Matthew HR

2013-01-01

The scientific consensus is that global warming is occurring and is largely the result of greenhouse gas emissions from human activity. This paper examines the health implications of global warming, the current socio-political attitudes towards action on climate change and highlight the health co-benefits of reducing greenhouse gas emissions. In addition, policy development for climate change and health should embrace health systems strengthening, commencing by incorporating climate change ta...

Rapid psychological assessment of depression and its relationship with physical health among urban elderly

OpenAIRE

Pavithra Cheluvaraj; Mangesh Balu Nanaware; Surya Prakasa Rao

2016-01-01

Background Old age is associated with increased occurrence of a wide array of Psychological impairments or losses, which might contribute to physical disabilities. As Depression has been identified as the most common aberration its rapid assessment would be able to identify the quality of individual and family life of the elderly. Aims To assess psychological health status with respect to depression among geriatric urban community, and the relationship of depression with health perce...

Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program.

Science.gov (United States)

Shin, Yong Seung; Ha, Jongsik

2012-01-01

Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities.

Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program

Science.gov (United States)

Shin, Yong Seung

2012-01-01

Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities. PMID:23256088

Climate Change: Science, Health and the Environment

Centers for Disease Control (CDC) Podcasts

2007-04-10

Climate Change: Science, Health and the Environment Howard Frumkin, MD, DrPH, Director of CDC's National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, discusses the science of climate change, the potential for shifts in the natural world to affect our wellbeing, and the challenges of emerging issues in environmental health.  Created: 4/10/2007 by CDC National Center for Environmental Health.   Date Released: 4/13/2007.

The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda

Science.gov (United States)

Workman, Annabelle; Blashki, Grant; Bowen, Kathryn J.; Karoly, David J.; Wiseman, John

2018-01-01

A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda. PMID:29617317

The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda.

Science.gov (United States)

Workman, Annabelle; Blashki, Grant; Bowen, Kathryn J; Karoly, David J; Wiseman, John

2018-04-04

A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda.

Health risks of climate change in the World Health Organization South-East Asia Region.

Science.gov (United States)

Bowen, Kathryn J; Ebi, Kristie L

2017-09-01

Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

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.

Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes.

Science.gov (United States)

Mache, Stefanie; Jensen, Sarah; Jahn, Reimo; Steudtner, Mirko; Ochsmann, Elke; Preuß, Geraldine

2015-11-01

The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity-, health-, and diet-related factors. Results showed that participants' body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m(2)). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended. © 2015 Society for Public Health Education.

Rapid improvement teams.

Science.gov (United States)

Alemi, F; Moore, S; Headrick, L; Neuhauser, D; Hekelman, F; Kizys, N

1998-03-01

Suggestions, most of which are supported by empirical studies, are provided on how total quality management (TQM) teams can be used to bring about faster organizationwide improvements. Ideas are offered on how to identify the right problem, have rapid meetings, plan rapidly, collect data rapidly, and make rapid whole-system changes. Suggestions for identifying the right problem include (1) postpone benchmarking when problems are obvious, (2) define the problem in terms of customer experience so as not to blame employees nor embed a solution in the problem statement, (3) communicate with the rest of the organization from the start, (4) state the problem from different perspectives, and (5) break large problems into smaller units. Suggestions for having rapid meetings include (1) choose a nonparticipating facilitator to expedite meetings, (2) meet with each team member before the team meeting, (3) postpone evaluation of ideas, and (4) rethink conclusions of a meeting before acting on them. Suggestions for rapid planning include reducing time spent on flowcharting by focusing on the future, not the present. Suggestions for rapid data collection include (1) sample patients for surveys, (2) rely on numerical estimates by process owners, and (3) plan for rapid data collection. Suggestions for rapid organizationwide implementation include (1) change membership on cross-functional teams, (2) get outside perspectives, (3) use unfolding storyboards, and (4) go beyond self-interest to motivate lasting change in the organization. Additional empirical investigations of time saved as a consequence of the strategies provided are needed. If organizations solve their problems rapidly, fewer unresolved problems may remain.

Transforming medical professionalism to fit changing health needs

Directory of Open Access Journals (Sweden)

Starfield Barbara

2009-10-01

Full Text Available Abstract Background The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs. Discussion Medical leaders, supported by health policy makers, can consciously activate the self-regulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1 defining and categorizing the health needs of the population; (2 reorganizing the specialty domains around the needs of population groups; (3 reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation. Summary Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.

Understanding the Rapid Reduction of Undernutrition in Nepal, 2001-2011.

Directory of Open Access Journals (Sweden)

Derek D Headey

Full Text Available South Asia has long been synonymous with unusually high rates of undernutrition. In the past decade, however, Nepal has arguably achieved the fastest recorded decline in child stunting in the world and has done so in the midst of civil war and post-conflict political instability. Given recent interest in reducing undernutrition-particularly the role of nutrition-sensitive policies-this paper aims to quantitatively understand this surprising success story by analyzing the 2001, 2006, and 2011 rounds of Nepal's Demographic Health Surveys. To do so, we construct models of the intermediate determinants of child and maternal nutritional change and then decompose predicted changes in nutrition outcomes over time. We identify four broad drivers of change: asset accumulation, health and nutrition interventions, maternal educational gains, and improvements in sanitation. Many of these changes were clearly influenced by policy decisions, including increased public investments in health and education and community-led health and sanitation campaigns. Other factors, such as rapid growth in migration-based remittances, are more a reflection of household responses to changing political and economic circumstances.

Reform, change, and continuity in Finnish health care.

Science.gov (United States)

Häkkinen, Unto; Lehto, Juhani

2005-01-01

This article describes some essential aspects of the Finnish political and governmental system and the evolution of the basic institutional elements of the health care system. We examine the developments that gave rise to a series of health care reforms and reform proposals in the late 1980s and early 1990s and relate them to changes in health care expenditure, structure, and performance. Finally, we discuss the relationship between policy changes, reforms, and health system changes and the strength of neo-institutional theory in explaining both continuity and change. Much of the change in Finnish health care can be explained by institutional path dependency. The tradition of strong but small local authorities and the lack of legitimate democratic regional authorities as well as the coexistence of a dominant Beveridge-style health system with a marginal Bismarckian element explain the specific path of Finnish health care reform. Public responsibility for health care has been decentralized to smaller local authorities (known as municipalities) more than in any other country. Even an exceptionally deep economic recession in the early 1990s did not lead to systems change; rather, the economic imperative was met by the traditional centralized policy pattern. Some of the developments of the 1990s are, however, difficult to explain by institutional theory. Thus, there is a need for testing alternative theories as well.

Climate Change and Health: Transcending Silos to Find Solutions.

Science.gov (United States)

Machalaba, Catherine; Romanelli, Cristina; Stoett, Peter; Baum, Sarah E; Bouley, Timothy A; Daszak, Peter; Karesh, William B

2015-01-01

Climate change has myriad implications for the health of humans, our ecosystems, and the ecological processes that sustain them. Projections of rising greenhouse gas emissions suggest increasing direct and indirect burden of infectious and noninfectious disease, effects on food and water security, and other societal disruptions. As the effects of climate change cannot be isolated from social and ecological determinants of disease that will mitigate or exacerbate forecasted health outcomes, multidisciplinary collaboration is critically needed. The aim of this article was to review the links between climate change and its upstream drivers (ie, processes leading to greenhouse gas emissions) and health outcomes, and identify existing opportunities to leverage more integrated global health and climate actions to prevent, prepare for, and respond to anthropogenic pressures. We conducted a literature review of current and projected health outcomes associated with climate change, drawing on findings and our collective expertise to review opportunities for adaptation and mitigation across disciplines. Health outcomes related to climate change affect a wide range of stakeholders, providing ready collaborative opportunities for interventions, which can be differentiated by addressing the upstream drivers leading to climate change or the downstream effects of climate change itself. Although health professionals are challenged with risks from climate change and its drivers, the adverse health outcomes cannot be resolved by the public health community alone. A phase change in global health is needed to move from a passive responder in partnership with other societal sectors to drive innovative alternatives. It is essential for global health to step outside of its traditional boundaries to engage with other stakeholders to develop policy and practical solutions to mitigate disease burden of climate change and its drivers; this will also yield compound benefits that help address

Climate Change, Soils, and Human Health

Science.gov (United States)

Brevik, Eric C.

2013-04-01

According to the Intergovernmental Panel on Climate Change, global temperatures are expected to increase 1.1 to 6.4 degrees C during the 21st century and precipitation patterns will be altered by climate change (IPCC, 2007). Soils are intricately linked to the atmospheric/climate system through the carbon, nitrogen, and hydrologic cycles. Altered climate will, therefore, have an effect on soil processes and properties. Studies into the effects of climate change on soil processes and properties are still incomplete, but have revealed that climate change will impact soil organic matter dynamics including soil organisms and the multiple soil properties that are tied to organic matter, soil water, and soil erosion. The exact direction and magnitude of those impacts will be dependent on the amount of change in atmospheric gases, temperature, and precipitation amounts and patterns. Recent studies give reason to believe at least some soils may become net sources of atmospheric carbon as temperatures rise; this is particularly true of high latitude regions with permanently frozen soils. Soil erosion by both wind and water is also likely to increase. These soil changes will lead to both direct and indirect impacts on human health. Possible indirect impacts include temperature extremes, food safety and air quality issues, increased and/or expanded disease incidences, and occupational health issues. Potential direct impacts include decreased food security and increased atmospheric dust levels. However, there are still many things we need to know more about. How climate change will affect the nitrogen cycle and, in turn, how the nitrogen cycle will affect carbon sequestration in soils is a major research need, as is a better understanding of soil water-CO2 level-temperature relationships. Knowledge of the response of plants to elevated atmospheric CO2 given limitations in nutrients like nitrogen and phosphorus and how that affects soil organic matter dynamics is a critical

Why Health Promotion Needs to Change.

Science.gov (United States)

Terry, Paul E

2018-01-01

If you ask most health professionals why they do what they do, they invariably speak of being of service. And being of service, for population health workers, becomes ever more meaningful as our work touches ever more lives. To wit, "Kaizen," a Japanese term meaning "change for better," sits shoulder to shoulder with our life's purpose. Health promotion professionals are high performers getting great results but we need to start working on our work. What would it take to increase our impact by 50%? And when we change our processes to accomplish that, what would we change next to get another 50% improvement? Only by stepping back and examining our processes can we see the time and motion required to make what's working now work better and be more accessible to more people next time.

RAPID SPECTRAL CHANGES OF CYGNUS X-1 IN THE LOW/HARD STATE WITH SUZAKU

Energy Technology Data Exchange (ETDEWEB)

Yamada, S.; Makishima, K. [Cosmic Radiation Laboratory, Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198 (Japan); Negoro, H. [Department of Physics, College of Science and Technology, Nihon University, 1-8 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8308 (Japan); Torii, S.; Noda, H. [Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Mineshige, S. [Department of Astronomy, Kyoto University, Kitashirakawa Oiwake-cho, Sakyo-ku, Kyoto 606-8502 (Japan)

2013-04-20

Rapid spectral changes in the hard X-ray on a timescale down to {approx}0.1 s are studied by applying a ''shot analysis'' technique to the Suzaku observations of the black hole binary Cygnus X-1, performed on 2008 April 18 during the low/hard state. We successfully obtained the shot profiles, covering 10-200 keV with the Suzaku HXD-PIN and HXD-GSO detector. It is notable that the 100-200 keV shot profile is acquired for the first time owing to the HXD-GSO detector. The intensity changes in a time-symmetric way, though the hardness changes in a time-asymmetric way. When the shot-phase-resolved spectra are quantified with the Compton model, the Compton y-parameter and the electron temperature are found to decrease gradually through the rising phase of the shot, while the optical depth appears to increase. All the parameters return to their time-averaged values immediately within 0.1 s past the shot peak. We have not only confirmed this feature previously found in energies below {approx}60 keV, but also found that the spectral change is more prominent in energies above {approx}100 keV, implying the existence of some instant mechanism for direct entropy production. We discuss possible interpretations of the rapid spectral changes in the hard X-ray band.

A rapid review of consumer health information needs and preferences.

Science.gov (United States)

Ramsey, Imogen; Corsini, Nadia; Peters, Micah D J; Eckert, Marion

2017-09-01

This rapid review summarizes best available evidence on consumers' needs and preferences for information about healthcare, with a focus on the Australian context. Three questions are addressed: 1) Where do consumers find and what platform do they use to access information about healthcare? 2) How do consumers use the healthcare information that they find? 3) About which topics or subjects do consumers need healthcare information? A hierarchical approach was adopted with evidence first sought from reviews then high quality studies using Medline (via PubMed), CINAHL, Embase, the JBI Database of Systematic Reviews and Implementation Reports, the Campbell Collaboration Library of Systematic Reviews, EPPI-Centre, and Epistemonikos. Twenty-eight articles were included; four systematic reviews, three literature reviews, thirteen quantitative studies, six qualitative studies, and two mixed methods studies. Consumers seek health information at varying times along the healthcare journey and through various modes of delivery. Complacency with historical health information modes is no longer appropriate and flexibility is essential to suit growing consumer demands. Health information should be readily available in different formats and not exclusive to any single medium. Copyright © 2017. Published by Elsevier B.V.

From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil

Directory of Open Access Journals (Sweden)

Ligia Bahia

Full Text Available Abstract: The concentration and internationalization of health plan companies in Brazil gave them a clearly financial face. Based on the need to understand the health care industry's capital accumulation patterns, the current study examines health plan companies' expansion strategies through the classification of their supply and demand characteristics by recent historical periods and an analysis of recent shareholding trends in one of the leading corporations in the Brazilian health care industry. The 1960s to 2000s witnessed changes in the scale of demands for health plans and adherence by companies to long-term accumulation strategies. Beginning in the early 21st century, changes in the shareholding structures of the largest Brazilian company, consistent with the financialization of its accumulation regime, resulted in the rapid multiplication of its capital. Deepening segmentation of the health care system in a context marked by the downturn in the national economy challenges the preservation of public subsidies for private health plans.

Feframing Climate Change for Environmental Health.

Science.gov (United States)

Weems, Caitlin; Subramaniam, Prithwi Raj

2017-04-01

Repeated warnings by the scientific community on the dire consequences of climate change through global warming to the ecology and sustenance of our planet have not been give appropriate attention by the U.S. public. Research has shown that climate change is responsible for catastrophic weather occurrences--such as floods, tornadoes, hurricanes, and heat waves--resulting in environmental and public health issues. The purpose of this report is to examine factors influencing public views on climate change. Theoretical and political perspectives are examined to unpack opinions held by the public in the U.S. on climate change. The Health Belief Model is used as an example to showcase the efficacy of an individual behavior change program in providing the synergy to understand climate change at the microlevel. The concept of reframing is discussed as a strategy to alter how the public views climate change.

Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety.

Science.gov (United States)

Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Llewellyn, Dawn; Williamson, Robert G; Carson, Chris A

2017-06-01

Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal. Phase I was implemented within three months of assuming management of the facility and involved a redesign of flow, space utilization, and clinical protocols. Phase II was implemented three months later and improved the provider staffing model. Organizational changes such as the development of shift leads and daily huddles were implemented to sustain change and create an environment supportive of future improvements. Post-Phase I, there were significant decreases (pre vs. post and one-year post) in median door-to-door dwell time (343 min vs. 118 and 99), calls to security for behavioral emergencies (13.5 per month vs. 4.3 and 4.8), and staff injuries (3.3 per month vs. 1.2 and 1.2). Post-Phase II, there were decreases in median door-to-doctor time (8.2 hours vs. 1.6 and 1.4) and hours on diversion (90% vs. 17% and 34%). Lean methods can positively affect safety and throughput and are complementary to patient-centered clinical goals in a behavioral health setting. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Health Care Facilities Resilient to Climate Change Impacts

Directory of Open Access Journals (Sweden)

Jaclyn Paterson

2014-12-01

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

Organizational change theory: implications for health promotion practice.

Science.gov (United States)

Batras, Dimitri; Duff, Cameron; Smith, Ben J

2016-03-01

Sophisticated understandings of organizational dynamics and processes of organizational change are crucial for the development and success of health promotion initiatives. Theory has a valuable contribution to make in understanding organizational change, for identifying influential factors that should be the focus of change efforts and for selecting the strategies that can be applied to promote change. This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners. Theoretically derived considerations for practitioners who seek to foster organizational change include the extent to which the initiative is modifiable to fit with the internal context; the amount of time that is allocated to truly institutionalize change; the ability of the agents of change to build short-term success deliberately into their implementation plan; whether or not the shared group experience of action for change is positive or negative and the degree to which agencies that are the intended recipients of change are resourced to focus on internal factors. In reviewing theories of organizational change, the article also addresses strategies for facilitating the adoption of key theoretical insights into the design and implementation of health promotion initiatives in diverse organizational settings. If nothing else, aligning health promotion with organizational change theory promises insights into what it is that health promoters do and the time that it can take to do it effectively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The climate change convention and human health.

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Rowbotham, E J

1995-01-01

The United Nations Framework Convention on Climate Change, signed at Rio in June 1992, is intended to minimize climate change and its impact. Much of its text is ambiguous and it is not specifically directed to health considerations. It is, however, recognized that adverse effects of climate change on health are a concern of humankind, and health is an integral part of the Convention. The Convention includes commitments by the developed countries to reduce emissions of greenhouse gases and to increase public awareness of these commitments. The significance of the Convention in these respects is discussed critically and future developments considered.

Fostering Learning Opportunities through Employee Participation amid Organizational Change

Science.gov (United States)

Valleala, Ulla Maija; Herranen, Sanna; Collin, Kaija; Paloniemi, Susanna

2015-01-01

Health care organizations are facing rapid changes, frequently involving modification of existing procedures. The case study reported here examined change processes and learning in a health care organization. The organizational change in question occurred in the emergency clinic of a Finnish central hospital where a new action model for…

An ill wind? Climate change, migration, and health.

Science.gov (United States)

McMichael, Celia; Barnett, Jon; McMichael, Anthony J

2012-05-01

Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Climate-change-related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change.

Tropical vegetation evidence for rapid sea level changes associated with Heinrich Events

Energy Technology Data Exchange (ETDEWEB)

Gonzalez, Catalina; Dupont, Lydie M, E-mail: catalina@uni-bremen.d, E-mail: dupont@uni-bremen.d [MARUM - Centre for Marine Environmental Sciences, University of Bremen, Leobener Strasse, D-28359 Germany (Germany)

2010-03-15

A Cariaco Basin pollen record shows the development of tropical salt marshes during marine isotope stage 3. Rapid and abrupt expansions of salt marsh vegetation in tropical South America are associated with north Atlantic Heinrich Events stadials (HE-stadials). Intervals of salt marsh expansion have an internal structure, which consists of a recurrent alternation of species that starts with pollen increments of Chenopodiaceae, that are followed by increments of grasses, and subsequently by increments of Cyperaceae. This pattern suggests a successional process that is determined by the close relationship between sea-level and plant community dynamics. The salt tolerant Chenopodiaceae, indicate hypersaline intertidal environments, which were most likely promoted by extremely dry atmospheric conditions. Rapid sea-level rise characterizes the onset of HE-stadials, causing the continued recruitment of pioneer species, which are the only ones tolerating rapid rates of disturbance. Once sea-level rise decelerates, marsh plants are able to trap and stabilize sediments, favouring the establishment of more competitive species. These results add to the scarce knowledge on the dynamics of tropical salt marsh ecosystems, and provide independent paleoclimatic evidence on sea-level changes following Antarctic climate variability.

Child health in Greenland

DEFF Research Database (Denmark)

Niclasen, Birgit V L; Bjerregaard, Peter

2007-01-01

. Overweight and obesity have tripled in 20 years and are a health threat as well as constituting negative health behaviour. Social ill health, socioeconomic inequity, and sociocultural changes also influence health but their consequences are not well investigated in children. CONCLUSIONS: A relatively high...... child mortality but the same morbidity pattern as in other Western societies was found. Negative health behaviour is frequent in schoolchildren. The influence of rapid cultural changes, and familial and societal factors related to social ill health, together with socioeconomic inequity, are of major...

Major Findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700.

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Fogel, Robert W; Grotte, Nathaniel

2011-12-01

This paper discusses findings from The Changing Body: Health, Nutrition, and Human Development in the Western World since 1700 (Cambridge University Press) The book is built on the authors' work with 300 years of height and nutrition data and discusses their findings in the context of technophysio evolution, a uniquely modern form of rapid physiological development, the result of humanity's ability to control its environment and create technological innovations to adapt to it.

The American Public Health Association's 2017 Year of Climate Change and Health: Time for Action.

Science.gov (United States)

DeJarnett, Natasha; Robb, Katherine; Castellanos, Ivana; Dettman, Louise; Patel, Surili S

2017-10-26

Climate change is today's greatest public health threat. 1 As the nation's leading voice in public health, the American Public Health Association (APHA) has demonstrated an enduring commitment to climate change as a health issue. As far back as the mid-1920s, AJPH reported on the health impacts of climate change. 2-4 Shaping the development of future organizational efforts, APHA members created the organization's first policy statement on climate change in 1995 (updated in 2007 and 2015). APHA continued to bring attention to climate change and public health, making it the theme of National Public Health Week 2008. Since then, evidence of climate change's causes and effects has mounted, but politicization of the issue and low prioritization by the public has made progress toward mitigation and adaptation slow. (Am J Public Health. Published online ahead of print October 26, 2017: e1-e2. doi:10.2105/AJPH.2017.304168).

Integrated ocean management as a strategy to meet rapid climate change: the Norwegian case.

Science.gov (United States)

Hoel, Alf Håkon; Olsen, Erik

2012-02-01

The prospects of rapid climate change and the potential existence of tipping points in marine ecosystems where nonlinear change may result from them being overstepped, raises the question of strategies for coping with ecosystem change. There is broad agreement that the combined forces of climate change, pollution and increasing economic activities necessitates more comprehensive approaches to oceans management, centering on the concept of ecosystem-based oceans management. This article addresses the Norwegian experience in introducing integrated, ecosystem-based oceans management, emphasizing how climate change, seen as a major long-term driver of change in ecosystems, is addressed in management plans. Understanding the direct effects of climate variability and change on ecosystems and indirect effects on human activities is essential for adaptive planning to be useful in the long-term management of the marine environment.

Climate Changes and Human Health: A Review of the Effect of Environmental Stressors on Cardiovascular Diseases Across Epidemiology and Biological Mechanisms.

Science.gov (United States)

Giorgini, Paolo; Di Giosia, Paolo; Petrarca, Marco; Lattanzio, Francesco; Stamerra, Cosimo Andrea; Ferri, Claudio

2017-01-01

Climate change is rapidly affecting all the regions of our planet. The most relevant example is global warming, which impacts on the earth's ecosystems, threatening human health. Other effects include extreme variations in temperature and increases in air pollution. These events may negatively impact mortality and morbidity for cardiovascular diseases. In this review, we discuss the main effects of climate changes on cardiovascular diseases, reporting the epidemiological evidences and the biological mechanisms linking climate change consequences to hypertension, diabetes, ischemic heart diseases, heart failure and stroke. Up to now, findings suggest that humans acclimate under different weather conditions, even though extreme temperatures and higher levels of air pollution can influence health-related outcomes. In these cases, climate change adversely affects cardiovascular system and the high-risk subjects for cardiovascular diseases are those more exposed. Finally, we examine climate change implications on publich health and suggest adaptation strategies to monitor the high-risk population, and reduce the amount of hospital admissions associated to these events. Such interventions may minimize the costs of public health and reduce the mortality for cardiovascular diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Impacts of Climate Change on Inequities in Child Health

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Charmian M. Bennett

2014-12-01

Full Text Available This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

Health-related mobile apps and behaviour change

African Journals Online (AJOL)

Kathryn van Boom

Health-related mobile apps and behaviour change. While our knowledge about physical activity and health, physical performance and the risk of injury increases in leaps and bounds, the conversion of this information into action and changed behaviour lags behind. There seems to be a sticking point which often causes a ...

Scaling up success to improve health: Towards a rapid assessment guide for decision makers

Directory of Open Access Journals (Sweden)

Jason Paltzer

2015-01-01

Full Text Available Introduction Evidence-based health interventions exist and are effectively implemented throughout resource-limited settings. The literature regarding scale-up strategies and frameworks is growing. The purpose of this paper is to identify and systematically document the variation in scale-up strategies to develop a rapid assessment tool for decision-makers looking to identify the most appropriate strategy for their organizational and environmental contexts. Methods A list of scale-up strategies and frameworks were identified through an in-depth literature review and conversations with scale-up and quality improvement leaders. The literature search included a broad range of terms that might be used interchangeably with scale-up of best practices. Terms included: implementation research, knowledge translation, translational research, quality improvement research, health systems improvement, scale-up, best practices, improvement collaborative, and community based research. Based on this research, 18 strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related strategies. We interviewed the key contact for four of the nine strategies to obtain additional information regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that facilitate or hinder the strategy’s success in scaling up health-related interventions were identified. Results Common features of scale-up strategies include: 1 the development of context-specific evidence; 2 collaborative partnerships; 3 iterative processes; and 4 shared decision-making. Facilitating factors include strong leadership, community engagement, communication, government collaboration, and a focus on

[Developmental changes of rapid automatized naming and Hiragana reading of Japanese in elementary-school children].

Science.gov (United States)

Kobayashi, Tomoka; Inagaki, Masumi; Gunji, Atsuko; Yatabe, Kiyomi; Kita, Yosuke; Kaga, Makiko; Gotoh, Takaaki; Koike, Toshihide

2011-11-01

Two hundred and seven Japanese elementary school children aged from 6 (Grade 1) to 12 (Grade 6) years old were tested for their abilities to name numbers and pictured objects along with reading Hiragana characters and words. These children all showed typical development and their classroom teachers judged that they were not having any problems with reading or writing. The children were randomly divided into two groups, the first group was assigned to two naming tasks;the rapid automatized naming (RAN) of "numbers" and "pictured objects," the second group was assigned to two rapid alternative stimulus (RAS) naming tasks using numbers and pictured objects. All children were asked to perform two reading tasks that were written in Hiragana script: single mora reading task and four syllable word reading task. The total articulation time for naming and reading and performance in terms of accuracy were measured for each task. Developmental changes in these variables were evaluated. The articulation time was significantly longer for the first graders, and it gradually shortened as they moved through to the upper grades in all tasks. The articulation time reached a plateau in the 5th grade for the number naming, while gradual change continued after drastic change in the lower grades for the pictured object naming. The articulation times for the single mora reading and RAN of numbers correlated strongly. The articulation time for the RAS naming was significantly longer compared to that for the RAN, though there were very few errors. The RAS naming showed the highest correlation with the four syllable word reading. This study demonstrated that the performance in rapid automatized naming of numbers and pictures were closely related with performance on reading tasks. Thus Japanese children with reading disorders such as developmental dyslexia should also be evaluated for rapid automatized naming.

Planning a change project in mental health nursing.

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Thorpe, Rebecca

2015-09-02

This article outlines a plan for a change project to improve the quality of physical health care on mental health wards. The plan was designed to improve the monitoring and recording of respiratory rates on mental health wards, through the implementation of a training programme for staff. A root cause analysis was used to explore the reasons for the low incidence of respiratory rate measurement on mental health wards, and the results of this establish the basis of the proposed change project and its aims and objectives. The article describes how the project could be implemented using a change management model, as well as how its effects could be measured and evaluated. Potential barriers to the planned change project are discussed, including the human dimensions of change. The article suggests methods to overcome such barriers, discusses the value of leadership as an important factor, and examines the principles of clinical governance in the context of the planned change project.

How Persuasive are Serious Games, Social Media and mHealth Technologies for Vulnerable Young Adults? Design Factors for Health Behavior and Lifestyle Change Support: Sexual Health Case. Proceedings Third International Workshop on Behavior Change Support Systems (BCSS 2015)

NARCIS (Netherlands)

Kulyk, Olga Anatoliyivna; van Gemert-Pijnen, Julia E.W.C.; den Daas, Chantal; David, Silke; Kelders, Saskia; Kulyk, Olga; van Gemert-Pijnen, Lisette; Oinas-Kukkonen, Harri

2015-01-01

Modern eHealth technologies, such as serious games, social media and mobile applications addressing health behavior support are evolving rapidly. High-risk young adults with low educational background and of foreign origin could especially benefit from personalized health technologies, designed for

Frequent job change and associated health.

Science.gov (United States)

Metcalfe, Chris; Davey Smith, George; Sterne, Jonathan A C; Heslop, Pauline; Macleod, John; Hart, Carole

2003-01-01

The contemporary labour market is widely regarded as having become more "flexible". It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a "preview" of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.

Changing health behaviors with social marketing.

Science.gov (United States)

Suarez-Almazor, M E

2011-08-01

Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.

