Sample records for street health clinic

  1. Health policy making for street children: challenges and strategies. (United States)

    Abdi, Fatemeh; Saeieh, Sara Esmaelzadeh; Roozbeh, Nasibeh; Yazdkhasti, Mansoureh


    Background The phenomenon of street children is a bio-psychological and social issue that not only harms children, but also endangers the health of a society. In line with the national programs for the development and promotion of street children's health in Iran, health policy making and essential strategies for this group of children will be presented in this paper. This paper will discuss the main issues and challenges of street children's health and, also, health policy and guidelines for this population. Methods In this review study, the keywords; street children, health, challenges, policy, and health policy making were searched through PubMed, SID, Iranmedex, World Health Organization (WHO), Emro, the Cochran Library, Medline and Google scholar to collect data. The search resulted in 84 related resources from which 48 cases that were more relevant to this research and covered the issue more comprehensively, were used. All data published during 2002-2015 have been included in this paper. Results Key concepts including street children and their health, health policy, strategies to improve the health of street children, health policy approaches for street children, the WHO's strategies, and social support program for street children must be considered in the health policy making processes for street children, as precise identification of the relevant information makes planning more effective in health policy making for this group of children. Conclusion The phenomenon of street children is a growing problem in the world and it has turned into a serious concern in many countries including Iran. The findings of this study can be used for identifying necessary measures in order to use research outcomes more effectively in policy making processes and reforming street children's health policies in Iran.

  2. [A Street Clinic in a state capital in Northeast Brazil from the perspective of homeless people]. (United States)

    Ferreira, Cíntia Priscila da Silva; Rozendo, Célia Alves; Melo, Givânya Bezerra de


    The objective of this study was to evaluate the Street Clinic strategy in Maceió, Alagoas State, Brazil, from the perspective of its users. This was a qualitative study in coverage areas of the Street Clinic in Maceió. Research subjects were 18 homeless individuals assisted by the clinic (10 men and 8 women), ranging from 20 to 40 years of age. Data were collected from September 2014 to February 2015 using a semi-structured interview. Content analysis was applied to the data and identified two categories: the first, the Street Clinic as such, revealed the strategy's critical points, challenges, and potentialities; the second showed the Street Clinic as social support, affect, and hope for change for the homeless. The strategy was rated positively by users, providing social support on health problems and other daily issues.

  3. Health problems of street children and women in Awassa, Southern ...

    African Journals Online (AJOL)

    Background: The number of street children and women in major towns of Ethiopia is rapidly increasing. Yet their problems have not been fully studied. Objective: To assess health and related problems in street children and women. Methods: A cross sectional survey was conducted in Awassa town, women southern ...

  4. Street outreach with no streets. (United States)

    Self, Bruce; Peters, Heather


    A street nurse position in the rural and small-town interior of British Columbia has been addressing the needs of street-involved or otherwise marginalized client populations by bringing healthcare services to wherever those clients are, rather than waiting for the clients to seek care. The primary reason for a street outreach approach is that marginalized populations face a variety of barriers to accessing traditional healthcare services--barriers such as homelessness, mental health problems, criminal involvement, lack of transportation, lack of ability to pay for prescriptions, lack of specialized or knowledgeable providers and provider discrimination. In the rural street nurse program, the target population includes the usual street nurse populations of illegal drug users and sex trade workers, which are more hidden in small communities than in larger urban centres, creating the community denial that is a barrier to healthcare access. Yet another barrier is the co-locaton of services common in small communities, where public health clinics might share a building with police services, making marginalized clients reluctant to attend clinics. The rural street nurse collaborates with public health nurses and other care providers (mental health workers, social workers, etc) with collegial advice and support, making and receiving referrals, and generally assisting one another--the street nurse through his rapport with the marginalized individuals and the others with their specialized knowledge. Rural street services are delivered whereverthe clientsfeel comfortable: a school, a drop-in centre, a mall, a youth centre or simplythe street. Services provided include sexually transmitted infection testing, chlamydia treatments, pregnancy testing emergency contraception pills and assistance with filling out forms for financial support. Accordingly, the street nurse's truck is equipped as a mobile treatment centre and office, with a cellphone and a stock of testing and


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    TEH GC


    Full Text Available Introduction: Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine. Clinical presentation: Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop. Treatment: Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion. Conclusion: Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.

  6. Reproductive health behaviour of street youth and associated ...

    African Journals Online (AJOL)



    Mar 30, 2014 ... street, alcohol drinking, cigarette smoking and khat chewing. Among the .... Street youth: In this study, youth is defined as the people ... factors that influence sexual behaviours of ... means of preventing pregnancy. Condom ...

  7. Neglected populations: safeguarding the health of street-involved children in Ghana. (United States)

    Osei-Twum, Jo-Ann; Wasan, Kishor M


    Ensuring the health of street-involved children is a growing public health challenge. These children are vulnerable, neglected, and rarely a priority for basic service providers and governments. Sizable populations of street-involved children are present in major urban areas worldwide and current trends in urbanization suggest these populations will grow in the coming years. Although migration offers employment and training opportunities, the health and wellbeing of children is negatively impacted by their interactions with the streets. However, systemic barriers may also prevent these children from achieving an adequate health status. The situation of street-involved children in Ghana, West Africa will be discussed. Copyright © 2012 Wiley Periodicals, Inc.

  8. Housing and sexual health among street-involved youth. (United States)

    Kumar, Maya M; Nisenbaum, Rosane; Barozzino, Tony; Sgro, Michael; Bonifacio, Herbert J; Maguire, Jonathon L


    Street-involved youth (SIY) carry a disproportionate burden of sexually transmitted diseases (STD). Studies among adults suggest that improving housing stability may be an effective primary prevention strategy for improving sexual health. Housing options available to SIY offer varying degrees of stability and adult supervision. This study investigated whether housing options offering more stability and adult supervision are associated with fewer STD and related risk behaviors among SIY. A cross-sectional study was performed using public health survey and laboratory data collected from Toronto SIY in 2010. Three exposure categories were defined a priori based on housing situation: (1) stable and supervised housing, (2) stable and unsupervised housing, and (3) unstable and unsupervised housing. Multivariate logistic regression was used to test the association between housing category and current or recent STD. Secondary analyses were performed using the following secondary outcomes: blood-borne infection, recent binge-drinking, and recent high-risk sexual behavior. The final analysis included 184 SIY. Of these, 28.8 % had a current or recent STD. Housing situation was stable and supervised for 12.5 %, stable and unsupervised for 46.2 %, and unstable and unsupervised for 41.3 %. Compared to stable and supervised housing, there was no significant association between current or recent STD among stable and unsupervised housing or unstable and unsupervised housing. There was no significant association between housing category and risk of blood-borne infection, binge-drinking, or high-risk sexual behavior. Although we did not demonstrate a significant association between stable and supervised housing and lower STD risk, our incorporation of both housing stability and adult supervision into a priori defined exposure groups may inform future studies of housing-related prevention strategies among SIY. Multi-modal interventions beyond housing alone may also be required to

  9. The health profile of street children in Africa: a literature review

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    Samuel Nambile Cumber


    Full Text Available The United Nations Children’s Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries

  10. The health profile of street children in Africa: a literature review

    Directory of Open Access Journals (Sweden)

    Samuel Nambile Cumber


    Full Text Available The United Nations Children’s Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries

  11. Street Crossing: Observational Research and Developing Health Communication Strategies (United States)

    Mackert, Michael; Lazard, Allison; Wyeth, Ben


    Students in communication, and particularly in advertising, are encouraged to value creativity. However, even in programs that value creativity, it can be difficult to encourage creativity in the process of research that guides communication efforts. The project described in this paper--"Street Crossing"--is used in upper-division and…

  12. People living on the street from the health point of view. (United States)

    Hino, Paula; Santos, Jaqueline de Oliveira; Rosa, Anderson da Silva


    To know the Brazilian scientific production of the last ten years (2007 to 2016) about people who experience street situations under the health gaze. Integrative literature review using the descriptors: street people, health policy and public health. We analyzed 21 articles available in the Virtual Health Library. Four categories of analysis emerged. There was an increase in the frequency of published work on the subject, showing that the experience of living on the street makes people vulnerable to various diseases and health problems and, in addition, increases the difficulties of access to health services. There was an increase in the discussion of this topic due to the increase in the number of published studies. Despite the existence of public health policies directed to this social group, much still needs to be done to guarantee the health of this population.

  13. Street children

    Directory of Open Access Journals (Sweden)

    Rončević Nevenka


    Full Text Available According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, these children face the highest level of risk. Street children more often suffer from the acute illness, injuries, infection, especially gastrointestinal, acute respiratory infections and sexually transmitted diseases, inadequate nutrition, mental disorders, and drug abuse. They are more often victims of abuse, sexual exploitation, trafficking; they have higher rate of adolescent pregnancy than their peers from poor families. Street children and youth have higher rates of hospitalization and longer hospital stay due to seriousness of illness and delayed health care. Street children/youth are reluctant to seek health care, and when they try, they face many barriers. Street children are invisible to the state and their number in Serbia is unknown. Recently, some non­governmental organizations from Belgrade, Novi Sad and Nis have recognized this problem and tried to offer some help to street children, by opening drop­in centers, but this is not enough. To solve this problem, an engagement of the state and the whole community is necessary, and primary responsibility lies in health, social and educational sector. The best interests of the child must serve as a basic guideline in all activities aimed at improving health, quality of life and rights of children involved in the life and work in the street.

  14. The Health and Well-Being of Neglected, Abused and Exploited Children: The Kyiv Street Children Project (United States)

    Kerfoot, Michael; Koshyl, Vira; Roganov, Oleksandr; Mikhailichenko, Kateryna; Gorbova, Irina; Pottage, David


    Objective: To report on the backgrounds and physical and emotional well-being of street children using two street shelters in Kyiv, Ukraine. This study is important because personal accounts of street children may highlight individual or family factors that are associated with vulnerability for and risk of poor mental health, and these could have…

  15. Children working on the streets in Brazil: predictors of mental health problems. (United States)

    Maciel, Mariana R; Mello, Andrea F; Fossaluza, Victor; Nobrega, Luciana P; Cividanes, Giuliana C; Mari, Jair J; Mello, Marcelo F


    The objective of this study was to determine which factors predict higher risk for mental health problems in children working on the streets. We studied a sample of families that had at least one child working on the streets, from October 2008 to March 2009. The instruments applied were the parent version strengths and difficulties questionnaire (SDQ), the childhood trauma questionnaire (CTQ) for children and caregivers, the WorldSAFE core questionnaire, the global assessment of relational functioning scale (GARF), the schedule for affective disorders and schizophrenia for school-age children (K-SADS), and a socio-demographic questionnaire. 191 children between 7 and 14 years of age were analyzed; 126 (66%) were working on the streets, and 65 were siblings who did not work on the streets. Multivariate analysis showed that mental health problems in the caregivers, violent behaviors of the caregivers toward the children, absence of a partner living in the house, and lower levels of family functioning increased the risk of mental health problems in the children. Caregivers reported severe forms of physical punishment against their children in 62% of cases. Caregivers who had suffered sexual abuse and emotional negligence in childhood were more violent with their children. Factors that increased risk for mental health symptoms in these children were caregivers' psychopathology, physical punishment at home, single-parent structure, and poor family functioning. Work on the streets did not influence the children's mental health, when multiple risk factors were considered; family characteristics were the most significant in this sample.

  16. Wall Street's assessment of plastic surgery--related technology: a clinical and financial analysis. (United States)

    Krieger, L M; Shaw, W W


    Many plastic surgeons develop technologies that are manufactured by Wall Street-financed companies. Others participate in the stock market as investors. This study examines the bioengineered skin industry to determine whether it integrates clinical and financial information as Wall Street tenets would predict, and to see whether the financial performance of these companies provides any lessons for practicing plastic surgeons. In efficient markets, the assumptions on which independent financial analysts base their company sales and earnings projections are clinically reasonable, the volatility of a company's stock price does not irrationally differ from that of its industry sector, and the buy/sell recommendations of analysts are roughly congruent. For the companies in this study, these key financial parameters were compared with a benchmark index of 69 biotech companies of similar age and annual revenues (Student's t test). Five bioengineered skin companies were included in the study. Analysts estimated that each company would sell its product to between 24 and 45 percent of its target clinical population. The average stock price volatility was significantly higher for study companies than for those in the benchmark index (p companies were significantly less congruent than those for the benchmark companies (p invest in the stock market, because of their unique clinical experience, may sometimes be in the position to evaluate new technologies and companies better than Wall Street experts. Well-timed trades that use this expertise can result in opportunities for profit.

  17. Hospitality Invites Sociability, Which Builds Cohesion: a Model for the Role of Main Streets in Population Mental Health. (United States)

    Izenberg, Jacob M; Fullilove, Mindy Thompson


    The aim of this study was to investigate the contribution of main streets to community social cohesion, a factor important to health. Prior work suggests that casual contact in public space, which we call "sociability," facilitates more sustained social bonds in the community. We appropriate the term "hospitality" to describe a main street's propensity to support a density of such social interactions. Hospitality is a result of the integrity and complex contents of the main street and surrounding area. We examine this using a typology we term "box-circle-line" to represent the streetscape (the box), the local neighborhood (the circle), and the relationship to the regional network of streets (the line). Through field visits to 50 main streets in New Jersey and elsewhere, and a systematic qualitative investigation of main streets in a densely interconnected urban region (Essex County, New Jersey), we observed significant variation in main street hospitality, which generally correlated closely with sociability. Physical elements such as street wall, neighborhood elements such as connectivity, inter-community elements such as access and perceived welcome, and socio-political elements such as investment and racial discrimination were identified as relevant to main street hospitality. We describe the box-circle-line as a theoretical model for main street hospitality that links these various factors and provides a viable framework for further research into main street hospitality, particularly with regard to geographic health disparities.

  18. Street football is a feasible health-enhancing activity for homeless men

    DEFF Research Database (Denmark)

    Helge, Eva Wulff; Randers, Morten Bredsgaard; Hornstrup, Therese


    This case-control study investigated the feasibility of street football as a health-enhancing activity for homeless men, specifically the musculoskeletal effects of 12 weeks of training. Twenty-two homeless men participated in the football group (FG) and 10 served as controls (C). Plasma.......095 to 0.969 ± 0.090 g/cm(2) (P = 0.02). No effects were observed in C. In conclusion, street football appears to be a feasible training activity with musculoskeletal health benefits for homeless men. The attendance rate and the training intensity were high, and 12 weeks of training resulted...... in a substantial anabolic response in bone metabolism. Postural balance improved markedly, and the overall risk of falling, and hospitalization due to sudden trauma, could be reduced by street football for homeless men....

  19. What's Your "Street Race"? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs. (United States)

    López, Nancy; Vargas, Edward D; Juarez, Melina; Cacari-Stone, Lisa; Bettez, Sonia


    Using the 2015 Latino National Health and Immigration Survey (N= 1,197) we examine the relationship between physical and mental health status and three multidimensional measures of race: 1) "street race," or how you believe other "Americans" perceive your race at the level of the street; 2) socially assigned race or what we call "ascribed race," which refers to how you believe others usually classify your race in the U.S.; and 3) "self-perceived race," or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx 1 or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that, for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that "street race" is a promising multidimensional measure of race for exploring inequality among Latinxs.

  20. Health of the street child: the relation between life-style, immunity ...

    African Journals Online (AJOL)

    A scrutiny and synergy of the research that was done on the health of street children revealed the relation between their poor living conditions and unhealthy life style and their depleted immune systems which, even in the best situations, wins a victory at a cost. This article probes the relation between the harsh ...

  1. Health and climate related ecosystem services provided by street trees in the urban environment. (United States)

    Salmond, Jennifer A; Tadaki, Marc; Vardoulakis, Sotiris; Arbuthnott, Katherine; Coutts, Andrew; Demuzere, Matthias; Dirks, Kim N; Heaviside, Clare; Lim, Shanon; Macintyre, Helen; McInnes, Rachel N; Wheeler, Benedict W


    Urban tree planting initiatives are being actively promoted as a planning tool to enable urban areas to adapt to and mitigate against climate change, enhance urban sustainability and improve human health and well-being. However, opportunities for creating new areas of green space within cities are often limited and tree planting initiatives may be constrained to kerbside locations. At this scale, the net impact of trees on human health and the local environment is less clear, and generalised approaches for evaluating their impact are not well developed.In this review, we use an urban ecosystems services framework to evaluate the direct, and locally-generated, ecosystems services and disservices provided by street trees. We focus our review on the services of major importance to human health and well-being which include 'climate regulation', 'air quality regulation' and 'aesthetics and cultural services'. These are themes that are commonly used to justify new street tree or street tree retention initiatives. We argue that current scientific understanding of the impact of street trees on human health and the urban environment has been limited by predominantly regional-scale reductionist approaches which consider vegetation generally and/or single out individual services or impacts without considering the wider synergistic impacts of street trees on urban ecosystems. This can lead planners and policymakers towards decision making based on single parameter optimisation strategies which may be problematic when a single intervention offers different outcomes and has multiple effects and potential trade-offs in different places.We suggest that a holistic approach is required to evaluate the services and disservices provided by street trees at different scales. We provide information to guide decision makers and planners in their attempts to evaluate the value of vegetation in their local setting. We show that by ensuring that the specific aim of the intervention, the

  2. Occupational health hazards in street sweepers of Chandrapur city, central India

    Directory of Open Access Journals (Sweden)

    V. Patil Priyanka


    Full Text Available Street sweepers play an important role in maintaining health and hygiene in cities. They are exposed to road dust and other contaminants while cleaning streets. Exposure of this dust and contaminants irritates respiratory symptoms and airway obstruction. Twenty workers were selected as sample size (10 male and 10 female and 10 individual as control (5 male and 5 female for analysis of occupational health hazards in street sweepers of Chandrapur city. The study was carried out from November 2015 to January 2016. Peak Expiratory Flow Rate analysis which was carried out through Breath-o meter and other occupational health hazards through interview schedule specially designed and developed for this study. The results of the study showed that, Peak Expiratory Flow Rate values were lower in exposed workers (sample population as compared with control group. These workers were exposed to number of environmental and occupational hazards leading to musculoskeletal disorders (100%, respiratory problems (95%, dermatological problems (90%, headache (75% and gastrointestinal problems (15% during work. It was further observed that theses workers were suffering from allergies (100%, cough and cold (75%, asthma and bronchitis lungs (65%, hearing disorder (50%, malaria and typhoid (25%, fever (15% and vomiting (10% after completion of work. To reduce occupational health hazards in sweepers, they must be made alert and aware of potential health risk arising from their work. Reduction in exposure and use of personal protective equipments should be encouraged.INTERNATIONAL JOURNAL OF ENVIRONMENTVolume-6, Issue-2, Mar-May 2017, Page: 9-18

  3. The health and well-being of neglected, abused and exploited children: the Kyiv Street Children Project. (United States)

    Kerfoot, Michael; Koshyl, Vira; Roganov, Oleksandr; Mikhailichenko, Kateryna; Gorbova, Irina; Pottage, David


    To report on the backgrounds and physical and emotional well-being of street children using two street shelters in Kyiv, Ukraine. This study is important because personal accounts of street children may highlight individual or family factors that are associated with vulnerability for and risk of poor mental health, and these could have serious repercussions for the future. This study also poses a challenge to research because street children are a highly elusive population that services find hard to reach. Ninety-seven children were recruited and interviewed using a semistructured, psychosocial interview schedule; psychopathology was measured using the Strengths and Difficulties Questionnaire (SDQ) and the Mood and Feelings Questionnaire (MFQ). Seventy percent of street children scored for behavioral and emotional difficulties on the SDQ, and 74% scored for depression on the MFQ. Current health problems were reported by 78%, with 43% described as persistent or severe. Two thirds of the children in this sample were not homeless but had chosen life on the streets in preference to permanent residence with their families. Their "survival" history on the streets contributed to the development of three different profiles of vulnerability. High rates of physical and emotional problems in a population of street children, many of whom were still connected to their families, emphasize the importance of developing different approaches for children with different vulnerabilities. This study also demonstrates the feasibility of embedding on-going field research into the service dimension of "front-line" social care agencies.

  4. Health Clinic Cost Reports (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  5. Extending Occupational Health and Safety to Urban Street Vendors: Reflections From a Project in Durban, South Africa. (United States)

    Alfers, Laura; Xulu, Phumzile; Dobson, Richard; Hariparsad, Sujatha


    This article focuses on an action-research project which is attempting to extend occupational health and safety to a group of street traders in Durban, South Africa, using a variety of different (and sometimes unconventional) institutional actors. The article is written from the perspective of key people who have played a role in conceptualizing and administering the project and is intended to deepen the conversation about what it means to extend occupational health to the informal economy. It explores this question through a reflection on three key project activities: the setting up of a trader-led health and safety committee, an occupational health and safety training course, and a clinical health assessment. It concludes with a discussion of the issues that emerge from the reflections of project participants, which include the need to bring occupational health and urban health into closer conversation with one another, the need to be cognizant of local "informal" politics and the impact that has on occupational health and safety interventions, and the need to create greater opportunities for occupational health and safety professionals to interact with workers in the informal economy. © The Author(s) 2016.

  6. Short-term street soccer improves fitness and cardiovascular health status of homeless men

    DEFF Research Database (Denmark)

    Randers, Morten Bredsgaard; Petersen, Jesper; Andersen, Lars Juel


    This study examined the effect of 12 weeks of small-sided street soccer (2.2 ± 0.7 sessions/week) and fitness center training (0.5 ± 0.2 sessions/week) on physical fitness and cardiovascular health profile for homeless men. Exercise capacity, maximal oxygen uptake (VO(2max)), body composition (DXA...... scans), blood pressure (BP), and blood lipid profile were determined before and after the intervention period for 22 soccer-group subjects (SG) and 10 waiting list controls (CO). In addition, time-motion analyses, HR measurements, and pedometer recordings were performed during street soccer training...... and daily-life activities. During a 60 min 4 versus 4 street soccer session 182 ± 62 intense running bouts were performed; mean HR was 82 ± 4% HR(max) and HR was >90% HR(max) for 21 ± 12% (±SD) of total time. On a day without training the participants performed 10,733 ± 4,341 steps and HR was >80% HR...

  7. Risk of HIV infection among indoor and street sex workers and their use of health services in Belgrade, Serbia


    Ilić Dragan; Šipetić Sandra; Bjegović Vesna


    Introduction. HIV in Serbia is most often transmitted through sexual contact, and therefore numerous prevention activities are geared towards sex workers (SW). Objective. To analyze the differences in knowledge, attitudes and risky behaviour between indoor and street SW in Belgrade; to examine the accessibility of health services to this vulnerable group. Methods. In this behavioural cross-sectional study, 113 street and 78 indoor SW were included. The sampling method used was snowball sample...

  8. Optimising measurement of health-related characteristics of the built environment: Comparing data collected by foot-based street audits, virtual street audits and routine secondary data sources. (United States)

    Pliakas, Triantafyllos; Hawkesworth, Sophie; Silverwood, Richard J; Nanchahal, Kiran; Grundy, Chris; Armstrong, Ben; Casas, Juan Pablo; Morris, Richard W; Wilkinson, Paul; Lock, Karen


    The role of the neighbourhood environment in influencing health behaviours continues to be an important topic in public health research and policy. Foot-based street audits, virtual street audits and secondary data sources are widespread data collection methods used to objectively measure the built environment in environment-health association studies. We compared these three methods using data collected in a nationally representative epidemiological study in 17 British towns to inform future development of research tools. There was good agreement between foot-based and virtual audit tools. Foot based audits were superior for fine detail features. Secondary data sources measured very different aspects of the local environment that could be used to derive a range of environmental measures if validated properly. Future built environment research should design studies a priori using multiple approaches and varied data sources in order to best capture features that operate on different health behaviours at varying spatial scales. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. The experience in the service of Street Clinic in the view of professionals: Contributions to the care for users of alcohol and other drugs

    Directory of Open Access Journals (Sweden)

    Viviane Cássia Aranda de Souza


    Full Text Available Assistance to users of alcohol and other drugs in Brazil has undergone several transformations owing to historical, social, and political phenomena. In 2009, the Ministry of Health created the ‘Street Clinic’ in order to reduce harm to the homeless and the population vulnerable to use of alcohol or other drugs. The aim of this study was to describe and analyze the experience at a ‘Street Clinic’ from the perspective of the professionals who compose the service team in a municipality located in the metropolitan region of Recife, Pernanbuco state. This is a qualitative study with data collected through semi-structured interviews with five professionals and submitted to qualitative analysis. The content of the interviews explained the dynamic character of the reality experienced by professionals and the time of implementation and consolidation of this service in the city, characterizing the objectives, clientele, user demand, and systematization of actions and difficulties in delivering the service. It was possible to identify similarities between the experiences of the research participants and what is recommended by the Ministry of Health, as well as similarities with other services described in the literature. Furthermore, the data revealed the day to day challenges experienced by the professionals expressed mainly in the difficulties reported in the interviews. The study provided a good basis for the implementation of other Street Clinic teams and the training of professionals, including occupational therapists, to work in this field.

  10. Pollution characteristics, source apportionment, and health risk of heavy metals in street dust of Suzhou, China. (United States)

    Lin, Manli; Gui, Herong; Wang, Yao; Peng, Weihua


    To analyze the pollution characteristics, source apportionment, and health risk of heavy metals (HMs) in street dust of Suzhou, China, 23 sampling sites were selected and periodically sampled for 12 months. A total of 276 samples were collected, and the concentrations of selected HMs (e.g., Cr, Cu, Fe, Mn, Pb, V, and Zn) were examined with an X-ray fluorescence spectrum analyzer. Results showed that the mean concentrations of Cr, Cu, Fe, Mn, Pb, V, and Zn in the street dust of Suzhou were 112.9, 27.5, 19941.3, 410.3, 45.2, 75.6, and 225.3 mg kg -1 , respectively. Cr, Cu, Pb, and Zn exceeded their background values in local natural soils by 1.3-3.6-fold, whereas Fe, Mn, and V were all within their background values. However, enrichment factor analysis revealed that Cr, Cu, Mn, Pb, V, and Zn, especially Cr, Cu, Pb, and Zn, were enriched in Suzhou street dust. The HMs showed no significant seasonal changes overall, but spatial distribution analysis implied that the high values of Cr, Cu, Mn, Pb, V, and Zn were mainly distributed in areas with frequent human activities. Results of multivariate techniques (e.g., Pearson correlation, hierarchical cluster, and principal components analyses) suggested that Pb and Zn had complicated sources; Cu and V mainly originated from traffic sources; Fe and Mn mainly came from natural sources; and Cr was dominantly related to industrial district. Health risk assessment revealed that a single heavy metal might not cause both non-cancer and carcinogenic risks to local residents. Nevertheless, the sum of the hazard index of all selected HMs for children slightly exceeded the safety value, thereby implying that the HMs from Suzhou street dust can possibly produce significant risk to children. Cr was the priority pollutant in the study area because of its high concentration, high enrichment, and high contribution to non-cancer risk values.

  11. Nonprofit health insurers: the story Wall Street doesn't tell. (United States)

    Johnson, Susan R


    For several years, Wall Street investment firms have campaigned for conversion of nonprofit health insurers to investor ownership, arguing that an infusion of equity capital is critical to insurers' survival. However, closer examination of the financial performance and capital position of not-for-profit health plans shows that: The lower operating margins reported by not-for-profit health plans very likely reflect the organizations' corporate missions to serve their communities by minimizing the cost of coverage and their ability to invest all gains back into the company for the future benefit of their customers. Their investor-owned counterparts must generate higher margins to give shareholders a return on their investment. Compared with investor-owned insurers, not-for-profit health plans use a significantly higher percentage of the customers' premium dollar to pay health care claims. A lower percentage goes for administrative expenses. Over the past 10 years, not-for-profit health plans have succeeded in using operational and investment gains to build and retain a strong capital position--stronger than that of investor-owned companies--while investing heavily in infrastructure, product development, and market growth.

  12. What’s Your “Street Race”? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs (United States)

    López, Nancy; Vargas, Edward D.; Juarez, Melina; Cacari-Stone, Lisa; Bettez, Sonia


    Using the 2015 Latino National Health and Immigration Survey (N= 1,197) we examine the relationship between physical and mental health status and three multidimensional measures of race: 1) “street race,” or how you believe other “Americans” perceive your race at the level of the street; 2) socially assigned race or what we call “ascribed race,” which refers to how you believe others usually classify your race in the U.S.; and 3) “self-perceived race,” or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx1 or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that, for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that “street race” is a promising multidimensional measure of race for exploring inequality among Latinxs. PMID:29423428

  13. Rare earth elements in street dust and associated health risk in a municipal industrial base of central China. (United States)

    Sun, Guangyi; Li, Zhonggen; Liu, Ting; Chen, Ji; Wu, Tingting; Feng, Xinbin


    The content levels, distribution characteristics, and health risks associated with 15 rare earth elements (REEs) in urban street dust from an industrial city, Zhuzhou, in central China were investigated. The total REE content (∑REE) ranged from 66.1 to 237.4 mg kg -1 , with an average of 115.9 mg kg -1 , which is lower than that of Chinese background soil and Yangtze river sediment. Average content of the individual REE in street dust decreased in the order Ce > La > Nd > Y > Pr > Sm > Gd > Dy > Er > Yb > Eu > Ho > Tb > Tm > Lu. The chondrite-normalized REE pattern indicated light REE (LREE) enrichment, a relatively steep LREE trend, heavy REE (HREE) depletion, a flat HREE trend, a Eu-negative anomaly and a Ce-positive anomaly. Foremost heavy local soil and to less degree anthropogenic pollution are the main sources of REE present in street dust. Health risk associated with the exposure of REE in street dust was assessed based on the carcinogenic and non-carcinogenic effect and lifetime average daily dose. The obtained cancer and non-cancer risk values prompt for no augmented health hazard. However, children had greater health risks than that of adults.

  14. Effective oral health in infective endocarditis: efficacy of high-street mouthwashes against the viridans group streptococci. (United States)

    Elshibly, Ahmed; Coulter, Wilson A; Millar, Beverley Cherie; Prendergast, Bernard D; Thornhill, Martin; Irwin, Christopher; Goldsmith, Colin E; Moore, John E


    Recent UK National Institute for Health and Clinical Excellence guidelines state that there is no longer a need for oral antibiotic prophylaxis in patients undergoing dental procedures who are at risk of infective endocarditis (IE), and advocate the importance of maintaining good oral health. As viridans group streptococci (VGS) are common etiological agents of IE and inhabitants of the mouth, the purpose of this study was to examine the efficacy of common high-street mouthwashes against four classes of VGS organisms (salivarius, mitis, anginosus, and mutans groupings). The survival of VGS, Streptococcus gordonii (National Collection of Type Cultures [NCTC] 7865), Streptococcus intermedius (NCTC 11324), Streptococcus mutans (NCTC 10449), Streptococcus oralis (NCTC 11427), Streptococcus pneumoniae (NCTC 7465, NCTC 7978, & American Type Culture Collection 49619) and Streptococcus salivarius (NCTC 8618) was assessed in vitro following treatment of approximately 10(7) c.f.u. in planktonic state with four mouthwashes. No organisms were culturable following 1-min exposure, and were not recovered following non-selective enrichment following incubation in Brain Heart Infusion broth supplemented with 0.8% (w/v) yeast extract. These data indicate that such mouthwashes are able to completely kill VGS organisms tested in planktonic solution, where their use would promote good oral hygiene in patients at risk of IE. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Urban streets

    NARCIS (Netherlands)

    Schönfeld, von Kim Carlotta; Bertolini, Luca


    Today's urban streets are usually planned for purposes of mobility: pedestrians, as well as a variety of vehicles such as cars, trucks, and sometimes bicycles, are usually factored into an urban street plan. However, urban streets are also increasingly recognized as public spaces, accommodating

  16. Female street sex workers in Hong Kong: moving beyond sexual health. (United States)

    Wong, William C W; Holroyd, Eleanor A; Gray, Ann; Ling, Davina C


    For many years, the sex industry in Hong Kong has appeared to be an integral and ever-expanding component of the city's sociocultural and economic structure. Accordingly, the physical and psychological health of sex workers is becoming an increasing concern for the workers themselves, the public, and government policy. A cross-sectional survey on the quality of life (World Health Organization Quality of Life [WHOQOL]) of female sex workers (FSWs) in Hong Kong was used to investigate the physical and psychological well-being of street FSWs, and the results were compared with those of non-sex-working Hong Kong women after adjusting for age, educational level, marital status, and health status. The 89 FSWs surveyed scored significantly lower on QOL--WHOQOL-BREF (HK)--measures compared with the non-sex-working women. One common aspect among these sex workers was their negative view of themselves and of life. Many sex workers were at risk of being abused while at work, and many women worked without legal protection. Most of the women surveyed engaged in sex work to support their families. Because their income was often insufficient, some of their needs, especially those concerning health, were often neglected. The low WHOQOL-BREF (HK) scores in FSWs indicate feelings of helplessness and entrapment, which may well result in detrimental effects on sex workers' health, self-esteem, and confidence when asserting their basic rights, such as access to healthcare and safety. The conclusion highlights the vulnerability of this population to apparent weaknesses in Hong Kong's current healthcare system.