Climate change and human health

DEFF Research Database (Denmark)

Warren, John A; Berner, James E; Curtis, Tine

2005-01-01

In northern regions, climate change can include changes in precipitation magnitude and frequency, reductions in sea ice extent and thickness, and climate warming and cooling. These changes can increase the frequency and severity of storms, flooding, or erosion; other changes may include drought...... or degradation of permafrost. Climate change can result in damage to sanitation infrastructure resulting in the spread of disease or threatening a community's ability to maintain its economy, geographic location and cultural tradition, leading to mental stress. Through monitoring of some basic indicators...... communities can begin to develop a response to climate change. With this information, planners, engineers, health care professionals and governments can begin to develop approaches to address the challenges related to climate change....

A Review of Frameworks for Developing Environmental Health Indicators for Climate Change and Health

Science.gov (United States)

Hambling, Tammy; Weinstein, Philip; Slaney, David

2011-01-01

The role climate change may play in altering human health, particularly in the emergence and spread of diseases, is an evolving area of research. It is important to understand this relationship because it will compound the already significant burden of diseases on national economies and public health. Authorities need to be able to assess, anticipate, and monitor human health vulnerability to climate change, in order to plan for, or implement action to avoid these eventualities. Environmental health indicators (EHIs) provide a tool to assess, monitor, and quantify human health vulnerability, to aid in the design and targeting of interventions, and measure the effectiveness of climate change adaptation and mitigation activities. Our aim was to identify the most suitable framework for developing EHIs to measure and monitor the impacts of climate change on human health and inform the development of interventions. Using published literature we reviewed the attributes of 11 frameworks. We identified the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework as the most suitable one for developing EHIs for climate change and health. We propose the use of EHIs as a valuable tool to assess, quantify, and monitor human health vulnerability, design and target interventions, and measure the effectiveness of climate change adaptation and mitigation activities. In this paper, we lay the groundwork for the future development of EHIs as a multidisciplinary approach to link existing environmental and epidemiological data and networks. Analysis of such data will contribute to an enhanced understanding of the relationship between climate change and human health. PMID:21845162

Extended impacts of climate change on health and wellbeing

International Nuclear Information System (INIS)

Thomas, Felicity; Sabel, Clive E.; Morton, Katherine; Hiscock, Rosemary; Depledge, Michael H.

2014-01-01

Highlights: • Incorporates wellbeing into understandings of climate change impacts on health. • Considers a range of secondary impacts of climate change on health and wellbeing. • Examines co-benefits and dis-benefits of climate change adaptation and mitigation strategies for health and wellbeing. • Emphasises the spatially and socially differentiated repercussions of adaptation and mitigation measures. - Abstract: Anthropogenic climate change is progressively transforming the environment despite political and technological attempts to reduce greenhouse gas emissions to tackle global warming. Here we propose that greater insight and understanding of the health-related impacts of climate change can be gained by integrating the positivist approaches used in public health and epidemiology, with holistic social science perspectives on health in which the concept of ‘wellbeing’ is more explicitly recognised. Such an approach enables us to acknowledge and explore a wide range of more subtle, yet important health-related outcomes of climate change. At the same time, incorporating notions of wellbeing enables recognition of both the health co-benefits and dis-benefits of climate change adaptation and mitigation strategies across different population groups and geographical contexts. The paper recommends that future adaptation and mitigation policies seek to ensure that benefits are available for all since current evidence suggests that they are spatially and socially differentiated, and their accessibility is dependent on a range of contextually specific socio-cultural factors

[Introduction of rapid syphilis and HIV testing in prenatal care in Colombia: qualitative analysis].

Science.gov (United States)

Ochoa-Manjarrés, María Teresa; Gaitán-Duarte, Hernando Guillermo; Caicedo, Sidia; Gómez, Berta; Pérez, Freddy

2016-12-01

Interpret perceptions of Colombian health professionals concerning factors that obstruct and facilitate the introduction of rapid syphilis and HIV testing in prenatal care services. A qualitative study based on semi-structured interviews was carried out. A convenience sample was selected with 37 participants, who included health professionals involved in prenatal care services, programs for pregnant women, clinical laboratories, and directors of health care units or centers, as well as representatives from regional departments and the Ministry of Health. Colombia does not do widespread screening with rapid syphilis and HIV tests in prenatal care. The professionals interviewed stated they did not have prior experience in the use of rapid tests-except for laboratory staff-or in the course of action in response to a positive result. The insurance system hinders access to timely diagnosis and treatment. Health authorities perceive a need to review existing standards, strengthen the first level of care, and promote comprehensive prenatal care starting with contracts between insurers and health service institutional providers. Participants recommended staff training and integration between health-policymaking and academic entities for updating training programs. The market approach and the characteristics of the Colombian health system constitute the main barriers to implementation of rapid testing as a strategy for elimination of mother-to-child transmission of syphilis and HIV. Measures identified include making changes in contracts between insurers and health service institutional providers, adapting the timing and duration of prenatal care procedures, and training physicians and nurses involved in prenatal care.

An Ill Wind? Climate Change, Migration, and Health

Science.gov (United States)

Barnett, Jon

2012-01-01

Background: Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. Objectives: In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. Methods: This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Discussion: Climate-change–related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Conclusions: Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change. PMID:22266739

Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China.

Science.gov (United States)

Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen

2016-06-14

With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved. © 2016 American Heart Association, Inc.

The health and wellbeing needs of veterans: a rapid review.

Science.gov (United States)

Oster, Candice; Morello, Andrea; Venning, Anthony; Redpath, Paula; Lawn, Sharon

2017-12-29

For the majority of serving members, life in the military has a positive effect on wellbeing. However, the type, intensity and duration of service, along with the transition from fulltime military to civilian life, may have a negative effect on veterans' wellbeing. Such negative consequences, alongside the growing veteran population, indicate the need for greater exploration of veterans' physical, mental and social wellbeing. The current paper reports on the findings of a rapid review of the literature on the health and wellbeing needs of veterans, commissioned by the Australian Department of Veterans' Affairs to inform future programs and services. The databases Embase, Medline, Cinahl, PubMed, Web of Science and Cochrane Database were searched for systematic reviews reporting on veterans' physical, mental and social wellbeing published in English in peer-reviewed journals. A total of 21 systematic reviews were included. The reviews reported on a range of mental, physical and social health problems affecting veterans. While there was limited information on prevalence rates of physical, mental and social health problems in veterans compared to civilian populations, the reviews demonstrated the interconnection between these domains and the effect of demographic and military service factors. A key finding of the review is the interconnection of the mental, physical, and social health of veterans, highlighting the importance that an integrated approach to veterans' wellbeing is adopted. It is suggested that understanding key factors, such as demographic factors and factors relating to military service, can support improved service provision for veterans.

Climate change and Public health: vulnerability, impacts, and adaptation

Science.gov (United States)

Guzzone, F.; Setegn, S.

2013-12-01

Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

Understanding and managing change in health care organizations.

Science.gov (United States)

Nagaike, K

1997-01-01

Change impacts affected people and often causes difficulties. Health care organizations, locally and nationally, have undergone tremendous change to deliver quality services in a more effective and efficient manner in a competitive environment, with varying degrees of success. This article presents Robbins's categories of change and relates them to current changes in health care organizations. It discusses areas to consider to develop adaptable plans and to assist affected employees to better deal with these changes throughout the transition.

Climate change, food, water and population health in China.

Science.gov (United States)

Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

2016-10-01

Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

OpenAIRE

Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-01-01

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within...

Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

Directory of Open Access Journals (Sweden)

Yasuhiro Homma

2014-01-01

Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

From Worker Health To Citizen Health: Moving Upstream

Science.gov (United States)

Sepulveda, Martin-Jose

2014-01-01

New rapid growth economies, urbanization, health systems crises and “big data” are causing fundamental changes in social structures and systems including health. These forces for change have significant consequences for occupational and environmental medicine and will challenge the specialty to think beyond workers and workplaces as the principal locus of innovation for health and performance. These trends are placing great emphasis on upstream strategies for addressing the complex systems dynamics of the social determinants of health. The need to engage systems in communities for healthier workforces is a shift in orientation from worker and workplace centric to citizen and community centric. This change for occupational and environmental medicine requires extending systems approaches in the workplace to communities which are systems of systems and which require different skills, data, tools and partnerships. PMID:24284749

Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

Science.gov (United States)

Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L

2017-03-01

The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Editorial: 3rd Special Issue on behavior change, health, and health disparities.

Science.gov (United States)

Higgins, Stephen T

2016-11-01

This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

Changing planet, changing health: how the climate crisis threatens our health and what we can do about it

National Research Council Canada - National Science Library

Epstein, Paul R; Ferber, Dan

2011-01-01

.... Brilliantly connecting stories of real people with cutting-edge scientific and medical information, Changing Planet, Changing Health brings us to places like Mozambique, Honduras, and the United...

Observations on the health of infants at a time of rapid societal change: a longitudinal study from birth to fifteen months in Abu Dhabi.

Science.gov (United States)

Gardner, Hazel; Green, Katherine; Gardner, Andrew S; Geddes, Donna

2018-02-07

Rapid economic and cultural transition in the United Arab Emirates has been accompanied by a rise in chronic disease. Early childhood is known to affect health outcomes in adulthood. This prospective longitudinal study examined the general health of Emirati infants born in a government maternity hospital in the Emirate of Abu Dhabi in October 2002. One hundred twenty-five women, who had recently given birth, were interviewed as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health. They were then re-interviewed at three (n = 94), six (n = 59) and 15 months postpartum (n = 52). Data are presented using univariate statistics. In this study seven infants (6%) were born prematurely and four infants (3%) were classified as small for gestational age, while 11 (9%) of the infants weighed less than 2500 g. Low birth weight infants (LBW) were significantly more likely to require treatment in the neonatal intensive care unit (OR = 30.83, p = 0.00). Iron supplementation during pregnancy was associated with fewer underweight infants (OR = 3.92, p = 0.042). No associations were found between infant birth weight and maternal age, age at marriage, consanguinity, education level, current maternal employment, parity, pre-existing anaemia or anaemia in pregnancy, diabetes, folic acid intake, multivitamin intake or infant gender. Maternally-reported infant health issues, vaccination, medication, breast-feeding and infant nutrition, and use of secure car seats are also reported. The health of infants at birth in this UAE sample showed improvements compared to previous studies. The proportion of LBW infants is decreasing and continuing improvements in health care in the UAE are having a positive impact on infant health.

Evolution under changing climates: climatic niche stasis despite rapid evolution in a non-native plant.

Science.gov (United States)

Alexander, Jake M

2013-09-22

A topic of great current interest is the capacity of populations to adapt genetically to rapidly changing climates, for example by evolving the timing of life-history events, but this is challenging to address experimentally. I use a plant invasion as a model system to tackle this question by combining molecular markers, a common garden experiment and climatic niche modelling. This approach reveals that non-native Lactuca serriola originates primarily from Europe, a climatic subset of its native range, with low rates of admixture from Asia. It has rapidly refilled its climatic niche in the new range, associated with the evolution of flowering phenology to produce clines along climate gradients that mirror those across the native range. Consequently, some non-native plants have evolved development times and grow under climates more extreme than those found in Europe, but not among populations from the native range as a whole. This suggests that many plant populations can adapt rapidly to changed climatic conditions that are already within the climatic niche space occupied by the species elsewhere in its range, but that evolution to conditions outside of this range is more difficult. These findings can also help to explain the prevalence of niche conservatism among non-native species.

Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

Directory of Open Access Journals (Sweden)

Åsa Holmner

2012-06-01

Full Text Available Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

Science.gov (United States)

Holmner, Åsa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

2012-01-01

Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT)’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies. PMID:22679398

The Science of Sustaining Health Behavior Change: The Health Maintenance Consortium

Science.gov (United States)

Ory, Marcia G.; Smith, Matthew Lee; Mier, Nelda; Wernicke, Meghan M.

2013-01-01

Objective The Health Maintenance Consortium (HMC) is a multisite Grantee Consortium funded by the National Institutes of Health from 2004–2009. The goal of HMC is to enhance understanding of the long-term maintenance of behavior change, as well as effective strategies for achieving sustainable health promotion and disease prevention. Methods This introductory research synthesis prepared by the Resource Center gives context to this theme issue by providing an overview of the HMC and the articles in this journal. Results It explores the contributions to our conceptualization of behavior change processes and intervention strategies, the trajectory of effectiveness of behavioral and social interventions, and factors influencing the long-term maintenance of behavioral and social interventions. Conclusions Future directions for furthering the science of maintaining behavior change and reducing the gaps between research and practice are recommended. PMID:20604691

Specific changes in rapidly transported proteins during regeneration of the goldfish optic nerve

International Nuclear Information System (INIS)

Benowitz, L.I.; Shashoua, V.E.; Yoon, M.G.

1981-01-01

Double labeling methods were used to identify changes in the complement of proteins synthesized in the retinal ganglion cells and transported down the optic nerve during the process of axonal regeneration. Eight to 62 days after goldfish underwent a unilateral optic nerve crush, one eye was labeled with [3H]-, the other with [14C]proline. Control and regenerating optic nerves were dissected out and homogenized together after 5 hr, a time which allowed us to examine selectively membrane-bound components which migrate in the rapid phase of axoplasmic transport. Proteins from the two sides were so-purified and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Analysis of the 3H and 14C incorporation patterns along the gels revealed a radical shift away from the normal labeling spectrum during regeneration, with selective changes in labeling at particular molecular weights varying over a 3-fold range. Eight days after crushing the optic nerve, the greatest increases in labeling were seen for material with apparent molecular weights of 24,000 to 27,000, 44,000, and 210,000 daltons. These peaks declined thereafter, and on days 29 to 39, the most prominent increases were at 110,000 to 140,000 daltons. These studies indicate a continuously changing pattern in the synthesis and/or degradation of proteins that are rapidly transported down the optic nerve during regeneration and point to molecular species potential significance in the establishment of the visual map upon the brain

Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

Science.gov (United States)

Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-03-22

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Changes in health indicators related to health promotion and microcredit programs in the Dominican Republic.