  17. Experience of emotional stress and resilience in street-involved youth: the need for early mental health intervention. (United States)

    McCay, Elizabeth


    Mental illness left untreated in adolescence and young adulthood can readily become a chronic illness in adulthood, seriously hampering the capacity of individuals to become healthy contributing members of society. Mental health challenges are of paramount importance to the health and well-being of Canadian adolescents and young adults, with 18% of Canadian youth, ages 15-24, reporting a mental illness (Leitch 2007). However, it is unlikely that this statistic accounts for those invisible youth (Rachlis et al. 2009) who are disconnected from families and caregivers, bereft of stable housing and familial support - in other words, youth who are street-involved. Mental health risk is amplified in street-involved youth and, as such, must be recognized as a priority for policy development that commits to accessible mental health programming, in order to realize the potential of these vulnerable youth.

  18. Rural health clinics infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Olson, K.


    The author discusses programs which were directed at the installation of photovoltaic power systems in rural health clinics. The objectives included: vaccine refrigeration; ice pack freezing; lighting; communications; medical appliances; sterilization; water purification; and income generation. The paper discusses two case histories, one in the Dominican Republic and one in Colombia. The author summarizes the results of the programs, both successes and failures, and offers an array of conclusions with regard to the implementation of future programs of this general nature.

  19. Health of the street child: the relation between life-style, immunity ...

    African Journals Online (AJOL)

    Erna Kinsey

    system, is a more effective strategy in fighting infection, than conquer- ing invading .... dustbins, parks, cemeteries, old cars, junk yards, drainpipes, sports grounds ... A study on the nutritional status of 97 street children showed that. 74% were ...

  20. Silent killers of the night: an exploration of psychological health and suicidality among female street sex workers. (United States)

    Ling, Davina C; Wong, William C W; Holroyd, Eleanor A; Gray, Sister Ann


    This article examines factors that relate to psychological health (as measured by the World Health Organization Quality of Life Instrument) as well as suicide attempts among female street sex workers (FSSWs) in Hong Kong. On average, our sampled FSSWs scored significantly lower on the psychological health domain in comparison to the general Hong Kong female population. Factors associated with the working environment in the sex industry were significantly associated with poor psychological health and suicidality. Greater attention is needed to examine the physical and emotional harm intrinsic to certain occupations and the role of financial needs in the experience of psychological stress.

  1. Assessment of cancer and noncancer health risks from exposure to PAHs in street dust in the Tamale Metropolis, Ghana. (United States)

    Obiri, Samuel; Cobbina, Samuel J; Armah, Frederick A; Luginaah, Isaac


    This study is part of a broader initiative to characterize, quantify and assess the human health risk associated with exposure to polycyclic aromatic hydrocarbons (PAHs) in street dust along the Trans-ECOWAS highway in West Africa. In the first part, PAHs were characterized and quantified in low- and high-traffic zones. In this study, cancer and noncancer human health risks from exposure to (PAHs) in street dust in the Tamale metropolis, Ghana were assessed in accordance with the USEPA risk assessment guidelines. The results of the study as obtained from inhalation of benzo [a] anthracene (BaA), benzo [a] pyrene (BaP), benzo [k] fluoranthene (BkF) and chrysene via central tendency exposure parameters (CTE) by trespassers (street hawkers including children and adults) in street dust within low traffic zones in the Tamale metropolis are 1.6E-02, 4.7E-02, 1.8E-03, and 1.6E-04 respectively. For reasonable maximum exposure parameters (RME), risk values of 1.2E-01, 3.5E-01, 1.3E-02 and 1.2E-03 respectively were obtained for benzo [a] anthracene, benzo [a] pyrene, benzo [k] fluoranthene and chrysene. Hazard index for acenaphthene, anthracene, fluoranthene, fluorine, naphthalene and pyrene in the CTE and RME scenarios were 2.2, 3.E-01, 2.6, 2.6, 100, 38 and 12, 1.7,15, 14, 550, 210 respectively. Generally, the cancer health risk associated with inhalation of benzo [a] anthracene, benzo [a] pyrene, benzo [k] fluoranthene and chrysene revealed that resident adults and children in the Tamale metropolis are at risk from exposure to these chemicals. The results of this preliminary assessment that quantified PAH related health risks along this part of the Trans-ECOWAS highway revealed that, there is the need for regulatory agencies to put in comprehensive measures to mitigate the risks posed to these categories of human receptors.

  2. Physical and sexual violence, mental health indicators, and treatment seeking among street-based population groups in Tegucigalpa, Honduras. (United States)

    Rio Navarro, Javier; Cohen, Julien; Rocillo Arechaga, Eva; Zuniga, Edgardo


    To establish the prevalence of exposure to physical and sexual violence, mental health symptoms, and medical treatment-seeking behavior among three street-based subpopulation groups in Tegucigalpa, Honduras, and to assess the association between sociodemographic group, mental health indicators, and exposure to violence. An anonymous, cross-sectional survey among randomly selected street-based adolescents, adults, and commercial sex workers (CSWs) was undertaken at the end of 2010 in Tegucigalpa. Médecins Sans Frontières (MSF) mapped places where the study population gathers. Stratified probability samples were drawn for all groups, using two-stage random sampling. Trained MSF staff administered on-site standardized face-to-face questionnaires. Self-reported exposure to severe physical violence in the previous year was 20.9% among street-based adolescents, 28.8% among adults, and 30.6% among CSWs. For the physical violence event self-defined as most severe, 50.0% of the adolescents, 81.4% of the adults, and 70.6% of the CSWs sought medical treatment. Their exposure to severe sexual violence was 8.6%, 28.8%, and 59.2%, respectively. After exposure to the self-defined most severe sexual violence event, 14.3% of adolescents, 31.9% of adults, and 29.1% of CSWs sought treatment. Common mental health and substance abuse symptoms were highly prevalent and strongly associated with exposure to physical (odds ratio 4.5, P < 0.0001) and sexual (odds ratio 3.7, P = 0.0001) violence. Exposure to physical and sexual violence reached extreme levels among street-based subpopulations. Treatment-seeking behavior, particularly after severe sexual violence, was limited. The association of mental health and substance abuse symptoms with exposure to violence could lead to further victimization. Medical and psychological treatments targeting these groups are needed and could help decrease their vulnerability.

  3. Process evaluation of the health education resource Abre los Ojos for street-involved youth in Medellín

    Directory of Open Access Journals (Sweden)

    John L. Wylie


    Full Text Available Objective: Conduct a process evaluation of a health education resource (pamphlet¸ Abre los Ojos, designed for street-involved youth in Medellín. The primary foci of the evaluation were the process of developing the resource and youth’s subsequent perception of the resource. Methodology: Drawing upon both qualitative and quantitative data, a process evaluation was undertaken. Ninety four street-involved youth between the ages of 14–24 years completed surveys about the resource. These semi-structured interviews were key for the information about youth perception of the resource. In addition to individual interviews, prior to resource creation, a series of focus groups were integral for the development of the resource. Results: The process of consulting with the target population through the focus groups was effective in obtaining their ideas and feedback about what type of content they would like to see in a health education resource, and how they wanted that content presented. After distribution, participants described that Abre los Ojos contained information that was valuable and relevant to their experiences. While not a primary focus of this evaluation, the individual interviews were also able to provide some preliminary insight into whether Abre los Ojos was an effective means for participants to increase their knowledge of content included in the resource. Conclusion: The collaborative process of jointly developing the resource content in partnership with the youth proved very worthwhile. While our research team chose to include information about HIV, through focus group dialogue, the youth themselves determined the additional content themes (piercings, use of solvents, and description of life on the street. The resulting resource was well-received by members of the street-involved population who had not been involved in its design.

  4. Dr. North and the Kansas City Newspaper War: Public Health Advocacy Collides with Main Street Respectability. (United States)

    Kovarik, Bill

    A case study examined a 1920 controversy between two newspapers. One of the last vestiges of the era of "yellow journalism" was the editorial "war" between the Kansas City "Star" and the Kansas City "Post" which culminated in a 1921 showdown. The "Star," a champion of main street interests and…

  5. Chemical speciation and human health risk of trace metals in urban street dusts from a metropolitan city, Nanjing, SE China

    Energy Technology Data Exchange (ETDEWEB)

    Li, Huiming; Qian, Xin, E-mail:; Hu, Wei; Wang, Yulei; Gao, Hailong


    The modified BCR (the European Community Bureau of Reference) sequential extraction procedure was applied for partitioning and evaluating the mobility, availability and persistence of trace metals (Al, Cd, Co, Cr, Cu, Ni, Pb, Sr, V and Zn) in urban street dusts collected from different areas of Nanjing, China. The mobility sequence based on the sum of the BCR sequential extraction stages was: Sr (91.65%) > Pb (79.16%) > Zn (74.26%) > Cu (68.53%) > Co (45.98%) > Al (40.01%) ≈ V (38.45%) ≈ Ni (37.88%) > Cr (29.35%) > Cd (22.68%). Almost every trace metal had its highest total concentrations in the industrial area, except for Sr which had its highest concentration in the commercial area. Contamination factors (Cf), risk assessment code (RAC) and enrichment factor (Ef) were then calculated to further assess the environmental risk and provide a preliminary estimate of the main sources of trace metals in street dusts. Non-carcinogenic effects and carcinogenic effects due to exposure to urban street dusts were assessed for both children and adults. For non-carcinogenic effects, ingestion was the main route of exposure to street dusts for these metals, followed by dermal contact and inhalation. Hazard index values for all studied metals were lower than the safe level of 1, and Pb exhibited the highest risk value (0.125) in the case of children. The carcinogenic risk for Cd, Co, Cr and Ni were all below the acceptable level (< 10{sup −6}). - Highlights: • This study assesses a comprehensive environmental risk of urban trace metal pollution. • This study evaluates human health risk combined with the speciation of trace metals. • This study points the critical contaminated metals that need to be paid special attention. • This study supplies useful information and reference on the application of BCR SPE method.

  6. City Streets (United States)

    Minnesota Department of Natural Resources — This data set contains roadway centerlines for city streets found on the USGS 1:24,000 mapping series. In some areas, these roadways are current through the 2000...

  7. Bioaccessibility and health risk of arsenic, mercury and other metals in urban street dusts from a mega-city, Nanjing, China

    International Nuclear Information System (INIS)

    Hu Xin; Zhang, Yun; Luo Jun; Wang Tijian; Lian Hongzhen; Ding Zhuhong


    The oral bioaccessibility and the human health risks of As, Hg and other metals (Cu, Pb, Zn, Ni, Co, Cd, Cr, Mn, V and Fe) in urban street dusts from different land use districts in Nanjing (a mega-city), China were investigated. Both the total contents and the oral bioaccessibility estimated by the Simple Bioaccessibility Extraction Test (SBET) of the studied elements varied with street dusts from different land use districts. Cd, Zn, Mn, Pb, Hg and As showed high bioaccessibility. SBET-extractable contents of elements were significantly correlated with their total contents and the dust properties (pH, organic matter contents). The carcinogenic risk probability for As and Cr to children and adults were under the acceptable level ( -4 ). Hazard Quotient values for single elements and Hazard Index values for all studied elements suggested potential non-carcinogenic health risk to children, but not to adults. - Highlights: → Spatial variation of elements in street dusts from different land use districts. → Oral bioaccessibility of elements in street dusts from different land use districts. → Human health risks of elements in street dusts from different land use districts. - Bioaccessibility and health risks of trace elements differed with street dusts from different land use districts in Nanjing.

  8. Health Belief Model and Labelling Theory in the Analysis of Preventive Behaviors to Address Biopsychosocial Impacts of Sexual Violence Among Street Children in YOGYAKARTA


    Intan Noor Khalifah; Argyo Demartoto; Harsono Salimo


    Background: Street children are at high risk of sexual violence. Necessary measures should be undertaken to address deleterious biopsychosocial impacts of sexual violence. This study aimed to analyze the preventive behaviors to address biopsychosocial impacts of sexual violence among street children in Yogyakarta using Health Belief Model and Labelling Theory.Subjects and Method: This study was qualitative descriptive with phenomenology approach. The key informants for this study included Hea...

  9. Clinic Health Awareness Program Subsystem - (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  10. Tracing source, distribution and health risk of potentially harmful elements (PHEs) in street dust of Durgapur, India. (United States)

    Gope, Manash; Masto, Reginald Ebhin; George, Joshy; Balachandran, Srinivasan


    Street dust samples from Durgapur, the steel city of eastern India, were collected from five different land use patterns, i.e., national highways, urban residential area, sensitive area, industrial area and busy traffic zone during summer, monsoon, and winter to analyze the pollution characteristics, chemical fractionation, source apportionment and health risk of heavy metals (HMs). The samples were fractionated into ≤ 53 µm and analyzed for potentially harmful elements (PHEs) viz. Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn. Summer season indicated higher concentrations of PHEs when compared to the other two seasons. Mean enrichment factor (EF), geo-accumulation index (Igeo), and contamination factor (CF) were high for Cd followed by Pb during all the three season in Durgapur. Chemical fractionation was executed in order to obtain distribution patterns of PHEs and to evaluate their bioavailable fractions in street dust samples. Mn was found to be highly bioavailable and bioavailability of the PHEs were in the order of Mn > Zn > Pb > Ni > Cd > Cu > Fe > Cr. Principal Component Analysis (PCA), cluster analysis, correlation analysis indicated the main sources of PHEs could be industrial, especially coal powered thermal plant, iron and steel industries and cement industries and vehicular. Multivariate analysis of variance (MANOVA) indicated that sites, seasons and their interaction were significantly affected by different PHEs as a whole. The health risk was calculated with total metal as well as mobile fraction of PHEs, which indicated that the actual non-carcinogenic risk due to bioavailable PHEs was less (HI < 1) when compared to total concentrations of PHEs. Carcinogenic risk was observed for total Cr in street dust (Child: 4.6E-06; Adult: 3.6E-06). Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Pollution characteristics and health risk assessment of heavy metals in street dusts from different functional areas in Beijing, China. (United States)

    Wei, Xin; Gao, Bo; Wang, Peng; Zhou, Huaidong; Lu, Jin


    Street dusts from Heavy Density Traffic Area, Residential Area, Educational Area and Tourism Area in Beijing, China, were collected to study the distribution, accumulation and health risk assessment of heavy metals. Cr, Cu, Zn, Cd and Pb concentrations were in higher concentrations in these four locations than in the local soil background. In comparison with the concentrations of selected metals in other cities, the concentrations of heavy metals in Beijing were generally at moderate or low levels. Ni, Cu, Zn and Pb concentrations in the Tourism Area were the highest among four different areas in Beijing. A pollution assessment by Geoaccumulation Index showed that the pollution level for the heavy metals is in the following order: Cd>Pb>Zn>Cu>Cr>Ni. The Cd levels can be considered "heavily contaminated" status. The health risk assessment model that was employed to calculate human exposure indicated that both non-carcinogenic and carcinogenic risks of selected metals in street dusts were generally in the low range, except for the carcinogenic risk from Cr for children. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Exploring social inclusion strategies for public health research and practice: The use of participatory visual methods to counter stigmas surrounding street-based substance abuse in Colombia. (United States)

    Ritterbusch, Amy E


    This paper presents the participatory visual research design and findings from a qualitative assessment of the social impact of bazuco and inhalant/glue consumption among street youth in Bogotá, Colombia. The paper presents the visual methodologies our participatory action research (PAR) team employed in order to identify and overcome the stigmas and discrimination that street youth experience in society and within state-sponsored drug rehabilitation programmes. I call for critical reflection regarding the broad application of the terms 'participation' and 'participatory' in visual research and urge scholars and public health practitioners to consider the transformative potential of PAR for both the research and practice of global public health in general and rehabilitation programmes for street-based substance abuse in Colombia in particular. The paper concludes with recommendations as to how participatory visual methods can be used to promote social inclusion practices and to work against stigma and discrimination in health-related research and within health institutions.

  13. Street Politics

    Directory of Open Access Journals (Sweden)

    Michael J. Shapiro


    Full Text Available I write from Prague, where, unlike in most urban formations, the main city street plays an iconic role; it references a history of political protest. However, before elaborating on the protest iconography of the Prague street, Vaclavske nam, I want to locate the ways in which the design of urban space is actualized in everyday life in the cities of the world. Three functions stand out; the first involves dwelling, the second seeing, and the third moving. With respect to the first function – dwelling – the design partitions and coordinates residential, commercial and leisure functions. At times these are organized to segregate different classes (Robert Moses’ redesign of much of New York stands out with respect to the segregation function. With respect to the second function – seeing – the design of urban space is allegiance-inspiring; it involves sight lines that afford urban dwellers and visitors views of iconic buildings and statues, which reference key founding moments in the past and/or authoritative political functions in the present (Here, L’Enfants design for Washington DC stands out as exemplary. Its manifest intention was to make the buildings housing executive, legislative and judicial functions visible from many vantage points. Rarely are the streets themselves iconic. Their dominant role is involved with the effectuation of movement. As for this third function: As Lewis Mumford famously points out, streets were once part of an asterisk design, radiating out from an exemplary, often spiritual center...

  14. Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors. (United States)

    Hughes, Alison; Condon, Louise


    Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

  15. Risk of HIV infection among indoor and street sex workers and their use of health services in Belgrade, Serbia. (United States)

    Ilić, Dragan; Sipetić, Sandra; Bjegović, Vesna


    HIV in Serbia is most often transmitted through sexual contact, and therefore numerous prevention activities are geared towards sex workers (SW). To analyse the differences in knowledge, attitudes and risky behaviour between indoor and street SW in Belgrade; to examine the accessibility of health services to this vulnerable group. In this behavioural cross-sectional study, 113 street and 78 indoor SW were included. The sampling method used was snowball samples. Data were gathered through structured questionnaires. Around 15% of respondents used drugs intravenously. Around 60% of SW used a condom during the last sexual intercourse with their private partner, and around 90% with a commercial partner. Indoor SW had lower levels of education more often than outdoor SW, and they used marijuana, sedatives and painkillers on a daily basis. A significantly higher number of indoor SW were informed about HIV, HBV and HCV testing, and that the risk for HIV infection is not lower ifa condom is used exclusively for vaginal sex. Indoor SW reported using health services and testing and counselling for HIV, HBV and HCV more frequently than outdoor SW. Outdoor SW had significantly more sex partners in the previous month than indoor SW. Indoor SW recognized more frequently that providing sex services posed a higher risk for HIV infection. The results of this research study show that even though outdoor SW had higher levels of education than indoor SW, their level of knowledge about HIV transmission was lower and they reported more risky behaviour than indoor SW. Data show that both groups reported not taking care of their health.

  16. Risk of HIV infection among indoor and street sex workers and their use of health services in Belgrade, Serbia

    Directory of Open Access Journals (Sweden)

    Ilić Dragan


    Full Text Available Introduction. HIV in Serbia is most often transmitted through sexual contact, and therefore numerous prevention activities are geared towards sex workers (SW. Objective. To analyze the differences in knowledge, attitudes and risky behaviour between indoor and street SW in Belgrade; to examine the accessibility of health services to this vulnerable group. Methods. In this behavioural cross-sectional study, 113 street and 78 indoor SW were included. The sampling method used was snowball samples. Data were gathered through structured questionnaires. Results. Around 15% of respondents used drugs intravenously. Around 60% of SW used a condom during the last sexual intercourse with their private partner, and around 90% with a commercial partner. Indoor SW had lower levels of education more often than outdoor SW, and they used marijuana, sedatives and painkillers on a daily basis. A significantly higher number of indoor SW were informed about HIV, HBV and HCV testing, and that the risk for HIV infection is not lower if a condom is used exclusively for vaginal sex. Indoor SW reported using health services and testing and counseling for HIV, HBV and HCV more frequently than outdoor SW. Outdoor SW had significantly more sex partners in the previous month than indoor SW. Indoor SW recognized more frequently that providing sex services posed a higher risk for HIV infection. Conclusion. The results of this research study show that even though outdoor SW had higher levels of education than indoor SW, their level of knowledge about HIV transmission was lower and they reported more risky behaviour than indoor SW. Data show that both groups reported not taking care of their health.

  17. Translating Universal Health Care for the Homeless: Barriers and potential facilitating factors for accessing health care amongst street dwellers in India

    Directory of Open Access Journals (Sweden)

    V Prasad


    Full Text Available Urban health policy has remained a neglected area in India, and amongst the urban poor, the homeless remain the most deprived, neglected and stigmatized group. While they suffer from a large burden of disease, there are a variety of reasons that prevent them from accessing the available health care services – particularly in the public health sector. These barriers have been poorly understood and documented. This report, based upon a detailed study of homeless participants in New Delhi, India, seeks to highlight the systemic changes that would be required within public health systems to enable street dwellers to avail of their services and realise the conceptual ambit of ' health for all' in the context of homeless persons. 

  18. The effects of local street network characteristics on the positional accuracy of automated geocoding for geographic health studies

    Directory of Open Access Journals (Sweden)

    Zimmerman Dale L


    Full Text Available Abstract Background Automated geocoding of patient addresses for the purpose of conducting spatial epidemiologic studies results in positional errors. It is well documented that errors tend to be larger in rural areas than in cities, but possible effects of local characteristics of the street network, such as street intersection density and street length, on errors have not yet been documented. Our study quantifies effects of these local street network characteristics on the means and the entire probability distributions of positional errors, using regression methods and tolerance intervals/regions, for more than 6000 geocoded patient addresses from an Iowa county. Results Positional errors were determined for 6376 addresses in Carroll County, Iowa, as the vector difference between each 100%-matched automated geocode and its ground-truthed location. Mean positional error magnitude was inversely related to proximate street intersection density. This effect was statistically significant for both rural and municipal addresses, but more so for the former. Also, the effect of street segment length on geocoding accuracy was statistically significant for municipal, but not rural, addresses; for municipal addresses mean error magnitude increased with length. Conclusion Local street network characteristics may have statistically significant effects on geocoding accuracy in some places, but not others. Even in those locales where their effects are statistically significant, street network characteristics may explain a relatively small portion of the variability among geocoding errors. It appears that additional factors besides rurality and local street network characteristics affect accuracy in general.

  19. Spatial distribution, health risk assessment, and isotopic composition of lead contamination of street dusts in different functional areas of Beijing, China. (United States)

    Han, Lanfang; Gao, Bo; Wei, Xin; Xu, Dongyu; Gao, Li


    Street dusts from heavy density traffic area (HDTA), tourism area (TA), residential area (RA), and educational area (EA) in Beijing were collected to explore the distribution, health risk assessment, and source of lead (Pb). The average concentration of Pb in TA was the highest among the four areas. Compared with other cities, Pb concentrations in Beijing were generally at moderate or low levels. The average value (14.05) of ecological risk index (RI) indicated that Pb was at "low pollution risk" status. According to the calculation on hazard index (HI), the ingestion of dust particles of children and adults was the major route of exposure to street dusts in four studied areas, followed by dermal contact. The lower values of HI than 1 further suggested that non-carcinogenic risks of Pb in the street dusts were in the low range. Comparing (206)Pb/(207)Pb and (208)Pb/(207)Pb ratios of street dusts with other environmental samples, it was found that atmospheric deposition of coal combustion dust might be the main pathway for anthropogenic Pb input to the street dusts in four functional areas.

  20. A study on reintegration of street children in Burundi: experienced violence and maltreatment are associated with mental health impairments and impeded educational progress (United States)

    Crombach, Anselm; Bambonyé, Manassé; Elbert, Thomas


    Street children are exposed to violence, and subsist in poor and generally precarious conditions. In conflict regions, institutional care facilities are often the only well established way to care for vulnerable children. Providing access to school education is considered to be key to allow successful integration into society. However, adverse effects of psychological disorders may pose another serious obstacle. In semi-structured interviews in a sample of 112 Burundian male youths (mean age = 15.9 years), we assessed exposure to traumatic stressors, regularly and recently occurring violence as well as prevalence of posttraumatic stress disorder (PTSD), depression, substance dependence, suicidal risk, and progress in school. Former street children (n = 32) and other vulnerable children (n = 50) in a residential center were compared to children living in the streets (n = 15) or with families (n = 15). While the children living in the center were less regularly exposed to violence and reported less substance dependence than street children, PTSD symptoms were common among the former street children. Furthermore, we provided empirical evidence that for the children living in the center, recently experienced violence – mostly minor physical conflicts, psychological violence and neglect – was associated with increased PTSD symptomatology and impeded progress in school. In a population of children who experienced many traumatic incidences and a lot of violence, even minor violent events may trigger and reinforce PTSD symptoms. Hence controlling exposure to violence and addressing mental ill-health in vulnerable children is mandatory for reintegration. PMID:25566123

  1. Simple street tree sampling (United States)

    David J. Nowak; Jeffrey T. Walton; James Baldwin; Jerry. Bond


    Information on street trees is critical for management of this important resource. Sampling of street tree populations provides an efficient means to obtain street tree population information. Long-term repeat measures of street tree samples supply additional information on street tree changes and can be used to report damages from catastrophic events. Analyses of...

  2. The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: a meta-ethnographic synthesis. (United States)

    Erasmus, Ermin


    This article presents a synthesis of studies that explicitly use the theory of street-level bureaucracy to illuminate health policy implementation in low- and middle-income countries. Street-level bureaucrats are frontline workers in bureaucracies, e.g. nurses, who regularly interact directly with citizens in discharging their policy implementation duties and who have some discretion over which services are offered, how services are offered and the benefits and sanctions allocated to citizens. This synthesis seeks to achieve the dual objectives of, first, reflecting on how street-level bureaucracy theory has been used in the literature and, second, providing an example of the application of the synthesis methodology of meta-ethnography to the health policy analysis literature. The article begins by outlining meta-ethnography and providing more information on the papers on which the synthesis is based. This is followed by a detailed account of how the synthesis was achieved and by an articulation of the synthesis. It then concludes with thoughts and questions on the value and relevance of the synthesis, the experience of conducting the synthesis and the partial way in which street-level bureaucracy theory has been used in the literature examined. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  3. 46th Street pilot street lighting project. (United States)


    Street lighting improvements provide an opportunity for governments to save money and to reduce their : environmental footprint. New energy-efficient technologies are being perfected that are more efficient than : standard high-pressure sodium street...

  4. The multiplicity and interdependency of factors influencing the health of street-based sex workers: a qualitative study. (United States)

    Jeal, N; Salisbury, C; Turner, K


    To obtain a detailed understanding of the lives of street-based commercial sex workers (SSWs) and how factors in their lives interrelate to affect their health. In-depth interviews with 22 SSW working in Bristol, England. The SSWs described their working day as a continuous cycle of selling sex, buying and using drugs, then returning to work. They explained that they placed themselves at risk of sexually transmitted infections, rape, physical assault, verbal abuse and murder when selling sex and physical violence when buying drugs. Most of the women injected drugs and detailed how this behaviour had resulted in life-threatening illnesses, including deep vein thromboses, pulmonary emboli and abscesses. Some interviewees gave accounts of sleeping in crack houses, on friends' floors or car parks, and most participants mentioned that they did not eat, drink or sleep regularly. This self-neglect led to weight loss and physical and mental ill-health. Respondents described pressures that forced them back out to work, such as unstable accommodation, separation from children and other individuals taking their drugs or money. SSWs are trapped in a cycle of selling sex and buying and using drugs. Multiple pressures from within and outwith this cycle keep them in this situation. The multiplicity and interdependency of health problems and pressures suggest that this group are best supported with integrated multi-agency services that work flexibly across all areas of their lives. A rigid or punitive approach is likely to be counterproductive and may increase risks to the wellbeing of SSWs.

  5. Homeless but Connected: The Role of Heterogeneous Social Network Ties and Social Networking Technology in the Mental Health Outcomes of Street-Living Youth


    Rice, Eric; Ray, Diana; Kurzban, Seth


    Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents’ social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through soci...

  6. Experiences of street harassment and associations with perceptions of social cohesion among women in Mexico City

    Directory of Open Access Journals (Sweden)

    Paola A Campos


    Full Text Available Objective. To document the frequency and forms of street harassment and examine the association between street harassment experiences and perceptions of social cohesion. Materials and methods. Baseline survey data collected among women seeking care in public health clinics in Mexico City were used for analysis. Results. Nearly two-thirds (62.8% of women reported experiencing some form of street harassment in the prior month; women with street harassment experiences reported significantly lower perceived social cohesion (b=-0.46; 95%CI:0.69,-0.22. Conclusions. Findings indicate reducing street harassment may have important implications for improving women’s perceived social cohesion and their safety in Mexico City.

  7. Human health risk assessment based on toxicity characteristic leaching procedure and simple bioaccessibility extraction test of toxic metals in urban street dust of Tianjin, China.

    Directory of Open Access Journals (Sweden)

    Binbin Yu

    Full Text Available The potential ecological and human health risk related with urban street dust from urban areas of Tianjin, China was quantitatively analyzed using the method of toxicity characteristic leaching procedure (TCLP and simple bioaccessibility extraction test (SBET. In the study, Hakason index, Nemerow index (P, the hazard index (HI and the cancer risk index (RI were calculated to assess the potential risk. The sequence of potential ecological risk based on Hakason index was arsenic (As > cadmium (Cd > lead (Pb > copper (Cu > chromium (Cr, in particular, As and Cd were regarded as high polluted metals. While the results of extraction of TCLP were assessed using P, the sequence was As > Pb > Cd > Cr > Cu, which mean that As and Pb should be low polluted, and Cd, Cr and Cu would barely not polluted. For human health, total carcinogenic risk for children and adults was 2.01 × 10(-3 and 1.05 × 10(-3, respectively. This could be considered to be intolerable in urban street dust exposure. The sequence in the hazard quotient (HQ of each element was As > Cr > Pb > Cu > Cd. The HI value of these toxic metals in urban street dust for children and adults was 5.88 × 10(-1 and 2.80 × 10(-1, respectively. According to the characters of chemistry, mobility, and bioavailability of metals in urban street dust, we estimated the hazards on the environment and human health, which will help us to get more reasonable information for risk management of metals in urban environment.

  8. Effects of 3 months of full-court and half-court street basketball training on health profile in untrained men

    DEFF Research Database (Denmark)

    Thomsen, Morten Bredsgaard Randers; Hagman, Marie von Ahnen; Brix, Jonathan


    Purpose: The aim of the present study was to investigate whether street basketball organized as 3 v 3 on either a half court (HC) with 1 basket or a full court (FC) with 2 baskets could improve fitness and health profiles of untrained men after 3 months of supervised training. Methods: Thirty.......5 ± 2.9 %HRmax in FC and HC, respectively. Results: The 3 months of street basketball training on an FC with 2 baskets increased maximal oxygen uptake (2.4 mL/min/kg (95% confidence interval (CI): 1.0-3.9)), time to exhaustion (47 s (95%CI: 26-67)), lean body mass (0.8 kg (95%CI: 0.1-1.5)), and bone...... (-0.9% (95%CI: -1.9 to -0.1)) were observed in this group. Conclusion: Three months of 3 v 3 street basketball training improved fitness and led to broad-spectrum improvements in variables related to overall health profile, with the most marked effects observed when playing on a FC with 2 baskets....

  9. Clinics in Mother and Child Health

    African Journals Online (AJOL)

    Clinics in Mother and Child Health is a bilingual journal and publishes (in ... Health Care Facility in South-South Nigeria: The Need for Middle Level Health Manpower ... Le syndrome des ovaires micropolykystiques chez les femmes infertiles à ...

  10. Street-level workers' inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey. (United States)

    Ridde, Valéry; Leppert, Gerald; Hien, Hervé; Robyn, Paul Jacob; De Allegri, Manuela


    Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective of this study was to measure and understand the determinants of street-level workers' knowledge and application of these exemption measures. We used cross-sectional data collected between October 2013 and March 2014. The survey targeted 1521 health workers distributed in 498 first-line centres, 18 district hospitals, 5 regional hospitals, and 11 private or other facilities across 24 districts. We used four different random effects models to identify factors associated with knowledge and application of each of the above-mentioned exemption policies. Only 9.2% of workers surveyed knew of the directive exempting the worst-off, and only 5% implemented it. Knowledge and application of the delivery exemption were higher, with 27% of all health workers being aware of the delivery exemption directive and 24.2% applying it. Mobile health workers were found to be consistently more likely to apply both exemptions. Health workers who were facility heads were significantly more likely to know about the indigent exemption for primary health care and to apply it. Health workers in districts with higher proportions of very poor people were significantly more likely to know about and apply the delivery exemption. Nearly 60% of respondents indicated either 5% or 10% as the percentage of people they would deem adequate to target for exemption. This quantitative study confirmed earlier qualitative results on the importance of training and informing health workers and monitoring the measures targeting equity, to ensure compliance with government directives. The local context (e.g., hierarchy, health system, interventions) and the ideas that street-level workers have about the policy

  11. Allegheny County Street Centerlines (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains the locations of the street centerlines for vehicular and foot traffic in Allegheny County. Street Centerlines are classified as Primary Road,...