Science.gov (United States)

Dohn, Anita L; Chávez, Andrea; Dohn, Michael N; Saturria, Luis; Pimentel, Carlos

2004-03-01

To assess the impact of health promotion programs and microcredit programs on three communities in the Dominican Republic. One community had only the health promotion program, one community had only the microcredit program, and one community had both a health promotion program and a microcredit program. This pilot project examined the hypothesis that the largest changes in 11 health indicators that were studied would be in the community with both a health promotion program and a microcredit program, that there would be intermediate changes in the community with only a health promotion program, and that the smallest changes would be in the community with only a microcredit program. The health promotion programs used community volunteers to address two major concerns: (1) the prevalent causes of mortality among children under 5 years of age and (2) women's health (specifically breast and cervical cancer screening). The microcredit program made small loans to individuals to start or expand small businesses. Outcome measures were based on comparisons for 11 health indicators from baseline community surveys (27 households surveyed in each of the three communities, done in December 2000 and January 2001) and from follow-up surveys (also 27 households surveyed in each of the three communities, in June and July 2002, after the health promotion program had been operating for about 13 months). Households were randomly chosen during both the baseline and follow-up surveys, without regard to their involvement in the microcredit or health promotion programs. The health indicators improved in all three communities. However, the degree of change was different among the communities (P microcredit and health promotion programs had the largest changes for 10 of the 11 health indicators. Multisector development is known to be important on a macroeconomic scale. The results of this pilot project support the view that multisector development is also important on a microeconomic level

Climate Change, Public Health, and Policy: A California Case Study.

Science.gov (United States)

Ganesh, Chandrakala; Smith, Jason A

2018-04-01

Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California's progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions.

Climate Change, Public Health, and Policy: A California Case Study

Science.gov (United States)

Smith, Jason A.

2018-01-01

Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California’s progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions. PMID:29072936

Rapidly Assessing Changes in Bone Mineral Balance Using Natural Stable Calcium Isotopes

Science.gov (United States)

Morgan, J. L. L.; Gordon, G. W.; Romaniello, S. J.; Skulan, J. L.; Smith, S. M.; Anbar, A. D.

2011-01-01

We demonstrate that variations in the Ca isotope ratios in urine rapidly and quantitatively reflect changes in bone mineral balance. This variation occurs because bone formation depletes soft tissue of light Ca isotopes, while bone resorption releases that isotopically light Ca back into soft tissue. In a study of 12 individuals confined to bed rest, a condition known to induce bone resorption, we show that Ca isotope ratios shift in a direction consistent with net bone loss after just 7 days, long before detectible changes in bone density occur. Consistent with this interpretation, the Ca isotope variations track changes observed in N-teleopeptide, a bone resorption biomarker, while bone-specific alkaline phosphatase, a bone formation biomarker, is unchanged. Ca isotopes can in principle be used to quantify net changes in bone mass. Ca isotopes indicate an average loss of 0.62 +/- 0.16 % in bone mass over the course of this 30-day study. The Ca isotope technique should accelerate the pace of discovery of new treatments for bone disease and provide novel insights into the dynamics of bone metabolism.

Achieving organizational change: findings from a case study of health promoting hospitals in Taiwan.

Science.gov (United States)

Lee, Chiachi Bonnie; Chen, Michael S; Powell, Michael; Chu, Cordia Ming-Yeuk

2014-06-01

The Taiwanese Network of Health Promoting Hospitals (HPH) has been in place since 2006 and developing rapidly. The criticism of inadequate evaluation of the HPH approach taken elsewhere also holds true for the Taiwan HPH Network. Organizational change is a key to sustainable and effective health promotion, and it is also an important aspect in the European HPH movement. Therefore, this study aims to evaluate changes in organizational capacity for the implementation of HPH in Taiwan. All 55 HPH coordinators were invited to participate in the study, and 52 of them completed the questionnaires. The survey covered seven dimensions of HPH organizational capacity, and a total score of each dimension was calculated and converted to a figure on a scale of 10. This study has shown that HPH made a positive impact on HP hospitals in Taiwan regarding organizational change in capacity building for HPH. Leadership, organization culture and mission and strategy received the top three highest mean scores (8.19 ± 1.25, 8.08 ± 1.39, 7.99 ± 1.42), while staff participation received the lowest score (7.62 ± 1.26). The high level of organizational change was associated with the high satisfaction levels of organizational support from the viewpoint of the HPH coordinators. Based on a cluster analysis, a majority of the HP hospitals in Taiwan seemed to have adopted the addition model in putting the HPH initiative into practice; a few hospitals appeared to have accepted HPH initiative well through the integration model. These results presented evidence that HPH contributed to organizational capacity building of hospitals for health promotion.

Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain.

Science.gov (United States)

Demiris, G

2016-05-20

Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges.

More rapid climate change promotes evolutionary rescue through selection for increased dispersal distance.

Science.gov (United States)

Boeye, Jeroen; Travis, Justin M J; Stoks, Robby; Bonte, Dries

2013-02-01

Species can either adapt to new conditions induced by climate change or shift their range in an attempt to track optimal environmental conditions. During current range shifts, species are simultaneously confronted with a second major anthropogenic disturbance, landscape fragmentation. Using individual-based models with a shifting climate window, we examine the effect of different rates of climate change on the evolution of dispersal distances through changes in the genetically determined dispersal kernel. Our results demonstrate that the rate of climate change is positively correlated to the evolved dispersal distances although too fast climate change causes the population to crash. When faced with realistic rates of climate change, greater dispersal distances evolve than those required for the population to keep track of the climate, thereby maximizing population size. Importantly, the greater dispersal distances that evolve when climate change is more rapid, induce evolutionary rescue by facilitating the population in crossing large gaps in the landscape. This could ensure population persistence in case of range shifting in fragmented landscapes. Furthermore, we highlight problems in using invasion speed as a proxy for potential range shifting abilities under climate change.

Future health care technology and the hospital

NARCIS (Netherlands)

Banta, H.D.

1990-01-01

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

Protecting health from climate change: Preparedness of medical interns

Directory of Open Access Journals (Sweden)

Majra Jai

2009-01-01

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

Health Behaviour Change Through Computer Games: Characterising Interventions.

Science.gov (United States)

Poultney, Nathan; Maeder, Anthony; Ginige, Jeewani Anupama

2016-01-01

Recently games in the form of video, computer, or mobile apps have been utilised as an effective component of interventions for health behaviour change. This paper provides an overview of related projects reported in peer-review literature in the period 2006 to 2016. Nine highly relevant references were considered for analysis. The findings are presented according to 3 dimensions of characterisation: health intention, behaviour change principle, and health purpose.

Rapid change of ion energy distribution and floating potential at L/H transition in the JFT-2M tokamak

International Nuclear Information System (INIS)

Miura, Y.; Nagashima, K.; Okano, F.

1994-01-01

Rapid changes of the main ion energy distribution at transitions from L-to-H, H-to-L and during ELMs are studied with the time of flight neutral measurement in the JFT-2M tokamak. The change of the main ion energy distribution after sawtooth crash during an L-mode phase is also studied. The change of the ion energy distribution just after sawtooth crash is the same as that at L/H-transition. The floating potential measured in the SOL also shows the rapid jump to more positive just after the sawtooth crash (at the same time of the change of an ion energy distribution). This shows the increase of ion outflux in the SOL and might correspond to the change of the ion energy distribution. This may be the reason why most of H-modes are triggered by a sawtooth. (author)

Self-guided Change: The most common form of long-term, maintained health behavior change

Science.gov (United States)

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review—similar in nature to a scoping review—was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80–90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated. PMID:29375888

Apps seeking theories: results of a study on the use of health behavior change theories in cancer survivorship mobile apps.

Science.gov (United States)

Vollmer Dahlke, Deborah; Fair, Kayla; Hong, Y Alicia; Beaudoin, Christopher E; Pulczinski, Jairus; Ory, Marcia G

2015-03-27

Thousands of mobile health apps are now available for use on mobile phones for a variety of uses and conditions, including cancer survivorship. Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories. This study is designed to assess the presence of and manner in which health behavior change and health communication theories are applied in mobile phone cancer survivorship apps. The research team selected a set of criteria-based health apps for mobile phones and assessed each app using qualitative coding methods to assess the application of health behavior change and communication theories. Each app was assessed using a coding derived from the taxonomy of 26 health behavior change techniques by Abraham and Michie with a few important changes based on the characteristics of mHealth apps that are specific to information processing and human computer interaction such as control theory and feedback systems. A total of 68 mobile phone apps and games built on the iOS and Android platforms were coded, with 65 being unique. Using a Cohen's kappa analysis statistic, the inter-rater reliability for the iOS apps was 86.1 (Papps, 77.4 (Papps were consistently higher than those of the Android platform apps. For personalization and tailoring, 67% of the iOS apps (24/36) had these elements as compared to 38% of the Android apps (12/32). In the area of prompting for intention formation, 67% of the iOS apps (34/36) indicated these elements as compared to 16% (5/32) of the Android apps. Mobile apps are rapidly emerging as a way to deliver health behavior change interventions that can be tailored or personalized for individuals. As these apps and games continue to evolve and include interactive and adaptive sensors and other forms of dynamic feedback, their content and interventional elements need to be grounded in human computer interface design and health

Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-12-09

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

Directory of Open Access Journals (Sweden)

Shilu Tong

2013-03-01

Full Text Available Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA, there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Change in vision, visual disability, and health after cataract surgery.

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Helbostad, Jorunn L; Oedegaard, Maria; Lamb, Sarah E; Delbaere, Kim; Lord, Stephen R; Sletvold, Olav

2013-04-01

Cataract surgery improves vision and visual functioning; the effect on general health is not established. We investigated if vision, visual functioning, and general health follow the same trajectory of change the year after cataract surgery and if changes in vision explain changes in visual disability and general health. One-hundred forty-eight persons, with a mean (SD) age of 78.9 (5.0) years (70% bilateral surgery), were assessed before and 6 weeks and 12 months after surgery. Visual disability and general health were assessed by the CatQuest-9SF and the Short Formular-36. Corrected binocular visual acuity, visual field, stereo acuity, and contrast vision improved (P visual acuity evident up to 12 months (P = 0.034). Cataract surgery had an effect on visual disability 1 year later (P visual disability and general health 6 weeks after surgery. Vision improved and visual disability decreased in the year after surgery, whereas changes in general health and visual functioning were short-term effects. Lack of associations between changes in vision and self-reported disability and general health suggests that the degree of vision changes and self-reported health do not have a linear relationship.

Is change bad? Personality change is associated with poorer psychological health and greater metabolic syndrome in midlife

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Human, Lauren J.; Biesanz, Jeremy C.; Miller, Gregory E.; Chen, Edith; Lachman, Margie E.; Seeman, Teresa E.

2013-01-01

Objective Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Method Utilizing the longitudinal Midlife in the United States Survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Results Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. Conclusions In sum, too much personality change may be bad for one’s health: socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality. PMID:22924900

Is change bad? Personality change is associated with poorer psychological health and greater metabolic syndrome in midlife.

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Human, Lauren J; Biesanz, Jeremy C; Miller, Gregory E; Chen, Edith; Lachman, Margie E; Seeman, Teresa E

2013-06-01

Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Utilizing the longitudinal Midlife in the United States survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. In sum, too much personality change may be bad for one's health: Socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality. © 2012 Wiley Periodicals, Inc.

Reducing health risks from indoor exposures in rapidly developing urban China.

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Zhang, Yinping; Mo, Jinhan; Weschler, Charles J

2013-07-01

Over the past two decades there has been a large migration of China's population from rural to urban regions. At the same time, residences in cities have changed in character from single-story or low-rise buildings to high-rise structures constructed and furnished with many synthetic materials. As a consequence, indoor exposures (to pollutants with outdoor and indoor sources) have changed significantly. We briefly discuss the inferred impact that urbanization and modernization have had on indoor exposures and public health in China. We argue that growing adverse health costs associated with these changes are not inevitable, and we present steps that could be taken to reduce indoor exposures to harmful pollutants. As documented by China's Ministry of Health, there have been significant increases in morbidity and mortality among urban residents over the past 20 years. Evidence suggests that the population's exposure to air pollutants has contributed to increases in lung cancer, cardiovascular disease, pulmonary disease, and birth defects. Whether a pollutant has an outdoor or an indoor source, most exposure to the pollutant occurs indoors. Going forward, indoor exposures can be reduced by limiting the ingress of outdoor pollutants (while providing adequate ventilation with clean air), minimizing indoor sources of pollutants, updating government policies related to indoor pollution, and addressing indoor air quality during a building's initial design. Taking the suggested steps could lead to significant reductions in morbidity and mortality, greatly reducing the societal costs associated with pollutant derived ill health.

Climate Change and Public Health Policy: Translating the Science

Directory of Open Access Journals (Sweden)

Marieta Braks

2013-12-01

Full Text Available Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

Climate change and public health policy: translating the science.

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Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-12-19

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

Climate Change and Public Health Policy: Translating the Science

Science.gov (United States)

Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-01-01

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character. PMID:24452252

One Health – a strategy for resilience in a changing arctic

Directory of Open Access Journals (Sweden)

Bruce A. Ruscio

2015-09-01

Full Text Available The circumpolar north is uniquely vulnerable to the health impacts of climate change. While international Arctic collaboration on health has enhanced partnerships and advanced the health of inhabitants, significant challenges lie ahead. One Health is an approach that considers the connections between the environment, plant, animal and human health. Understanding this is increasingly critical in assessing the impact of global climate change on the health of Arctic inhabitants. The effects of climate change are complex and difficult to predict with certainty. Health risks include changes in the distribution of infectious disease, expansion of zoonotic diseases and vectors, changing migration patterns, impacts on food security and changes in water availability and quality, among others. A regional network of diverse stakeholder and transdisciplinary specialists from circumpolar nations and Indigenous groups can advance the understanding of complex climate-driven health risks and provide community-based strategies for early identification, prevention and adaption of health risks in human, animals and environment. We propose a regional One Health approach for assessing interactions at the Arctic human–animal–environment interface to enhance the understanding of, and response to, the complexities of climate change on the health of the Arctic inhabitants.

Social Change and Health Policy in Venezuela

Directory of Open Access Journals (Sweden)

Nuramy J. Gutiérrez

2008-07-01

Full Text Available This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.

Assessment of the Health Impacts of Climate Change in Kiribati

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McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

2014-01-01

Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

The Future of Occupational Health Nursing in a Changing Health Care System.

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McCauley, Linda; Peterman, Katherine

2017-04-01

Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.

[Rapid determination of illicit beta2-agonist additives in health foods and traditional Chinese patent medicines with DCBI-MS/MS method].