  12. A dose-dependent relationship between exposure to a street-based drug scene and health-related harms among people who use injection drugs. (United States)

    Debeck, Kora; Wood, Evan; Zhang, Ruth; Buxton, Jane; Montaner, Julio; Kerr, Thomas


    While the community impacts of drug-related street disorder have been well described, lesser attention has been given to the potential health and social implications of drug scene exposure on street-involved people who use illicit drugs. Therefore, we sought to assess the impacts of exposure to a street-based drug scene among injection drug users (IDU) in a Canadian setting. Data were derived from a prospective cohort study known as the Vancouver Injection Drug Users Study. Four categories of drug scene exposure were defined based on the numbers of hours spent on the street each day. Three generalized estimating equation (GEE) logistic regression models were constructed to identify factors associated with varying levels of drug scene exposure (2-6, 6-15, over 15 hours) during the period of December 2005 to March 2009. Among our sample of 1,486 IDU, at baseline, a total of 314 (21%) fit the criteria for high drug scene exposure (>15 hours per day). In multivariate GEE analysis, factors significantly and independently associated with high exposure included: unstable housing (adjusted odds ratio [AOR] = 9.50; 95% confidence interval [CI], 6.36-14.20); daily crack use (AOR = 2.70; 95% CI, 2.07-3.52); encounters with police (AOR = 2.11; 95% CI, 1.62-2.75); and being a victim of violence (AOR = 1.49; 95 % CI, 1.14-1.95). Regular employment (AOR = 0.50; 95% CI, 0.38-0.65), and engagement with addiction treatment (AOR = 0.58; 95% CI, 0.45-0.75) were negatively associated with high exposure. Our findings indicate that drug scene exposure is associated with markers of vulnerability and higher intensity addiction. Intensity of drug scene exposure was associated with indicators of vulnerability to harm in a dose-dependent fashion. These findings highlight opportunities for policy interventions to address exposure to street disorder in the areas of employment, housing, and addiction treatment.

  13. Metal Exposure and Associated Health Risk to Human Beings by Street Dust in a Heavily Industrialized City of Hunan Province, Central China

    Directory of Open Access Journals (Sweden)

    Guangyi Sun


    Full Text Available Fifty-five urban street dust samples were collected from Zhuzhou, an industrial city in central China and analyzed for a range of toxic elements. Potential carcinogenic and non-carcinogenic health effects on children and adults due to exposure to street dust were assessed. Concerning the two subgroups, the child cohort is confronted with considerably greater health risks than adults. According to the Hazard Quotient (HQ method, ingestion of dust particles poses primary risk to children and adults, followed by dermal contact and inhalation for all of the metals investigated except Hg, for which inhalation of its elemental vapor constitute a slightly higher risk than ingestion. For children, Pb, As, Cd, Cr, Hg and Sb exposure were deemed as the highest contributors to non-cancer health risks, while As and Cr represent an enhanced cancer risk for children. For adults, risk indicator values for both cancer and non-cancer effects obtained were within the safety threshold. In a comparison with other locations within and outside mainland China, exposure to arsenic is prominent for the population of Zhuzhou, indicating more attention and preventive actions should been taken.

  14. Psychosocial profile of institutionalised street children in Alexandria ...

    African Journals Online (AJOL)

    Objective: The phenomenon of street children in Egypt constitutes a public health concern. This study aimed to investigate the characteristics of institutionalised street children in Alexandria, to compare the prevalence of substance abuse and conduct disorder between street children and school children, and to identify ...

  15. Electronic health records to facilitate clinical research


    Cowie, Martin R.; Blomster, Juuso I.; Curtis, Lesley H.; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, J?rg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P.; Southworth, Mary Ross; Stough, Wendy Gattis


    Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the pr...

  16. A ubiquitous method for street scale spatial data collection and analysis in challenging urban environments: mapping health risks using spatial video in Haiti. (United States)

    Curtis, Andrew; Blackburn, Jason K; Widmer, Jocelyn M; Morris, J Glenn


    Fine-scale and longitudinal geospatial analysis of health risks in challenging urban areas is often limited by the lack of other spatial layers even if case data are available. Underlying population counts, residential context, and associated causative factors such as standing water or trash locations are often missing unless collected through logistically difficult, and often expensive, surveys. The lack of spatial context also hinders the interpretation of results and designing intervention strategies structured around analytical insights. This paper offers a ubiquitous spatial data collection approach using a spatial video that can be used to improve analysis and involve participatory collaborations. A case study will be used to illustrate this approach with three health risks mapped at the street scale for a coastal community in Haiti. Spatial video was used to collect street and building scale information, including standing water, trash accumulation, presence of dogs, cohort specific population characteristics, and other cultural phenomena. These data were digitized into Google Earth and then coded and analyzed in a GIS using kernel density and spatial filtering approaches. The concentrations of these risks around area schools which are sometimes sources of diarrheal disease infection because of the high concentration of children and variable sanitary practices will show the utility of the method. In addition schools offer potential locations for cholera education interventions. Previously unavailable fine scale health risk data vary in concentration across the town, with some schools being proximate to greater concentrations of the mapped risks. The spatial video is also used to validate coded data and location specific risks within these "hotspots". Spatial video is a tool that can be used in any environment to improve local area health analysis and intervention. The process is rapid and can be repeated in study sites through time to track spatio

  17. Electronic health records to facilitate clinical research. (United States)

    Cowie, Martin R; Blomster, Juuso I; Curtis, Lesley H; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, Jörg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P; Southworth, Mary Ross; Stough, Wendy Gattis; Thoenes, Martin; Zannad, Faiez; Zalewski, Andrew


    Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research.

  18. Intelligent street lighting clustering

    NARCIS (Netherlands)

    Verhoeven, R.; Jovanovic, N.; Lukkien, J.J.


    The advances in dynamic street lighting introduce new functionality for control and maintenance of the street lighting infrastructure. Vital elements in this infrastructure are the powerful controlling devices that control separate groups of light poles and collect information from the system. For

  19. [Street Outreach Offices: visibility, invisibility, and enhanced visibility]. (United States)

    Hallais, Janaína Alves da Silveira; Barros, Nelson Filice de


    This article discusses care for street people from a socio-anthropological perspective, using participant observation conducted with a team from a street outreach project. Based on observations, street people are historically viewed as marginal and rarely obtain access to health services, thus making them invisible to the Brazilian Unified National Health System. Brazil's National Policy for the Homeless provides for their access to health care, but such care is not always guaranteed in practice, because health services and professionals have little experience in dealing with homeless persons. The study concludes that enhanced visibility is needed to ensure care for people living on the street, establishing a therapeutic bond that deconstructs stigmatizing practice.

  20. Health record systems that meet clinical needs

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini


    Full Text Available Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

  1. Senior health clinics: are they financially viable? (United States)

    McAtee, Robin E; Crandall, Debra; Wright, Larry D; Beverly, Claudia J


    Are hospital-based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital-based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults. The findings highlight the similarities and differences in the three clinics' operating and financial structures in addition to the clinics' and providers' productivity. The analysis presents an evidence-based illustration that SHCs can break even or lose large amounts of money.

  2. Leveraging electronic health records for clinical research. (United States)

    Raman, Sudha R; Curtis, Lesley H; Temple, Robert; Andersson, Tomas; Ezekowitz, Justin; Ford, Ian; James, Stefan; Marsolo, Keith; Mirhaji, Parsa; Rocca, Mitra; Rothman, Russell L; Sethuraman, Barathi; Stockbridge, Norman; Terry, Sharon; Wasserman, Scott M; Peterson, Eric D; Hernandez, Adrian F


    Electronic health records (EHRs) can be a major tool in the quest to decrease costs and timelines of clinical trial research, generate better evidence for clinical decision making, and advance health care. Over the past decade, EHRs have increasingly offered opportunities to speed up, streamline, and enhance clinical research. EHRs offer a wide range of possible uses in clinical trials, including assisting with prestudy feasibility assessment, patient recruitment, and data capture in care delivery. To fully appreciate these opportunities, health care stakeholders must come together to face critical challenges in leveraging EHR data, including data quality/completeness, information security, stakeholder engagement, and increasing the scale of research infrastructure and related governance. Leaders from academia, government, industry, and professional societies representing patient, provider, researcher, industry, and regulator perspectives convened the Leveraging EHR for Clinical Research Now! Think Tank in Washington, DC (February 18-19, 2016), to identify barriers to using EHRs in clinical research and to generate potential solutions. Think tank members identified a broad range of issues surrounding the use of EHRs in research and proposed a variety of solutions. Recognizing the challenges, the participants identified the urgent need to look more deeply at previous efforts to use these data, share lessons learned, and develop a multidisciplinary agenda for best practices for using EHRs in clinical research. We report the proceedings from this think tank meeting in the following paper. Copyright © 2018 Elsevier, Inc. All rights reserved.

  3. [The analysis of a mobile mental health outreach team activity: from psychiatric emergencies on the street to practice of hospitalization at home for homeless people]. (United States)

    Girard, Vincent; Sarradon-Eck, Aline; Payan, Noura; Bonin, Jean-Pierre; Perrot, Sylvain; Vialars, Vanessa; Boyer, Laurent; Tinland, Aurélie; Simeoni, Marie-Claude


    Since their creation in 2005 in France, mobile mental health outreach teams (EMPP) have been working to improve the health of the homeless who, for 30 to 50% of them, present severe mental disorders. Their missions are defined by ministerial circular's specifications. Few studies have been undertaken in France to analyze the practices of these teams' professionals, nor the characteristics of the populations with whom they are involved. The EMPP described in this paper had in 2010 a greater staff than other French EMPPs. It has 15 full-time staff, including four doctors (two psychiatrists, one GP, one house physician), two nurses, two educators, one social worker, three peer-workers, one secretary and two coordinators. The article analyzes the way of support developed within the range of EMPP's missions defined by the ministerial circular. Descriptive statistical analysis was carried out using standardized data from four different sources (round sheet, record of activity, record of hospitalization, housing information, interviews conducted by medical and social professionals with patients). Another source of data consists of records describing the operation of the team (reference framework) and annual activities (annual report). The method of care was developed based on a street working, involving a full medical and its relationship with the hospital and a place to live in a semi-community context. The Mobile Mental Health Outreach team documented 318 rounds in 2010, describing 666 contacts among whom 87.9% were followed regularly thereafter. It focuses to a target population. The team actively followed 198 people including 161 for whom a psychiatric diagnosis was done: 48.5% of the patients followed presented schizophrenic-type disorders, 21.8% bipolar disorders and other mood-linked problems, 13% behavioral disorders and 6.2% substance-use disorders. A percentage of 44.9 presented with a physical disease. Among the 89 hospitalizations, 86.5% were motivated by

  4. StreetWise: developing a serious game to support forensic mental health service users' preparation for discharge: a feasibility study. (United States)

    Reynolds, L M; Davies, J P; Mann, B; Tulloch, S; Nidsjo, A; Hodge, P; Maiden, N; Simpson, A


    WHAT IS KNOWN ON THE SUBJECT?: Serious gaming can support learning and development. The use of serious games for skills development and the rehearsal of the management of events that cannot be replicated in real life is well established. Few serious games have been used in mental health services, and none in forensic mental health care. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: How a serious game may be coproduced by forensic mental health service users and game developers The acceptability of the therapeutic use of serious gaming by forensic mental health service users and providers. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Computer games may be used by practitioners in their therapeutic work with forensic mental health service users. Mental health nurses to use serious games to creatively and safely bridge the gap for service users between receiving care in controlled environments and living more independent in the community. Introduction Assessment of users' skills and confidence to safely respond to risky community-based situations underpins discharge planning. Serious games have been used for skills development, and this study trialled their use in forensic mental health services. Aim The aim was to develop and test the acceptability and usability of an innovative serious game to support forensic mental health service users' preparation for discharge. Method A prototype serious game was developed by service users and researchers. Acceptability and usability testing was undertaken and service providers interviewed about the acceptability of serious gaming for forensic mental health services. Result A prototype game was produced and successfully trialled by service users. However, both service users and providers identified that work needed to be done to develop and test a game with greater complexity. Discussion The acceptability and usability of using serious games to support service users to develop skills needed for successful discharge was demonstrated

  5. Out on the Street: A Public Health and Policy Agenda for Lesbian, Gay, Bisexual, and Transgender Youth Who Are Homeless (United States)

    Keuroghlian, Alex S.; Shtasel, Derri; Bassuk, Ellen L.


    A disproportionate number of lesbian, gay, bisexual and transgender (LGBT) youth experience homelessness each year in the United States. LGBT youth who are homeless have particularly high rates of mental health and substance use problems, suicidal acts, violent victimization, and a range of HIV risk behaviors. Given the intense needs of LGBT youth experiencing homelessness, it is imperative that we understand their unique experiences and develop responsive practices and policies. The range and severity of health risks vary across subgroups of all homeless LGBT youth, and since the population is nonhomogeneous their particular needs must be identified and addressed. Thus the purpose of this article is to review the causes of homelessness among LGBT youth, discuss the mental health and victimization risks faced by this population, address differences among homeless LGBT subgoups, and recommend effective interventions and best practices. We conclude by discussing promising future research and public policy directions. PMID:24826829

  6. Mobile clinics for women's and children's health. (United States)

    Abdel-Aleem, Hany; El-Gibaly, Omaima M H; El-Gazzar, Amira F E-S; Al-Attar, Ghada S T


    The accessibility of health services is an important factor that affects the health outcomes of populations. A mobile clinic provides a wide range of services but in most countries the main focus is on health services for women and children. It is anticipated that improvement of the accessibility of health services via mobile clinics will improve women's and children's health. To evaluate the impact of mobile clinic services on women's and children's health. For related systematic reviews, we searched the Database of Abstracts of Reviews of Effectiveness (DARE), CRD; Health Technology Assessment Database (HTA), CRD; NHS Economic Evaluation Database (NHS EED), CRD (searched 20 February 2014).For primary studies, we searched ISI Web of Science, for studies that have cited the included studies in this review (searched 18 January 2016); WHO ICTRP, and (searched 23 May 2016); Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 7 April 2015); MEDLINE, OvidSP (searched 7 April 2015); Embase, OvidSP (searched 7 April 2015); CINAHL, EbscoHost (searched 7 April 2015); Global Health, OvidSP (searched 8 April 2015); POPLINE, K4Health (searched 8 April 2015); Science Citation Index and Social Sciences Citation Index, ISI Web of Science (searched 8 April 2015); Global Health Library, WHO (searched 8 April 2015); PAHO, VHL (searched 8 April 2015); WHOLIS, WHO (searched 8 April 2015); LILACS, VHL (searched 9 April 2015). We included individual- and cluster-randomised controlled trials (RCTs) and non-RCTs. We included controlled before-and-after (CBA) studies provided they had at least two intervention sites and two control sites. Also, we included interrupted time series (ITS) studies if there was a clearly defined point in time when the intervention occurred and at least three data points

  7. Street-art


    Rybnikářová, Klára


    This thesis is concerned with the street-art and graffiti phenomenon. The theoretical research is focused on presenting the essence and character of this art style, while also watching it from socio-cultural point of view and observing it in context of art history. The theoretical study is followed by the didactical part of thesis, where I present possibilities of using the street-art theme in art education programs in the school setting. My thesis is concluded with a discussion of a practica...

  8. Street level society

    DEFF Research Database (Denmark)

    Vinum, Christine; Nissen, Morten


    This paper aims to reflect on research findings from different empirical studies of social work with young drug users and socially excluded young people in Copenhagen. In the paper we account for historical changes in social policy and interventions into young people's drug taking in Copenhagen......, and partly from the decentralizing and specializing efforts characteristic of the Danish welfare state and its institutions. We discuss a general turn towards street level interventions to address the problems of social exclusion, as well as different attempts to create what we term street level heterotopias...

  9. Implementing Home Health Standards in Clinical Practice. (United States)

    Gorski, Lisa A


    In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

  10. Electronic health records improve clinical note quality. (United States)

    Burke, Harry B; Sessums, Laura L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W


    The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. A five and a half year longitudinal retrospective multicenter quantitative study comparing the quality of handwritten and electronic outpatient clinical visit notes for 100 patients with type 2 diabetes at three time points: 6 months prior to the introduction of the EHR (before-EHR), 6 months after the introduction of the EHR (after-EHR), and 5 years after the introduction of the EHR (5-year-EHR). QNOTE, a validated quantitative instrument, was used to assess the quality of outpatient clinical notes. Its scores can range from a low of 0 to a high of 100. Sixteen primary care physicians with active practices used QNOTE to determine the quality of the 300 patient notes. The before-EHR, after-EHR, and 5-year-EHR grand mean scores (SD) were 52.0 (18.4), 61.2 (16.3), and 80.4 (8.9), respectively, and the change in scores for before-EHR to after-EHR and before-EHR to 5-year-EHR were 18% (pquality scores significantly improved over the 5-year time interval. The EHR significantly improved the overall quality of the outpatient clinical note and the quality of all its elements, including the core and non-core elements. To our knowledge, this is the first study to demonstrate that the EHR significantly improves the quality of clinical notes. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  11. A Violência enquanto agravo à saúde de meninas que vivem nas ruas Violence against the health of street girls

    Directory of Open Access Journals (Sweden)

    Romeu Gomes


    Full Text Available O artigo consiste num recorte de uma pesquisa que aborda a relação entre prostituição infantil, processo saúde-doença ligado à sexualidade e violência, configurada no ambiente de meninas que vivem nas ruas. Neste trabalho são apresentados apenas os resultados sobre violência revelados na fala das meninas. Para uma compreensão destes dados, inicialmente são tecidas considerações básicas sobre a .violência e sobre a pesquisa em geral. Após esta discussão procura-se caracterizar, de forma sintética, o cenário dos atores sociais estudados. Dentro deste cenário analisam-se aspectos da história de vida das meninas, bem como a fala delas sobre a violência, dentro de uma dimensão social. A partir desta análise conclui-se que as situações de violência vividas pelas meninas comprometem a saúde, deixando marcas profundas em seus corpos e em suas mentes.This article is a part of a study focusing on the relationship between child prostitution and the health/disease process as related to sexuality and violence, considering the three categories in the context of street girls. The paper analyzes the violence revealed by the girls themselves. Considerations on violence in general and the research as a whole are introduced first to facilitate an understanding of the purposes of the study. The social actors under study are then characterized. Within that scenario, aspects of the girls' life histories and their views on violence are analyzed in the social context. The conclusion is that such violent situations damages their health directly, leaving deep scars on their bodies and minds.

  12. Street Children and Employment Opportunities

    International Nuclear Information System (INIS)

    Enos, H.N.; Njoka, M.


    Although there is a general realization that there are 'people' in the streets, we often take the phenomenon for granted probably because we wake up and go home only to come to the streets the following morning and still find the people. This situation is however changing with the emergence of 'birth' and increase of street children as we begin to take into consideration the category of people to be routinely found on the streets. The phrase 'street children' refer to the children below the statutory adult age living on or found on the streets. These children derive their livelihood from the streets. While the children on the streets may have a 'home' to go to, the latter are an integral part of the street having nowhere to retire to at the end of the day. The street children live in abject poverty and are exposed to many risks. They suffer from malnutrition and deficiency diseases due to low and poor nutrition intake. The street girls get trapped in teenage prostitution quite early in life. Of concern are the issues related to the working street children. Many street children engage in collecting and selling waste paper, bottles and plastics. They are referred to as 'chokora' because of their work of turning garbage upside down as they look for something useful. Unfortunately they have to sell these wastes to powerful forces including people who underpay and harrass them

  13. Diversity of contexts in drug use among street adolescents. (United States)

    Goncalves de Moura, Yone; van der Meer Sanchez, Zila; Noto, Ana Regina


    In this study we aimed to investigate through ethnographic methods the different contexts of drug use by street adolescents in Sao Paulo, Brazil. Participant observations and semistructured interviews were performed at 11 major points of adolescent concentration in the streets of the city and in 10 care institutions. The sample was composed of 17 adolescents between 12 and 17 years of age. Data showed diverse patterns of drug use distributed by geographic situation and street circumstances. Observations were grouped into three main contexts: (a) immersion: greater intensity of drug use associated with greater involvement in the street culture; (b) surface: less drug use associated with family closeness; and (c) alternative-migratory: greater involvement with drug trafficking and prostitution associated with less family closeness and street culture. The drug use patterns varied in accordance with the diversity of street situations. Therefore, the peculiarities of each context should be taken into consideration in the development of social/ health policies.

  14. The City Street

    NARCIS (Netherlands)

    H.C. van der Wouden


    Original title: De stad op straat. The city street; the public space in perspective (De stad op straat; de openbare ruimte in perspectief) by the Netherlands Institute for Social Research/SCP is intended to contribute to the formation of new ideas about the public space and the future of

  15. Occupy Wall Street

    DEFF Research Database (Denmark)

    Jensen, Michael J.; Bang, Henrik


    This article analyzes the political form of Occupy Wall Street on Twitter. Drawing on evidence contained within the profiles of over 50,000 Twitter users, political identities of participants are characterized using natural language processing. The results find evidence of a traditional...

  16. Saving Mango Street (United States)

    Van Winkle, Katie


    The author first learned about cultural diversity and racial justice in Mr. Sanderson's middle school English class. They read a book called "The House on Mango Street" by Sandra Cisneros and learned about a different culture, but also about a community with striking similarities to their own. The main character in the novel, Esperanza,…

  17. Organizing the public health-clinical health interface: theoretical bases. (United States)

    St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard


    This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

  18. Street Lines, US, 2015, NAVTEQ (United States)

    U.S. Environmental Protection Agency — NAVTEQ Streets for the United States. The Streets layer contains all roads plus all Road Network attributes such as direction of travel, lanes, dividers, speed...

  19. Wall Street som kreationistisk forkynder

    DEFF Research Database (Denmark)

    Ekman, Susanne


    Artiklen gennemgår Karen Hos etnografi om Wall Street: "Liquidated: An ethnography of Wall Street" set i lyset af den offentlige debat vedrørende Goldman Sachs opkøb af Dong......Artiklen gennemgår Karen Hos etnografi om Wall Street: "Liquidated: An ethnography of Wall Street" set i lyset af den offentlige debat vedrørende Goldman Sachs opkøb af Dong...

  20. Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada—a qualitative study (United States)

    Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K


    Objectives To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers’ working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Design Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Setting Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers’ safety over arrest, while continuing to target clients. Participants 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Outcome measures Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers’ working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January–November 2013). Results Sex workers’ narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants’ accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. Conclusions These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in

  1. Considering virtue: public health and clinical ethics. (United States)

    Meagher, Karen M


    As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse. © 2011 Blackwell Publishing Ltd.

  2. Street children of India -- a glimpse. (United States)

    Nigam, S


    In India, 90% of street children are working children with regular family ties who live with their families, but are on the streets due to poverty and their parents' unemployment. The remaining 10% are either working children with few family ties who view the streets as their homes or abandoned and neglected children with no family ties. The National Policy for Children established in 1974 emphasizes the provision of equal opportunities for the development to all children during their growing years. Policy stresses programs to maintain, educate, and train destitute children and orphans. Policy is also to protect children against neglect, cruelty, and exploitation, but this is only on paper. An UNICEF study found that almost 40,000 children die every day in developing countries, 25% of whom are in India. Studies in some major cities indicate that the street children in India are of moderate health status, suffering from various chronic diseases and undernourishment. They are deprived of all health programs, but seem to prefer government hospitals in case of dire need. Street children often have to pay for water. Almost 97% in Calcutta, 99% in Bangalore, and 90% in Madras reported having no access to toilet and bathing facilities; 83% in Kanpur, however, had access to such facilities. Nothing has been heard in recent years of the National Children's Board established in 1975. Apparently the board has gradually waned. Various schemes were planned in 1992 by the Union Welfare Ministry in association with UNICEF. Extending extra health facilities, establishing nutrition programs, providing vocational training, protecting children from abuse, distributing dry-food polypacks, providing night shelters, providing ration cards, and creating bathing and toilet facilities would go far in improving the quality of life and the future of street children in India.

  3. Assessing clinical competency in the health sciences (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p performances on the ISPE with other independent estimates of students' competence. The unique integration questions of the ISPE were judged to have good content validity from experts and students, suggestive that integration, a most crucial element of clinical competence, while done in the mind of the student, can be practiced, learned and assessed.

  4. Smart street lighting management

    Energy Technology Data Exchange (ETDEWEB)

    Pizzuti, S.; Annunziato, M. [Energy New Technologies and Sustainable Economic Development Agency ENEA, Rome (Italy); Moretti, F. [Automation and Computer Science Department, University & #x27; Roma Tre& #x27; , Rome (Italy)


    In this work, we propose a new street lighting energy management system in order to reduce energy consumption. The key idea we want to accomplish is that of 'energy on demand' meaning that energy, in this case light, is provided only when needed. In order to achieve this goal, it is critical to have a reliable demand model, which in the case of street lighting turns out to be a traffic flow rate forecasting model. In order to achieve this goal, several methods on the 1-h prediction have been compared and the one providing the best results is based on artificial neural networks. Moreover, several control strategies have been tested and the one which gave the best energy savings is the adaptive one we carried out. Experimentation has been carried out on real data and the study shows that with the proposed approach, it is possible to save up to 50 % of energy compared to no regulation systems.

  5. Clinical Trials: A Crucial Key to Human Health Research (United States)

    ... Past Issues Clinical Trials: A Crucial Key to Human Health Research Past Issues / Summer 2006 Table of Contents ... Javascript on. Photo: PhotoDisc At the forefront of human health research today are clinical trials—studies that use ...

  6. [Street prostitution and drug addiction]. (United States)

    Ishøy, Torben; Ishøy, Pelle Lau; Olsen, Lis Raabaek


    Street-based prostitution accounts for 10% of the prostitution activity in Denmark, mainly involving female drug addicts. We studied a group of women with a common history of substance abuse and their comparative psychosocial characteristics, correlated with whether they had previously been a prostitute or not. Their psychic symptoms were evaluated and compared with those of controls. 27 females receiving maintenance treatment for substance abuse completed a questionnaire dealing with their social background, substance abuse profile, and history of sexual abuse and prostitution, as well as their current health status, including SCL-90. The scores were compared to those of a control group of an age- and gender-matched Danish standard population. Neglect in childhood and adulthood corresponded to international findings. 14 of the women had previous sex-trading experience, and early use of heroin and cocaine was a predictor for starting a career in prostitution. The SCL-90 scores for the dimensions of somatization and depression were significantly higher for drug-abusing women in general than in the control group. The scores of drug-abusing former prostitutes were similarly significantly higher on most of the dimensions except the hostility dimension when compared to those of drug-abusing women who had never been involved in prostitution. Rape and domestic violence were characteristic phenomena among drug-abusing prostitutes (p prostitution. Various psychosocial stress factors among street-based prostitutes indicate the need for broader psychiatric approaches in Danish drug addiction maintenance programmes.

  7. [Who told you to grow old and live on the streets?]. (United States)

    Brêtas, Ana Cristina Passarella; Marcolan, João Fernando; Rosa, Anderson da Silva; Fernandes, Flávia Saraiva Leão; Raizer, Milena Veiga


    This qualitative case study is part of another study: Aging, health and work. The objective of this excerpt was to identify the meaning of aging on the streets for the elderly living on the street. The subjects' statements were analyzed under the light of the following themes: history of aging and history of life on the streets. It was understood that the streets are usually a hostile environment for the elderly. It does not guarantee the basic life conditions, affecting the mental health of people who are forced to live on the streets, particularly the elderly. The street does not offer any way out and, together with to the life conditions of the elderly living on the streets leads to the gradual loss of self-esteem, significantly affecting self-care. In addition to these issues, we found that compromised functional capacity puts the life/survival of the elderly living on the streets at risk.

  8. Playing Sport In The Stormy Sea Of Street Life | Human | African ...

    African Journals Online (AJOL)

    Currently, there are many street children in South Africa (SA). They have been robbed from the safe harbour of family life and on a daily basis experience the stormy sea of street life. Society has an obligation to intervene in the lives of these street children through, for example, quality education, basic health services and ...

  9. Socio-economic and hygiene features of street food vending in ...

    African Journals Online (AJOL)

    The objectives of the study were firstly to determine the health risks associated with street food vending, secondly to determine the opinions of street food ... such as South Africa be allowed to earn their livelihood by means of an 'easy-to-enter' business such as street food vending when hygiene standards are acceptable.

  10. Street as Public Space - Measuring Street Life of Kuala Lumpur (United States)

    Sulaiman, Normah; Ayu Abdullah, Yusfida; Hamdan, Hazlina


    Kuala Lumpur has envisioning in becoming World Class City by the year 2020. Essential elements of form and function of the urban environment are streets. Streets showcase the community and connect people. It’s one of the most comfortable social environment that provides aesthetical and interaction pleasure for everyone. Classified as main shopping streets in the local Kuala Lumpur urban design guidelines, Jalan Masjid India (JMI) has its uniqueness of shopping experience and social interaction. This conceptual paper will study the physical and cultural characteristics of the street that will generate the street character by mapping its original characters. The findings will focus on strengthening the methodology applied to promote improvements in evaluating it as a great public space. Results will also contribute to understanding the overall site context, the street connectivity, and urban dynamics. This paper is part of a larger study that addresses on transforming the sociability of public space.

  11. [Agnosia for streets and defective root finding]. (United States)

    Takahashi, Nobuyoshi


    Topographical disorientation is identified as a condition in which patients are unable to find their way in familiar surroundings, such as their home neighborhood or the admitting hospital after the onset of illness. I proposed to classify topographical disorientation into two categories: agnosia for streets (landmark agnosia) and defective root finding (heading disorientation). Patients with agnosia for streets are unable to identify familiar buildings and landscapes. They can, however, morphologically perceive them and remember their way around familiar areas. The lesions are located in the right posterior part of the parahippocampus gyrus, anterior half of the lingual gyrus and adjacent fusiform gyrus. Clinical findings and functional imaging studies suggest that these regions play a crucial role in the interaction between the visual information of streets and memories of them, which are thought to be retained in the right anterior part of the temporal lobe. In particular, the posterior part of the parahippocampus gyrus is critical for the acquisition of novel information. On the other hand, patients with defective root finding can identify familiar streets, but cannot remember their own location or positional relation between two points within a comparatively wide range not surveyable at one time. The lesions are located in the right retrosplenial cortex (Areas 29, 30), posterior cingulate cortex (Areas 23, 31) and precuneus. Clinical findings and functional imaging studies suggest that these regions are involved in the orientation function for navigating in wide spaces. In particular, the retrosplenial cortex is critical for encoding novel information.

  12. Agnosia for streets and defective root finding

    International Nuclear Information System (INIS)

    Takahashi, Nobuyoshi


    Topographical disorientation is identified as a condition in which patients are unable to find their way in familiar surroundings, such as their home neighborhood or the admitting hospital after the onset of illness. I proposed to classify topographical disorientation into two categories: agnosia for streets (landmark agnosia) and defective root finding (heading disorientation). Patients with agnosia for streets are unable to identify familiar buildings and landscapes. They can, however, morphologically perceive them and remember their way around familiar areas. The lesions are located in the right posterior part of the parahippocampus gyrus, anterior half of the lingual gyrus and adjacent fusiform gyrus. Clinical findings and functional imaging studies suggest that these regions play a crucial role in the interaction between the visual information of streets and memories of them, which are thought to be retained in the right anterior part of the temporal lobe. In particular, the posterior part of the parahippocampus gyrus is critical for the acquisition of novel information. On the other hand, patients with defective root finding can identify familiar streets, but cannot remember their own location or positional relation between two points within a comparatively wide range not surveyable at one time. The lesions are located in the right retrosplenial cortex (Areas 29, 30), posterior cingulate cortex (Areas 23, 31) and precuneus. Clinical findings and functional imaging studies suggest that these regions are involved in the orientation function for navigating in wide spaces. In particular, the retrosplenial cortex is critical for encoding novel information. (author)

  13. Risk behaviour of street children in Colombo. (United States)

    Senaratna, B C V; Wijewardana, B V N


    Sri Lankan street children live in insecure and disadvantaged environments and have disrupted and poorly functioning families resulting in their poor socialisation. In this backdrop they are at high risk of adopting delinquent and antisocial behaviour and becoming victims of abuse. Despite recognition of this as a social problem, an in-depth exploration of their behaviour and its correlates has not been attempted. To describe risk behaviour among street children in Colombo city and the determinants of such behaviour. A cross sectional qualitative study in Colombo Fort, Pettah, Slave Island, and Maradana areas was conducted using focus group discussions (FGDs) with street children and semi-structured interviews (SSIs) with street children and key informants in their environment. Data generated were used to profile 283 children identified through referral sampling. An observation study was conducted to validate data generated through FGDs and SSIs. Semi-structured questionnaires, a moderator guide, an interviewer-administered questionnaire, and an observational checklist were used for SSIs, FGDs, profiling, and observational study, respectively. Majority of street children were boys and were aged 14 years or less. Nearly 18% lived alone without a guardian. Two thirds had never enrolled in a school. Many children were used for begging, neglecting their health vulnerabilities. Occupational risk behaviour included heavy manual labour, transportation and sale of illicit alcohol and narcotics, robbing/pick-pocketing, commercial sex work, and pimping. Recreational risk behaviour included abuse of alcohol/narcotics, smoking, sexual promiscuity, and patronising commercial sex workers. Increased awareness and strategies are required to minimise threats to street children and society.

  14. Childcare needs of female street vendors in Mexico City. (United States)

    Hernandez, P; Zetina, A; Tapia, M; Ortiz, C; Soto, I C


    This article reports on strategies developed by female street vendors (vendedoras ambulantes) in Mexico City to ensure the care of their young children in the absence of a specific and operational government policy to fulfil this need. The information concerning child care and health was gathered by a survey of 426 street traders selected by multi-stage random cluster sampling in four of the administrative districts (delegaciones politicas) of Mexico City during 1990. It was found that, as mothers of young children, street vendors most frequently looked after their children personally on the street or left them with other members of the family. Related factors were availability of alternative child care providers in the family, the age of the children and working conditions of the mother. Children who remained on the streets with their mothers suffered more frequently from gastro-intestinal diseases and accidents than the national average. The incidence of acute respiratory diseases, however, was similar in the cases of maternal care in the street and care by family members in another environment. Existing public health measures show a greater concern for the health of food consumers than that of workers in this area. Current public policy seeks to regulate street vending activities and to concentrate traders in ad hoc areas and facilities. Our research results document the need for actions that can contribute to an improvement in the care and health conditions of these young children.

  15. [Clinical bioethics for primary health care]. (United States)

    González-de Paz, L


    The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. The Education Rights of Street-Involved Children

    Directory of Open Access Journals (Sweden)

    Sonja Grover


    Full Text Available This paper provides an overview of certain key aspects of the practical and legal situation of street-involved children globally. The inadequate protection of these children under both domestic and international law is addressed. The diversity of the population of street-involved children is considered as is the fact that this group is composed of both legally stateless and de facto stateless children. The relationship of street involvement to child labor, various health risks and victimization is discussed. The educational needs of older street-involved children are addressed including their right to participate in decision-making regarding aspects of educational service design and delivery. The overall objective of this paper is to encourage those who are involved in, or could impact upon educational policy to include street-involved children in their educational planning implementation and advocacy efforts.

  17. Street Prostitution Zones and Crime


    Bisschop, Paul; Kastoryano, Stephen; van der Klaauw, Bas


    This paper studies the effects of introducing legal street prostitution zones on both registered and perceived crime. We exploit a unique setting in the Netherlands where legal street prostitution zones were opened in nine cities under different regulation systems. We provide evidence that the opening of these zones was not in response to changes in crime. Our difference-in-difference analysis using data on the largest 25 Dutch cities between 1994 and 2011 shows that opening a legal street pr...

  18. Health Informatics and E-health Curriculum for Clinical Health Profession Degrees. (United States)

    Gray, Kathleen; Choo, Dawn; Butler-Henderson, Kerryn; Whetton, Sue; Maeder, Anthony


    The project reported in this paper models a new approach to making health informatics and e-health education widely available to students in a range of Australian clinical health profession degrees. The development of a Masters level subject uses design-based research to apply educational quality assurance practices which are consistent with university qualification frameworks, and with clinical health profession education standards; at the same time it gives recognition to health informatics as a specialised profession in its own right. The paper presents details of (a) design with reference to the Australian Qualifications Framework and CHIA competencies, (b) peer review within a three-university teaching team, (c) external review by experts from the professions, (d) cross-institutional interprofessional online learning, (e) methods for evaluating student learning experiences and outcomes, and (f) mechanisms for making the curriculum openly available to interested parties. The project has sought and found demand among clinical health professionals for formal health informatics and e-health education that is designed for them. It has helped the educators and organisations involved to understand the need for nuanced and complementary health informatics educational offerings in Australian universities. These insights may aid in further efforts to address substantive and systemic challenges that clinical informatics faces in Australia.

  19. Department of Defense, Deployment Health Clinical Center (United States)

    ... general public of trends in mental health and mental health care within the Military Health System Get The Numbers Real Warriors Campaign Real Warriors Campaign A multimedia public awareness campaign designed to combat the stigma associated with ...

  20. An investigation on the effect of street morphology to ambient air quality using six real-world cases (United States)

    Shen, Jialei; Gao, Zhi; Ding, Wowo; Yu, Ying


    Street canyons are vulnerable to air pollution mainly caused by vehicle emissions, which are therefore closely related to pedestrians' health. Previous studies have showed that air quality in street canyons is associated with street morphology, though the majority of them have focused on idealized street models. This paper attempts to investigate the relationship of street morphology to air quality for 6 irregular real-world cases selected from America, Europe, and China, i.e. Manhattan, Paris, Barcelona, Berlin, London and Nanjing. Each street is analyzed as a set of slices to propose a couple of morphology indices for quantitatively assessing the actual street morphology. Pollutant transport rate of mean flows and turbulent diffusion, net escape velocity and age of air are obtained from computational fluid dynamics (CFD) simulations to assess the ventilations and pollutant dispersion within street canyons with a parallel approaching wind. The results show that the street morphology characteristics, including the street width, lateral openings and intersections, are closely related to the air flows in street canyons. The air quality improves with a decreasing aspect ratio of central street owing to a larger vertical exchange through the street roof, which suggests an open central street is of better air quality. The lateral openings and intersections of streets have important effects on the air flows in street canyons, and the effects are particularly pronounced when the street widths are similar. The street continuity ratio indicates street continuity. It relates to the openings and the symmetry of a street and impacts on the air flows and pollutant dispersion through the lateral openings of the central street. The street spatial closure ratio is determined by the street continuity ratio and the aspect ratio of the central street. When the aspect ratio of central street is not excessively high, higher values of street continuity ratio and spatial closure ratio

  1. Street Papers, Work, and Begging

    DEFF Research Database (Denmark)

    Cockburn, Patrick Joseph


    Street papers are publications produced specifically for sale by the homeless and other vulnerable people in many countries around the world. Their social status is, however, often conspicuously unstable: ‘Get a job!’ has been reported as a common insult addressed to vendors, and street paper...

  2. The Regulation of Street Foods

    DEFF Research Database (Denmark)

    Forkour, John Boulard; Samuelsen, Helle; Yeboah, Eric Henry


    the challenges and negotiating strategies of regulators of street-vended foods in Ghana and analyses the implication for their relationship with street food vendors. The paper reveals that regulators operate in a context of limited resources, leading to a general feeling of neglect. In coping, regulators adopt...

  3. Spontaneous Pneumomediastinum: Case Presentation to a College Student Health Clinic (United States)

    Spotts, P. Hunter


    The author describes a case of spontaneous pneumomediastinum (SPM) in a 19-year-old man presenting to a college student health clinic. The author also provides a review on SPM, including clinical manifestations, diagnostic evaluation, and management.

  4. Platform links clinical data with electronic health records (United States)

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  5. What is Clinical Safety in Electronic Health Care Record Systems? (United States)

    Davies, George

    There is mounting public awareness of an increasing number of adverse clinical incidents within the National Health Service (NHS), but at the same time, large health care projects like the National Programme for IT (NPFIT) are claiming that safer care is one of the benefits of the project and that health software systems in particular have the potential to reduce the likelihood of accidental or unintentional harm to patients. This paper outlines the approach to clinical safety management taken by CSC, a major supplier to NPFIT; discusses acceptable levels of risk and clinical safety as an end-to-end concept; and touches on the future for clinical safety in health systems software.

  6. Mobile health clinics in the era of reform. (United States)

    Hill, Caterina F; Powers, Brian W; Jain, Sachin H; Bennet, Jennifer; Vavasis, Anthony; Oriol, Nancy E


    Despite the role of mobile clinics in delivering care to the full spectrum of at-risk populations, the collective impact of mobile clinics has never been assessed. This study characterizes the scope of the mobile clinic sector and its impact on access, costs, and quality. It explores the role of mobile clinics in the era of delivery reform and expanded insurance coverage. A synthesis of observational data collected through Mobile Health Map and published literature related to mobile clinics. Analysis of data from the Mobile Health Map Project, an online platform that aggregates data on mobile health clinics in the United States, supplemented by a comprehensive literature review. Mobile clinics represent an integral component of the healthcare system that serves vulnerable populations and promotes high-quality care at low cost. There are an estimated 1500 mobile clinics receiving 5 million visits nationwide per year. Mobile clinics improve access for vulnerable populations, bolster prevention and chronic disease management, and reduce costs. Expanded coverage and delivery reform increase opportunities for mobile clinics to partner with hospitals, health systems, and insurers to improve care and lower costs. Mobile clinics have a critical role to play in providing high-quality, low-cost care to vulnerable populations. The postreform environment, with increasing accountability for population health management and expanded access among historically underserved populations, should strengthen the ability for mobile clinics to partner with hospitals, health systems, and payers to improve care and lower costs.

  7. Community Mental Health Clinic Cost Reports (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Community Mental Health Center (CMHC). This data was reported on form CMS-2088-92. The data in this...

  8. Second generation plant health clinics in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, Frank; Mutebi, Emmanuel

    coverage, Regularity/timeliness and Quality of plant healthcare. Field work was carried out over 15 months between July 2010 and September 2011 in 13 districts in the eastern, central and western parts of Uganda. A total of 205 plant clinic sessions were held in the period. The plant clinics received 2...... from the clinics to diagnostic laboratories. Although the plant clinics have become part of Ministry policy and districts showed increasing interest and commitment, there are some structural barriers that made it difficult for the districts to institutionalise the clinics and for the Ministry to play...... their leading role. A mismatch between institutional mandates/authority and allocated resources limited the scope of the actions both at district and national level. The plant clinics risk ‘falling between the two chairs’ of extension and pest and disease control. Finding a solid institutional base...

  9. Violence in the Street, Violence of the Street

    DEFF Research Database (Denmark)

    Heinskou, Marie Bruvik; Liebst, Lasse Suonperä

    While in his early and general theory of interaction rituals Randall Collins emphasised that social situations are both ’symbolic’ and ’material’, the latter dimension is largely absent from Collins’ theory of violence(Collins 2004; 1993: 214). Compared with criminology’s more recent situational...... studies of violence, it is noticeable that the analytical success of these studies is closely linked with understanding street violence as a spatial-situational phenomenon (Clarke 1997; Eck & Weisburd 1995; Bragand & Weisburd; 2010; Wikström et al. 2012; Sampson et al. 1997). In light of evidence...... for the spatial concentration of street violence, this paper takes its point of departure in a large study of Street Violence among youth in Copenhagen, Denmark (combining quantitative data from filed police reports (N = 501), data from CCTV (N=100) and qualitative analysis of selected cases of street violence...

  10. Clinical placements in mental health: a literature review. (United States)

    Happell, Brenda; Gaskin, Cadeyrn J; Byrne, Louise; Welch, Anthony; Gellion, Stephen


    Gaining experience in clinical mental health settings is central to the education of health practitioners. To facilitate the ongoing development of knowledge and practice in this area, we performed a review of the literature on clinical placements in mental health settings. Searches in Academic Search Complete, CINAHL, Medline and PsycINFO databases returned 244 records, of which 36 met the selection criteria for this review. Five additional papers were obtained through scanning the reference lists of those papers included from the initial search. The evidence suggests that clinical placements may have multiple benefits (e.g. improving students' skills, knowledge, attitudes towards people with mental health issues and confidence, as well as reducing their fears and anxieties about working in mental health). The location and structure of placements may affect outcomes, with mental health placements in non-mental health settings appearing to have minimal impact on key outcomes. The availability of clinical placements in mental health settings varies considerably among education providers, with some students completing their training without undertaking such structured clinical experiences. Students have generally reported that their placements in mental health settings have been positive and valuable experiences, but have raised concerns about the amount of support they received from education providers and healthcare staff. Several strategies have been shown to enhance clinical placement experiences (e.g. providing students with adequate preparation in the classroom, implementing learning contracts and providing clinical supervision). Educators and healthcare staff need to work together for the betterment of student learning and the healthcare professions.

  11. Health Literacy Assessment in an Otolaryngology Clinic Population. (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y


    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  12. Health Management Information System in Private Clinics in Ilorin ...

    African Journals Online (AJOL)

    This descriptive survey was conducted among private clinics located in Ilorin, Kwara State, Nigeria to determine the awareness and level of involvement of private clinic operators towards the National Health Management Information System. A total of 37 functional clinics responded to the survey. Structured questionnaire ...

  13. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne


    Safe work processes and information systems are vital in health care. Methods for design of health IT focusing on patient safety are one of many initiatives trying to prevent adverse events. Possible patient safety hazards need to be investigated before health IT is integrated with local clinical...... work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...... tasks. Clinical simulation study assesses effects on clinical workflow and enables identification and evaluation of patient safety hazards before implementation at a hospital. Clinical simulation also offers an opportunity to create a space in which healthcare professionals working in different...

  14. Clinical investigations for SUS, the Brazilian public health system. (United States)

    Paula, Ana Patrícia de; Giozza, Silvana Pereira; Pereira, Michelle Zanon; Boaventura, Patrícia Souza; Santos, Leonor Maria Pacheco; Sachetti, Camile Giaretta; Tamayo, César Omar Carranza; Kowalski, Clarissa Campos Guaragna; Elias, Flavia Tavares Silva; Serruya, Suzanne Jacob; Guimarães, Reinaldo


    Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa), especially with regard to establishing a National Clinical Research Network. The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex.

  15. Clinical Trials Shed Light on Minority Health (United States)

    ... Native Hawaiian and Pacific Islander communities. OMH project manager Christine Merenda, M.P.H., R.N. explains ... are disproportionately affected by diabetes. But historically, both women and minorities have been under-represented in clinical ...

  16. Sexual Health Attitudes, Knowledge, and Clinical Behaviors: Implications for Counseling (United States)

    Russell, Elizabeth B.


    This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…

  17. Multiple traumas and resilience among street children in Haiti: Psychopathology of survival. (United States)

    Cénat, Jude Mary; Derivois, Daniel; Hébert, Martine; Amédée, Laetitia Mélissande; Karray, Amira


    In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. "Tobacco Truths": Health Magazine, Clinical Epidemiology, and the Cigarette Connection. (United States)

    Wilmshurst, Sara


    In the 1950s, Health, a magazine published by the Health League of Canada, was nonchalant about the risks of smoking and largely ignored early epidemiological studies of lung cancer. In the 1960s the magazine stopped accepting cigarette advertising and began to oppose smoking. Health's writers adjusted to new knowledge; the magazine gradually accepted clinical epidemiology as a source of medical knowledge and recognized smoking as a public health risk. As Canada's only devoted health publication for a lay audience at the time, Health provides a unique window into ways that smoking and health were portrayed to its readers.

  19. Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

    Directory of Open Access Journals (Sweden)

    In Young Choi


    Full Text Available The advances in electronic medical records (EMRs and bioinformatics (BI represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

  20. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services. (United States)


    ... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...

  1. Safety of street: The role of street design (United States)

    Rashid, Suhaila Abdul; Wahab, Mohammad Hussaini; Rani, Wan Nurul Mardiah Wan Mohd.; Ismail, Syuhaida


    Living in the cities poses many challenges for the vulnerable group of user especially women where they are exposed to many issues related to safety. With the changing of lifestyle and demands, women are expected to play multiple roles in the society and working is one of the tasks. When women are expected to be working as men do, they are no longer occupied at one place. Women nowadays travel on a daily basis and being in the streets is one of the important activities. With the influx of diverse group of people into the country, our streets are dominated by different types of people from different background. Due to these factors, there are possibilities of challenges and threats for users especially women. Therefore, city spaces especially the street become an important public realm for women. The design of the street should be able to make women feel safe as these are the public space where they spend time getting to and from work. The way women perceived their environment might be different from men especially when they fear of crime. Perception of safety will affect the quality of life where fear is an important psychological factor in human life. Living in fear will restrict human's freedom. Therefore, this study aimed to explore women's perception of safety in the streets of Kuala Lumpur. The study adopted a mixed-method approach of qualitative and quantitative in order to understand the safety perception among women that will later establish the relationship between built environment and human psychology. 120 respondents were selected randomly around Jalan Benteng, Jalan Tun Perak, Jalan Melaka and Jalan Melayu. Questionnaire survey forms were distributed and structured observation was conducted at interval period at these streets to examined and assess women's behavior. Finding shows that fear does affect women's perception and physical design of the streets are important in affecting their behavior.

  2. A review of analytics and clinical informatics in health care. (United States)

    Simpao, Allan F; Ahumada, Luis M; Gálvez, Jorge A; Rehman, Mohamed A


    Federal investment in health information technology has incentivized the adoption of electronic health record systems by physicians and health care organizations; the result has been a massive rise in the collection of patient data in electronic form (i.e. "Big Data"). Health care systems have leveraged Big Data for quality and performance improvements using analytics-the systematic use of data combined with quantitative as well as qualitative analysis to make decisions. Analytics have been utilized in various aspects of health care including predictive risk assessment, clinical decision support, home health monitoring, finance, and resource allocation. Visual analytics is one example of an analytics technique with an array of health care and research applications that are well described in the literature. The proliferation of Big Data and analytics in health care has spawned a growing demand for clinical informatics professionals who can bridge the gap between the medical and information sciences.

  3. An electronic health record for infertility clinics

    African Journals Online (AJOL)

    ART [assisted reproductive technology] data monitoring is not a substitute for sound ... Medical history, i.e. a detailed history of the patient's past health/ illnesses .... been done in the North Shore Hospital System on Long Island in. New York[6] ...

  4. Faeco-oral parasitic infection in street food vendors in Tamale, Ghana

    African Journals Online (AJOL)

    Poor environmental sanitation, personal and food hygiene practices of food vendors are major causes of street food contamination and outbreak of foodborne illness. The unregulated and rapid growth of the street food industry in the Tamale Metropolis with its associated health risk calls for strict public health surveillance to ...

  5. Integration of clinical research documentation in electronic health records. (United States)

    Broach, Debra


    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

  6. Managing risk: clinical decision-making in mental health services. (United States)

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice


    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

  7. Clinical genomics in the world of the electronic health record. (United States)

    Marsolo, Keith; Spooner, S Andrew


    The widespread adoption of electronic health records presents a number of benefits to the field of clinical genomics. They include the ability to return results to the practitioner, to use genetic findings in clinical decision support, and to have data collected in the electronic health record that serve as a source of phenotypic information for analysis purposes. Not all electronic health records are created equal, however. They differ in their features, capabilities, and ease of use. Therefore, to understand the potential of the electronic health record, it is first necessary to understand its capabilities and the impact that implementation strategy has on usability. Specifically, we focus on the following areas: (i) how the electronic health record is used to capture data in clinical practice settings; (ii) how the implementation and configuration of the electronic health record affect the quality and availability of data; (iii) the management of clinical genetic test results and the feasibility of electronic health record integration; and (iv) the challenges of implementing an electronic health record in a research-intensive environment. This is followed by a discussion of the minimum functional requirements that an electronic health record must meet to enable the satisfactory integration of genomic results as well as the open issues that remain.


    Directory of Open Access Journals (Sweden)

    Rita Patriasih


    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The objectives of this research were to analyze food habits and nutrients intake, and health and nutritional status of street children. The research was carried out in the City of Bandung, West Java; Indonesia. A sample of 324 street children was selected randomly. The sample consisted of 232 boys and 92 girls. The data obtained from questionnaires. Means, standard deviation, frequency and proportion were calculated with a combination of software applications:  Microsoft Excel and Statistical Analysis System. The result showed the level of consumption adequacy did not meet the recommended dietary allowances i.e. with the shortage of 10-15%, this is an indication that the street children should be aware of their daily food consumption. The most common diseases suffered by the respondents were acute respiratory infections (ARI (47%. In addition, 22.7 % and 18.4 % of them suffered from diarrhoea and skin diseases, respectively. Blood haemoglobin status of street children shows that the incidence of anemia was 29.3%. Based on the classification of nutritional status, 42.7% and 80.4 % of street children were underweight and stunted, respectively. Key words: nutrients intake, nutritional status, street children

  9. Drug use among street children and adolescents: what helps?

    Directory of Open Access Journals (Sweden)

    Yone Gonçalves de Moura

    Full Text Available The aim of this study was to investigate factors associated to frequent and heavy drug use among street children and adolescents aged 10 to 18 years. A sample of 2,807 street children and adolescents from the 27 Brazilian state capital cities was analyzed. A World Health Organization questionnaire for non-students was adapted for use in Brazil. Data analysis was performed using logistic regression and decision tree models. Factors inversely associated with frequent and heavy drug use were: being age nine to 11 years (OR = 0.1; school attendance (OR = 0.3; daily time (one to five hours spent on the streets (OR = 0.3 and 0.4; not sleeping on the streets (OR = 0.4; being on the streets for less than one year (OR = 0.4; maintenance of some family bonds (OR = 0.5; presence on the streets of a family member (OR = 0.6; not suffering domestic violence (OR = 0.6; being female (OR = 0.8. All of these variables were significant at the p < 0.05 level. The findings suggest that being younger, having family bonds and engagement in school are important protective factors that affect drug use among this population and should be considered in the formulation of public policies.

  10. Health literacy and usability of clinical trial search engines. (United States)

    Utami, Dina; Bickmore, Timothy W; Barry, Barbara; Paasche-Orlow, Michael K


    Several web-based search engines have been developed to assist individuals to find clinical trials for which they may be interested in volunteering. However, these search engines may be difficult for individuals with low health and computer literacy to navigate. The authors present findings from a usability evaluation of clinical trial search tools with 41 participants across the health and computer literacy spectrum. The study consisted of 3 parts: (a) a usability study of an existing web-based clinical trial search tool; (b) a usability study of a keyword-based clinical trial search tool; and (c) an exploratory study investigating users' information needs when deciding among 2 or more candidate clinical trials. From the first 2 studies, the authors found that users with low health literacy have difficulty forming queries using keywords and have significantly more difficulty using a standard web-based clinical trial search tool compared with users with adequate health literacy. From the third study, the authors identified the search factors most important to individuals searching for clinical trials and how these varied by health literacy level.

  11. An electronic health record for infertility clinics | Coetsee | South ...

    African Journals Online (AJOL)

    Objective. To design a user-friendly electronic health record system for infertility clinics (EHRIC) to capture quality data that will allow advanced audit and practice analysis, and to use the captured data for the South African Register of Assisted Reproductive Techniques (SARA) database and as a clinical research function.

  12. Clinical trial registration in oral health journals. (United States)

    Smaïl-Faugeron, V; Fron-Chabouis, H; Durieux, P


    Prospective registration of randomized controlled trials (RCTs) represents the best solution to reporting bias. The extent to which oral health journals have endorsed and complied with RCT registration is unknown. We identified journals publishing RCTs in dentistry, oral surgery, and medicine in the Journal Citation Reports. We classified journals into 3 groups: journals requiring or recommending trial registration, journals referring indirectly to registration, and journals providing no reference to registration. For the 5 journals with the highest 2012 impact factors in each group, we assessed whether RCTs with results published in 2013 had been registered. Of 78 journals examined, 32 (41%) required or recommended trial registration, 19 (24%) referred indirectly to registration, and 27 (35%) provided no reference to registration. We identified 317 RCTs with results published in the 15 selected journals in 2013. Overall, 73 (23%) were registered in a trial registry. Among those, 91% were registered retrospectively and 32% did not report trial registration in the published article. The proportion of trials registered was not significantly associated with editorial policies: 29% with results in journals that required or recommended registration, 15% in those that referred indirectly to registration, and 21% in those providing no reference to registration (P = 0.05). Less than one-quarter of RCTs with results published in a sample of oral health journals were registered with a public registry. Improvements are needed with respect to how journals inform and require their authors to register their trials. © International & American Associations for Dental Research.

  13. Clinical, classroom, or personal education: attitudes about health literacy. (United States)

    Logan, Robert A


    This study explores how diverse attitudes about health literacy are assessed by medical librarians and other health care professionals. An online survey of thirty-six items was conducted using Q methodology in two phases in spring 2005 and winter 2006. Respondents (n = 51) were nonrandomly self-selected from a convenience sample of members of the Medical Library Association and a group of environmental health consultants to the National Library of Medicine. Three factors were identified. Factor 1 is optimistic and supportive of health literacy's transformative sociocultural and professional potential, if clinical settings become a launching point for health literacy activities. Factor 2 is less optimistic about health literacy's potential to improve clinical or patient outcomes and prefers to focus health literacy initiatives on classroom education settings. Factor 3 supports improving the nation's health literacy but tends to support health literacy initiatives when people privately interact with health information materials. Each factor's attitudes about the appropriate educational venue to initiate health literacy activities are different and somewhat mutually exclusive. This suggests that health literacy is seen through different perceptual frameworks that represent a possible source of professional disagreement.

  14. Clinical investigations for SUS, the Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Ana Patrícia de Paula

    Full Text Available CONTEXT AND OBJECTIVE: Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING: Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. METHODS: The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. RESULTS: The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa, especially with regard to establishing a National Clinical Research Network. CONCLUSION: The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex.

  15. Modelling traffic pollution in streets

    Energy Technology Data Exchange (ETDEWEB)

    Berkowicz, R.; Hertel, O. [National Environmental Research Inst., Dept. of Atmospheric Environment, Roskilde (Denmark); Larsen, S.E.; Soerensen, N.N.; Nielsen, M. [Risoe National Lab., Dept. of Meteorology and Wind Energy, Roskilde (Denmark)


    This report concerns mainly the subject related to modelling air pollution from traffic in urban streets. A short overview is presented over the theoretical aspects and examples of most commonly used methods and models are given. Flow and dispersion conditions in street canyons are discussed and the presentation is substantiated with the analysis of the experimental data. The main emphasis is on the modelling methods that are suitable for routine applications and a more detailed presentation is given of the Operational Street Pollution Model (OSPM), which was developed by the National Environmental Research Institute. The model is used for surveillance of air pollution from traffic in Danish cities and also for special air pollution studies. (au) 76 refs.

  16. The (Street) Art of Resistance

    DEFF Research Database (Denmark)

    Awad, Sarah H.; Wagoner, Brady; Glaveanu, Vlad Petre


    This chapter focuses on the interrelation between resistance, novelty and social change We will consider resistance as both a social and individual phenomenon, a constructive process that articulates continuity and change and as an act oriented towards an imagined future of different communities....... In this account, resistance is thus a creative act having its own dynamic and, most of all, aesthetic dimension. In fact, it is one such visibly artistic form of resistance that will be considered here, the case of street art as a tool of social protest and revolution in Egypt. Street art is commonly defined...... in sharp contrast with high or fine art because of its collective nature and anonymity, its different kind of aesthetics, and most of all its disruptive, ‘anti-social’ outcomes. With the use of illustrations, we will argue here that street art is prototypical of a creative form of resistance, situated...

  17. Sensation Seeking in Street Violence

    DEFF Research Database (Denmark)

    Heinskou, Marie Bruvik; Liebst, Lasse Suonperä

    Sensation seeking leads to violence—runs an influential hypothesis in the social scientific study of violent behavior. Although studies confirm that violence is sometimes structured by sensation-seeking motives, the literature seldom comments on the limits to this explanation of violence....... The present study examines the scale of violence motivated by sensation seeking and the degree to which there are several distinct forms of sensation seeking motives operative in violence, rather than a sensation-seeking motive in the singular. The study draws on a sample of situations from Copenhagen...... involving street violence, which are coded quantitatively and qualitatively. Our analysis shows that sensation seeking only seldom seems to play a role in the structuring of street violence. Moreover, the data indicate that sensation seeking finds expression in street violence situations in two different...

  18. Free Tax Services in Pediatric Clinics. (United States)

    Marcil, Lucy E; Hole, Michael K; Wenren, Larissa M; Schuler, Megan S; Zuckerman, Barry S; Vinci, Robert J


    The earned income tax credit (EITC), refundable monies for America's working poor, is associated with improved child health. Yet, 20% of eligible families do not receive it. We provided free tax preparation services in clinics serving low-income families and assessed use, financial impact, and accuracy. Free tax preparation services ("StreetCred") were available at 4 clinics in Boston in 2016 and 2017. We surveyed a convenience sample of clients ( n = 244) about experiences with StreetCred and previous tax services and of nonparticipants ( n = 100; 69% response rate) and clinic staff ( n = 41; 48% response rate) about acceptability and feasibility. A total of 753 clients received $1 619 650 in federal tax refunds. StreetCred was associated with significant improvement in tax filing rates. Of surveyed clients, 21% were new filers, 47% were new users of free tax preparation, 14% reported new receipt of the EITC, and 21% reported new knowledge of the EITC. StreetCred had high client acceptability; 96% would use StreetCred again. Families with children were significantly more likely to report StreetCred made them feel more connected to their doctor ( P = .02). Clinic staff viewed the program favorably (97% approval). Free tax services in urban clinics are a promising, feasible financial intervention to increase tax filing and refunds, save fees, and link clients to the EITC. With future studies, we will assess scalability and measure impact on health. StreetCred offers an innovative approach to improving child health in primary care settings through a financial intervention. Copyright © 2018 by the American Academy of Pediatrics.

  19. Alcohol in urban streetscapes: a comparison of the use of Google Street View and on-street observation. (United States)

    Clews, Chris; Brajkovich-Payne, Roza; Dwight, Emily; Ahmad Fauzul, Ayob; Burton, Madeleine; Carleton, Olivia; Cook, Julie; Deroles, Charlotte; Faulkner, Ruby; Furniss, Mary; Herewini, Anahera; Huband, Daymen; Jones, Nerissa; Kim, Cho Wool; Li, Alice; Lu, Jacky; Stanley, James; Wilson, Nick; Thomson, George


    Alcohol-related harm is a major global health issue, and controls on alcohol marketing are one intervention utilized by governments. This study investigated the use of Google Street View (GSV) as a novel research method for collecting alcohol-related data in the urban environment. The efficacy of GSV and on-street observation by observer teams was compared by surveying 400 m stretches of 12 streets in Wellington, the capital city of New Zealand. Data on alcohol sale, alcohol-related advertising, health promotion materials, regulatory information and visible alcohol consumption were collected. A total of 403 retailers with evidence of alcohol sales and 1161 items of alcohol-related communication were identified in on-street observation. Of the latter, 1028 items (89 %) were for alcohol marketing and 133 (11 %) were for alcohol-related health promotion and alcohol regulation. GSV was found to be a less sensitive tool than on-street observation with only 50 % of the alcohol venues identified and 52 % of the venue-associated brand marketing identified. A high degree of inter-observer reliability was generally found between pairs of observers e.g., for the detection of alcohol retail venues the intra-class correlation coefficient (ICC) was 0.93 (95 % CI: 0.78 to 0.98) for on-street observation and 0.85 (95 % CI: 0.49 to 0.96) for using GSV. GSV does not seem suitable for the comprehensive study of the influences on alcohol consumption in the urban streetscape. However, it may still have value for large, static objects in the environment and be more time efficient than traditional on-street observation measures, especially when used to collect data across a wide geographical area. Furthermore, GSV might become a more useful research tool in settings with better image quality (such as more 'footpath views') and with more regularly updated GSV imagery.

  20. Strategies for Improving Nursing Students' Mental Health Clinical Rotation. (United States)

    Kroning, Maureen


    Mental illness is a huge problem many people face in the U.S. and around the world. The American Psychiatric Nurses Association indicates there is a shortage of nurses in every level and role in psychiatric-mental health nursing. Raising up a generation of nurses who want to work with the mentally ill is a challenge for nurse educators. The use of role playing and simulation in the learning lab prior to entering the clinical setting and reflective journaling in the clinical rotation can improve undergraduate nursing students' mental health clinical experience.

  1. Mean Streets: An analysis on street level pollution in NYC (United States)

    Parker, G.


    The overarching objective of this study is to quantify the spatial and temporal variability in particulatematter concentration (PM 2.5) along crowded streets in New York City. Due to their fine size and lowdensity PM 2.5 stays longer in the atmosphere and could bypass human nose and throat and penetratedeep in to the lungs and even enter the circulatory system. PM 2.5 is a by-product of automobilecombustion and is a primary cause of respiratory malfunction in NYC. The study would monitor streetlevel concentration of PM2.5 across three different routes that witness significant pedestrian traffic;observations will be conducted along these three routes at different time periods. The study will use theAirBeam community air quality monitor. The monitor tracks PM 2.5 concentration along with GPS, airtemperature and relative humidity. The surface level concentration monitored by AirBeam will becompared with atmospheric concentration of PM 2.5 that are monitored at the NOAA CREST facility onCCNY campus. The lower atmospheric values will be correlated with street level values to assess thevalidity of using of lower atmospheric values to predict street level concentrations. The street levelconcentration will be compared to the air quality forecasted by the New York Department ofEnvironment Conservation to estimate its accuracy and applicability.

  2. A Numerical Simulation of Traffic-Related Air Pollution Exposures in Urban Street Canyons (United States)

    Liu, J.; Fu, X.; Tao, S.