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Hou, Yu-Lan; Wu, Shuang; Wang, Hua; Zhao, Yong; Liao, Peng; Tian, Qing-Qing; Sun, Wen-Jian; Chen, Bo

2013-01-01

A novel rapid method for detection of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines was developed with the desorption corona beam ionization mass spectrometry (DCBI-MS) technique. The DCBI conditions including temperature and sample volume were optimized according to the resulting mass spectra intensity. Matrix effect on 9 beta2-agonists additives was not significant in the proposed rapid determination procedure. All of the 9 target molecules were detected within 1 min. Quantification was achieved based on the typical fragment ion in MS2 spectra of each analyte. The method showed good linear coefficients in the range of 1-100 mg x L(-1) for all analytes. The relative deviation values were between 14.29% and 25.13%. Ten claimed antitussive and antiasthmatic health foods and traditional Chinese patent medicines from local pharmacies were analyzed. All of them were negative with the proposed DCBI-MS method. Without tedious sample pretreatments, the developed DCBI-MS is simple, rapid and sensitive for rapid qualification and semi-quantification of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines.

The Effects of Climate Change on Cardiac Health.

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De Blois, Jonathan; Kjellstrom, Tord; Agewall, Stefan; Ezekowitz, Justin A; Armstrong, Paul W; Atar, Dan

2015-01-01

The earth's climate is changing and increasing ambient heat levels are emerging in large areas of the world. An important cause of this change is the anthropogenic emission of greenhouse gases. Climate changes have a variety of negative effects on health, including cardiac health. People with pre-existing medical conditions such as cardiovascular disease (including heart failure), people carrying out physically demanding work and the elderly are particularly vulnerable. This review evaluates the evidence base for the cardiac health consequences of climate conditions, with particular reference to increasing heat exposure, and it also explores the potential further implications. © 2015 S. Karger AG, Basel.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-01-01

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

Public Health Adaptation to Climate Change in OECD Countries

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Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

2016-01-01

Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning. PMID:27618074

Public Health Adaptation to Climate Change in OECD Countries.

Science.gov (United States)

Austin, Stephanie E; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D; Parker, Stephen; Fleury, Manon D

2016-09-07

Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

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Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

2010-01-01

Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

Impacts of Climate Change on Human Health in the United ...

Science.gov (United States)

Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

Health care delivery in Malaysia: changes, challenges and champions

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Thomas, Susan; Beh, LooSee; Nordin, Rusli Bin

2011-01-01

Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care. PMID:28299064

Climate change: challenges and opportunities for global health.

Science.gov (United States)

Patz, Jonathan A; Frumkin, Howard; Holloway, Tracey; Vimont, Daniel J; Haines, Andrew

2014-10-15

Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy. To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions. We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center. By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be

Climate change, human health, and biomedical research: analysis of the National Institutes of Health research portfolio.

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Jessup, Christine M; Balbus, John M; Christian, Carole; Haque, Ehsanul; Howe, Sally E; Newton, Sheila A; Reid, Britt C; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P

2013-04-01

According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH's strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health.

Climate change impacts health in Tunisia | IDRC - International ...

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

2012-03-26

Mar 26, 2012 ... Research is showing that climate change is having major impacts on human health. Weather-related disasters are on the rise and water- and vector-borne diseases are spreading. Strategies to adapt to the effects of climate change may also pose unforeseen health risks. Read more about a project in ...

Accounting for health in climate change policies: a case study of Fiji.

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Morrow, Georgina; Bowen, Kathryn

2014-01-01

Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to consider climate change and its impact on human

Accounting for health in climate change policies: a case study of Fiji

Directory of Open Access Journals (Sweden)

Georgina Morrow

2014-05-01

Full Text Available Background: Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. Objective: The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. Design: The study employed a three-pronged policy analysis to evaluate: 1 the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2 the context within which the policy was developed; 3 the relevant processes; and 4 the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. Results: The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. Conclusions: The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should

The gender perspective in climate change and global health

Directory of Open Access Journals (Sweden)

Birgitta Evengård

2010-12-01

Full Text Available Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policy-making concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms ‘climate change,’ ‘health,’ ‘gender,’ and ‘policy.’ Climate change and health-related policy documents of the World Health Organization (WHO and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study's viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.

The Challenge of Behaviour Change and Health Promotion

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Glenn Laverack

2017-10-01

Full Text Available The evidence about the effectiveness of behaviour change approaches—what works and what does not work—is unclear. What we do know is that single interventions that target a specific behavioural risk have little impact on the determinants that actually cause poor health, especially for vulnerable people. This has not prevented health promoters from continuing to invest in behaviour change interventions which are widely used in a range of programs. The future of behaviour change and health promotion is through the application of a comprehensive strategy with three core components: (1 a behaviour change approach; (2 a strong policy framework that creates a supportive environment and (3 the empowerment of people to gain more control over making healthy lifestyle decisions. This will require the better planning of policy interventions and the coordination of agencies involved in behaviour change and empowerment activities at the community level, with government to help develop policy at the national level.

Time and change in health care.

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Waterworth, Susan

2017-10-02

Purpose The purpose of this paper is to explore the dimensions of temporality that are rarely considered in the literature on leading change. Design/methodology/approach The analysis is informed by Adams' (1995) social theory of time encompassing temporality, timing and tempo. This will illustrate the complexities of time as they relate to the individual, teams and organisation. Findings This paper demonstrates the multidimensional nature of time: temporality, timing and tempo, and how each of these can contribute to our understanding of the temporal nature and complexity of change within the health system. A framework to inform much-needed research in the area of time and change is presented. Practical implications Challenging assumptions that there is only one common time, that is clock time, can provide opportunities for further discussion and understanding of how various people view time and the influence this has on leading and participating in change in health care. Originality/value There is limited literature on the temporal dimensions of change at an organisational, team and individual level. The perspective offered in this paper presents the multidimensional nature of time and the influence this has on understanding the temporal nature of change and critically identifies some key areas for future research.

Health behaviour changes and onset of chronic health problems in later life

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Marijke Veenstra

2012-11-01

Full Text Available Objectives: To assess five-year changes in health behaviours in later life and associations with onset of chronic health problems. The results may inform policy and interventions to promote healthy life years in ageing populations.Methods: Data are derived from the Norwegian study on Life-course, Ageing and Generation (NorLAG, a five-year (2002-2007 panel survey comprising a nation wide community sample. The present analyses include a sample of 1,019 respondents aged 60 years and older. Five-year changes in smoking, alcohol use, physical exercise and Body Mass Index (BMI are assessed according to prevalent and incident chronic health problems. Multivariate logistic analyses of “healthy” behavioural changes are conducted.Results: A total of 453 respondents (45% reported at least one chronic condition and 13% (N=133 reported onset of chronic conditions in the course of the past five years. Over a five-year period, there was an overall reduction in smoking rates and a decrease in regular physical activity. Alcohol consumption in older people slightly increased over time, but the incidence of chronic health problems tended to reduce alcohol intake. Older persons experiencing chronic health problems were less likely to initiate physical activity.Conclusions: The results provide limited support for the assumption that the onset of a chronic health condition triggers improved health behaviours. This suggests that the health care system could do more in targeting a potential “window of opportunity” for individuals to adopt new healthy behaviours in later life.

Editorial: 2nd Special Issue on behavior change, health, and health disparities.

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Higgins, Stephen T

2015-11-01

This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

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Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

2017-12-11

To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems

Directory of Open Access Journals (Sweden)

Marleen Kraaij-Dirkzwager

2017-12-01

Full Text Available To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS, and concerns about the process to control the risks. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS, and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Roundtable on health and climate change : summary proceedings, final report

International Nuclear Information System (INIS)

2001-02-01

The gradual warming of the earth's atmosphere is expected to increase the frequency and severity of droughts, winter storms and tornadoes, change the pattern and distribution of many diseases and allergens, and cause a rise in the number of very hot days in larger cities, exasperating existing smog problems. This paper provides highlights of the Roundtable on Health and Climate Change held in September 2000. The discussions focused on the fact that climatic and environmental factors are important determinants of human and ecosystem health. The major findings and outcomes that received the most attention during the Roundtable process were presented. The panellists addressed the following five themes linking health and climate change: (1) health impacts and costs of climate change, (2) health implications of reducing emissions, (3) climate change scenarios, (4) the role of the health sector, and (5) collaborative and coordinated approaches. Each theme reflected the mandate of public health which is to prevent disease, ease suffering and heal the sick. Several actions were recommended by the panelists for collaborative action between health professionals, special interest groups and all levels of government and the private sector

Climate Change, Human Health, and Biomedical Research: Analysis of the National Institutes of Health Research Portfolio

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Balbus, John M.; Christian, Carole; Haque, Ehsanul; Howe, Sally E.; Newton, Sheila A.; Reid, Britt C.; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P.

2013-01-01

Background: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. Objectives: In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. Methods: A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. Results: This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Conclusions: Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH’s strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health. PMID:23552460

Health Implications of Climate Change: a Review of the Literature About the Perception of the Public and Health Professionals.

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Hathaway, Julia; Maibach, Edward W

2018-03-01

Through a systematic search of English language peer-reviewed studies, we assess how health professionals and the public, worldwide, perceive the health implications of climate change. Among health professionals, perception that climate change is harming health appears to be high, although self-assessed knowledge is low, and perceived need to learn more is high. Among the public, few North Americans can list any health impacts of climate change, or who is at risk, but appear to view climate change as harmful to health. Among vulnerable publics in Asia and Africa, awareness of increasing health harms due to specific changing climatic conditions is high. Americans across the political and climate change opinion spectra appear receptive to information about the health aspects of climate change, although findings are mixed. Health professionals feel the need to learn more, and the public appears open to learning more, about the health consequences of climate change.

History in health: health promotion's underexplored tool for change.

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Madsen, Wendy

2018-01-01

This paper outlined an argument as to why history and historians should be included in a healthy settings approach. Qualitative descriptive study. A narrative review of the literature across a broad cross-section of history, health promotion and public health disciplines was undertaken. Three reasons for including history were identified relating to the social role of history as a means of analysing social memory, of changing social narratives and by raising social consciousness. This allowed for a distinction between history in health and history of health. Precedents of this social role can be found in the fields of feminist and postcolonial histories, oral history and museums in health. Reasons for why historians and health promotion practitioners and researchers have not previously had working relationships were explored, as were some of the factors that would need to be considered for such relationships to work well, including the need to recognise different languages, different understandings of the role of history, and a potential lack of awareness of the health implications of historical work. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Nurses' occupational health as a driver for curriculum change emphasising health promotion: an historical research study.

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Wood, Pamela J

2014-05-01

Reasons stated for curriculum change in nursing education are usually shifts in knowledge, care delivery, roles, regulatory standards and population health needs. In New Zealand in the 1930s, a curriculum change was driven instead by the need to protect and promote nurses' health. Tuberculosis was an international occupational health risk among nurses. Mary Lambie, New Zealand's chief nurse, considered nursing a "hazardous profession". One remedy she instituted was curriculum change in the national nurse training programme to emphasise health promotion among nurses. Global nursing issues today also impact on nurses' health. Curriculum changes again address this by promoting self-care and resilience. To examine how international and national concern for nurses' occupational health drove a curriculum change in New Zealand nurse training in the 1930s. Historical Research International occupational health reports (1930s), Lambie's annual reports (1932-1950), and questions and examiners' comments in a new state examination (1940s-1950s), were analysed to identify the reasons for and direction of the curriculum change. Findings were interpreted within international and national concerns and measures related to occupational health in nursing. Lambie used the political leverage of international and national worry over tuberculosis as a nursing occupational health risk to protect nurses' health more generally. In 1933 she revised the first year of the three-year national nursing curriculum to emphasise personal hygiene and bacteriology related to cross-infection, and in 1938 introduced a State Preliminary Examination at the end of the first year of training to test this knowledge. Analysis of examinations, 1940s-1950s, confirms that the curriculum change driver was a concern to make nursing a less "hazardous profession". Nurse educators today should be aware of the variety of factors that can lead to curriculum change in nursing. In addition, concern for nurses' health

Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India.

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Kumar, A M V; Satyanarayana, S; Wilson, N C; Chadha, S S; Gupta, D; Nair, S; Zachariah, R; Kapur, A; Harries, A D

2014-06-21

In 2011, bi-directional screening for tuberculosis (TB) and diabetes mellitus (DM) was recommended by the World Health Organization (WHO), although how best to implement the activity was not clear. In India, with early engagement of national programme managers and all important stakeholders, a countrywide, multicentre operational research (OR) project was designed in October 2011 and completed in 2012. The results led to a rapid national policy decision to routinely screen all TB patients for DM in September 2012. The process, experience and enablers of implementing this unique and successful collaborative model of operational research are presented.

Rapid evolution of phenology during range expansion with recent climate change.

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Lustenhouwer, Nicky; Wilschut, Rutger A; Williams, Jennifer L; van der Putten, Wim H; Levine, Jonathan M

2018-02-01

Although climate warming is expected to make habitat beyond species' current cold range edge suitable for future colonization, this new habitat may present an array of biotic or abiotic conditions not experienced within the current range. Species' ability to shift their range with climate change may therefore depend on how populations evolve in response to such novel environmental conditions. However, due to the recent nature of thus far observed range expansions, the role of rapid adaptation during climate change migration is only beginning to be understood. Here, we evaluated evolution during the recent native range expansion of the annual plant Dittrichia graveolens, which is spreading northward in Europe from the Mediterranean region. We examined genetically based differentiation between core and edge populations in their phenology, a trait that is likely under selection with shorter growing seasons and greater seasonality at northern latitudes. In parallel common garden experiments at range edges in Switzerland and the Netherlands, we grew plants from Dutch, Swiss, and central and southern French populations. Population genetic analysis following RAD-sequencing of these populations supported the hypothesized central France origins of the Swiss and Dutch range edge populations. We found that in both common gardens, northern plants flowered up to 4 weeks earlier than southern plants. This differentiation in phenology extended from the core of the range to the Netherlands, a region only reached from central France over approximately the last 50 years. Fitness decreased as plants flowered later, supporting the hypothesized benefits of earlier flowering at the range edge. Our results suggest that native range expanding populations can rapidly adapt to novel environmental conditions in the expanded range, potentially promoting their ability to spread. © 2017 John Wiley & Sons Ltd.

Health behavior change in hearing healthcare: a discussion paper

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Vinaya K. C. Manchaiah

2012-02-01

Full Text Available Health behavior change (HBC refers to facilitating changes to habits and/or behavior related to health. In healthcare practice, it is quite common that the interactions between practitioner and patient involve conversations related to HBC. This could be mainly in relation to the practitioner trying to directly persuade the patients to make some changes in their health behavior. However, the patients may not be motivated to do so as they do not see this change as important. For this reason, direct persuasion may result in a breakdown of communication. In such instances, alternative approaches and means of indirect persuasion, such as empowering the patient and their family members, could be helpful. Furthermore, there are several models and/or theories proposed which explain the health behavior and also provide a structured framework for health behavior change. Many such models/approaches have been proven effective in facilitating HBC and health promotion in areas such as cessation of smoking, weight loss and so on. This paper provides an overview of main models/theories related to HBC and some insights into how these models/approaches could be adapted to facilitate behavior change in hearing healthcare, mainly in relation to: i hearing help-seeking and hearing-aid uptake; and ii hearing conservation in relation to music-induced hearing loss (MIHL. In addition, elements of current research related to this area and future directions are highlighted.

A pilot biomedical engineering course in rapid prototyping for mobile health.

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Stokes, Todd H; Venugopalan, Janani; Hubbard, Elena N; Wang, May D

2013-01-01

Rapid prototyping of medically assistive mobile devices promises to fuel innovation and provides opportunity for hands-on engineering training in biomedical engineering curricula. This paper presents the design and outcomes of a course offered during a 16-week semester in Fall 2011 with 11 students enrolled. The syllabus covered a mobile health design process from end-to-end, including storyboarding, non-functional prototypes, integrated circuit programming, 3D modeling, 3D printing, cloud computing database programming, and developing patient engagement through animated videos describing the benefits of a new device. Most technologies presented in this class are open source and thus provide unlimited "hackability". They are also cost-effective and easily transferrable to other departments.

Millennial health care: change you can believe in.

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Pingleton, Susan K

2012-07-01

A millennium is 1,000 years. In little over a decade after the beginning of the new millennium in 2000, remarkable changes have occurred in health-care education and health-care delivery. A new millennial generation of students, trainees, junior faculty, and young practicing physicians has come of age. The numbers of women in medicine have vastly increased. Technology has impacted education with an array of educational content-delivery techniques vastly different from the usual broadcast method of teaching. New curricula have expanded to encompass teamwork with interprofessional education of the entire team. Outcomes of educational efforts now include not only knowledge transfer but also performance improvement. Delivery of health care is also dramatically different. The sentinel driver of the quality and patient safety moment, To Err Is Human, was published only 12 years ago, yet fundamental changes in expectations and measurement for health-care quality and safety have occurred to alter the health-care landscape. Financing health care has become a prime issue in the current state of the US economy. New themes in health-care delivery include teamwork and highly functioning teams to improve patient safety, the dramatic increase in palliative care and end-of-life care, and the expanded role of nursing in health-care delivery. Each issue emanating since the beginning of the millennium does not have a right vs wrong implication. This discussion is an apolitical "environmental scan" with the purpose of illuminating these dramatic changes and then outlining the implications for health-care education and health-care delivery in the coming years.

Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review.

OpenAIRE

Fitzpatrick-Lewis, D; Ganann, R; Krishnaratne, S; Ciliska, D; Kouyoumdjian, F; Hwang, SW

2011-01-01

Abstract Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databas...

Impact of organisational change on mental health: a systematic review.

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Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

2012-08-01

Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.

Management system of organizational and economic changes in health services

Directory of Open Access Journals (Sweden)

Natalya Vasilyevna Krivenko

2013-03-01

Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

The changing emphases in health physics

International Nuclear Information System (INIS)

Denham, D.H.; Kathren, R.L.

1987-11-01

This paper explores the changing emphases in health physics as evidenced by the subject matter of published papers in four primary English language journals of interest to health physicists. Articles from each journal were first grouped by subject and date of publication and were then compiled according to the list of professional domains practiced by health physicists. Five domains of practice were examined, measurements including dosimetry and environmental monitoring; regulations and standards; facilities and equipment including shielding, ventilation, and instrumentation; operations and procedures; and education and training. 2 tabs

Enculturating science: Community-centric design of behavior change interactions for accelerating health impact.

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Kumar, Vishwajeet; Kumar, Aarti; Ghosh, Amit Kumar; Samphel, Rigzin; Yadav, Ranjanaa; Yeung, Diana; Darmstadt, Gary L

2015-08-01

and social cognition, and the behavioral sciences. These are illustrated through a case study of designing effective interactions in Shivgarh, India, that led to rapid and substantial changes in newborn health behaviors and reduction in NMR by half over a span of 16 months. Copyright © 2015 Elsevier Inc. All rights reserved.

Systems change for the social determinants of health.

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Carey, Gemma; Crammond, Brad

2015-07-14

Inequalities in the distribution of the social determinants of health are now a widely recognised problem, seen as requiring immediate and significant action (CSDH. Closing the Gap in a Generation. Geneva: WHO; 2008; Marmot M. Fair Society, Healthy Lives: The Marmot Review. Strategic Review of Health Inequalitites in England Post-2010. London; 2010). Despite recommendations for action on the social determinants of health dating back to the 1980s, inequalities in many countries continue to grow. In this paper we provide an analysis of recommendations from major social determinants of health reports using the concept of 'system leverage points'. Increasingly, powerful and effective action on the social determinants of health is conceptualised as that which targets government action on the non-health issues which drive health outcomes. Recommendations for action from 6 major national reports on the social determinants of health were sourced. Recommendations from each report were coded against two frameworks: Johnston et al's recently developed Intervention Level Framework (ILF) and Meadow's seminal '12 places to intervene in a system' (Johnston LM, Matteson CL, Finegood DT. Systems Science and Obesity Policy: A Novel Framework for Analyzing and Rethinking Population-Level Planning. American journal of public health. 2014;(0):e1-e9; Meadows D. Thinking in Systems. USA: Sustainability Institute; 1999) (N = 166). Our analysis found several major changes over time to the types of recommendations being made, including a shift towards paradigmatic change and away from individual interventions. Results from Meadow's framework revealed a number of potentially powerful system intervention points that are currently underutilised in public health thinking regarding action on the social determinants of health. When viewed through a systems lens, it is evident that the power of an intervention comes not from where it is targeted, but rather how it works to create change within the

Understanding and managing organizational change: implications for public health management.

Science.gov (United States)

Thompson, Jon M

2010-01-01

Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.

The Change in Mental Health Status of Indonesian Health Care Migrant Worker in Japan

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Susiana Nugraha

2017-11-01

Full Text Available Under the Japan – Indonesia Economic Partnership Agreement, more than 1,000 of Indonesian health care workers have migrated to Japan. Social adjustment during the process of migration is linked to mental health changes. This study aimed to figure out the strongest predictor that influences the change in mental health status as a result of migration. Baseline data were collected in Jakarta in 2013 during pre-departure orientation. Follow-up study was conducted one year after the study participants migrated to Japan in 2014. Using longitudinal design, this study employed 92 participants consisting of nurse and certified care worker candidates. The multiple linear regression analysis was conducted to figure out the predictors that influence the change in mental health status. The prediction model expected to explain 39.9% of the change in mental health status, p value < 0.01, while sex (b = 0.201, p value < 0.05, economic conditions in pre-migration (b = -0.200, p value < 0.05, and the socio cultural adaptation competency (b = -0.238, p value < 0.05. This finding assumed that female candidates and those who have economic constraint in pre-migration stage, and those who have declining in socio-cultural adaptation competency tend to have lower mental health one year after the migration.

Using health psychology to help patients: theories of behaviour change.

Science.gov (United States)

Barley, Elizabeth; Lawson, Victoria

2016-09-08

Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change.

The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda

OpenAIRE

Annabelle Workman; Grant Blashki; Kathryn J. Bowen; David J. Karoly; John Wiseman

2018-01-01

A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate chan...

Assessing perceived health risks of climate change : Canadian public opinion 2008

International Nuclear Information System (INIS)

2008-03-01

This paper discussed a survey conducted to evaluate the awareness, knowledge, attitudes, and behaviours of Canadians in relation to climatic change. A total of 1600 telephone surveys were conducted with a broad range of age groups. The study showed that climate change is considered by many Canadians to pose a significant threat at both local and global levels. Evidence of climate change has been noted in many communities. However, relatively few Canadians understand how climate change may impact human health. While many Canadians associated climatic change with air pollution hazards and ozone depletion, most Canadians were not aware of the potential negative health impacts related to changes in disease vectors, extreme weather events, and coastal flooding. The strongest awareness and concern about health impacts were expressed by Canadians concerned about global warming. Individuals with chronic health conditions were more likely to be attuned to the potential health impacts of climatic change. Seniors viewed climate change as a longer term problem. Only 10 per cent of Canadians viewed global warming as a major health risk. Sixty-nine per cent of Canadians believed that global warming was happening, while 63 per cent attributed climate change to human activity. Nearly half of all respondents believed that an extreme weather disaster would affect their community during the course of their lifetime. The report suggested that marketing or communications campaigns should build public awareness of the health risks associated with direct or proximal environmental risks. Information about health risks should be specific, and communications should be tailored to age cohorts. Television and print media should be used to build awareness of the health risks of climate change. Provincial concerns related to climatic change were also outlined. tabs., figs

Social and health dimensions of climate change in the Amazon.

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Brondízio, Eduardo S; de Lima, Ana C B; Schramski, Sam; Adams, Cristina

2016-07-01

The Amazon region has been part of climate change debates for decades, yet attention to its social and health dimensions has been limited. This paper assesses literature on the social and health dimensions of climate change in the Amazon. A conceptual framework underscores multiple stresses and exposures created by interactions between climate change and local social-environmental conditions. Using the Thomson-Reuter Web of Science, this study bibliometrically assessed the overall literature on climate change in the Amazon, including Physical Sciences, Social Sciences, Anthropology, Environmental Science/Ecology and Public, Environmental/Occupational Health. From this assessment, a relevant sub-sample was selected and complemented with literature from the Brazilian database SciELO. This sample discusses three dimensions of climate change impacts in the region: livelihood changes, vector-borne diseases and microbial proliferation, and respiratory diseases. This analysis elucidates imbalance and disconnect between ecological, physical and social and health dimensions of climate change and between continental and regional climate analysis, and sub-regional and local levels. Work on the social and health implications of climate change in the Amazon falls significantly behind other research areas, limiting reliable information for analytical models and for Amazonian policy-makers and society at large. Collaborative research is called for.

Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

Directory of Open Access Journals (Sweden)

Knol Dirk L

2006-08-01

Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

Women's Health Leadership to Enhance Community Health Workers as Change Agents.

Science.gov (United States)

Ingram, Maia; Chang, Jean; Kunz, Susan; Piper, Rosie; de Zapien, Jill Guernsey; Strawder, Kay

2016-05-01

Objectives A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women's Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates' leadership skills to the national sample. Results Participants reported statistically significant pre-/postimprovements in all competencies. Interviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities. © 2016 Society for Public Health Education.

Czechoslovakia's changing health care system.

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Raffel, M W; Raffel, N K

1992-01-01

Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

Relationships of working conditions, health problems and vehicle accidents in bus rapid transit (BRT) drivers.

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Gómez-Ortiz, Viviola; Cendales, Boris; Useche, Sergio; Bocarejo, Juan P

2018-04-01

The aim of this study was to estimate accident risk rates and mental health of bus rapid transit (BRT) drivers based on psychosocial risk factors at work leading to increased stress and health problems. A cross-sectional research design utilized a self-report questionnaire completed by 524 BRT drivers. Some working conditions of BRT drivers (lack of social support from supervisors and perceived potential for risk) may partially explain Bogota's BRT drivers' involvement in road accidents. Drivers' mental health problems were associated with higher job strain, less support from co-workers, fewer rewards and greater signal conflict while driving. To prevent bus accidents, supervisory support may need to be increased. To prevent mental health problems, other interventions may be needed such as reducing demands, increasing job control, reducing amount of incoming information, simplifying current signals, making signals less contradictory, and revising rewards. © 2018 Wiley Periodicals, Inc.

Integrated Theory of Health Behavior Change: background and intervention development.

Science.gov (United States)

Ryan, Polly

2009-01-01

An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.

Public health adaptation to climate change in OECD countries

NARCIS (Netherlands)

Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

2016-01-01

Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine

Rapid landscape change in 6th century northern Jordan: interdisciplinary geoarchaeological perspectives

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Lucke, Bernhard

2016-04-01

Landscapes of the ancient fertile crescent are considered affected by soil degradation as result of long-term farming since the Neolithic, and impressive ruins of antiquity led to assumptions that their abandonment must have been conntected with reduced agricultural productivity. In this context, a valley fill near the site of Abila of the Decapolis in northern Jordan was apparently deposited largely during the 6th century AD, and provides evidence for a rapid and intense landscape change during the Late Byzantine period. However, an interdisciplinary case study of land use, soil development, and sediments found that the valley fill cannot be connected with large-scale soil erosion in the vicinity of the site. On the one hand, this is indicated by the distribution of soil development and archaeological material as marker of past land use activity in the past, which suggests that the best soils were and still are used intensively. On the other hand, the sediments seem to point to the occurrence of climatic extremes such as heavy floods, the occurrence of soil creep after water saturation, but also a significant shift to aridity which may have triggered socio-economic changes of subsistence strategies from agriculture to pastoralism. The dates of sediments which are available so far indicate that the climatic change seemingly occurred rapidly within approximately 100 years during the late 6th and early 7th century AD, possibly connected with the "year without sun" or 'Mystery Veil' which the Byzantine historian Procopius described in the year 536 AD. Modern analogies of the Pinatubo eruption in 1991 let it seem possible that a volcanic event, perhaps the outbreak of the Ilopango volcano, was connected with these environmental turbulences. Such events cannot be understood by isolated studies: without a broad interdisciplinary framework, single archives are prone to misinterpretation, and our understanding of the environmental history of Abila is still very limited.

Ethical Theories for Promoting Health through Behavioral Change.

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O'Connell, Janelle K.; Price, James H.

1983-01-01

Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to health behavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)

Designing Work, Family & Health Organizational Change Initiatives.

Science.gov (United States)

Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

2014-01-01

For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

Development of flexural vibration inspection techniques to rapidly assess the structural health of rural bridge systems

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Brian K. Brashaw; Robert Vatalaro; Xiping Wang; Kevin Sarvela; James P. Wacker

2008-01-01

Approximately 4,000 vehicle bridges in the State of Minnesota contain structural timber members. Recent research at the University of Minnesota Duluth Natural Resources Research Institute (UMD NRRI) has been conducted on vibration testing of timber bridges as a means of developing rapid in-place testing techniques for assessing the structural health of bridges. The...