    Urban street canyons are usually associated with intensive vehicle emissions. However, the high buildings successively along both sides of a street block the dispersion of traffic-generated air pollutants, which enhances human exposure and adversely affects human health. In this study, an urban scale traffic pollution dispersion model is developed with the consideration of street distribution, canyon geometry, background meteorology, traffic assignment, traffic emissions and air pollutant dispersion. Vehicle exhausts generated from traffic flows will first disperse inside a street canyon along the micro-scale wind field (generated by computational fluid dynamics (CFD) model) and then leave the street canyon and further disperse over the urban area. On the basis of this model, the effects of canyon geometry on the distribution of NOx and CO from traffic emissions were studied over the center of Beijing, China. We found that an increase of building height along the streets leads to higher pollution levels inside streets and lower pollution levels outside, resulting in higher domain-averaged concentrations over the area. In addition, street canyons with equal (or highly uneven) building heights on two sides of a street tend to lower the urban-scale air pollution concentrations at pedestrian level. Our results indicate that canyon geometry strongly influences human exposure to traffic pollutants in the populated urban area. Carefully planning street layout and canyon geometry in consideration of traffic demand as well as local weather pattern may significantly reduce the chances of unhealthy air being inhaled by urban residents.

  3. [Homeless on the streets of Copenhagen]. (United States)

    Nordentoft, M


    A group of homeless people living in the streets is described with the purpose of gaining the knowledge necessary to prevent development of homelessness and establishing programmes for the homeless. Out-reach work in the streets and cooperation with private and religious organisations was conducted during a two-year period and 59 homeless persons were interviewed. Fifteen were women and 44 were men. Upbringing, social conditions, daily living, physical and mental health and contact with health services, social security and private organisations were highlighted in a structured and semistructured interview. Compared with the background population the homeless had much more frequently childhood experience of parents' divorce or death of one of the parents. The women were significantly older than the men and the majority of the women were suffering from schizophrenia and had very little contact with network and public services. The majority of the men were abusing alcohol or drugs, many had had a troublesome childhood with stays in institutions. Many had had many contacts with different social institutions and a criminal record. Among the homeless in the streets of Copenhagen, the prevalence of mental illness, especially schizophrenia, is high. It is recommended that homelessness among the mentally ill is prevented by a special effort directed towards the patient group at risk of becoming homeless and through establishing different housing facilities with varying degrees of professional support. Out-reach work towards the homeless mentally ill should be carried out with the purpose of establishing contact with psychiatric services and securing the possibility of compulsory admission.

  4. Collaborative learning of clinical skills in health professions education

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G.; Kulasegaram, Kulamakan M.; Ringsted, Charlotte V


    Objectives: This study is designed to provide an overview of why, how, when and for whom collaborative learning of clinical skills may work in health professions education. Why: Collaborative learning of clinical skills may influence learning positively according to the non-medical literature...... suggests that learning is dependent on cognitive co-construction, shared knowledge and reduced cognitive load. When and for whom: The literature on the collaborative learning of clinical skills in health science education is reviewed to support or contradict the hypotheses provided by the theories outlined...... above. Collaborative learning of clinical skills leads to improvements in self-efficacy, confidence and performance when task processing is observable or communicable. However, the effects of collaborative learning of clinical skills may decrease over time as benefits in terms of shared cognition...

  5. Characteristics of Health Educators Desired by Inner-City Health Clinic Patients: A Case Study (United States)

    Price, James; Sidani, Jaime


    A group (n = 170) of inner-city, predominantly African American, health clinic patients were asked to identify the characteristics they desired in a new clinic health educator. A plurality (44%) of the patients perceived a bachelor's degree would be a sufficient level of education. The vast majority of patients claimed the sex of the health…

  6. Mayo Clinic Care Network: A Collaborative Health Care Model. (United States)

    Wald, John T; Lowery-Schrandt, Sherri; Hayes, David L; Kotsenas, Amy L


    By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Reducing stigma in healthcare and law enforcement: a novel approach to service provision for street level sex workers. (United States)

    Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim


    Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and those that arise specific to their line of work. Despite being a diverse population, studies have identified some specific health needs for sex workers including addictions treatment, mental health. Additionally, studies have shown a higher risk of physical and sexual assault for this population. The Persons at Risk program (PAR) in London, Ontario, Canada was started in 2005 to address the specific needs of street level sex workers by using a harm-reduction model for policing and healthcare provision. This qualitative study evaluated this model of care in terms of improving access to healthcare and essential police services for street level sex workers. A total of 14 semi-structured interviews were conducted with current and former female street level sex workers enrolled in the PAR program. In addition, 3 semi-structured interviews were conducted with health and law enforcement professionals. The research team then analyzed and coded the transcripts using qualitative description to identify key themes in the data. Results indicated that participants represent a vulnerable population with increased safety concerns and healthcare needs relating to addictions, mental health and infectious disease. Despite this, participants reported avoiding healthcare workers and police officers in the past because of fear of stigma or repercussions. All participants identified the harm reduction approach of the PAR program as being essential to their continued engagement with the program. Other important aspects included flexible hours, the location of the clinic, streamlined access to mental health and addictions treatment and the female gender of the police and healthcare worker. The PAR program provides sex workers access to much needed primary healthcare that is flexible and without judgment. In addition, they are

  8. Street photography as social interaction

    Directory of Open Access Journals (Sweden)

    Andrea Mubi Brighenti


    Full Text Available Street photographers know quite well that taking a picture is a form of social interaction. The birth of this genre of photography, they have been discussing at length about the ethical problems involved in taking pictures of personal strangers in public places without asking permission.

  9. Wary Eyes Monitoring Wall Street (United States)

    Jacobson, Linda


    School business officials kept a close watch on the financial markets this week--and on district investment portfolios and teacher-retirement funds--as stock prices gyrated and once-sound institutions got government bailouts or crumbled into bankruptcy. While financial observers said it was too soon to predict how Wall Street's upheaval might…

  10. Street prostitution zones and crime

    NARCIS (Netherlands)

    Bisschop, P.; Kastoryano, S.; van der Klaauw, B.


    This paper studies the effects of legal street prostitution zones on registered and perceived crime. We exploit a unique setting in the Netherlands where these tippelzones were opened in nine cities under different regulation systems. Our difference-in-difference analysis of 25 Dutch cities between

  11. Cost analysis of public health influenza vaccine clinics in Ontario. (United States)

    Mercer, Nicola J


    Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

  12. Health claims on foods: challenge for clinical research companies

    Directory of Open Access Journals (Sweden)

    Essi Sarkkinen


    Full Text Available Background The Nutrition and Health Claim Regulation 1924/2006/EC, together with EFSA guidances on the scientific requirements for different type of health claims, is setting the basis for health claim substantiation in the EU. Aim The aim of this presentation is to bring up the key challenges that the food industry and clinical research organizations are facing when meeting these requirements. Results and discussion Key issues in clinical research planning to meet the requirements set for the health claim substantiation are: (1 Selection of right outcome markers since the selection of outcome marker defines actually the formulation of the health claim to be used on food or food ingredient. (2 Selection of right target population since that determines the target consumer group for the food with a health claim. (3 Selection of dose regime and food matrices used since these largely determine the conditions set for the use of the health claim. One of the major challenges in health claim substantiation is the deviant approach to risk factors or biomarkers. From the regulation point of view, a single risk factor approach is emphasized, but from the clinical and scientific point of view the pattern of different risk markers or biomarkers could, in some cases, be a more relevant choice to reflect the final health outcome. This is especially the case in the nutrition and health area because we are often dealing with weak but multiple health effects of certain food items or ingredients. Also the lack of validated well-established biomarkers potent to be affected by diet is a challenge in health claim substantiation.The selection of right target population is often a compromise between choosing a more potential target group to obtain efficacy (i.e. risk factors elevated vs. patient groups and choosing a rationale to generalize the results to wider population (target consumer group.The selection of optimal dosing regime and matrices for a clinical study is

  13. Employee Health in the Mental Health Workplace: Clinical, Administrative, and Organizational Perspectives. (United States)

    Shah, Jai L; Kapoor, Reena; Cole, Robert; Steiner, Jeanne L


    Issues of mental health and employee health have risen to increasing prominence in recent years. However, there have been few explorations of the clinical and administrative challenges that these issues raise, particularly in settings that are themselves mental health workplaces. In order to identify and understand such challenges, a brief case of acute employee illness in a mental health workplace is described followed by a discussion of salient clinical, administrative, and organizational considerations. The case raises questions about medicolegal responsibilities and relationships between clinicians and patients in mental health settings, illuminates tensions between clinical staff and human resources processes, and draws attention to the need for illness prevention and mental health promotion initiatives in the workplace. Increased awareness of these issues, complications, and potential solutions would benefit clinicians, administrators, and mental health institutions.

  14. Support for Offering Sexual Health Services through School-Based Health Clinics (United States)

    Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey


    Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…

  15. Whole genome sequencing in clinical and public health microbiology. (United States)

    Kwong, J C; McCallum, N; Sintchenko, V; Howden, B P


    Genomics and whole genome sequencing (WGS) have the capacity to greatly enhance knowledge and understanding of infectious diseases and clinical microbiology.The growth and availability of bench-top WGS analysers has facilitated the feasibility of genomics in clinical and public health microbiology.Given current resource and infrastructure limitations, WGS is most applicable to use in public health laboratories, reference laboratories, and hospital infection control-affiliated laboratories.As WGS represents the pinnacle for strain characterisation and epidemiological analyses, it is likely to replace traditional typing methods, resistance gene detection and other sequence-based investigations (e.g., 16S rDNA PCR) in the near future.Although genomic technologies are rapidly evolving, widespread implementation in clinical and public health microbiology laboratories is limited by the need for effective semi-automated pipelines, standardised quality control and data interpretation, bioinformatics expertise, and infrastructure.

  16. The balance of planting and mortality in a street tree population (United States)

    Lara A. Roman; John J. Battles; Joe R. McBride


    Street trees have aesthetic, environmental, human health, and economic benefits in urban ecosystems. Street tree populations are constructed by cycles of planting, growth, death, removal and replacement. The goals of this study were to understand how tree mortality and planting rates affect net population growth, evaluate the shape of the mortality curve, and assess...

  17. Machine learning methods for clinical forms analysis in mental health. (United States)

    Strauss, John; Peguero, Arturo Martinez; Hirst, Graeme


    In preparation for a clinical information system implementation, the Centre for Addiction and Mental Health (CAMH) Clinical Information Transformation project completed multiple preparation steps. An automated process was desired to supplement the onerous task of manual analysis of clinical forms. We used natural language processing (NLP) and machine learning (ML) methods for a series of 266 separate clinical forms. For the investigation, documents were represented by feature vectors. We used four ML algorithms for our examination of the forms: cluster analysis, k-nearest neigh-bours (kNN), decision trees and support vector machines (SVM). Parameters for each algorithm were optimized. SVM had the best performance with a precision of 64.6%. Though we did not find any method sufficiently accurate for practical use, to our knowledge this approach to forms has not been used previously in mental health.

  18. Federally qualified health center dental clinics: financial information. (United States)

    Bailit, Howard L; Devitto, Judy; Myne-Joslin, Ronnie; Beazoglou, Tryfon; McGowan, Taegan


    Federally Qualified Health Center (FQHC) dental clinics are a major component of the dental safety net system, providing care to 3.75 million patients annually. This study describes the financial and clinical operations of a sample of FQHCs. In cooperation with the National Network for Oral Health Access, FQHC dental clinics that could provide 12 months of electronic dental record information were asked to participate in the study. Based on data from 28 dental clinics (14 FQHCs), 50 percent of patients were under 21 years of age. The primary payers were Medicaid (72.4 percent) and sliding-scale/self-pay patients (17.5 percent). Sites averaged 3.1 operatories, 0.66 dental hygienists, and 1.9 other staff per dentist. Annually, each FTE dentist and hygienist provided 2,801 and 2,073 patient visits, respectively. Eighty percent of services were diagnostic, preventive, and restorative. Patient care accounted for 82 percent of revenues, and personnel (64.2 percent) and central administration (13.4 percent) accounted for most expenses. Based on a small convenience sample of FQHC dental clinics, this study presents descriptive data on their clinical and financial operations. Compared with data from the UDS (Uniform Data System) report, study FQHCs were larger in terms of space, staff, and patients served. However, there was substantial variation among clinics for almost all measures. As the number and size of FQHC dental clinics increase, the Health Resources and Services Administration needs to provide them access to comparative data that they can use to benchmark their operations. © 2013 American Association of Public Health Dentistry.

  19. Street Pastors : on security, care and faith

    NARCIS (Netherlands)

    van Steden, R.


    This paper presents a study of Street Pastors in Cardiff, the capital city of Wales. Street Pastors are Christian volunteers who look after vulnerable people in the night-time economy. In this manner, they provide ‘securitas’ through empathy and care. The motives of Street Pastors for engaging with

  20. School Me, School Me Not, Street Me, Street Me Not…

    DEFF Research Database (Denmark)

    Gravesen, David Thore; Frostholm, Peter Hornbæk

    School Me, School Me Not, Street Me, Street Me Not… (1099) David Thore Gravesen, Peter Hornbæk Frostholm ECER 2016, 14. Communities, Families and Schooling in Educational Research, Session: 14 SES 10 A When picking leaves of a marguerite, whilst doing the “she loves me, she loves me not” game, you....... Obviously, the skaters attend the site to skate. But also other, more vulnerable groupings, use the site to socialize, meet peers and perhaps escape an unreliable and risky family arena. One particular group, the self-named Thugz, primarily formed around a number of young boys with non-Danish ethnic...... milieu. With a criminal gang-like behavior (Hoeben & Weerman 2013; Hviid 2007; Rasmussen 2012) involving petty crime and violence, one would think the group members would be indifferent towards their schooling and future careers. This was not the case. The informants proved to be very aware...

  1. Emerging uses of patient generated health data in clinical research. (United States)

    Wood, William A; Bennett, Antonia V; Basch, Ethan


    Recent advancements in consumer directed personal computing technology have led to the generation of biomedically-relevant data streams with potential health applications. This has catalyzed international interest in Patient Generated Health Data (PGHD), defined as "health-related data - including health history, symptoms, biometric data, treatment history, lifestyle choices, and other information-created, recorded, gathered, or inferred by or from patients or their designees (i.e. care partners or those who assist them) to help address a health concern."(Shapiro et al., 2012) PGHD offers several opportunities to improve the efficiency and output of clinical trials, particularly within oncology. These range from using PGHD to understand mechanisms of action of therapeutic strategies, to understanding and predicting treatment-related toxicity, to designing interventions to improve adherence and clinical outcomes. To facilitate the optimal use of PGHD, methodological research around considerations related to feasibility, validation, measure selection, and modeling of PGHD streams is needed. With successful integration, PGHD can catalyze the application of "big data" to cancer clinical research, creating both "n of 1" and population-level observations, and generating new insights into the nature of health and disease. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  2. Modelling the air flow in symmetric and asymmetric street canyons

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, J.L.; Martin, F. [Research Center for Energy, Environment and Technology (CIEMAT), Madrid (Spain). Fossil Fuels Dept., Numerical Simulation and Modelling Program


    In recent years a large amount of research has been conducted on urban scale and street canyon. Control of air quality inside cities is important for human health. To achieve this objective, street canyon modelling plays a significant role. Pollutant dispersion inside canyons are determined by wind flow around this complex geometry. Experimental investigations have been made by means of field measurements such as Vachon, G. et al. or wind tunnel experiences as Meroney, R.N. et al. or Kastner-Klein, P. and E.J. Plate. In many of these researches, they have used CFD models in several configurations, for instance Assimakopoulos, V.D. et al. or Sini, J.-F. et al. These models are based on a numerical resolution of Navier-Stokes equations with a turbulence closure. In this study, the aim is contribute to the understanding of air circulation inside street canyons. In order to achieve this purpose, several configurations of canyons are investigated. Two-dimensional sequences of real-scale street canyons (order to obstacles height is meters) with different features (symmetric canyons and asymmetric canyons forming step-up and step-down notch configurations) are simulated. These general configurations are modified to investigate some parameters such as aspect ratio, W/H, where W is the width of street and H is the height of buildings. Flows with high Reynolds numbers are modelling. FLUENT CFD software is used. (orig.)

  3. Philippines: street children, children at risk. (United States)

    Tantoco, F G


    Almost 2 million of Manila's 2.5 million children younger than 15 years old live on or below the poverty line. 75,000 of these children live on the streets after having run away from home or being abandoned. They beg, steal, scavenge for food, and sell newspapers, cigarettes, and leis. About 20,000 of the street children prostitute themselves. It is these latter children and adolescents who are at particular risk of HIV infection. Studies in the Philippines indicate that 91% of reported HIV infections are among individuals aged 15-44, the male/female infection ratio is one to one, the transmission rate is 45%, and the most common mode of transmission is through heterosexual intercourse. The high incidence of child sexual abuse and child prostitution in the Philippines would suggest that there are a significant number of children and adolescents under age 15 who are infected with HIV. Caritas Manila has developed an information, education, and communication program for HIV/AIDS prevention focusing upon individuals who have direct influence upon and are in direct contact with people: clergy, religious and civic associations, educators, and social and health workers. Caritas has also to a limited extent reached out directly to populations at risk, while collaborating with human rights advocacy groups and networking with other children-oriented agencies in the interest of providing resources to street children. Efforts must be made to protect the rights of children and provide them with an environment conducive to their growth and development. The author notes how off-duty policemen in Manila help real estate developers forcibly eject the poor from their shelters to clear the way for the construction of new infrastructure without concern for the legal processes and requirements in the humane and peaceful relocation of the homeless poor. Many women and children are hurt and killed in the process. It has also been reported that off-duty policemen in Rio de Janeiro

  4. Street art - vandalismus nebo umění?


    Grabmüllerová, Eva


    The diploma thesis ‚Street Art - Vandalism or Art?' deals with a world-wide phenomenon of contemporary art. The thesis focuses on the characterization of street art and history of street art (its origin and development) and analyzes the difference between street art and graffiti. The thesis presents street art techniques as well as notable street artists. The thesis also observes street art scene in the Czech Republic and depicts features that street art has in common with other art movements...

  5. Clinical quality performance in U.S. health centers. (United States)

    Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen


    To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. National data from the 2009 Uniform Data System. Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. © Health Research and Educational Trust.

  6. Integrative Mental Health (IMH): paradigm, research, and clinical practice. (United States)

    Lake, James; Helgason, Chanel; Sarris, Jerome


    This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Street Connectivity is Negatively Associated with Physical Activity in Canadian Youth

    Directory of Open Access Journals (Sweden)

    Ian Janssen


    Full Text Available Street connectivity, defined as how well streets connect to one and other and the density of intersections, is positively associated with active transportation in adults. Our objective was to study the relation between street connectivity and physical activity in youth. Study participants consisted of 8,535 students in grades 6–10 from 180 schools across Canada who completed the 2006 Health Behaviour in School-aged Children (HBSC survey. Street connectivity was measured in a 5 km circular buffer around these schools using established geographic information system measures. Physical activity performed outside of school hours was assessed by questionnaire, and multi-level regression analyses were used to estimate associations with street connectivity after controlling for several covariates. Compared to students living in the highest street connectivity quartile, those in the second (relative risk = 1.22, 95% confidence interval = 1.10–1.35, third (1.25, 1.13–1.37, and fourth (1.21, 1.09–1.34 quartiles were more likely to be physically active outside of school. In conclusion, youth in neighbourhoods with the most highly connected streets reported less physical activity outside of school than youth from neighbourhoods with less connected streets. Relationships between street connectivity and physical activity reported in this national study are in the opposite direction to those previously observed for active transportation in adult populations.

  8. Public health importance of lassa fever epidemiology, clinical ...

    African Journals Online (AJOL)

    The public health importance of Lassa fever can not be over emphasized if one considers the high infectivity and mortality rates associated with the disease. This study dealt extensively on the epidemiology, clinical features and current management of Lassa fever through literature review. The aim of this study is to sensitise ...

  9. Rigorous Clinical Trial Design in Public Health Emergencies Is Essential

    DEFF Research Database (Denmark)

    Ellenberg, Susan S; Keusch, Gerald T; Babiker, Abdel G


    Randomized clinical trials are the most reliable approaches to evaluating the effects of new treatments and vaccines. During the 2014-15 West African Ebola epidemic, many argued that such trials were neither ethical nor feasible in an environment of limited health infrastructure and severe disease...

  10. Using Clinical Decision Support Software in Health Insurance Company (United States)

    Konovalov, R.; Kumlander, Deniss

    This paper proposes the idea to use Clinical Decision Support software in Health Insurance Company as a tool to reduce the expenses related to Medication Errors. As a prove that this class of software will help insurance companies reducing the expenses, the research was conducted in eight hospitals in United Arab Emirates to analyze the amount of preventable common Medication Errors in drug prescription.


    Directory of Open Access Journals (Sweden)

    Burcak Balamber


    Full Text Available Graffiti movement, born as a result of an effort of the youth, who felt themselves socially excluded and alone, to show their existence and identities during the 1960s, expanded its scope owing to street based artists such as Keith Haring and Jean-Michel Basquiat entering to the galleries, and transformed into an artistic manner of expression having aesthetic concerns by adopting a more inclusive definition ‘street art’. During this transformation of street art,street artists experimented with various methods from many different disciplines and hence created works in a wide range of varieties in terms of plastic and artistic values. Among these disciplines, printmakinghastaken its own place in street artas a discipline thatdeeply influenced street artists.Printmaking has fascinated street artists and become a part of their production process, not only with its philosophy sharing common grounds with street art and advantages in terms of its tecnical practices but also its unique plastic and linear values.Thanks to the opportunities of printmaking, street art has succeeded creating a tremendous impression worldwide, and even positioned itself into today’s greatest museums/gallery halls. This article aims to show how and in what way printmaking has influenced street art being in a transformation since the 1960s, and to put an emphasis on theimportance of printmaking on today’s street art.

  12. Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. (United States)

    Delany, Clare; Golding, Clinton


    Clinical reasoning is fundamental to all forms of professional health practice, however it is also difficult to teach and learn because it is complex, tacit, and effectively invisible for students. In this paper we present an approach for teaching clinical reasoning based on making expert thinking visible and accessible to students. Twenty-one experienced allied health clinical educators from three tertiary Australian hospitals attended up to seven action research discussion sessions, where they developed a tentative heuristic of their own clinical reasoning, trialled it with students, evaluated if it helped their students to reason clinically, and then refined it so the heuristic was targeted to developing each student's reasoning skills. Data included participants' written descriptions of the thinking routines they developed and trialed with their students and the transcribed action research discussion sessions. Content analysis was used to summarise this data and categorise themes about teaching and learning clinical reasoning. Two overriding themes emerged from participants' reports about using the 'making thinking visible approach'. The first was a specific focus by participating educators on students' understanding of the reasoning process and the second was heightened awareness of personal teaching styles and approaches to teaching clinical reasoning. We suggest that the making thinking visible approach has potential to assist educators to become more reflective about their clinical reasoning teaching and acts as a scaffold to assist them to articulate their own expert reasoning and for students to access and use.

  13. Self-Esteem, Oral Health Behaviours, and Clinical Oral Health Status in Chinese Adults: An Exploratory Study (United States)

    Chin, Luzy Siu-Hei; Chan, Joanne Chung-Yan


    Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…

  14. Renaming Zagreb Streets and Squares

    Directory of Open Access Journals (Sweden)

    Jelena Stanić


    Full Text Available The paper deals with changes in street names in the city of Zagreb. Taking the Lower Town (Donji grad city area as an example, the first part of the paper analyses diachronic street name changes commencing from the systematic naming of streets in 1878. Analysis of official changes in street names throughout Zagreb’s history resulted in categorisation of five periods of ideologically motivated naming/name-changing: 1. the Croatia modernisation period, when the first official naming was put into effect, with a marked tendency towards politicisation and nationalisation of the urban landscape; 2. the period of the Kingdom of the Serbs, Croatians and Slovenians/Yugoslavia, when symbols of the new monarchy, the idea of the fellowship of the Southern Slavs, Slavenophilism and the pro-Slavic geopolitical orientation were incorporated into the street names, and when the national idea was highly evident and remained so in that process; 3. the period of the NDH, the Independent State of Croatia, with decanonisation of the tokens of the Yugoslavian monarchy and the Southern Slavic orientation, and reference to the Ustashi and the German Nazi and Italian Fascist movement; 4. the period of Socialism, embedding the ideals and heroes of the workers’ movement and the War of National Liberation into the canonical system; and, 5. the period following the democratic changes in 1990, when almost all the signs of Socialism and the Communist/Antifascist struggle were erased, with the prominent presence of a process of installing new references to early national culture and historical tradition. The closing part of the paper deals with public discussions connected with the selection of a location for a square to bear the name of the first president of independent Croatia, Franjo Tuđman. Analysis of these public polemics shows two opposing discourses: the right-wing political option, which supports a central position for the square and considers the chosen area to

  15. Effects of dry period length on clinical mastitis and other major clinical health disorders

    DEFF Research Database (Denmark)

    Enevoldsen, Carsten; Sørensen, J.T.


    Four, 7-, and 10-wk dry periods were randomly assigned to 366 dairy cows in eight herds. A multiple polytomous logistic regression analysis was conducted with the objective to reveal possible important effects of the dry period on the risk of contracting major clinical health disorders. Several...... complex statistical interactions were revealed. Complications around and after drying off occurred least frequently at 7-wk dry periods. There was little evidence of an effect of the dry period on the risk of clinical mastitis and other severe clinical disorders around and after calving. With short...... like milk yield at drying off and previous mastitis are much more important predisposing factors....

  16. The normativity of clinical health care: perspectives on moral realism. (United States)

    Nortvedt, Per


    The paper argues that a particular version of moral realism constitutes an important basis for ethics in medicine and health care. Moral realism is the position that moral value is a part of the fabric of relational and interpersonal reality. But even though moral values are subject to human interpretations, they are not themselves the sole product of these interpretations. Moral values are not invented but discovered by the subject. Moral realism argues that values are open to perception and experience and that moral subjectivity must be portrayed in how moral values are discovered and perceived by the human subject. Moral values may exist independent of the particular subject's interpretative evaluations as a part of reality. This epistemological point about normativity is particularly significant in medical care and in health care. The clinician perceives moral value in the clinical encounter in a way that is important for competent clinical understanding. Clinical understanding in medical care and health care bears on the encounter with moral values in the direct and embodied relations to patients, with their experiences of illness and their vulnerabilities. Good clinical care is then partly conditioned upon adequate understanding of such moral realities.

  17. Precautions used by occupational health nursing students during clinical placements

    Directory of Open Access Journals (Sweden)

    T.M.M. Maja


    Full Text Available Protection of health care workers including students from being infected when caring for high risk patients is a major cause for concern to all promoting occupational health. Safety of every employee is mandatory. Furthermore, universal guidelines for precautions must be used by all interacting with high risk patients and clients to protect themselves and prevent the spread of infection. The aim of this paper was to ascertain the availability of universal guidelines for precautions against the spread of infection in clinical settings and determine the precautions used by OHN students during their clinical placements. To realise these objectives, a quantitative and descriptive design was followed. A purposive sampling method was used to select 45 Occupational health nursing students who participated in the study. Data was collected with the use of a structured questionnaire and the results revealed that: most units where OHN students were placed for clinical experience had guidelines for universal precautions although these were not always accessible to them; regarding compliance to universal precautions, OHN students were reportedly aware of the hazards of failure to comply although in some emergencies and where personal protective material was not available, they had to provide care without using protective equipments. Recommendations made include that employers and staff at all occupational settings must ensure that updated guidelines for universal precautions are available and accessible to every body interacting with high risk patients; health care providers and students must be fully informed about and should always adhere to universal precautions.

  18. Solar radiation and street temperature as function of street orientation. An analysis of the status quo and simulation of future scenarios towards sustainability in Bahrain (United States)

    Silva, Joao Pinelo


    This paper discusses the contribution of street orientation towards the development of a comfortable microclimate for pedestrians in Bahrain. Increasing walkability is a global agenda to address issues such as a) transportation, b) energy consumption, c) health, and d) air pollution, all of which are topics of the sustainability agenda. Thermal comfort is one of the pre-requisites for walkability. In warm climates, this is a challenging goal. Street design is paramount for pedestrian comfort in warm climates. The roles of street orientation and aspect ratio are of particular importance as they determine the intake of solar radiation into the urban canyon. We investigate the state of affairs in Bahrain, by measuring the frequency with which the street orientations E-W, N-S, NE-SW, and NW-SE, currently occur. Research suggests that the street orientation E-W presents the lesser performance for mitigating the effects of heat gain. The ideal grid orientation would, therefore, be N-S, and NE-SW - NW-SE, avoiding street segments with E-W orientation. A countrywide analysis shows that E-W orientation accounts for the highest overall street length with 37%. The second most frequent orientation is N-S (29%), the best performer. NW-SE and NE-SW both have frequencies of only 17%. Preference for a street grid with N-S, NW-SE, and NE-SW orientation would improve the thermal performance of streets and provide a continuous network of a comfortable pedestrian environment. We simulate two future scenarios based on avoiding new E-W streets, or not. We measure their potential reduction in thermal gain and conclude that a simple policy could reduce solar exposition in 40%.

  19. Health profiles of foreigners attending primary care clinics in Malaysia. (United States)

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming


    The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care. Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters. More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public

  20. Health information technology: integration of clinical workflow into meaningful use of electronic health records. (United States)

    Bowens, Felicia M; Frye, Patricia A; Jones, Warren A


    This article examines the role that clinical workflow plays in successful implementation and meaningful use of electronic health record (EHR) technology in ambulatory care. The benefits and barriers of implementing EHRs in ambulatory care settings are discussed. The researchers conclude that widespread adoption and meaningful use of EHR technology rely on the successful integration of health information technology (HIT) into clinical workflow. Without successful integration of HIT into clinical workflow, clinicians in today's ambulatory care settings will continue to resist adoption and implementation of EHR technology.

  1. Masculinity in Majma: An Ethnography of Street Healing in Bangladesh


    Anam, Mujibul


    Based on empirical research in peri-urban areas in Dhaka, this thesis took the form of an anthropological enquiry into the forms of sexuality popularized by street-canvassers and their advertisement and sale of male potency medicines in Bangladesh. The field study raises as well as explores questions regarding male sexuality and sexual health problems. This study has demonstrated, using ethnographic data, one of the multiple ways in which males’ sexual health problems are being understood and...

  2. Implementation of an Electronic Health Records System in a Small Clinic: The Viewpoint of Clinic Staff (United States)

    Carayon, Pascale; Smith, Paul; Hundt, Ann Schoofs; Kuruchittham, Vipat; Li, Qian


    In this study, we examined the implementation of an electronic health records (EHR) system in a small family practice clinic. We used three data collection instruments to evaluate user experience, work pattern changes, and organisational changes related to the implementation and use of the EHR system: (1) an EHR user survey, (2) interviews with…

  3. Adolescent health care maintenance in a teen-friendly clinic. (United States)

    Chaisson, Nicole; Shore, William B


    Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations. Through the creation of teen-friendly clinics, primary care providers are well positioned to offer guidance and support to teens and their parents during this time of transition and growth. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. The lived experiences of children living on the streets of Hillbrow

    Directory of Open Access Journals (Sweden)

    Chris Myburgh


    Full Text Available Background: The effects of daily abuse and hardship on the streets lead to poor mental health in children living on the streets, resulting in them choosing ineffective and self-destructive coping strategies that impact their physical health and overall sense of wellbeing. The facilitation of the mental health of children living on the streets who are subjected to daily threats to their survival is thus crucial. Objectives: The aim of this research was to explore and describe the lived experiences of children living on the streets of Hillbrow, Johannesburg. Method: The research design was qualitative, exploratory, descriptive and contextual. A purposive sample was selected through a temporary shelter in Johannesburg, Gauteng, South Africa and consisted of 14 male children living on the streets. Data were collected using drawings, in-depth phenomenological interviews and field notes. The central interview opening statement was: ‘Tell me about your life on the street’. Results: The results obtained indicated that children living on the streets are threatened, exploited and exposed to physical, sexual and emotional abuse on a daily basis by the community, the authorities and other street dwellers. This leads to feelings of sadness, fear, anxiety, misery, despair, hopelessness, helplessness and suicide ideation, which in turn lead to drug abuse and criminal activities. In contrast, positive feelings of sympathy for other children living on the streets emerged and these children also displayed perseverance, resilience and a striving for autonomy. Conclusion: Street life exposes children to a variety of experiences, both positive and negative. A striving after autonomy is clearly depicted by these children, who are able to tap into a range of responses, both on- and off-street.

  5. Developing a manual for strengthening mental health nurses' clinical supervision

    DEFF Research Database (Denmark)

    Buus, Niels; Cassedy, Paul; Gonge, Henrik


    In this article, we report findings from a study aimed at developing the content and implementation of a manual for a research-based intervention on clinical supervision of mental health nursing staff. The intervention was designed to strengthen already existing supervision practices through...... educational preparation for supervision and systematic reflection on supervision. The intervention consists of three sessions and was implemented on two groups of mental health hospital staff. We present an outline of the manual and explain how the trial sessions made us adjust the preliminary manual....... The effects of implementing the manual will subsequently be analysed in an independent randomised controlled trial....


    Directory of Open Access Journals (Sweden)

    M.G. Kucherov


    Full Text Available In 90-ies years of last century in our country happened the crash of the system of values with transition to the standards of capitalistic society, and it lead to the formation of chronicle psychosocial stress of high and medium levels. Medics of all directions started to face functional psychosomatic diseases. Raised the necessity in grounding of health manpower in discipline of clinical psychology, with the learning of psychophisiological bases of diseases and possibilities if their correction. This direction of development of soviet medical education and health service in general seems progressive and prospective.

  7. Pollutant Dilution and Diffusion in Urban Street Canyon Neighboring Streets (United States)

    Sun, Z.; Fu, Zh. M.


    In the present study we investigated the airflow patterns and air quality of a series of typical street canyon combinations, developed a mass balance model to determine the local pollutant dilution rate, and discuss the impact of upstream canyon on the air quality of downstream canyon. The results indicated that the geometrical size of upstream and downstream buildings have significant impacts on the ambient airflow patterns. The pollution distribution within the canyons varies with different building combinations and flow patterns. Within the upstream canyon, pollution always accumulates to the low building side for non-symmetrical canyon, and for symmetrical canyon high level of pollution occurs at the leeward side. The height of the middle and downstream buildings can evidently change the pollutant dispersion direction during the transport process. Within the polluted canyon, the pollutant dilution rate (PDR) also varies with different street canyon combinations. The highest PDR is observed when the upstream buildings are both low buildings no matter the height of downstream building. However, the two cases are likely to contribution pollution to the downstream canyon. The H-L-H combination is mostly against local pollution remove, while the L-H-L case is considered the best optimistic building combination with both the ability of diluting local pollution and not remarkably decreasing air quality of downstream canyon. The current work is expected instructive for city designers to optimize traffic patterns under typical existing geometry or in the development of urban geometry modification for air quality control.

  8. The Union Health Center: a working model of clinical care linked to preventive occupational health services. (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J


    As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success

  9. Structural value of Yerevan streets

    Directory of Open Access Journals (Sweden)

    Avetisyan Arsen Grantovich


    Full Text Available The absence of the methods of urban analysis in the process of urban development of Yerevan is the reason of urban planning activities that tend to decrease the urban value of Yerevan territories. Meanwhile the studies in the sphere of urban planning and urban analysis prove the dependence of the life in the city on its structure and distribution of the functions. The mentioned issue highlights the importance of urban analysis. The paper discusses space syntax, which is one of the initial methods of urban analysis. The basic concept of Space syntax is based on the assumption that urban fabric can be presented and studied as a power graph. The method provides the measures that evaluate the land use, traffic and pedestrian movement, land value and even carbon emissions. The paper discusses also recent attempts of integration of space syntax method into GIS environment. GIS databases provide researchers with vast amount of urban data. Analyses presented in the current paper were performed on the basis of the open street map, which was imported from the GIS environment. With the application of space syntax methods analysis of connectivity, integration choice (betweenness and depth from the city center were performed to evaluate the structural value of Yerevan streets. Municipal regions of Yerevan were classified by the level of their accessibility and by their distances from the city center on the base of the results of depth measures from the city center. Evaluation of the street network aims to define the most integrated and centrally positioned parts of the city. These areas can be locations for the organization of sub centers of Yerevan in the municipal regions.

  10. Cultural politics and clinical competence in Australian health services. (United States)

    Manderson, Lenore; Allotey, Pascale


    Medical competence is demonstrated in multiple ways in clinical settings, and includes technical competence, both in terms of diagnosis and management, and cultural competence, as demonstrated in communication between providers and clients. In cross-cultural contexts, such communication is complicated by interpersonal communication and the social and cultural context. To illustrate this, we present four case studies that illustrate the themes from interviews with immigrant women and refugees from Middle Eastern and Sahel African backgrounds, conducted as part of a study of their reproductive health. In our analysis, we highlight the limitations of conventional models of communication. We illustrate the need for health providers to appreciate the possible barriers of education, ethnicity, religion and gender that can impede communication, and the need to be mindful of broader structural, institutional and inter-cultural factors that affect the quality of the clinical encounter.

  11. Moving targets: Promoting physical activity in public spaces via open streets in the US. (United States)

    Hipp, J Aaron; Bird, Alyssa; van Bakergem, Margaret; Yarnall, Elizabeth


    Popularity of Open Streets, temporarily opening streets to communities and closing streets to vehicles, in the US has recently surged. As of January 2016, 122 cities have hosted an Open Streets program. Even with this great expansion, the sustainability of Open Streets remains a challenge in many cities and overall Open Streets in the US differ from their successful counterparts in Central and South America. Between summer 2015 and winter 2016, we reviewed the websites and social media of the 122 identified programs and interviewed 32 unique Open Streets programs. Websites and social media were reviewed for program initiation, number of Open Streets days, length of routes, duration of program, and reported participation. Interview questions focused on barriers and facilitators of expanding Open Streets and specific questioning regarding local evaluation activities. All interviews were transcribed verbatim and analyzed with constant comparative methodology. Over three-quarters of US Open Streets programs have been initiated since 2010, with median frequency of one time per year, 4h per date, and 5000-9999 participants. Seventy-seven percent of program routes are under 5km in length. Success of programs was measured by enthusiasm, attendance, social media, survey metrics, and sustainability. Thirteen of 32 program organizers expressed interest in expanding their programs to 12 dates per year, but noted consistent barriers to expansion including funding, permitting, and branding. Though many cities now host Open Streets programs, their ability to effect public health remains limited with few program dates per year. Coordinated efforts, especially around funding, permitting, and branding may assist in expanding program dates. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Sleep Health Issues for Children with FASD: Clinical Considerations


    Jan, James E.; Asante, Kwadwo O.; Conry, Julianne L.; Fast, Diane K.; Bax, Martin C. O.; Ipsiroglu, Osman S.; Bredberg, Elizabeth; Loock, Christine A.; Wasdell, Michael B.


    This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD) focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniqu...

  13. Evidence-based health care: its place within clinical governance. (United States)

    McSherry, R; Haddock, J

    This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers 'The New NHS: Modern, Dependable' (Department of Health (DoH), 1997) and 'A First Class Service: Quality in the New NHS' (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence. This article also examines what evidence-based practice is and what processes are required to promote effective healthcare interventions. The authors also look at how clinical governance relates to other methods/systems involved in clinical effectiveness. Finally, the importance for nurses and other healthcare professionals of familiarizing themselves with the development of critical appraisal skills, and their implications for developing evidence-based practice, is emphasized.

  14. Role of pharmacogenetics in public health and clinical health care: a SWOT analysis. (United States)

    Kapoor, Ritika; Tan-Koi, Wei Chuen; Teo, Yik-Ying


    Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively.

  15. Clinical working postures of bachelor of oral health students. (United States)

    Horton, S J; Johnstone, C L; Hutchinson, C M W; Taylor, P A; Wade, K J


    To observe and describe the clinical working postures of final-year Bachelor of Oral Health (BOH) students. Pilot observational study. The University of Otago Faculty of Dentistry and School of Physiotherapy. Eight final-year BOH students voluntarily participated in this study, where postural data were collected using a digital video camera during a standard clinical treatment session. The postural data were analysed using 3D Match biomechanical software. Final-year BOH students who work in the seated position are exposed to neck flexion of greater than 35 degrees, together with trunk flexion greater than 20 degrees and bilateral elbow flexion greater than 90 degrees. The findings of this study agree with the findings of previous postural studies of dental professionals. Dental hygiene students, together with their clinical supervisors, need to be aware of the importance of good working posture early in their careers, and pay particular attention to the degree of neck flexion occurring for prolonged periods.

  16. Clinical interdisciplinary health team care: an educational experiment. (United States)

    Mazur, H; Beeston, J J; Yerxa, E J


    With increasing concern for teamwork in clinical practice in health care settings, the need to identify the concepts, methods, and learning processes for improving interdisciplinary team skills is apparent. This paper describes patient-centered, clinical-research-demonstration programs for teams of students, preceptors, and faculty members from six disciplines who provided patient care in a long-term rehabilitation setting. The teams were involved in the theory and practice of team-building, including weekly sessions on leadership styles, communication, group decision-making, and team effectiveness assessment. Objective and subjective measurements were administered throughout the program. The results indicate that task-oriented patient care favors the learning of team skills, especially when all levels of administration support and participate in the processes. Question are raised concerning the effect of clinical teams on the quality of patient care, their cost-effectiveness, and the low priority given to teaching interdisciplinary team skills in professional education.

  17. PLC based Smart Street Lighting Control


    D.V.Pushpa Latha; K.R.Sudha; Swati Devabhaktuni


    Conventional street lighting systems in most of the areas are Online at regular intervals of time irrespective of the seasonal variations. The street lights are simply switched on at afternoon and turned off in the morning. The consequence is that a large amount of Power is wasted meaninglessly. As energy consumption is an issue of increasing interest, possible energy savings in public street lighting systems are recently discussed from different viewpoints. The purpose of this work is to des...

  18. Computer-assisted self interviewing in sexual health clinics. (United States)

    Fairley, Christopher K; Sze, Jun Kit; Vodstrcil, Lenka A; Chen, Marcus Y


    This review describes the published information on what constitutes the elements of a core sexual history and the use of computer-assisted self interviewing (CASI) within sexually transmitted disease clinics. We searched OVID Medline from 1990 to February 2010 using the terms "computer assisted interviewing" and "sex," and to identify published articles on a core sexual history, we used the term "core sexual history." Since 1990, 3 published articles used a combination of expert consensus, formal clinician surveys, and the Delphi technique to decide on what questions form a core sexual health history. Sexual health histories from 4 countries mostly ask about the sex of the partners, the number of partners (although the time period varies), the types of sex (oral, anal, and vaginal) and condom use, pregnancy intent, and contraceptive methods. Five published studies in the United States, Australia, and the United Kingdom compared CASI with in person interviews in sexually transmitted disease clinics. In general, CASI identified higher risk behavior more commonly than clinician interviews, although there were substantial differences between studies. CASI was found to be highly acceptable and individuals felt it allowed more honest reporting. Currently, there are insufficient data to determine whether CASI results in differences in sexually transmitted infection testing, diagnosis, or treatment or if CASI improves the quality of sexual health care or its efficiency. The potential public health advantages of the widespread use of CASI are discussed.

  19. Clinical contributions to addressing the social determinants of health. (United States)

    Patel, Kiran C R; Spilsbury, Peter; Shukla, Rashmi


    The drive to address social determinants of health is gaining momentum. Appreciating that health outcomes are only partly affected by healthcare, clinicians and clinical communities can play a significant role in this crusade by action at local, regional, national and global levels. A concerted and systematic focus on integrating and industrialising upstream interventions at every healthcare encounter is essential to prevent future illness, thus enabling a paradigm shift in the healthcare service from being one of illness management to health preservation. The evidence base demonstrates the cost efficacy of upstream interventions. The challenge is how this evidence is utilised to implement these interventions in everyday healthcare. Today, with a global economic crisis and challenged public sector funding, the need to address prevention has never been more pressing. Clinical engagement at all levels, from the front line to the boardroom is vital. Clinicians must address access, communication, strategy and commissioning to fulfil a professional responsibility to become and remain the corporate memory of a health service focused on preventing illness while simultaneously delivering cost-effective healthcare.

  20. Georges Charpak street sign unveiled

    CERN Multimedia

    Paola Catapano


    While it might not be the only French street named in honour of the late Georges Charpak, who passed away in September 2010 at the age of 87, the street chosen by the mayor of Saint-Genis-Pouilly is certainly the only one located directly opposite the CERN "campus". The road overlooks buildings on the CERN Meyrin site, where Georges Charpak spent most of his career as a physicist, conducting the research that won him the Nobel Prize in Physics in 1992.   From left to right: Sigurd Lettow, Dominique Charpak and the mayor of Saint-Genis-Pouilly. The unveiling took place on 17 October and was organised by the mayor of Saint-Genis-Pouilly. George Charpak’s wife, Dominique, and Sigurd Lettow, CERN Director of Administration and General Infrastructure, attended what was an intimate and touching ceremony. The mayor’s speech at the event praised Georges’ commitment to scientific education. The highlight of the event, however, was a witty and humorous ...

  1. Evaluation of a pharmacist-managed asthma clinic in an Indian Health Service clinic. (United States)

    Pett, Ryan G; Nye, Shane


    To observe whether American Indian and Alaskan Native (AI/AN) patients at the Yakama Indian Health Service seen at the pharmacist-managed asthma clinic improved asthma outcomes. Retrospective chart review, single group, preintervention and postintervention. Pharmacist-managed asthma clinic at an Indian Health Service ambulatory care clinic. Sixty-one AI/AN patients who were seen at least once in the asthma clinic from 2010 to 2014. Pharmacist-provided asthma education and medication management. Asthma-related hospitalizations and emergency department or urgent care (ED) visits. The total number of asthma-related hospitalizations and ED visits between the 12-month periods preceding and following the initial asthma clinic visit were 11 versus 2 hospitalizations (P = 0.02) and 43 versus 25 ED visits (P = 0.02), respectively. Over the same period, asthma-related oral corticosteroid use showed a nonsignificant decrease in the number of prescriptions filled (n = 59, P = 0.08). In contrast, inhaled corticosteroid prescription fills significantly increased (n = 42, P = 0.01). A reduction of asthma-related hospitalizations and ED visits were observed during the course of the intervention. Increased access to formal asthma education and appropriate asthma care benefit the Yakama AI/AN people. A controlled trial is needed to confirm that the intervention causes the intended effect. Published by Elsevier Inc.

  2. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland. (United States)

    Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi


    Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

  3. An exploration of clinical decision making in mental health triage. (United States)

    Sands, Natisha


    Mental health (MH) triage is a specialist area of clinical nursing practice that involves complex decision making. The discussion in this article draws on the findings of a Ph.D. study that involved a statewide investigation of the scope of MH triage nursing practice in Victoria, Australia. Although the original Ph.D. study investigated a number of core practices in MH triage, the focus of the discussion in this article is specifically on the findings related to clinical decision making in MH triage, which have not previously been published. The study employed an exploratory descriptive research design that used mixed data collection methods including a survey questionnaire (n = 139) and semistructured interviews (n = 21). The study findings related to decision making revealed a lack of empirically tested evidence-based decision-making frameworks currently in use to support MH triage nursing practice. MH triage clinicians in Australia rely heavily on clinical experience to underpin decision making and have little of knowledge of theoretical models for practice, such as methodologies for rating urgency. A key recommendation arising from the study is the need to develop evidence-based decision-making frameworks such as clinical guidelines to inform and support MH triage clinical decision making.

  4. Alcohol in urban streetscapes: a comparison of the use of Google Street View and on-street observation

    Directory of Open Access Journals (Sweden)

    Chris Clews


    Full Text Available Abstract Background Alcohol-related harm is a major global health issue, and controls on alcohol marketing are one intervention utilized by governments. This study investigated the use of Google Street View (GSV as a novel research method for collecting alcohol-related data in the urban environment. Methods The efficacy of GSV and on-street observation by observer teams was compared by surveying 400 m stretches of 12 streets in Wellington, the capital city of New Zealand. Data on alcohol sale, alcohol-related advertising, health promotion materials, regulatory information and visible alcohol consumption were collected. Results A total of 403 retailers with evidence of alcohol sales and 1161 items of alcohol-related communication were identified in on-street observation. Of the latter, 1028 items (89 % were for alcohol marketing and 133 (11 % were for alcohol-related health promotion and alcohol regulation. GSV was found to be a less sensitive tool than on-street observation with only 50 % of the alcohol venues identified and 52 % of the venue-associated brand marketing identified. A high degree of inter-observer reliability was generally found between pairs of observers e.g., for the detection of alcohol retail venues the intra-class correlation coefficient (ICC was 0.93 (95 % CI: 0.78 to 0.98 for on-street observation and 0.85 (95 % CI: 0.49 to 0.96 for using GSV. Conclusions GSV does not seem suitable for the comprehensive study of the influences on alcohol consumption in the urban streetscape. However, it may still have value for large, static objects in the environment and be more time efficient than traditional on-street observation measures, especially when used to collect data across a wide geographical area. Furthermore, GSV might become a more useful research tool in settings with better image quality (such as more ‘footpath views’ and with more regularly updated GSV imagery.

  5. Models for Clinical Education Accompanying in Mental Health and Psychiatry

    Directory of Open Access Journals (Sweden)

    Lino Ramos


    Full Text Available Objective: To analyze the available scientific literature on the follow-up models in Clinical Teaching in Mental Health, carrying out a systematic review of the literature with re- search in the electronic databases PubMed, B-On, EBSCO platform and Scielo, as well as the Open Access scientific repositories of Portugal. Methodology: The present work consists of a systematic literature review (RSL. Keyword databases were searched first, the results were filtered according to exclusion and inclusion criteria and only selected the most appropriate references to answer the research question that were subsequently submitted to an evaluation by CASPe. The final sample includes 11 articles. Results: In the last decades, the training of nursing students has been the subject of several changes and transformations, once it is agreed that the training takes place in moments of theoretical training and moments of practical training in clinical teaching. Clinical teaching is a privileged space for the learning of nursing students. This is where they have the possibility to develop and mobilize skills and build knowledge The orientation of nursing students in clinical education has been the subject of numerous investigations in recent years; the area of Mental Health and Psychiatry (MHP shows a significant role in the development and construction of the identity of the nursing professional future. in the follow-up of students in clinical teaching, several actors stand out: the student, the teacher and the nurse orientate, who take special importance in the process of personal and professional development of the student, having a pedagogical, social and professional responsibility. The provision of care in MHP Clinical Teaching requires a wide range that allows the student to develop several aspects, namely creativity, therapeutic communication, sensitivity to care, listening, empathy, and interpersonal relationship capacity with the person, multi- disciplinary

  6. Adolescent Hopefulness in Tanzania: Street Youth, Former Street Youth, and School Youth (United States)

    Nalkur, Priya G.


    This study compares hope in street youth, former street youth, and school youth (aged 12-18) in Tanzania. Responding to Snyder's hope theory, the author argues that not only personal agency but also the stability of living context (street, shelter, home) shapes hopefulness. Employing qualitative and quantitative analyses, the author presents a…

  7. Personal and Familial Properties of Street Children--"Street Children: The Forgotten or Not Remembered Ones" (United States)

    Özbas, Mehmet


    With this research it is aimed to determine the personal traits of Street Children depending on them and also the socio-economic variables of Street Children resulting from their families. For this main aim in the research process, it is provided to have communication directly with the parents of Street Children using one-to-one and face-to-face…

  8. [Ethics in clinical practice and in health care]. (United States)

    Pintor, S; Mennuni, G; Fontana, M; Nocchi, S; Giarrusso, P; Serio, A; Fraioli, A


    The clinical ethics is the identification, analysis and solution of moral problems that can arise during the care of a patient. Given that when dealing with ethical issues in health care some risks will be encountered (talking about ethics in general, or as a problem overlapped with others in this area, or by delegation to legislative determinations) in the text certain important aspects of the topic are examined. First of all ethics as human quality of the relationship between people for the common good, especially in health services where there are serious problems like the life and the health. It is also necessary a "humanizing relationship" between those who work in these services in order to achieve quality and efficiency in this business. It is important a proper training of health professionals, especially doctors, so that they can identify the real needs and means of intervention. It is also important that scientific research must respect fundamental ethical assumptions. In conclusion, ethics in health care is not a simple matter of "cookbook" rules, but involves the responsibility and consciousness of individual operators.

  9. Timing of Clinical Billing Reimbursement for a Local Health Department. (United States)

    McCullough, J Mac


    A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt. Reimbursement records for all transactions at Maricopa County Department of Public Health immunization clinics from January 2013 through June 2014 were compiled and analyzed to determine the duration between service and reimbursement. Outcomes included daily and cumulative revenues received. Time to reimbursement for Medicaid and private payers was also compared. Reimbursement for immunization services was received a median of 68 days after service. Payments were sometimes taken back by payers through credit transactions that occurred a median of 333 days from service. No differences in time to reimbursement between Medicaid and private payers were found. Billing represents an important financial opportunity for LHDs to continue to sustainably assure population health. Yet, the lag from service provision to reimbursement may complicate budgeting, especially in initial years of new billing activities. Special consideration may be necessary to establish flexibility in the budget-setting processes for services with clinical billing revenues, because funds for services delivered in one budget period may not be received in the same period. LHDs may also benefit from exploring strategies used by other delivery organizations to streamline billing processes.

  10. Health Professionals Facing Suicidal Patients: What Are Their Clinical Practices?

    Directory of Open Access Journals (Sweden)

    Inês Rothes


    Full Text Available Clinical work with suicidal people is a demanding area. Little is known about health professionals’ practices when faced with suicidal patients. The aims of this study were to: (1 describe the practices most likely to be adopted by professionals facing a suicidal patient and (2 analyze the differences according to professional characteristics (group, specific training on suicide, and experience with suicidal patients. A self-report questionnaire that was developed for this study was filled out by 239 participants. Participants were psychologists, psychiatrists, and general practitioners who work in different contexts: hospitals, public health centres, schools or colleges, and community centres. Principal components analysis, analyses of variance, and t-tests were used. Four components were identified: (1 Comprehensive risk assessment; (2 protocols, psychotherapy and connectedness; (3 multidisciplinary clinical approach; and, (4 family, explaining a total of variance of 44%. Positive associations between suicide-related variables (training and experience and practices were found. In general, health professionals’ practices are evidence-based, however a relevant percentage of professionals can benefit from training and improve their practices.

  11. Clinical and Para Clinical Information Needs of Infertility Electronic Health Records in Iran: A Delphi Study. (United States)

    Farzandipour, Mehrdad; Jeddi, Fateme Rangraz; Gilasi, Hamid Reza; Shirzadi, Diana


    infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method. Designing the questionnaire was done based on library studies and Gathering experts' views was done based on Delphi technique. 261 items from clinical and Para clinical information of infertile patients' electronic health records were subjected to an opinion poll by experts. During this process 223 items were accepted and 38 items have been rejected after two sessions of surveys by infertility experts. Para clinical information section consisted of 57 items that all of them have been accepted by the experts. Also, clinical information section consisted of 242 items from which 204 items were accepted and 38 items were rejected by the experts. existence of a structured electronic record system of infertile patients' information leads to the integration of patients' information, improvement of health care services and a decrease in treatment costs: all working to increase information safety. Furthermore, only essential and relevant information would be provided for the specialists and it will facilitate and direct the future infertility related studies due to the coherence, unity and relevance of the information.

  12. A model linking clinical workforce skill mix planning to health and health care dynamics

    Directory of Open Access Journals (Sweden)

    McDonnell Geoff


    Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  13. A model linking clinical workforce skill mix planning to health and health care dynamics. (United States)

    Masnick, Keith; McDonnell, Geoff


    In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  14. Trabajo informal: motivos, bienestar subjetivo, salud, y felicidad en vendedores ambulantes Trabalho informal: motivos, bem-estar subjetivo, saúde e felicidade de vendedores ambulantes Informal work: motives, well being, health and happiness in street vendors

    Directory of Open Access Journals (Sweden)

    Emilio Moyano Díaz


    Full Text Available Las relaciones entre trabajo, bienestar subjetivo (B.S., felicidad y salud son complejas y de alto interés teórico y empírico. Ellas son analizadas aquí en trabajadores informales de comercio ambulante. Mediante observación y fotografías en las cinco ciudades más pobladas de la región del Maule (Chile, se registra 1556 puestos de venta de los que aleatoriamente se selecciona 258 para encuestar. Resultados: presentan una satisfacción vital global moderada, estando menos satisfechos con sus amigos y ocio, que con su trabajo y su familia. Su mayor felicidad proviene de ésta (χ2Friedman=389,47; gl=3; pAs relações entre trabalho, bem-estar subjetivo (B.S., felicidade e saúde são complexas e de alto interesse teórico e empírico. Elas são analisadas aqui em trabalhadores informais do comércio ambulante. Mediante observação e fotografias nas cinco cidades mais populosas da região do Maule (Chile, registram-se 1556 postos de venda. Foram selecionados aleatoriamente 258 para interrogar. Resultados: os trabalhadores informais apresentam uma satisfação vital global moderada, estando menos satisfeitos com seus amigos e tempo de lazer do que com seu trabalho e sua família. Sua maior felicidade provém desta (χ2Friedman=389,47; gl=3; pRelationships among work, subjective well being (SWB, happiness and health are complex and have a high theoretical and empirical relevance. In this study, these relationships are analyzed in street vendors. Using observation and photographs in the five bigger cities Maule Region (Chile, 1556 sale points were found and 258 of them were randomly selected for this study. Results: vendors have a moderated life satisfaction, with lower satisfaction levels about their friends and leisure than about their work and family. The highest report of happiness comes from their family (χ2Friedman=389,47; gl=3; p<0,001. They report being sick M= 6 days per month, although they only miss work one day per month. Their

  15. Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices. (United States)

    Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R


    Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.


    Stewart, Eric A.; Simons, Ronald L.


    The study outlined in this article drew on Elijah Anderson’s (1999) code of the street perspective to examine the impact of neighborhood street culture on violent delinquency. Using data from more than 700 African American adolescents, we examined 1) whether neighborhood street culture predicts adolescent violence above and beyond an adolescent’s own street code values and 2) whether neighborhood street culture moderates individual-level street code values on adolescent violence. Consistent with Anderson’s hypotheses, neighborhood street culture significantly predicts violent delinquency independent of individual-level street code effects. Additionally, neighborhood street culture moderates individual-level street code values on violence in neighborhoods where the street culture is widespread. In particular, the effect of street code values on violence is enhanced in neighborhoods where the street culture is endorsed widely. PMID:21666759

  17. MAPCERN links to Google Street View

    CERN Multimedia

    Matilda Heron


    CERN’s online maps, MAPCERN, now have the added bonus of Google Street View, thanks to the new release of images of many CERN sites captured by Google.   New Street View images of CERN sites have been added to MAPCERN, see bottom-right-hand image in the screenshot above.   Google Street View, an integrated service of Google Maps introduced in 2007, links 360-degree panoramic photos into a virtual tour. CERN and Google began collaborating on this Street View project in 2010 and now these Street View images have been embedded into MAPCERN, accessible by clicking the “Street View” tab in MAPCERN’s bottom-right-hand window. If you need to locate a building at CERN, or plan an operation on some equipment, you can save time by using the Street View images to check out the area in advance. The CERN Meyrin site has been fully mapped, as well as the surfaces of the eight LHC points, BA2 and BA3. New Street View images of CERN, including the Pr...

  18. Do changes to the local street environment alter behaviour and quality of life of older adults? The 'DIY Streets' intervention. (United States)

    Ward Thompson, Catharine; Curl, Angela; Aspinall, Peter; Alves, Susana; Zuin, Affonso


    The burden of ill-health due to inactivity has recently been highlighted. Better studies on environments that support physical activity are called for, including longitudinal studies of environmental interventions. A programme of residential street improvements in the UK (Sustrans 'DIY Streets') allowed a rare opportunity for a prospective, longitudinal study of the effect of such changes on older adults' activities, health and quality of life. Pre-post, cross-sectional surveys were carried out in locations across England, Wales and Scotland; participants were aged 65+ living in intervention or comparison streets. A questionnaire covered health and quality of life, frequency of outdoor trips, time outdoors in different activities and a 38-item scale on neighbourhood open space. A cohort study explored changes in self-report activity and well-being postintervention. Activity levels were also measured by accelerometer and accompanying diary records. The cross-sectional surveys showed outdoor activity predicted by having a clean, nuisance-free local park, attractive, barrier-free routes to it and other natural environments nearby. Being able to park one's car outside the house also predicted time outdoors. The environmental changes had an impact on perceptions of street walkability and safety at night, but not on overall activity levels, health or quality of life. Participants' moderate-to-vigorous activity levels rarely met UK health recommendations. Our study contributes to methodology in a longitudinal, pre-post design and points to factors in the built environment that support active ageing. We include an example of knowledge exchange guidance on age-friendly built environments for policy-makers and planners. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  19. Sleep Health Issues for Children with FASD: Clinical Considerations

    Directory of Open Access Journals (Sweden)

    James E. Jan


    Full Text Available This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniques used for typical children are less suitable for children with FASD who need individually designed interventions. The types, causes, and adverse effects of sleep disorders, the modification of environment, scheduling and preparation for sleep, and sleep health for their caregivers are discussed. It is our hope that parents and also researchers, who are interested in the sleep disorders of children with FASD, will benefit from this presentation and that this discussion will stimulate much needed evidence-based research.

  20. Sleep Health Issues for Children with FASD: Clinical Considerations. (United States)

    Jan, James E; Asante, Kwadwo O; Conry, Julianne L; Fast, Diane K; Bax, Martin C O; Ipsiroglu, Osman S; Bredberg, Elizabeth; Loock, Christine A; Wasdell, Michael B


    This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD) focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniques used for typical children are less suitable for children with FASD who need individually designed interventions. The types, causes, and adverse effects of sleep disorders, the modification of environment, scheduling and preparation for sleep, and sleep health for their caregivers are discussed. It is our hope that parents and also researchers, who are interested in the sleep disorders of children with FASD, will benefit from this presentation and that this discussion will stimulate much needed evidence-based research.


    Directory of Open Access Journals (Sweden)



    Full Text Available Non-communicable diseases (NCDs represent among the most common and debilitating conditions seen in primary care. Patients’ care will often involves multiple providers and follow-up requires persistence by patients and clinicians alike, therefore ideal outcomes are often difficult to achieve. The need for better disease management policies and practice is growing. This is due to the changing demographic profile of the population, the increasing cost of managing people in acute care hospitals and the availability of new technologies and services. All these changes enable a different care paradigm which is more cost effective and provides people with chronic conditions an improved quality of life. Management of the NCDs therefore offers an excellent opportunity to practice chronic disease management - a systems approach designed to ensure excellent care. The NCD team has developed a comprehensive approach to chronic disease care. We would like to describe the NCD Program in Ampangan Health Clinic which represents many typical government health clinics in Malaysia and the processes by which it was developed. Included are specific examples of the tools and how they can be used by individual clinicians incaring for patients. The integration of Chronic Disease Management Services into health care systems is the direction being undertaken to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector.

  2. eHealth in cardiovascular medicine: A clinical update. (United States)

    Saner, Hugo; van der Velde, Enno


    Demographic changes, progress in medicine technology and regional problems in providing healthcare to low density populations are posing great challenges to our healthcare systems. Rapid progress in computer sciences and information technologies have a great impact on the way healthcare will be delivered in the near future. This article describes opportunities and challenges of eHealth and telemedicine in the framework of our health systems and, in particular, in the context of today's cardiology services. The most promising applications of eHealth and telemedicine include: (a) prevention and lifestyle interventions; (b) chronic disease management including hypertension, diabetes and heart failure; (c) arrhythmia detection including early detection of atrial fibrillation and telemonitoring of devices such as pacemaker, internal cardioverter defibrillators and implantable rhythm monitoring devices; (d) telerehabilitation. Major obstacles to the integration of eHealth and telemedicine into daily clinical practice include limited large-scale evidence, in particular, for cost-effectiveness, as well as lack of interoperability, inadequate or fragmented legal frameworks and lack of reimbursement. An important challenge for those involved in these new technologies will be to keep the main focus on patient's individual needs and to carefully evaluate the evidence behind the practice. © The European Society of Cardiology 2016.

  3. Street as Sustainable City Structural Element (United States)

    Leyzerova, A. V.; Bagina, E. J.


    Sustainability in architecture is nowadays of particular significance in the course of globalization and information density. The technospehere spontaneous development poses a threat to the sustainability of traditional urban forms where a street is one of the essential forming elements in the urban structure. The article proposes to consider formally compositional street features in relation to one of the traditional streets in the historic center of Ekaterinburg. The study examines the street-planning structure, the development of its skeleton elements, silhouette and fabric elevation characteristics as well as the scale characteristics and visual complexity of objects. The study provided architectural and artistic aspects of street sustainability, and limits of the appropriate scale and composition consistency under which the compatibility of alternative compositional forms existing at different times is possible.

  4. Cleaning up the Streets of Denver

    International Nuclear Information System (INIS)

    Stegen, R.L.; Wood, T.R.; Hackett, J.R.; Sogue, A.