Climate change and wildlife health: direct and indirect effects

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Hofmeister, Erik K.; Moede Rogall, Gail; Wesenberg, Katherine; Abbott, Rachel C.; Work, Thierry M.; Schuler, Krysten; Sleeman, Jonathan M.; Winton, James

2010-01-01

Climate change will have significant effects on the health of wildlife, domestic animals, and humans, according to scientists. The Intergovernmental Panel on Climate Change projects that unprecedented rates of climate change will result in increasing average global temperatures; rising sea levels; changing global precipitation patterns, including increasing amounts and variability; and increasing midcontinental summer drought (Intergovernmental Panel on Climate Change, 2007). Increasing temperatures, combined with changes in rainfall and humidity, may have significant impacts on wildlife, domestic animal, and human health and diseases. When combined with expanding human populations, these changes could increase demand on limited water resources, lead to more habitat destruction, and provide yet more opportunities for infectious diseases to cross from one species to another.

Private health insurance: New measures of a complex and changing industry

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Arnett, Ross H.; Trapnell, Gordon R.

1984-01-01

Private health insurance benefit payments are an integral component of estimates of national health expenditures. Recent analyses indicate that the insurance industry has undergone significant changes since the mid-1970's. As a result of these study findings and corresponding changes to estimating techniques, private health insurance estimates have been revised upward. This has had a major impact on national health expenditure estimates. This article describes the changes that have occurred in the industry, discusses some of the implications of those changes, presents a new methodology to measure private health insurance and the resulting estimate levels, and then examines concepts that underpin these estimates. PMID:10310950

Climate Change and Health: Nurses as Drivers of Climate Action

Directory of Open Access Journals (Sweden)

Cara Cook

2018-02-01

Full Text Available Changes to Earth’s climate are occurring globally at unprecedented rates with significant impacts to human and population health, including increased likelihood of mental health illnesses, food and water insecurity, insect-borne and heat-related illnesses, and respiratory diseases. Those in the health sector are seeing the challenges patients and community members are experiencing as a result of current and projected climate threats. Health professionals, including nurses, have an opportunity to lead the charge to significantly improve society’s response to climate change and foster the strategies needed to promote health. This article highlights the current work of the Alliance of Nurses for Healthy Environments, a national nursing organization focused solely on environmental health concerns, in inspiring and empowering nurses across the country to engage in action to reduce their climate impact, move climate solutions forward, and improve the ability of health care institutions and communities to respond to the health impacts of climate change.

Readying Health Services for Climate Change: A Policy Framework for Regional Development

Science.gov (United States)

2011-01-01

Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change. PMID:21421953

Readying health services for climate change: a policy framework for regional development.

Science.gov (United States)

Bell, Erica

2011-05-01

Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change.

Changes in Optimism Are Associated with Changes in Health Over Time Among Older Adults

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Chopik, William J.; Kim, Eric S.; Smith, Jacqui

2016-01-01

Little is known about how optimism differs by age and changes over time, particularly among older adults. Even less is known about how changes in optimism are related to changes in physical health. We examined age differences and longitudinal changes in optimism in 9,790 older adults over a four-year period. We found an inverted U-shaped pattern between optimism and age both cross-sectionally and longitudinally, such that optimism generally increased in older adults before decreasing. Increases in optimism over a four-year period were associated with improvements in self-rated health and fewer chronic illnesses over the same time frame. The findings from the current study are consistent with changes in emotion regulation strategies employed by older adults and age-related changes in well-being. PMID:27114753

Changes in Optimism Are Associated with Changes in Health Over Time Among Older Adults.

Science.gov (United States)

Chopik, William J; Kim, Eric S; Smith, Jacqui

2015-09-01

Little is known about how optimism differs by age and changes over time, particularly among older adults. Even less is known about how changes in optimism are related to changes in physical health. We examined age differences and longitudinal changes in optimism in 9,790 older adults over a four-year period. We found an inverted U-shaped pattern between optimism and age both cross-sectionally and longitudinally, such that optimism generally increased in older adults before decreasing. Increases in optimism over a four-year period were associated with improvements in self-rated health and fewer chronic illnesses over the same time frame. The findings from the current study are consistent with changes in emotion regulation strategies employed by older adults and age-related changes in well-being.

Systems Thinking for Transformational Change in Health

Science.gov (United States)

Willis, Cameron D.; Best, Allan; Riley, Barbara; Herbert, Carol P.; Millar, John; Howland, David

2014-01-01

Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

Renewal and change for health care executives.

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Burke, G C; Bice, M O

1991-01-01

Health care executives must consider renewal and change within their own lives if they are to breathe life into their own institutions. Yet numerous barriers to executive renewal exist, including time pressures, fatigue, cultural factors, and trustee attitudes. This essay discusses such barriers and suggests approaches that health care executives may consider for programming renewal into their careers. These include self-assessment for professional and personal goals, career or job change, process vs. outcome considerations, solitude, networking, lifelong education, surrounding oneself with change agents, business travel and sabbaticals, reading outside the field, physical exercise, mentoring, learning from failures, a sense of humor, spiritual reflection, and family and friends. Renewal is a continuous, lifelong process requiring constant learning. Individual executives would do well to develop a framework for renewal in their careers and organizations.

Modelling the effect of hydrological change on estuarine health: An Australian Perspective. (Invited)

Science.gov (United States)

Bruce, L. C.; Adiyanti, S.; Ruibal, A. L.; Hipsey, M. R.

2013-12-01

Estuaries provide an important role in the filtering and transformation of carbon and nutrients from coastal catchments into the marine environment. Global trends including climate change, increased population, industrialization and agriculture have led to the rapid deterioration of estuarine ecosystems across the world. Within the Australian context, a particular concern is how changes to hydrological regimes, due to both water diversions and climate variability, are contributing to increased stress and consequent decline in estuarine health. In this study we report the modeling output of five Australian estuaries, each with different hydrological regimes and alternative management issues relating to altered hydrology: 1) The Yarra River estuary is a highly urbanized system, also receiving agriculturally derived nutrients, where the concern is the role of periodic hypoxia in reducing the assimilation capacity of nitrogen and thus increased risk of algal blooms forming in the coastal environment; 2) The upper Swan River estuary in Western Australia, which experiences persistent anoxia and hypoxia brought about by reduced flows has led to the commissioning of several oxygenation plants to alleviate stress on biodiversity and overall estuarine health; 3) The health of the Caboolture estuary in Queensland has deteriorated in the past decade with the aim of model development to quantify the various sources of surface and groundwater derived nutrients; 4) The construction of an additional channel to increase flushing in the Peel Harvey estuary in Western Australia was designed to control persistent harmful algal blooms; and 5) The Lower River Murray estuary experienced a prolonged drought that led to the development of acid sulfate soils and acid drainage deteriorating water quality. For these applications we applied 3-D hydrodynamic-biogeochemical models to determine underlying relationships between altered flow regimes, increased temperatures and the response of

Financing reform and structural change in the health services industry.

Science.gov (United States)

Higgins, C W; Phillips, B U

1986-08-01

This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.

Wiki management a revolutionary new model for a rapidly changing and collaborative world

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Collins, Rod

2013-01-01

We now live in a "wiki" world where mass collaboration is not only possible-it's often the best solution. Conventional management thought assumes that command-and-control is the most effective way to organize the efforts of large numbers of people, but rapid change and increasing complexity have rendered that model obsolete. As a result, most managers today lack the skills and knowledge needed to succeed in an age when networks are proving smarter and faster than hierarchies. Designing organizations for mass collaboration demands a new and very different model-wiki management.

Help Preferences Among Employees Who Wish to Change Health Behaviors.

Science.gov (United States)

Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L

2014-08-01

To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e., wellness service). Respondents to an electronic questionnaire who acknowledged wishing to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4,431), and physical activity (n = 5,179) were asked to choose up to three help alternatives on a predefined list. In descending order, smokers preferred help from nicotine gum, no help, and help and support from family and friends. Alcohol consumers preferred no help or help and support from family and friends or "other" forms. Employees who wanted to change eating habits preferred a free fruit bowl, free nutritional guidance, and healthy food at work. Employees who wanted to change physical activity patterns preferred exercise at work, offers of free exercise, and exercise in a social/collegial context. Wishing to change health behaviors is not always accompanied by perceiving a need for assistance. The no-help option was selected fairly frequently and mostly in relation to alcohol and smoking. A fruit bowl was the most preferred option for help, followed by exercise at work and free exercise. Help from traditional health services was ranked low, possibly reflecting that they are primarily viewed as a solution for stopping disease rather than promoting health. © 2013 Society for Public Health Education.

Economy-Wide estimates of the implications of climate change: Human health

NARCIS (Netherlands)

Bosello, F.; Roson, R.; Tol, R.S.J.

2006-01-01

We study the economic impacts of climate-change-induced change in human health, viz. cardiovascular and respiratory disorders, diarrhoea, malaria, dengue fever and schistosomiasis. Changes in morbidity and mortality are interpreted as changes in labour productivity and demand for health care, and

[Changes necessary for continuing health reform: I. The "external" change].

Science.gov (United States)

Martín Martín, J; de Manuel Keenoy, E; Carmona López, G; Martínez Olmos, J

1990-01-01

The article analyzes the need to obtain support from all actors if the reform of the health system is to be finalized. The relevant groups are the government, professional groups, workers, the population, civil servants, managers and firms with interests in the health field. It is necessary to develop a social marketing strategy that reinforces and broadens the current supports to change. Basic elements would be: Develop new service to satisfy users' needs; orient the services to defined "market" segments; position new services or "re-position" the existing ones in order to communicate their advantages; develop a plan of marketing based on promotion, prize and place focused on the role of health professionals as the main service sellers.

Observation of reversible, rapid changes in drug susceptibility of hypoxic tumor cells in a microfluidic device

Energy Technology Data Exchange (ETDEWEB)

Germain, Todd; Ansari, Megan; Pappas, Dimitri, E-mail: d.pappas@ttu.edu

2016-09-14

Hypoxia is a major stimulus for increased drug resistance and for survival of tumor cells. Work from our group and others has shown that hypoxia increases resistance to anti-cancer compounds, radiation, and other damage-pathway cytotoxic agents. In this work we utilize a microfluidic culture system capable of rapid switching of local oxygen concentrations to determine changes in drug resistance in prostate cancer cells. We observed rapid adaptation to hypoxia, with drug resistance to 2 μM staurosporine established within 30 min of hypoxia. Annexin-V/Sytox Green apoptosis assays over 9 h showed 78.0% viability, compared to 84.5% viability in control cells (normoxic cells with no staurosporine). Normoxic cells exposed to the same staurosporine concentration had a viability of 48.6% after 9 h. Hypoxia adaptation was rapid and reversible, with Hypoxic cells treated with 20% oxygen for 30 min responding to staurosporine with 51.6% viability after drug treatment for 9 h. Induction of apoptosis through the receptor-mediated pathway, which bypasses anti-apoptosis mechanisms induced by hypoxia, resulted in 39.4 ± 7% cell viability. The rapid reversibility indicates co-treatment of oxygen with anti-cancer compounds may be a potential therapeutic target. - Highlights: • Microfluidic system switches rapidly between normoxia and hypoxia (5 min). • Observation of rapid adaptation of PC3 cells to hypoxia and normoxia (30 min). • Drug susceptibility in tumor cells restored after chip switched to normoxia for 30 min.

The health impacts of climate change and variability in developing countries

Energy Technology Data Exchange (ETDEWEB)

Menne, B. [WHO European Centre for Environment and Health, Rome (Italy). Global Change and Health; Kunzil, N. [Institute for Social and Preventive Medicine University, Los Angeles, CA (United States). Basel and Keck School of Medicine; Bertollini, R. [WHO Regional Office for Europe, Copenhagen (Denmark). Technical Support Div.

2002-07-01

Health is a focus reflecting the combined impacts of climate change on the physical environment, ecosystems, the economic environment and society. Long-term changes in the world's climate may affect many requisites of good health - sufficient food, safe and adequate drinking water and secure dwelling. The current large-scale social and environmental changes mean that we must assign a much higher priority to population health in the policy debate on climate change. Climate change will affect human health and wellbeing through a variety of mechanisms. Climate change can adversely impact on the availability of fresh water supply and the efficiency of local sewerage systems. It is also likely to affect food security. Cereal yields are expected to increase at high and mid latitudes but decrease at lower latitudes. Changes in food production are likely to significantly affect health in Africa. In addition, the distribution and seasonal transmission of several vector-borne infectious diseases (such as malaria and dengue) may be affected by climate change. Altered distribution of some vector species may be among the early signals of climate change. A change in the world climate could increase the frequency and severity of extreme weather events. The impacts on health of natural disasters are considerable - the number of people killed, injured or made homeless from such causes is increasingly alarming. The vulnerability of people living in risk-prone areas is an important contributor to disaster casualties and damage. An increase in heatwaves (and possibly air pollution) will be a problem in urban areas, where excess mortality and morbidity is currently observed during hot weather episodes. We can assume that climate change will affect the most vulnerable in developing countries. These might be socio-economic deprived populations, people who lack access to a health care system, technology and communication, as well as immuno compromised persons. The health community

Development of students’ eHealth, mHealth and serious games expertise in health behavior change during health and social studies

Directory of Open Access Journals (Sweden)

Mari Punna

2015-10-01

New clienthoods require new ways to work in health care and social services at the future. Professionals’ expertise in different kind of digital environments is essential. Expertise should be a combination of evidence-based practice, behavior change theories and the practical experiences of using different kind of applications and they should also overcome of the possible fear of unknown and technological challenges. These are the reasons why eHealth, mHealth and serious games should be involved to curriculum in health care and social services studies. When the expertise has started to develop during the studies by varied methods, the interest and motivation to utilize digital solutions could be increased. Skills to critically assess various digital applications in the aspect of behavior change theories also increase the quality of evidence based practice in health care and social services.

Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study

Directory of Open Access Journals (Sweden)

Foets Marleen

2008-01-01

Full Text Available Abstract Background Social environment and health status are related, and changes affecting social relations may also affect the general health state of a group. During the past few years, several events have affected the relationships between Muslim immigrants and the non-immigrant population in many countries. This study investigates whether the health status of the Moroccan and Turkish immigrants in the Netherlands has changed in four years, whether changes in health status have had any influence on primary health care use, and which socio-demographic factors might explain this relationship. Methods A cohort of 108 Turkish and 102 Moroccan respondents were interviewed in 2001 and in 2005. The questionnaire included the SF-36 and the GP contact frequency (in the past two months. Interviews were conducted in the language preferred by the respondents. Data were analysed using multivariate linear regression. Results The mental health of the Moroccan group improved between 2001 and 2005. Physical health remained unchanged for both groups. The number of GP contacts decreased with half a contact/2 months among the Turkish group. Significant predictors of physical health change were: age, educational level. For mental health change, these were: ethnicity, age, civil status, work situation in 2001, change in work situation. For change in GP contacts: ethnicity, age and change in mental and physical health. Conclusion Changes in health status concerned the mental health component. Changes in health status were paired with changes in health care utilization. Among the Turkish group, an unexpected decrease in GP contacts was noticed, whilst showing a generally unchanged health status. Further research taking perceived quality of care into account might help shedding some light on this outcome.