    Between 1913 and 1924, several Denver area facilities extracted radium from carnotite ore mined from the Paradox basin region of Colorado. Tailings or abandoned ores from these facilities were apparently incorporated into asphalt used to pave approximately 7.2 kilometers (4.5 miles) of streets in Denver. A majority of the streets are located in residential areas. The radionuclides are bound within the asphalt matrix and pose minimal risk unless they are disturbed. The City and County of Denver (CCoD) is responsible for controlling repairs and maintenance on these impacted streets. Since 2002, the CCoD has embarked on a significant capital improvement project to remove the impacted asphalt for secure disposal followed by street reconstruction. To date, Parsons has removed approximately 55 percent of the impacted asphalt. This paper discusses the history of the Denver Radium Streets and summarizes on-going project efforts. (authors)

  5. Thermal Comfort Assessment in The Open Space in Bandung Case Study Dago Street and Riau Street (United States)

    Sugangga, M.; Janesonia, K. I.; Illiyin, D. F.; Donny Koerniawan, M.


    Bandung’s temperature has been higher since last years. This phenomenon affects the level of thermal comfort in open space. One indicator that determines the thermal comfort level is the type of activity performed by the open space user. Riau Street and Dago Street are corridors that are often used by the people for strolling, jogging, shopping. Dago Street has special event every Sunday namely car free day. Both corridors have different orientation; Dago Street is North to South corridor while Riau Street’s is West to East. The goal of the study is to compare people’s perception of thermal comfort in both corridors. This research uses two methods, namely qualitative method and quantitative method. Based on the results of qualitative analysis found that the thermal conditions in Dago Street more comfortable than the Riau Street. The result of quantitative analysis found that the average PET (thermal comfort indices) value of Dago Street was at 27.5 °C PET and Riau Street 28.6 °C PET. Dago Street is considered more convenient because it has a lower PET value than Riau Street. The people perception of thermal comfort is very important to start the steps for designing the orientation of street in urban design.

  6. Road and Street Centerlines, Street-The data set is a line feature consisting of 13948 line segments representing streets. It was created to maintain the location of city and county based streets., Published in 1989, Davis County Government. (United States)

    NSGIC Local Govt | GIS Inventory — Road and Street Centerlines dataset current as of 1989. Street-The data set is a line feature consisting of 13948 line segments representing streets. It was created...

  7. Diet and Sleep Physiology: Public Health and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Sarah Frank


    Full Text Available This mini-review examines the complex relationship between diet and sleep and explores the clinical and public health implications of the current evidence. Dietary quality and intake of specific nutrients can impact regulatory hormonal pathways to alter sleep quantity and quality. Sleep, in turn, affects the intake of total energy, as well as of specific foods and nutrients, through biological and behavioral mechanisms. Initial research in this field focused primarily on the effects of short sleep duration on nutritional quality. However, more recent studies have explored the dynamic relationship between long sleep duration and diet. Current evidence suggests that extremes of sleep duration alter sleep patterns, hormonal levels, and circadian rhythms, which contribute to weight-related outcomes and obesity, and other risk factors for the development of chronic disease such as type 2 diabetes and cardiovascular disease. These patterns may begin as early as childhood and have impacts throughout the life course. Given that non-communicable diseases are among the leading causes of death globally, deeper understanding of the interactions between sleep and nutrition has implications for both public health and clinical practice.

  8. Communication between hospitals and isolated aboriginal community health clinics. (United States)

    Mackenzie, G; Currie, B J


    This study described the communication dynamics, identified problems and recommended changes to improve patient follow-up and communication between Royal Darwin Hospital (RDH) and isolated Aboriginal community health clinics (CHC) in the Northern Territory (NT). In 1995, staff interviews were conducted and an audit of isolated Aboriginal patients' RDH discharge summaries (DS). Eighteen per cent of RDH DSs never arrived in CHCs. DSs were often prepared late and more likely to be in CHC records if written on time and if the referral source was specified. Interviews revealed discontent between CHCs and RDH regarding: communication, DS documentation, the supply of discharge medication, as well as different hospital and community perceptions of Aboriginies' reliability to carry a DS and CHC desire for patients to be given DSs at discharge. Aboriginal patients should be given a DS at discharge and resident medical officers should be educated as to the function and importance of the DS. In 18 months following this study, RDH appointed unit-based Aboriginal health workers and a policy was produced for written communication between hospital and CHCs, as well as a discharge planning manual for Aboriginal communities. Projects investigating communication between hospitals and isolated Aboriginal clinics and patient follow-up may result in significant policy changes concerning these processes.

  9. Structura, diversitatea și starea de sănătate a vegetației urbane în București: un studiu de caz bazat pe aliniamente [Structure, diversity and health status of urban vegetation in Bucharest: a case study based on street tree alignments

    Directory of Open Access Journals (Sweden)

    Badea C.A.


    Full Text Available Street tree alignments are among the most common green spaces within urban areas. The aim of this study was to assess the interspecific variability and the degree of defoliation of the trees within street alignments situated along four of the most common boulevards from Bucharest, namely Kiseleff, Ştefan cel Mare, Virtuţii and Timişoara. The total evaluated distance was 17.6 km. 1621 trees were sampled and more than 30 taxa were recorded. Autochthonous species were more numerous, compared with the allochthonous ones, but the non-indigenous trees were better represented, mainly due to the large number of London plane tree, northern red oak and horse-chestnut. The most common autochthonous species were smallleaved lime, silver linden and narrow-leafed ash. Half of the species were large, reaching heights up to 25 m or more. All four boulevards were dominated by three species. Almost 80% of the trees were in good health and only 7% were almost dead. Several tree features in accordance with the conditions for establishment of future street tree alignments were discussed

  10. Decision analytic model exploring the cost and cost-offset implications of street triage. (United States)

    Heslin, Margaret; Callaghan, Lynne; Packwood, Martin; Badu, Vincent; Byford, Sarah


    To determine if street triage is effective at reducing the total number of people with mental health needs detained under section 136, and is associated with cost savings compared to usual police response. Routine data from a 6-month period in the year before and after the implementation of a street triage scheme were used to explore detentions under section 136, and to populate a decision analytic model to explore the impact of street triage on the cost to the NHS and the criminal justice sector of supporting people with a mental health need. A predefined area of Sussex, South East England, UK. All people who were detained under section 136 within the predefined area or had contact with the street triage team. The street triage model used here was based on a psychiatric nurse attending incidents with a police constable. The primary outcome was change in the total number of detentions under section 136 between the before and after periods assessed. Secondary analysis focused on whether the additional costs of street triage were offset by cost savings as a result of changes in detentions under section 136. Detentions under section 136 in the street triage period were significantly lower than in the usual response period (118 vs 194 incidents, respectively; χ(2) (1df) 18.542, p<0.001). Total NHS and criminal justice costs were estimated to be £1043 in the street triage period compared to £1077 in the usual response period. Investment in street triage was offset by savings as a result of reduced detentions under section 136, particularly detentions in custody. Data available did not include assessment of patient outcomes, so a full economic evaluation was not possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION Street vended foods are a very common consumable commodity across age and income groups. It covers a wide range of a variety of food items to suit every need, and are hugely popular all over the country. They can, however, contain toxic heavy metals, like lead, which can pose serious health hazards, including neuropathy, cardiovascular, renal as well as bone diseases. Source of lead can be various artificial food colorants used to increase the palatability of such food, and also automobile emission exhaust smoke that pollutes the street atmosphere, the very place where such food is prepared or kept ready to consume. Contamination with heavy metals is a serious threat because of their toxicity, bioaccumulation and bio magnifications in the food chain. This source of lead toxicity, however, is one aspect of the health hazards that has not been widely explored. The aim of this study is to increase awareness among general population, both consumers and vendors, regarding a very common but often overlooked source of heavy metal contamination. METHODOLOGY Lead was measured by flame atomic absorption spectrophotometry after digestion of food with 98% Nitric acid. RESULTS This present study measures the level of lead in various commonly consumed street vended food items across the streets of Kolkata, India, and shows that the range of its level is much higher than the WHO recommended level of lead in food materials. The level also has close association with the food colorant used. In conclusion, the gross lack of awareness among the general population, both at the vendor and the consumer level, regarding this particular health hazard related to the food they consume on a regular basis, needs to be addressed as a serious issue, and personal safety measures should be undertaken.

  12. Clinical guideline implementation strategies for common mental health disorders. (United States)

    Moreno, Eliana María; Moriana, Juan Antonio


    There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide. A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope. A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%). Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments. Copyright © 2015. Published by Elsevier España.

  13. After the clinic? Researching sexual health technology in context. (United States)

    Davis, Mark


    There is great interest in what testing, pharmaceutical, information and social media technology can do for sexual health. Much programmatic and research activity is focused on assessing how these technologies can be used to best effect. Less obvious are analyses that place technology into historical, political and real-world settings. Developing an 'in-context' analysis of sexual health technology, this paper draws on interviews with leading community advocates, researchers and clinicians in Australia, Canada and the UK and looks across examples, including social media, rapid HIV testing, pre-Exposure Prophylaxis for HIV and polymerase chain reaction Chlamydia testing. The analysis is framed by studies of techno-society and the dialectics of sex-affirmative advocacy with biomedical authority and attends to: the rationalistic and affective dimensions of the imaginary associated with technology; the role of technology in the re-spatialisation and re-temporalisation of the sexual health clinic; and the re-invention of technology in its real-world contexts. This in-context approach is important for: the effective implementation of new technology; strengthening the social science contribution to the field; and enriching social theory in general on life in techno-societies.

  14. The Fountain of Health: Bringing Seniors’ Mental Health Promotion into Clinical Practice (United States)

    Thoo, Vanessa; Freer, Janya; Cassidy, Keri-Leigh


    Background The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors’ risks of mental disorders, including dementia. Methods A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors’ mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Results A total of 74 mental health clinicians received the FoH education session. There was a highly significant (p < .0001) difference in clinicians’ knowledge transfer questionnaire scores pre- and post-educational session. At a two-month follow-up, 19 (25.7%) participants completed a quality assurance questionnaire, with all 19 (100%) of respondents stating they would positively recommend the FoH information to colleagues and patients. Eleven (20.4%) translation-to-practice forms were also collected at this interval, tracking clinician use of the educational materials. Conclusions The use of a formalized network for knowledge transfer allows for education and evaluation of health-care practitioners in both acquisition of practical knowledge and subsequent clinical behavior change. PMID:26740830

  15. Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire

    Directory of Open Access Journals (Sweden)

    van den Berg JWK


    Full Text Available Abstract Background Patient-reported outcomes (PRO questionnaires are being increasingly used in COPD clinical studies. The challenge facing investigators is to determine what change is significant, ie what is the minimal clinically important difference (MCID. This study aimed to identify the MCID for the clinical COPD questionnaire (CCQ in terms of patient referencing, criterion referencing, and by the standard error of measurement (SEM. Methods Patients were ≥40 years of age, diagnosed with COPD, had a smoking history of >10 pack-years, and were participating in a randomized, controlled clinical trial comparing intravenous and oral prednisolone in patients admitted with an acute exacerbation of COPD. The CCQ was completed on Days 1–7 and 42. A Global Rating of Change (GRC assessment was taken to establish the MCID by patient referencing. For criterion referencing, health events during a period of 1 year after Day 42 were included in this analysis. Results 210 patients were recruited, 168 completed the CCQ questionnaire on Day42. The MCID of the CCQ total score, as indicated by patient referencing in terms of the GRC, was 0.44. The MCID of the CCQ in terms of criterion referencing for the major outcomes was 0.39, and calculation of the SEM resulted in a value of 0.21. Conclusion This investigation, which is the first to determine the MCID of a PRO questionnaire via more than one approach, indicates that the MCID of the CCQ total score is 0.4.

  16. Clinical reasoning and population health: decision making for an emerging paradigm of health care. (United States)

    Edwards, Ian; Richardson, Barbara


    Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

  17. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services. (United States)


    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic services... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

  18. Effectiveness of green infrastructure for improvement of air quality in urban street canyons. (United States)

    Pugh, Thomas A M; Mackenzie, A Robert; Whyatt, J Duncan; Hewitt, C Nicholas


    Street-level concentrations of nitrogen dioxide (NO(2)) and particulate matter (PM) exceed public health standards in many cities, causing increased mortality and morbidity. Concentrations can be reduced by controlling emissions, increasing dispersion, or increasing deposition rates, but little attention has been paid to the latter as a pollution control method. Both NO(2) and PM are deposited onto surfaces at rates that vary according to the nature of the surface; deposition rates to vegetation are much higher than those to hard, built surfaces. Previously, city-scale studies have suggested that deposition to vegetation can make a very modest improvement (street canyons. This study shows that increasing deposition by the planting of vegetation in street canyons can reduce street-level concentrations in those canyons by as much as 40% for NO(2) and 60% for PM. Substantial street-level air quality improvements can be gained through action at the scale of a single street canyon or across city-sized areas of canyons. Moreover, vegetation will continue to offer benefits in the reduction of pollution even if the traffic source is removed from city centers. Thus, judicious use of vegetation can create an efficient urban pollutant filter, yielding rapid and sustained improvements in street-level air quality in dense urban areas.

  19. Nutritional contribution of street foods to the diet of people in developing countries: a systematic review. (United States)

    Steyn, Nelia Patricia; McHiza, Zandile; Hill, Jillian; Davids, Yul Derek; Venter, Irma; Hinrichsen, Enid; Opperman, Maretha; Rumbelow, Julien; Jacobs, Peter


    To review studies examining the nutritional value of street foods and their contribution to the diet of consumers in developing countries. The electronic databases PubMed/MEDLINE, Web of Science, Cochrane Library, Proquest Health and Science Direct were searched for articles on street foods in developing countries that included findings on nutritional value. From a total of 639 articles, twenty-three studies were retained since they met the inclusion criteria. In summary, daily energy intake from street foods in adults ranged from 13 % to 50 % of energy and in children from 13 % to 40 % of energy. Although the amounts differed from place to place, even at the lowest values of the percentage of energy intake range, energy from street foods made a significant contribution to the diet. Furthermore, the majority of studies suggest that street foods contributed significantly to the daily intake of protein, often at 50 % of the RDA. The data on fat and carbohydrate intakes are of some concern because of the assumed high contribution of street foods to the total intakes of fat, trans-fat, salt and sugar in numerous studies and their possible role in the development of obesity and non-communicable diseases. Few studies have provided data on the intake of micronutrients, but these tended to be high for Fe and vitamin A while low for Ca and thiamin. Street foods make a significant contribution to energy and protein intakes of people in developing countries and their use should be encouraged if they are healthy traditional foods.

  20. Barriers to Providing Health Education During Primary Care Visits at Community Health Centers: Clinical Staff Insights. (United States)

    Alicea-Planas, Jessica; Pose, Alix; Smith, Linda


    The rapid increase of diverse patients living in the US has created a different set of needs in healthcare, with the persistence of health disparities continuing to challenge the current system. Chronic disease management has been discussed as a way to improve health outcomes, with quality patient education being a key component. Using a community based participatory research framework, this study utilized a web-based survey and explored clinical staff perceptions of barriers to providing patient education during primary care visits. With a response rate of nearly 42 %, appointment time allotment seemed to be one of the most critical factors related to the delivery of health education and should be considered key. The importance of team-based care and staff training were also significant. Various suggestions were made in order to improve the delivery of quality patient education at community health centers located in underserved areas.

  1. Evaluation of impacts of trees on PM2.5 dispersion in urban streets (United States)

    Jin, Sijia; Guo, Jiankang; Wheeler, Stephen; Kan, Liyan; Che, Shengquan


    Reducing airborne particulate matter (PM), especially PM2.5 (PM with aerodynamic diameters of 2.5 μm or less), in urban street canyons is critical to the health of central city population. Tree-planting in urban street canyons is a double-edged sword, providing landscape benefits while inevitably resulting in PM2.5 concentrating at street level, thus showing negative environmental effects. Thereby, it is necessary to quantify the impact of trees on PM2.5 dispersion and obtain the optimum structure of street trees for minimizing the PM2.5 concentration in street canyons. However, most of the previous findings in this field were derived from wind tunnel or numerical simulation rather than on-site measuring data. In this study, a seasonal investigation was performed in six typical street canyons in the residential area of central Shanghai, which has been suffering from haze pollution while having large numbers of green streets. We monitored and measured PM2.5 concentrations at five heights, structural parameters of street trees and weather. For tree-free street canyons, declining PM2.5 concentrations were found with increasing height. However, in presence of trees the reduction rate of PM2.5 concentrations was less pronounced, and for some cases, the concentrations even increased at the top of street canyons, indicating tree canopies are trapping PM2.5. To quantify the decrease of PM2.5 reduction rate, we developed the attenuation coefficient of PM2.5 (PMAC). The wind speed was significantly lower in street canyons with trees than in tree-free ones. A mixed-effects model indicated that canopy density (CD), leaf area index (LAI), rate of change of wind speed were the most significant predictors influencing PMAC. Further regression analysis showed that in order to balance both environmental and landscape benefits of green streets, the optimum range of CD and LAI was 50%-60% and 1.5-2.0 respectively. We concluded by suggesting an optimized tree-planting pattern and

  2. Street children and political violence: a socio-demographic analysis of street children in Rwanda. (United States)

    Veale, Angela; Donà, Giorgia


    The aims were: (1) to examine the profile of African street children and to assess the link between street children in Africa and political violence; (2) to undertake a systematic examination of causal factors of street children in postgenocide Rwanda; and (3) to situate this analysis in the context of the socio-cultural and political impact of the genocide on Rwandan communities. Observational mapping examined the profile and activities of Rwandan street children. Structured interviews were carried out with 290 children in four regional towns to obtain information on socio-demographic, familial, educational background, causal factors surrounding street life involvement, psychological well-being, and relationship to the street. Focus group discussions and key informant interviews examined the relationship between street children and the broader Rwandan society. Street children in Rwanda were predominantly adolescent boys, almost half of whom were homeless (42%), with a high proportion of orphaned children or children who had lost at least one parent. Two variables predicted homelessness: child's guardian and reason for being in street. Qualitative accounts of children conveyed the impact of death of family members, repatriation, imprisonment of parents, and poverty on their lives. The analysis highlighted the need for community based support for children in alternative guardianship care and for policies to support the reintegration of male youths in postconflict welfare strategies as prevention strategies for street migration.

  3. Safety Evaluation of Potential Toxic Metals Exposure from Street Foods Consumed in Mid-West Nigeria

    Directory of Open Access Journals (Sweden)

    O. C. Ekhator


    Full Text Available Objective. Street-vended foods offer numerous advantages to food security; nevertheless, the safety of street food should be considered. This study has investigated the level of potential toxic metal (Pb, Cd, Hg, Sb, Mn, and Al contamination among street-vended foods in Benin City and Umunede. Methods. Twenty street food samples were purchased from vendors at bus stops. Metals were analyzed with atomic absorption spectrophotometry. The methods developed by the US EPA were employed to evaluate the potential health risk of toxic metals. Results. The concentrations of the toxic metals in mg/kg were in the range of Pb (0.014–1.37, Cd (0.00–0.00017, Hg (0.00–0.00014, Sb (0.00–0.021, Mn (0.00–0.012, and Al (0.00–0.22. All the toxic metals except Pb were below permissible limit set by WHO, EU, and USEPA. The daily intake, hazard quotient, and hazard index of all toxic metals except for Pb in some street foods were below the tolerable daily intake and threshold value of 1, indicating an insignificant health risk. Total cancer risk was within the priority risk level of 1.0E-04 but higher than the acceptable risk level of 1E-06. Conclusion. Consumption of some of these street foods is of public health concern.

  4. Characterizing implicit mental health associations across clinical domains. (United States)

    Werntz, Alexandra J; Steinman, Shari A; Glenn, Jeffrey J; Nock, Matthew K; Teachman, Bethany A


    Implicit associations are relatively uncontrollable associations between concepts in memory. The current investigation focuses on implicit associations in four mental health domains (alcohol use, anxiety, depression, and eating disorders) and how these implicit associations: a) relate to explicit associations and b) self-reported clinical symptoms within the same domains, and c) vary based on demographic characteristics (age, gender, race, ethnicity, and education). Participants (volunteers over age 18 to a research website) completed implicit association (Implicit Association Tests), explicit association (self + psychopathology or attitudes toward food, using semantic differential items), and symptom measures at the Project Implicit Mental Health website tied to: alcohol use (N = 12,387), anxiety (N = 21,304), depression (N = 24,126), or eating disorders (N = 10,115). Within each domain, implicit associations showed small to moderate associations with explicit associations and symptoms, and predicted self-reported symptoms beyond explicit associations. In general, implicit association strength varied little by race and ethnicity, but showed small ties to age, gender, and education. This research was conducted on a public research and education website, where participants could take more than one of the studies. Among a large and diverse sample, implicit associations in the four domains are congruent with explicit associations and self-reported symptoms, and also add to our prediction of self-reported symptoms over and above explicit associations, pointing to the potential future clinical utility and validity of using implicit association measures with diverse populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. [Clinical governance and patient safety culture in clinical laboratories in the Spanish National Health System]. (United States)

    Giménez-Marín, Á; Rivas-Ruiz, F

    To conduct a situational analysis of patient safety culture in public laboratories in the Spanish National Health System and to determine the clinical governance variables that most strongly influence patient safety. A descriptive cross-sectional study was carried out, in which a Survey of Patient Safety in Clinical Laboratories was addressed to workers in 26 participating laboratories. In this survey, which consisted of 45 items grouped into 6 areas, scores were assigned on a scale from 0 to 100 (where 0 is the lowest perception of patient safety). Laboratory managers were asked specific questions about quality management systems and technology. The mean scores for the 26 participating hospitals were evaluated, and the following results observed: in 4of the 6areas, the mean score was higher than 70 points. In the third area (equipment and resources) and the fourth area (working conditions), the scores were lower than 60 points. Every hospital had a digital medical record system. This 100% level of provision was followed by that of an electronic request management system, which was implemented in 82.6% of the hospitals. The results obtained show that the culture of security is homogeneous and of high quality in health service laboratories, probably due to the steady improvement observed. However, in terms of clinical governance, there is still some way to go, as shown by the presence of weaknesses in crucial dimensions of safety culture, together with variable levels of implementation of fail-safe technologies and quality management systems. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Complementary therapy use by women's health clinic clients. (United States)

    Pettigrew, Amy C; King, Margaret O'Brien; McGee, Karen; Rudolph, Connie


    While it is known that more women than men use complementary and alternative therapies, it is important to look at women who are pregnant or possibly receiving hormonal therapy, as side effects and consequences of these therapies may have a significant effect on their health status. To assess women's knowledge, perceived effectiveness and use of 20 complementary and alternative therapies. Descriptive four-page questionnaire to obtain data on the use, reason for use, knowledge, perceived effectiveness, and sources of information of twenty complementary and alternative therapies. Women's Health Center at a large Midwestern hospital. A convenience sample of 250 women waiting to be seen by either a nurse midwife or obstetrician/gynecologist at an outpatient clinic. Sixty-nine percent of the participants used one or more complementary therapy. The most frequently used therapies included prayer, vitamins, massage, diet, and aromatherapy. The best predictor of use of each therapy was the participant's knowledge of the therapy. Participants generally rated the efficacy of the therapies higher than their knowledge level. Frequently cited sources of information were popular media and family. The least common information sources were nurse-midwives, drug stores, Internet, and other professional healthcare providers. Women in this setting use complementary therapies at a rate greater than the general population. The participants obtained a great deal of their information about the therapies from popular press, media, friends, and family members rather than from licensed healthcare providers.

  7. Evaluation of specialist referrals at a rural health care clinic. (United States)

    Biggerstaff, Mary Ellen; Short, Nancy


    Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

  8. Hygiene practices among street food vendors

    African Journals Online (AJOL)


    giene regulations to keep street food save for consumers. Journal of Medical ... UDS Publishers Limited All Right Reserved 2026-6294 ... authorities to enforce food safety regulations, unlike .... (50%) school food vendors sampled in Konongo.

  9. Capturing the benefits of complete streets. (United States)


    Anecdotal information indicates that private investment and property value increases are associated : with featured Complete Streets projects. However, to date, little research has been done to confirm : these benefits. Much of the relevant literatur...

  10. Pühendusega isadele - Baker Street

    Index Scriptorium Estoniae


    Üritusest 7. novembril Kuressaares Arensburg lounge-restoranis Muusa toimuvast isadepäevahõngulisest üritusest, esinevad Virgo Veldi & Band kavaga "Baker Street", erikülalisena Villu Veski. Saksofonistist Virgo Veldist

  11. Hiding in Plain Sight: Street artists online

    Directory of Open Access Journals (Sweden)

    Kim Barbour


    Full Text Available Identity and privacy concerns related to social media are the subject of widespread academic enquiry and mass media reporting. Although in most circumstances academic research tends to present identity play and online self­presentation as positive, media reporting in Australia makes much of the risks of identity theft, privacy breaches and online predators. This research explores the phenomenological experience of creating an online persona, focusing particularly on street artists. For street artists, the threat of unwanted exposure has to be balanced with the positive implications of sharing their creative work outside its geographical and temporal constraints. I argue that street artists use complex persona­creation strategies in order to both protect and promote themselves. The two street artists discussed in this article experience their engagement with social media and digital networks in ways that offer new insight into the opportunities and problems associated with the presentation of a persona online.

  12. Modelling Pollutant Dispersion in a Street Network (United States)

    Salem, N. Ben; Garbero, V.; Salizzoni, P.; Lamaison, G.; Soulhac, L.


    This study constitutes a further step in the analysis of the performances of a street network model to simulate atmospheric pollutant dispersion in urban areas. The model, named SIRANE, is based on the decomposition of the urban atmosphere into two sub-domains: the urban boundary layer, whose dynamics is assumed to be well established, and the urban canopy, represented as a series of interconnected boxes. Parametric laws govern the mass exchanges between the boxes under the assumption that the pollutant dispersion within the canopy can be fully simulated by modelling three main bulk transfer phenomena: channelling along street axes, transfers at street intersections, and vertical exchange between street canyons and the overlying atmosphere. Here, we aim to evaluate the reliability of the parametrizations adopted to simulate these phenomena, by focusing on their possible dependence on the external wind direction. To this end, we test the model against concentration measurements within an idealized urban district whose geometrical layout closely matches the street network represented in SIRANE. The analysis is performed for an urban array with a fixed geometry and a varying wind incidence angle. The results show that the model provides generally good results with the reference parametrizations adopted in SIRANE and that its performances are quite robust for a wide range of the model parameters. This proves the reliability of the street network approach in simulating pollutant dispersion in densely built city districts. The results also show that the model performances may be improved by considering a dependence of the wind fluctuations at street intersections and of the vertical exchange velocity on the direction of the incident wind. This opens the way for further investigations to clarify the dependence of these parameters on wind direction and street aspect ratios.

  13. Street-Level Bureaucrats as Individual Policymakers:

    DEFF Research Database (Denmark)

    Baviskar, Siddhartha; Winter, Søren


    Lipsky (1980) pointed out that street-level bureaucrats (SLBs) are important policymakers due to the discretion they exercise and argued from a structural perspective that these workers manifest relatively similar coping behaviors owing to their shared working conditions, characterized by chronic......Lipsky (1980) pointed out that street-level bureaucrats (SLBs) are important policymakers due to the discretion they exercise and argued from a structural perspective that these workers manifest relatively similar coping behaviors owing to their shared working conditions, characterized...

  14. Solar charge controller in solar street light


    Dong, Haibo


    Recently, with the rapid development of scientific technology, the conventional energy cannot meet the requirement of human beings. People are looking for the utilization of renew energy. Solar en-ergy as a new clean energy has attract the eyes of people. The applications of solar energy are popular to human society. Solar street light is a good example. This thesis will focus on a deeper research of the popular and ubiquitous solar street light in China. However, solar charge controll...

  15. OpenStreetMap over WMS

    Directory of Open Access Journals (Sweden)

    Přemysl Vohnout


    Full Text Available This paper discuss the issues which we faced, while preparing WMS server with OpenStreetMap data of whole Europe. This article is divided into three sections. First is about mandatory applications which are required for working WMS service with OpenStreetMap data. Second is focused on tuning up PostgreSQL. Third is focused on rendering time improvement of layers.


    CERN Multimedia

    ST-FM Group


    The ST Division informs you that the control and maintenance of the carpark and street lighting will be carried out during the next few weeks. These lightings work normally by photocells but during these tests they will be turned on zone by zone during the day. So we ask the users not to be surprised to see the street lighting on during the day and thank them for their comprehension. ST-FM Group

  17. Acceptability of health information technology aimed at environmental health education in a prenatal clinic. (United States)

    Rosas, Lisa G; Trujillo, Celina; Camacho, Jose; Madrigal, Daniel; Bradman, Asa; Eskenazi, Brenda


    To describe the acceptability of an interactive computer kiosk that provides environmental health education to low-income Latina prenatal patients. A mixed-methods approach was used to assess the acceptability of the Prenatal Environmental Health Kiosk pregnant Latina women in Salinas, CA (n=152). The kiosk is a low literacy, interactive touch-screen computer program with an audio component and includes graphics and an interactive game. The majority had never used a kiosk before. Over 90% of women reported that they learned something new while using the kiosk. Prior to using the kiosk, 22% of women reported their preference of receiving health education from a kiosk over a pamphlet or video compared with 57% after using the kiosk (peducation; and (3) popularity of the interactive game. The Prenatal Environmental Health Kiosk is an innovative patient health education modality that was shown to be acceptable among a population of low-income Latino pregnant women in a prenatal care clinic. This pilot study demonstrated that a health education kiosk was an acceptable strategy for providing Latina prenatal patients with information on pertinent environmental exposures. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Disease pattern and social needs of street people in the race course area of Kano, Nigeria. (United States)

    Abdu, Lawan; Withers, James; Habib, Abdulrazaq G; Mijinyawa, Muhammad S; Yusef, Shehu M


    The study is aimed at examining street people on Race Course Street in Kano, Nigeria for prevalence of common diseases. Descriptive report. Institutional ethical approval was obtained. Information was obtained on age, sex, place of residence, drug habits, source of drinking water, toilet facility used, visual acuity, blood pressure, random blood sugar level, presence of skin diseases and physical disability. Sixty five subjects were examined and 7 declined. There were 16 males and 49 females (M:F=1:3). The mean age was 48 + 9.2 years. They were mainly widows, some live in the street and have no access to basic amenities and six use non-narcotic medicinal substances. Diseases observed are hypertension, visual problems, and trauma. Religious factors, socio-cultural factors, and lack of government policy leads to poor access to health care for street people.

  19. Street connectivity and obesity in Glasgow, Scotland: impact of age, sex and socioeconomic position. (United States)

    Ball, Kylie; Lamb, Karen; Travaglini, Noemi; Ellaway, Anne


    This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for individual level covariates, street connectivity was not significantly associated with either BMI or BMI category; nor were there any significant interactions between age, sex or socioeconomic position and street connectivity. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. [Sharing and distrusting: street merchants' view of children in street situations]. (United States)

    Sánchez-Suárez, Diana M; Giraldo-Puerta, Alexandra; Giraldo-Pineda, Álvaro; Forero-Pulido, Constanza


    Objective To understand the meanings, through the description of experiences that street merchants have of their interactions with children in a street situation in downtown of Medellin in 2013. Methodology Qualitative investigation with ethnographic approach. Observations were made in the zone at different times of the day. Twelve interviews with street merchants were held in their work places. Records were kept in a field journal. Results The street merchants and children in street situations share the same space. Both groups try to survive and their relationship is mediated by the trust-distrust that is established between them. The coexistence generates ambivalent feelings. For the street merchants, children in street situations are the result of abandonment by the family, the state and society. They live in a hard world in which they are exposed to a series of risks that they must face. Conclusion The interaction between street merchants and children in street situations is good to the extent that conflicts are avoided, establishing norms of coexistence. The element that determines this relationship is trust-distrust. In trust, strong affective ties are generated, considering each other family. Distrust generates a preventative attitude.

  1. Universal design characteristic on themed streets (United States)

    Harsritanto, Bangun IR; Indriastjario; Wijayanti


    People around the world can access the streets to fulfil their daily activities regardless of their gender, age, and abilities. The streetscape is an urban public space which is built to facilitate the basic needs of people as social being. The themed street is an urban streetscape designed and built in detail with a theme or special purpose in an of urban development process. Universal design facilitates the full range of human diversity as physical appearance, perception, cognitive abilities, sizes, and shapes. By designing for the diversity, the specialized streets become more functional and user-friendly. The purpose of this study is to examine several design characteristics of themed streets in several countries from three different continents using universal design principles for giving proper directions to develop more user-friendly streets. Literature review and case study were used as research methods. The literature review was extracted and compiled from manuscripts, streetscape design books, and from universal design principles. Furthermore, the constructed theory were used to examine the case studies of themed streets. The findings indicated that themed streets’ character design were strongly influenced by local cultural aspect even though the basic guidelines were universal design principles; the resumed design direction can be suggested universal along with the richness of local aspects.