The human health chapter of climate change and ozone depletion ...

African Journals Online (AJOL)

Climate change is one of the greatest emerging threats of the 21st century. There is much scientific evidence that climate change is giving birth to direct health events including more frequent weather extremes, increase in epidemics, food and water scarcity. Indirect risks to health are related to changes in temperature and ...

Climate change and human health

International Nuclear Information System (INIS)

Sanderson, G.

1991-01-01

Changes in the earth's climate, stemming from the greenhouse effect, are highly likely to damage human health. As well as the disruptions to food and fresh water supplies, there is the prospect of major diseases flourishing in warmer conditions, in addition the decrease in the ozone layer is causing an increased incidence of skin cancer

Influences of sex and activity level on physiological changes in individual adult sockeye salmon during rapid senescence.

Science.gov (United States)

Hruska, Kimberly A; Hinch, Scott G; Healey, Michael C; Patterson, David A; Larsson, Stefan; Farrell, Anthony P

2010-01-01

A noninvasive biopsy protocol was used to sample plasma and gill tissue in individual sockeye salmon (Oncorhynchus nerka) during the critical life stage associated with spawning-arrival at a spawning channel through senescence to death several days later. Our main objective was to characterize the physiological changes associated with rapid senescence in terms of the physiological stress/cortisol hypersecretion model and the energy exhaustion model. Salmon lived an average of 5 d in the spawning channel, during which time there were three major physiological trends that were independent of sexual status: a large increase in plasma indicators of stress and exercise (i.e., lactate and cortisol), a decrease in the major plasma ions (i.e., Cl(-) and Na(+)) and osmolality, and a decrease in gross somatic energy reserves. Contrary to a generalized stress response, plasma glucose decreased in approximately 2/3 of the fish after arrival, as opposed to increasing. Furthermore, plasma cortisol levels at spawning-ground arrival were not correlated with the degree of ionoregulatory changes during rapid senescence. One mechanism of mortality in some fish may involve the exhaustion of energy reserves, resulting in the inability to mobilize plasma glucose. Sex had a significant modulating effect on the degree of physiological change. Females exhibited a greater magnitude of change for gross somatic energy, osmolality, and plasma concentrations of Cl(-), Na(+), cortisol, testosterone, 11-ketotestosterone, 17,20beta-progesterone, and estradiol. The activity level of an individual on the spawning grounds appeared to influence the degree of some physiological changes during senescence. For example, males that received a greater frequency of attacks exhibited larger net decreases in plasma 11-ketotestosterone while on the spawning grounds. These results suggest that rapid senescence on spawning grounds is influenced by multiple physiological processes and perhaps behavior. This study

Assessing health systems for type 1 diabetes in sub-Saharan Africa: developing a 'Rapid Assessment Protocol for Insulin Access'

Directory of Open Access Journals (Sweden)

de Courten Maximilian

2006-02-01

Full Text Available Abstract Background In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol for the gathering of other data through site visits, discussions, and document reviews. Methods The Rapid Assessment Protocol for Insulin Access draws on the principles of Rapid Assessment Protocols which have been developed and implemented in several different areas. This protocol was adapted through a thorough literature review on diabetes, chronic condition management and medicine supply in developing countries. A visit to three countries in sub-Saharan Africa and meetings with different experts in the field of diabetes helped refine the questionnaires. Following the development of the questionnaires these were tested with various people familiar with diabetes and/or healthcare in developing countries. The Protocol was piloted in Mozambique then refined and had two further iterations in Zambia and Mali. Translations of questionnaires were made into local languages when necessary, with back translation to ensure precision. Results In each country the protocol was implemented in 3 areas – the capital city, a large urban centre and a predominantly rural area and their respective surroundings. Interviews were carried out by local teams trained on how to use the tool. Data was then collected and entered into a database for analysis. Conclusion The Rapid Assessment Protocol for Insulin Access was developed to provide a situational analysis of Type 1 diabetes, in order to make recommendations to the national Ministries of Health and Diabetes Associations. It provided valuable information on patients' access to insulin, syringes, monitoring and care. It was thus able to sketch a picture of the health care system with regards to its ability to

A Behavior Change Framework of Health Socialization and Identity

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Stanley, Christopher T.; Stanley, Lauren H. K.

2017-01-01

An individual's identity related to health is critically important in terms of the adoption and maintenance of health behaviors, and guides approaches to health change across the lifespan. This article presents a review of the literature and proposes a health socialization and health identity framework, which may be used to clarify challenges in…

Health Rights and Equity-oriented Health System Change in ...

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

The private sector is the largest health provider in India, and unregulated private ... and girls in the last two decades, yet gender inequality and gender-based ... View moreIWRA/IDRC webinar on climate change and adaptive water ... Socially equitable climate action is essential to strengthen the resilience of all people, ...

'Rapid Learning health care in oncology' - an approach towards decision support systems enabling customised radiotherapy'.

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Lambin, Philippe; Roelofs, Erik; Reymen, Bart; Velazquez, Emmanuel Rios; Buijsen, Jeroen; Zegers, Catharina M L; Carvalho, Sara; Leijenaar, Ralph T H; Nalbantov, Georgi; Oberije, Cary; Scott Marshall, M; Hoebers, Frank; Troost, Esther G C; van Stiphout, Ruud G P M; van Elmpt, Wouter; van der Weijden, Trudy; Boersma, Liesbeth; Valentini, Vincenzo; Dekker, Andre

2013-10-01

An overview of the Rapid Learning methodology, its results, and the potential impact on radiotherapy. Rapid Learning methodology is divided into four phases. In the data phase, diverse data are collected about past patients, treatments used, and outcomes. Innovative information technologies that support semantic interoperability enable distributed learning and data sharing without additional burden on health care professionals and without the need for data to leave the hospital. In the knowledge phase, prediction models are developed for new data and treatment outcomes by applying machine learning methods to data. In the application phase, this knowledge is applied in clinical practice via novel decision support systems or via extensions of existing models such as Tumour Control Probability models. In the evaluation phase, the predictability of treatment outcomes allows the new knowledge to be evaluated by comparing predicted and actual outcomes. Personalised or tailored cancer therapy ensures not only that patients receive an optimal treatment, but also that the right resources are being used for the right patients. Rapid Learning approaches combined with evidence based medicine are expected to improve the predictability of outcome and radiotherapy is the ideal field to study the value of Rapid Learning. The next step will be to include patient preferences in the decision making. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia: a cross-sectional study.

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Nigatu, Andualem S; Asamoah, Benedict O; Kloos, Helmut

2014-06-11

Climate change affects human health in various ways. Health planners and policy makers are increasingly addressing potential health impacts of climate change. Ethiopia is vulnerable to these impacts. Assessing students' knowledge, understanding and perception about the health impact of climate change may promote educational endeavors to increase awareness of health impacts linked to climate change and to facilitate interventions. A cross-sectional study using a questionnaire was carried out among the health science students at Haramaya University. Quantitative methods were used to analyze the results. Over three quarters of the students were aware of health consequences of climate change, with slightly higher rates in females than males and a range from 60.7% (pharmacy students) to 100% (environmental health and post-graduate public health students). Electronic mass media was reportedly the major source of information but almost all (87.7%) students stated that their knowledge was insufficient to fully understand the public health impacts of climate change. Students who knew about climate change were more likely to perceive it as a serious health threat than those who were unaware of these impacts [OR: 17.8, 95% CI: 8.8-32.1] and also considered their departments to be concerned about climate change (OR: 7.3, 95% CI: 2.8-18.8), a perception that was also significantly more common among students who obtained their information from the electronic mass media and schools (p health impacts of climate change. Health sciences students at Haramaya University may benefit from a more comprehensive curriculum on climate change and its impacts on health.

An evidence-based public health approach to climate change adaptation.

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Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

2014-11-01

Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

Health workers' compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis

NARCIS (Netherlands)

Kabaghe, Alinune N.; Visser, Benjamin J.; Spijker, Rene; Phiri, Kamija S.; Grobusch, Martin P.; van Vugt, Michèle

2016-01-01

The World Health Organization recommends malaria to be confirmed by either microscopy or a rapid diagnostic test (RDT) before treatment. The correct use of RDTs in resource-limited settings facilitates basing treatment onto a confirmed diagnosis; contributes to speeding up considering a correct

Global Governance for Health: how to motivate political change?

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McNeill, D; Ottersen, O P

2015-07-01

In this article, we address a central theme that was discussed at the Durham Health Summit: how can politics be brought back into global health governance and figure much more prominently in discussions around policy? We begin by briefly summarizing the report of the Lancet - University of Oslo Commission on Global Governance for Health: 'The Political Origins of Health Inequity' Ottersen et al. In order to provide compelling evidence of the central argument, the Commission selected seven case studies relating to, inter alia, economic and fiscal policy, food security, and foreign trade and investment agreements. Based on an analysis of these studies, the report concludes that the problems identified are often due to political choices: an unwillingness to change the global system of governance. This raises the question: what is the most effective way that a report of this kind can be used to motivate policy-makers, and the public at large, to demand change? What kind of moral or rational argument is most likely to lead to action? In this paper we assess the merits of various alternative perspectives: health as an investment; health as a global public good; health and human security; health and human development; health as a human right; health and global justice. We conclude that what is required in order to motivate change is a more explicitly political and moral perspective - favouring the later rather than the earlier alternatives just listed. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Climate Change in the US: Potential Consequences for Human Health

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Maynard, Nancy G.

2001-01-01

The U.S. National Assessment identified five major areas of consequences of climate change in the United States: temperature-related illnesses and deaths, health effects related to extreme weather events, air pollution-related health effects, water- and food-borne diseases, and insect-, tick-, and rodent-borne diseases. The U.S. National Assessment final conclusions about these potential health effects will be described. In addition, a summary of some of the new tools for studying human health aspects of climate change as well as environment-health linkages through remotely sensed data and observations will be provided.

Purchasing power: business and health policy change in Massachusetts.

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Bergthold, L A

1988-01-01

As in many states around the country, health care costs in Massachusetts had risen to an unprecedented proportion of the state budget by the early 1980s. State health policymakers realized that dramatic changes were needed in the political process to break provider control over health policy decisions. This paper presents a case study of policy change in Massachusetts between 1982 and 1988. State officials formulated a strategy to mobilize corporate interests, which were already awakening to the problems of high health care costs, as a countervailing power to the political monopoly of provider interests. Once mobilized, business interests became organized politically and even became dominant at times, controlling both the policy agenda and its process. Ultimately, business came to be viewed as a permanent part of the coalitions and commissions that helped formulate state health policy. Although initially allied with provider interests, business eventually forged a stronger alliance with the state, an alliance that has the potential to force structural change in health care politics in Massachusetts for years to come. The paper raises questions about the consequences of such alliances between public and private power for both the content and the process of health policymaking at the state level.

Public Health Adaptation to Climate Change in Canadian Jurisdictions

Directory of Open Access Journals (Sweden)

Stephanie E. Austin

2015-01-01

Full Text Available Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting autonomously.

Public Health Adaptation to Climate Change in Canadian Jurisdictions

Science.gov (United States)

Austin, Stephanie E.; Ford, James D.; Berrang-Ford, Lea; Araos, Malcolm; Parker, Stephen; Fleury, Manon D.

2015-01-01

Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously. PMID:25588156

Exploring the health context : a multimethod approach to climate change adaptation evaluation

OpenAIRE

Böckmann, Melanie

2015-01-01

Climate change is a major environmental Public Health issue of the 21st century. Extreme heat and cold, weather events such as flooding or storms, disease vector distribution changes, and increased pathogen loads in water might all put human health at risk. To protect health from inevitable changes, climate change adaptation strategies are implemented at local, national, and global level. Are these measures effectively reducing health risks? This dissertation explores multiple methods to eval...

Changes in retiree health benefits: results of a national survey.

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de Lissovoy, G; Kasper, J D; Di Carlo, S; Gabel, J

1990-01-01

Employers are increasingly concerned by the cost of health benefits provided to retired workers. One reason is that the Financial Accounting Standards Board (FASB), the organization that establishes "generally accepted accounting principles," has proposed altering the way firms report expenditures for retiree medical coverage on financial statements. We recently completed a national survey of business firms offering retiree health benefits to address three issues: 1) What is the current structure of retiree health benefit plans? 2) What changes are firms planning to implement in the structure of their retiree health benefits? 3) To what extent are these changes due to the FASB proposal? The FASB reporting proposal is only one factor underlying these changes. More important is the real financial pressure on firms due to the accelerating cost of retiree health care.

Health behaviour change interventions for couples: A systematic review.

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Arden-Close, Emily; McGrath, Nuala

2017-05-01

Partners are a significant influence on individuals' health, and concordance in health behaviours increases over time in couples. Several theories suggest that couple-focused interventions for health behaviour change may therefore be more effective than individual interventions. A systematic review of health behaviour change interventions for couples was conducted. Systematic search methods identified randomized controlled trials (RCTs) and non-randomized interventions of health behaviour change for couples with at least one member at risk of a chronic physical illness, published from 1990-2014. We identified 14 studies, targeting the following health behaviours: cancer prevention (6), obesity (1), diet (2), smoking in pregnancy (2), physical activity (1) and multiple health behaviours (2). In four out of seven trials couple-focused interventions were more effective than usual care. Of four RCTs comparing a couple-focused intervention to an individual intervention, two found that the couple-focused intervention was more effective. The studies were heterogeneous, and included participants at risk of a variety of illnesses. In many cases the intervention was compared to usual care for an individual or an individual-focused intervention, which meant the impact of the couplebased content could not be isolated. Three arm studies could determine whether any added benefits of couple-focused interventions are due to adding the partner or specific content of couple-focused interventions. Statement of contribution What is already known on this subject? Health behaviours and health behaviour change are more often concordant across couples than between individuals in the general population. Couple-focused interventions for chronic conditions are more effective than individual interventions or usual care (Martire, Schulz, Helgeson, Small, & Saghafi, ). What does this study add? Identified studies targeted a variety of health behaviours, with few studies in any one area. Further