  2. Identification of specific microorganisms in fresh squeezed street vended fruit juices

    Directory of Open Access Journals (Sweden)

    K Sahithi Reddy


    Full Text Available Introduction: In developing country like India, street foods such as salads and fresh cut fruits are widely consumed. Among all street foods, fruit juices are common beverages, consumed more because of higher consumer preference both in terms of taste and health. Moreover, there is a dearth of Indian studies on contamination of street vended fruit juices. Aim: To determine the pH and specific microorganisms in freshly squeezed street vended fruit juices. Materials and Methods: Four fruit juices i.e., Grapes, Sweet Lime, Pineapple and Sapota were chosen for the study. Juices were collected in summer season in months between April and June 2013. Ten samples of 50 ml each fruit juice was collected in sterile bottles from various street vendors of Dilshuknagar area of Hyderabad city. Transportation of samples to Food Toxicology laboratory, National Institute of Nutrition was done in the ice box and processing was done within 2–4 h. Results: All juices showed bacterial contamination except one sample of grape juice. Pineapple juice samples showed the high bacterial contamination with all samples positive for fecal coliforms and Shigella spp. (100%. Salmonella spp. was detected only in one sample of Sapota juice (10%. Significant difference among fruit juices for prevalence of microorganisms was seen only for Escherichia coli (P = 0.03 with least count in Grape juice (20%. Conclusion: Freshly squeezed street vended fruit juices were contaminated with pathogenic bacteria, which significantly attributed to public health problem.

  3. Designing safe and inclusive streets in India | CRDI - Centre de ...

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

    17 nov. 2016 ... Safe streets play a crucial role in enabling livelihoods, mobility, and access to services. In fast-growing Indian cities such as Ahmedabad, streets are also the site of conflict. With incomes and vehicle ownership on the rise, traffic has replaced people as the central point of street design. Vehicle-focused street ...

  4. The Emerging Business Models and Value Proposition of Mobile Health Clinics. (United States)

    Aung, Khin-Kyemon; Hill, Caterina; Bennet, Jennifer; Song, Zirui; Oriol, Nancy E


    Mobile health clinics are increasingly used to deliver healthcare to urban and rural populations. An estimated 2000 vehicles in the United States are now delivering between 5 and 6 million visits annually; however, despite this growth, mobile health clinics represent an underutilized resource that could transform the way healthcare is delivered, especially in underserved areas. Preliminary research has shown that mobile health clinics have the potential to reduce costs and improve health outcomes. Their value lies primarily in their mobility, their ability to be flexibly deployed and customized to fit the evolving needs of populations and health systems, and their ability to link clinical and community settings. Few studies have identified how mobile health clinics can be sustainably utilized. We discuss the value proposition of mobile health clinics and propose 3 potential business models for them-adoption by accountable care organizations, payers, and employers.

  5. Demographic and Mental Health Characteristics of Individuals Who Present to Community Health Clinics With Substance Misuse

    Directory of Open Access Journals (Sweden)

    Praise O. Iyiewuare


    Full Text Available Introduction: Community health clinics (CHCs are an opportune setting to identify and treat substance misuse. This study assessed the characteristics of patients who presented to a CHC with substance misuse. Methods: Personnel at a large CHC administered a 5-question screener to patients between June 3, 2014, and January 15, 2016, to assess past 3-month alcohol use, prescription opioid misuse, or illicit drug use. We stratified screen-positive patients into 4 diagnostic groups: (1 probable alcohol use disorder (AUD and no comorbid opioid use disorder (OUD; (2 probable heroin use disorder; (3 probable prescription OUD, with or without comorbid AUD; and (4 no probable substance use disorder. We describe substance use and mental health characteristics of screen-positive patients and compare the characteristics of patients in the diagnostic groups. Results: Compared to the clinic population, screen-positive patients (N = 733 included more males ( P < .0001 and had a higher prevalence of probable bipolar disorder ( P < .0001 and schizophrenia ( P < .0001. Eighty-seven percent of screen-positive patients had probable AUD or OUD; only 7% were currently receiving substance use treatment. The prescription opioid and heroin groups had higher rates of past bipolar disorder and consequences of mental health conditions than the alcohol only or no diagnosis groups ( P < .0001. Conclusions: Patients presenting to CHCs who screen positive for alcohol or opioid misuse have a high likelihood of having an AUD or OUD, with or without a comorbid serious mental illness. Community health clinics offering substance use treatment may be an important resource for addressing unmet need for substance use treatment and comorbid mental illness.

  6. StreetMekka - Ledelse af Københavns nye streetkulturhus


    Gjelstrup, Mikkel


    Street culture is spreading out through the streets of Denmark and in the summer of 2009 the City of Copenhagen will open up an indoor street culture facility called StreetMekka. Moving street culture from its natural concrete habitat to a communal facility presents challenges. The City of Copenhagen has made official guideline for the StreetMekka facility to follow, but the free and self organized street culture is not an easy thing to keep within guidelines. This master thesis discusses fro...

  7. Public Reactions to New Street Tree Planting

    Directory of Open Access Journals (Sweden)

    Ruth A. Rae


    Full Text Available MillionTreesNYC, which has the goal of planting one million trees in New York City by 2017, is intended to make New York City a greener, more sustainable city and is part of the Mayor’s comprehensive long term strategic plan, PlaNYC. Through planting a tree at every suitable sidewalk location in the city, the City of New York is transforming blocks and communities, and providing a variety of environmental, social and aesthetic benefits. This article examines the large scale municipal planting of new street trees and the reaction by some of the pubic to this planting.Trees offer benefits to the city overall, but the public may not understand these benefits or the street tree planting process. Between 2007 and 2009, the Department of Parks & Recreation planted 53,235 new street trees, and received 4,108 items of correspondence from the public. The majority of this correspondence consisted of public comments about the City’s new street tree planting policies and processes including placement objections, maintenance concerns, reports of resultant damage from tree planting operations, requests for new street trees and reports of tree conditions.This study describes the operational policies that guide New York City's municipal street tree planting, and results of content and spatial analysis of the correspondence. Qualitative analysis of the correspondence revealed the public perceptions and concerns related to the MillionTreesNYC program. Spatial analysis explored the relationship between the planting locations of new street trees and the locations of the citizen correspondence.Public reactions to this large scale municipal planting are related to the dual public and private nature of the sidewalk, issues of territoriality, responsibility, aesthetics and place attachment. Correspondence volume was associated with the scale of the new street tree block planting program, and the effectiveness of NYC’s 311 Customer Service Center. The discussion

  8. A Return to "The Clinic" for Community Psychology: Lessons from a Clinical Ethnography in Urban American Indian Behavioral Health. (United States)

    Hartmann, William E; St Arnault, Denise M; Gone, Joseph P


    Community psychology (CP) abandoned the clinic and disengaged from movements for community mental health (CMH) to escape clinical convention and pursue growing aspirations as an independent field of context-oriented, community-engaged, and values-driven research and action. In doing so, however, CP positioned itself on the sidelines of influential contemporary movements that promote potentially harmful, reductionist biomedical narratives in mental health. We advocate for a return to the clinic-the seat of institutional power in mental health-using critical clinic-based inquiry to open sites for clinical-community dialogue that can instigate transformative change locally and nationally. To inform such works within the collaborative and emancipatory traditions of CP, we detail a recently completed clinical ethnography and offer "lessons learned" regarding challenges likely to re-emerge in similar efforts. Conducted with an urban American Indian community behavioral health clinic, this ethnography examined how culture and culture concepts (e.g., cultural competence) shaped clinical practice with socio-political implications for American Indian peoples and the pursuit of transformative change in CMH. Lessons learned identify exceptional clinicians versed in ecological thinking and contextualist discourses of human suffering as ideal partners for this work; encourage intense contextualization and constraining critique to areas of mutual interest; and support relational approaches to clinic collaborations. © Society for Community Research and Action 2017.

  9. Pharmacists' Perception of the Sale of Non-Clinically Proven Health ...

    African Journals Online (AJOL)

    Pharmacists' Perception of the Sale of Non-Clinically Proven Health Supplements in Penang, Malaysia. ... A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists ... Keywords: Perception, Health promotion, Urban poor, Health supplements.

  10. Burnout in Veterans Health Administration Mental Health Providers in Posttraumatic Stress Clinics (United States)

    Garcia, Hector A.; McGeary, Cindy A.; McGeary, Donald D.; Finley, Erin P.; Peterson, Alan L.


    The purpose of this study was to conduct the first assessment of burnout among Veterans Health Administration (VHA) mental health clinicians providing evidence-based posttraumatic stress disorder (PTSD) care. This study consisted of 138 participants and the sample was mostly female (67%), Caucasian (non-Hispanic; 81%), and married (70%) with a mean age of 44.3 years (SD = 11.2). Recruitment was directed through VHA PTSD Clinical Teams (PCT) throughout the United States based on a nationwide mailing list of PCT Clinic Directors. Participants completed an electronic survey that assessed demographics, organizational work factors, absenteeism, and burnout (assessed through the Maslach Burnout Inventory-General Survey, MBI-GS). Twelve percent of the sample reported low Professional Efficacy, 50% reported high levels of Exhaustion, and 47% reported high levels of Cynicism as determined by the MBI-GS cut-off scores. Only workplace characteristics were significantly associated with provider scores on all 3 scales. Exhaustion and Cynicism were most impacted by perceptions of organizational politics/bureaucracy, increased clinical workload and control over how work is done. Organizational factors were also significantly associated with provider absenteeism and intent to leave his/her job. Findings suggest that providers in VHA specialty PTSD care settings may benefit from programs or supports aimed at preventing and/or ameliorating burnout. PMID:24564443

  11. A Study on Evaluation for Street Space using AHP Method


    小塚, みすず; 許, 彦; 川本, 義海; 本多, 義明


    Street space is an important public area which forms the framework of city space. In addition, from the view of the traffic functions, street space also plays a role to support people's activities performed in city. This paper examines the evaluations of street space among the cities of Fukui (Japan), Toyota (Japan) and Suzhou (China). Therefore, a questionnaire has been carried out and actual conditions of street space are grasped. In addition street functions were evaluated with the AHP met...

  12. IBM’s Health Analytics and Clinical Decision Support (United States)

    Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.


    Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

  13. National Service Frameworks and UK general practitioners: street-level bureaucrats at work? (United States)

    Checkland, Kath


    This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

  14. Clinical Simulation and Workflow by use of two Clinical Information Systems, the Electronic Health Record and Digital Dictation

    DEFF Research Database (Denmark)

    Schou Jensen, Iben; Koldby, Sven


    digital dictation and the EHR (electronic health record) were simulated in realistic and controlled clinical environments. Useful information dealing with workflow and patient safety were obtained. The clinical simulation demonstrated that the EHR locks during use of the integration of digital dictation......Clinical information systems do not always support clinician workflows. An increasing number of unintended clinical inci-dents might be related to implementation of clinical infor-mation systems and to a new registration praxis of unin-tended clinical incidents. Evidence of performing clinical...... simulations before implementation of new clinical information systems provides the basis for use of this method. The intention has been to evaluate patient safety issues, functionality, workflow, and usefulness of a new solution before implementation in the hospitals. Use of a solution which integrates...

  15. Service quality in public health clinics: perceptions of users and health professionals. (United States)

    Campos, Domingos Fernandes; Negromonte Filho, Rinaldo Bezerra; Castro, Felipe Nalon


    Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers - doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student's test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the

  16. Road and Street Centerlines - COUNTY_STREET_CENTERLINES_IDHS_IN: Street Centerlines Maintained by County Agencies in Indiana (Indiana Department of Homeland Security, Line Shapefile) (United States)

    NSGIC State | GIS Inventory — COUNTY_STREET_CENTERLINES_IDHS_IN is a line feature class that contains street centerlines maintained by county agencies in Indiana, provided by personnel of Indiana...

  17. Effect of immersive workplace experience on undergraduate nurses' mental health clinical confidence. (United States)

    Patterson, Christopher; Moxham, Lorna; Taylor, Ellie K; Perlman, Dana; Brighton, Renee; Sumskis, Susan; Heffernan, Tim; Lee-Bates, Benjamin


    Preregistration education needs to ensure that student nurses are properly trained with the required skills and knowledge, and have the confidence to work with people who have a mental illness. With increased attention on non-traditional mental health clinical placements, further research is required to determine the effects of non-traditional mental health clinical placements on mental health clinical confidence. The aim of the present study was to investigate the impact of a non-traditional mental health clinical placement on mental health nursing clinical confidence compared to nursing students undergoing traditional clinical placements. Using the Mental Health Nursing Clinical Confidence Scale, the study investigated the relative effects of two placement programmes on the mental health clinical confidence of 79 nursing students. The two placement programmes included a non-traditional clinical placement of Recovery Camp and a comparison group that attended traditional clinical placements. Overall, the results indicated that, for both groups, mental health placement had a significant effect on improving mean mental health clinical confidence, both immediately upon conclusion of placement and at the 3-month follow up. Students who attended Recovery Camp reported a significant positive difference, compared to the comparison group, for ratings related to communicating effectively with clients with a mental illness, having a basic knowledge of antipsychotic medications and their side-effects, and providing client education regarding the effects and side-effects of medications. The findings suggest that a unique clinical placement, such as Recovery Camp, can improve and maintain facets of mental health clinical confidence for students of nursing. © 2017 Australian College of Mental Health Nurses Inc.

  18. The social world of street children : street children's peer friendship, group life and subculture in Addis Ababa, Ethiopia


    Fikre, Kaleab


    This study attempts to explore the street children’s social world, focusing on their peer friendship, group life, and street subculture in Addis Ababa, Ethiopia. The study shows how street children’s peer friendship, street group, and subculture are part and parcel of children’s quest for survival in the street in the absence of guardians conventionally considered as responsible for the provision and protection of children. The main perspective of the study is grounded in the p...

  19. Street Children as M arginal People: The Relationship between Life History and Social Networks on the Street


    SUCHARITKUL, Juthathip


    This paper assumes that street children are victims of socioeconomic development policy. As a consequence of the street life experience, children are labeled as street children by society and their way of their life is different from ordinary children, thus pushing them to become marginalized people. The purpose of this paper is to examine the Street Children phenomenon, and especially to study the relationship between their life history and personal networks on the street. The focus is to...

  20. Travel characteristics and health practices among travellers at the travellers' health and vaccination clinic in Singapore. (United States)

    Lee, Vernon J; Wilder-Smith, Annelies


    Singapore has a fast-growing travel industry, but few studies have been done on travel characteristics and travel health practices. This study describes the profile and healthseeking behaviour of travellers attending a travel health clinic in Singapore. A cross-sectional survey was conducted on travellers attending the Traveller's Health and Vaccination Centre (THVC) between September and November 2002 using a standardised questionnaire. Information obtained included individual demographic and medical information, travel patterns, vaccination status and travel health practices. Four hundred and ninetyfive (74%) eligible travellers seen at THVC responded to the questionnaire. Their mean age was 36 years; 77% were professionals, managers, executives, and businessmen, students, and white collar workers. Asia was the main travel destination, and most travelled for leisure and resided in hotels or hostels. The median duration of travel was 16 days. Although >90% had previously travelled overseas, only 20% had previously sought pre-travel advice. Malays were significantly underrepresented (P travel advice compared with Chinese, Indians and Malays. Factors associated with seeking pre-travel advice included travel outside of Asia, especially Africa and South America. Singaporean travellers travel more often to cities rather than rural areas, compared with non-Asian travellers. Asia is the preferred destination, and travel outside of Asia is perceived as more risky and is associated with seeking pre-travel advice and vaccinations. Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia.

  1. Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition on self-reported health status (United States)

    Public health researchers ideally integrate social, environmental, and clinical measures to identify predictors of poor health. Chemicals measured in human tissues are often evaluated in relation to intangible or rare health outcomes, or are studied one chemical at a time. Using ...

  2. Generative Street Addresses from Satellite Imagery

    Directory of Open Access Journals (Sweden)

    İlke Demir


    Full Text Available We describe our automatic generative algorithm to create street addresses from satellite images by learning and labeling roads, regions, and address cells. Currently, 75% of the world’s roads lack adequate street addressing systems. Recent geocoding initiatives tend to convert pure latitude and longitude information into a memorable form for unknown areas. However, settlements are identified by streets, and such addressing schemes are not coherent with the road topology. Instead, we propose a generative address design that maps the globe in accordance with streets. Our algorithm starts with extracting roads from satellite imagery by utilizing deep learning. Then, it uniquely labels the regions, roads, and structures using some graph- and proximity-based algorithms. We also extend our addressing scheme to (i cover inaccessible areas following similar design principles; (ii be inclusive and flexible for changes on the ground; and (iii lead as a pioneer for a unified street-based global geodatabase. We present our results on an example of a developed city and multiple undeveloped cities. We also compare productivity on the basis of current ad hoc and new complete addresses. We conclude by contrasting our generative addresses to current industrial and open solutions.

  3. Keeping Up Appearances: Perceptions of Street Food Safety in Urban Kumasi, Ghana (United States)

    Olsen, Mette; Bakang, John Abubakar; Takyi, Harriet; Konradsen, Flemming; Samuelsen, Helle


    The growing street food sector in low-income countries offers easy access to inexpensive food as well as new job opportunities for urban residents. While this development is positive in many ways, it also presents new public health challenges for the urban population. Safe food hygiene is difficult to practice at street level, and outbreaks of diarrheal diseases have been linked to street food. This study investigates local perceptions of food safety among street food vendors and their consumers in Kumasi, Ghana in order to identify the most important aspects to be included in future public health interventions concerning street food safety. This qualitative study includes data from a triangulation of various qualitative methods. Observations at several markets and street food vending sites in Kumasi were performed. Fourteen street food vendors were chosen for in-depth studies, and extensive participant observations and several interviews were carried out with case vendors. In addition, street interviews and Focus Group Discussions were carried out with street food customers. The study found that although vendors and consumers demonstrated basic knowledge of food safety, the criteria did not emphasize basic hygiene practices such as hand washing, cleaning of utensils, washing of raw vegetables, and quality of ingredients. Instead, four main food selection criteria could be identified and were related to (1) aesthetic appearance of food and food stand, (2) appearance of the food vendor, (3) interpersonal trust in the vendor, and (4) consumers often chose to prioritize price and accessibility of food—not putting much stress on food safety. Hence, consumers relied on risk avoidance strategies by assessing neatness, appearance, and trustworthiness of vendor. Vendors were also found to emphasize appearance while vending and to ignore core food safety practices while preparing food. These findings are discussed in this paper using social and anthropological theoretical

  4. Assessment of ambient noise levels in the urban residential streets of Eastern Alexandria, Egypt. (United States)

    Zaki, Gehan R


    Street of Alexandria have numerous unplanned, mixed, and noisy activities that may interfere with public health and comfort. The aim of this study was to assess A-weighted ambient noise levels in urban residential streets of Eastern Alexandria, Egypt, from September 2010 to January 2011, with the objective of recommending corrective actions to minimize high noise levels. A descriptive cross-sectional study was carried out, in which A-weighted ambient noise levels were measured on the basis of 24-h periods, using Ono sokki la-5120--precision integrating sound level meter, from September 2010 to January 2011. The measurements were taken on three streets, which were selected using stratified random sampling. Seven measurement sites, along the three streets under study, were selected by site visits according to predetermined criteria. A-weighted ambient noise levels (LAeq) were the highest [70.7 (24.2) dB] on high-traffic-density and high-human-activity streets followed by streets with moderate and low traffic density and human activity [67.5 (31.3) and 62.8 (38.2) dB], respectively. It varied significantly depending on means of transportation (road traffic, train, and/or tram) and human activities (parking lots, shops, and/or street merchants). The A-weighted ambient noise levels on urban residential streets of Eastern Alexandria, Egypt, exceeded the Egyptian National Standards during the three periods of the day (daytime, evening, and night), except in some relatively quiet locations during the night. Consequently, remedial actions to reduce noise levels were recommended.

  5. Health providers' perceptions of clinical trials : lessons from Ghana, Kenya and Burkina Faso

    NARCIS (Netherlands)

    Angwenyi, Vibian; Asante, Kwaku-Poku; Traoré, Abdoulaye; Febir, Lawrence Gyabaa; Tawiah, Charlotte; Kwarteng, Anthony; Ouédraogo, Alphonse; Sirima, Sodiomon Bienvenue; Owusu-Agyei, Seth; Imoukhuede, Egeruan Babatunde; Webster, Jayne; Chandramohan, Daniel; Molyneux, Sassy; Jones, Caroline


    BACKGROUND: Clinical trials conducted in Africa often require substantial investments to support trial centres and public health facilities. Trial resources could potentially generate benefits for routine health service delivery but may have unintended consequences. Strengthening ethical practice

  6. Evaluating Faculty Clinical Excellence in the Academic Health Sciences Center. (United States)

    Carey, Robert M.; And Others


    Evaluation of the clinical competence of medical faculty in teaching hospitals is discussed. Different approaches to clinical assessment and theoretical and practical problems in assessing clinical faculty's performance are discussed. A University of Virginia medical school system for evaluation that combines objective and subjective assessment is…

  7. mHealth for Clinical Decision-Making in Sub-Saharan Africa : A Scoping Review

    NARCIS (Netherlands)

    Adepoju, Ibukun-Oluwa Omolade; Albersen, Bregje Joanna Antonia; De Brouwere, Vincent; van Roosmalen, Jos; Zweekhorst, M.B.M.


    BACKGROUND: In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for

  8. [Health care activity in a headache-specific clinic]. (United States)

    Garcia-Escrivà, A; Asensio-Asensio, M; López-Hernández, N; González-Aznar, O J; Oliver-Navarrete, C; Alvarez-Saúco, M; Pampliega-Pérez, A

    It is reckoned that headaches affect, at least once a year, around 90% of the population. The socioeconomic repercussion occasioned by this malady justifies the appearance in recent years of headache units. To conduct a descriptive epidemiological and health care study of the activity carried out in a headache-specific clinic. All the relevant points from the histories of patients who visited our surgery over a period of two years were collected prospectively and consecutively. The different types of headaches were classified according to the 1988 IHS criteria. Both the symptomatic and the preventive treatment were analysed. In all, a total of 866 patients were found; 691 (79.8%) were females and the mean age was 39.8 +/- 15.9 years (range: 6-90 years); 208 (24%) had a history of migraine in the family; 399 (49.9%) were diagnosed as suffering from migraine: 256 (64.2%) had migraine without aura, 152 (19%) were diagnosed as having tension-type headache, and 218 (27.3%) presented chronic daily headache (CDH). The most frequently used symptomatic treatments were NSAI drugs (36.7%) and triptanes (28.4%). Amitriptyline (47.7%), beta-blockers (14.5%) and calcium antagonists (11.3%) were the main drugs used as preventive treatment. After several years' operation of our Headache Unit, we thought there was a need to analyse the population seen in the visits. The fact that the majority of our patients were middle-aged females matched our expectations. Although most of the patients were diagnosed as suffering from M, we also want to highlight the high proportion of cases of CDH, above all associated with the abuse of analgesics.

  9. Notes on LED Installations in Street Illumination

    Directory of Open Access Journals (Sweden)

    Elisabeta Spunei


    Full Text Available The paper presents a study made on choosing LED street lighting installations, such that the quality requirements for exterior artificial lighting are fulfilled. We analyze two types of LED street lighting installations from a technical point of view, together with lighting level and brightness values obtained during the measurements. Following on the field measurements, the lighting quality parameters are calculated, and, for the lighting installation with the best performance, optimal mounting suggestions are made. The optimal quality parameters are calculated by simulations using the Dialux software. The same software and the same light sources we also compute an optimal street lighting by determining the size of the installation that provides the best lighting parameter values.

  10. Lead in Glasgow street dirt and soil

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J G [Univ. of Glasgow; Lyon, T D.B.


    The levels of lead in city street dirt and in soil from various locations in Glasgow were investigated during spring 1976. Lead concentrations in street dirt ranged from 150 to 2300 ppM, mean 960 ppM, and were significantly elevated with respect to the observed ''natural'' level of 78 ppM. Lead derived from anti-knock compounds in petrol and introduced to the environment via automobile exhausts was clearly implicated as the main source of lead pollution in a series of soil lead measurements at the centre and periphery of eight Glasgow parks. Various chemical leaching techniques were employed and compared. Less than 5 percent of street dirt and soil lead was found to be associated with the organic phase.

  11. Street Cries and the urban refrain

    DEFF Research Database (Denmark)

    Kreutzfeldt, Jacob


    Rasmussen have investigated Danish street cries as respectably a musical and a spatial phenomenon. Such studies – from each their perspectives – can be said to explore the aesthetics of urban environments, since street calls are specifically developed and heard in the context of the city. Investigating...... the different methods employed in the two studies and presenting Deleuze and Guattaris theory about the refrain as a framework for further studies in the field, this article seeks to outline a fertile area of study for sound studies: the investigation of everyday refrains and the environmental relations...

  12. Enabling professional development in mental health nursing: the role of clinical leadership. (United States)

    Ennis, G; Happell, B; Reid-Searl, K


    Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

  13. Citygml and the Streets of New York - a Proposal for Detailed Street Space Modelling (United States)

    Beil, C.; Kolbe, T. H.


    Three-dimensional semantic city models are increasingly used for the analysis of large urban areas. Until now the focus has mostly been on buildings. Nonetheless many applications could also benefit from detailed models of public street space for further analysis. However, there are only few guidelines for representing roads within city models. Therefore, related standards dealing with street modelling are examined and discussed. Nearly all street representations are based on linear abstractions. However, there are many use cases that require or would benefit from the detailed geometrical and semantic representation of street space. A variety of potential applications for detailed street space models are presented. Subsequently, based on related standards as well as on user requirements, a concept for a CityGML-compliant representation of street space in multiple levels of detail is developed. In the course of this process, the CityGML Transportation model of the currently valid OGC standard CityGML2.0 is examined to discover possibilities for further developments. Moreover, a number of improvements are presented. Finally, based on open data sources, the proposed concept is implemented within a semantic 3D city model of New York City generating a detailed 3D street space model for the entire city. As a result, 11 thematic classes, such as roadbeds, sidewalks or traffic islands are generated and enriched with a large number of thematic attributes.

  14. The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model. (United States)

    Maddineshat, Maryam; Hashemi, Mitra; Besharati, Reza; Gholami, Sepideh; Ghavidel, Fatemeh


    Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick's model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. The students have evaluated clinical supervision as a useful approach, and appreciated the instructor's supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick's model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students' attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. The results of clinical mental health teaching through clinical supervision and Kirkpatrick's model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To

  15. Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts. (United States)

    Bouchelle, Zoe; Rawlins, Yasmin; Hill, Caterina; Bennet, Jennifer; Perez, Leonor Xochitl; Oriol, Nancy


    There are approximately 2000 mobile health clinics operating in the United States. While researchers have established that mobile health clinics can be cost effective and improve outcomes, there is scant research examining the healthcare experience on a mobile health clinic from patients' perspectives. Data were gathered from interviews with 25 clients receiving care on a Boston-based mobile health clinic and analyzed using grounded theory methodology. Emerging patterns in the data revealed three relational and three structural factors most significant to participants' experience of care on The Family Van. Relational factors include providers who 1) Communicate understandably, 2) Create a culture of respect and inclusivity, and 3) Are diverse with knowledge of the community. Structural factors include 1) A focus on preventative health and managing chronic disease, 2) Expeditious, free, and multiple services, and 3) Location. The participant accounts in this report serve to expand on prior research exploring mobile health clinics' role in patients' healthcare, to more clearly define the most salient aspects of the mobile health clinic model for the patients they serve, and to give voice to patients too seldom heard in the academic literature.

  16. Mental health and clinical correlates in lesbian, gay, bisexual, and queer young adults

    DEFF Research Database (Denmark)

    Grant, Jon E; Odlaug, Brian Lawrence; Derbyshire, Katherine


    This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students.......This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students....

  17. Frontline health care can be improved by bringing research into the clinic

    DEFF Research Database (Denmark)

    Steinhausen, Kirsten; Berghmans, Stephane; Højgaard, Liselotte


    Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals.......Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals....

  18. Investigation Clinical Competence and Its Relationship with Professional Ethics and Spiritual Health in Nurses

    Directory of Open Access Journals (Sweden)

    Elahe Ramezanzade Tabriz


    Full Text Available Abstract Background and Objectives: Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses. Methods: In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21. Results: The total scores for self-assessment scale of nurses' clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence. Conclusion: Managers' and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.

  19. Looking Neat on the Street

    DEFF Research Database (Denmark)

    Dahl, Dorte Boesby


    Research on aesthetic labor has been confined to service encounters in private sector industries. Aesthetic labor theory is critical of the commercialism that drives management of service labor and points to the discrimination of employees on the grounds of their “looks” that this entails. Consid...... apply aesthetic labor principles to promote health and safety and workforce diversity, but also that the use of aesthetics has ambivalent purposes. Aesthetic labor is not as unequivocally applied for commercial purposes as hitherto assumed....... of aesthetic labor. This paper analyzes the aesthetic labor of Danish parking attendants in an organizational ethnography. A change management process in this organization has applied the principles of aesthetic labor actively for the purposes of diversity and health and safety. The paper shows how managers...



    Boscá Tomás, Diego


    [EN] Healthcare domain produces and consumes big quantities of people's health data. Although data exchange is the norm rather than the exception, being able to access to all patient data is still far from achieved. Current developments such as personal health records will introduce even more data and complexity to the Electronic Health Records (EHR). Achieving semantic interoperability is one of the biggest challenges to overcome in order to benefit from all the information contained in the ...

  1. Oral health literacy in adult dental patients - A clinical study


    Stein, Linda


    The papers II and III of this thesis are not available in Munin. Paper II: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: “The association between oral health literacy and alexithymia: Implications for patient-clinician communication”. (Manuscript). Published version with title “Exploring the association between oral health literacy and alexithymia” available in Community Dental Health 2015, 32(3):143 - 147. Paper III: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl...

  2. Sex differences in health research and clinical guideline development

    NARCIS (Netherlands)

    Keuken, D.G.


    In current medical practice, research based evidence is an important foundation for clinical decision making. Clinical practice guidelines are a major instrument for keeping physicians up-to-date about this evidence. In order to provide optimal care to both men and women, it is important that sex

  3. The impact of traffic-flow patterns on air quality in urban street canyons

    International Nuclear Information System (INIS)

    Thaker, Prashant; Gokhale, Sharad


    We investigated the effect of different urban traffic-flow patterns on pollutant dispersion in different winds in a real asymmetric street canyon. Free-flow traffic causes more turbulence in the canyon facilitating more dispersion and a reduction in pedestrian level concentration. The comparison of with and without a vehicle-induced-turbulence revealed that when winds were perpendicular, the free-flow traffic reduced the concentration by 73% on the windward side with a minor increase of 17% on the leeward side, whereas for parallel winds, it reduced the concentration by 51% and 29%. The congested-flow traffic increased the concentrations on the leeward side by 47% when winds were perpendicular posing a higher risk to health, whereas reduced it by 17–42% for parallel winds. The urban air quality and public health can, therefore, be improved by improving the traffic-flow patterns in street canyons as vehicle-induced turbulence has been shown to contribute significantly to dispersion. - Highlights: • CFD is used to study impact of traffic-flow patterns on urban air quality. • Facilitating free-flow patterns induce more turbulence in street canyons. • Traffic-generated turbulence alters pollutant levels in urban street canyons. - This study investigates the effect of vehicle-induced-turbulence generated during free-flow traffic pattern in reduction of air pollutant concentrations in urban street canyons.

  4. The lived experiences of street children in Durban, South Africa: Violence, substance use, and resilience

    Directory of Open Access Journals (Sweden)

    Frances Hills


    Full Text Available South African studies have suggested that street children are resilient but also suicidal, engage in unprotected sex and other high risk sexual behaviour as a means of survival, have high rates of substance abuse and are physically abused and stigmatized due to their state of homelessness. However, few studies have explored in a more holistic manner the lived experiences of street children in South Africa. The main purpose of this study was to explore qualitatively the lived experiences of street children living on the street of Durban, in the province of KwaZulu-Natal, South Africa. Adolescents (six males and four females between the ages of 14 and 18 years (average age=16 were purposively selected and in-depth semi-structured interviews were conducted. An interpretative phenomenological analysis of the transcribed data revealed that incidence of violence and drug and alcohol use were common experiences of street life. Yet despite these challenges survival was made possible through personal and emotional strength, cultural values, religious beliefs, supportive peer relationships, and participation in sports activities. These protective, resilience resources should be strengthened in health promotion interventions with a focus on mental health, the prevention of violence, substance use, and daily physical activities that seems to provide meaning and hope.


    African Journals Online (AJOL)

    A sample of 50 (36 male and 14 female) street children currently in a remand home at Kabete in Nairobi, Kenya, were interviewed using a predesigned questionnaire in order to estimate prevalence rates for use of selected substances. The lifetime prevalence rates of the drugs most commonly used were volatile ...

  6. Wall Street sours on nuke plants

    International Nuclear Information System (INIS)



    Wall Street has been threatening to join the antinuclear campaign for years as construction lead times and costs grew and the financial condition of utilities building reactors deteriorated. With nuclear plant cancellations, licensing problems, quality-assurance breakdowns, and elevated costs, stock prices have dropped causing unrest among utility investors

  7. Smart street lights using power line communication

    CSIR Research Space (South Africa)

    Du Toit, P


    Full Text Available The increasing popularity of automation has resulted in the development of “smart” systems for a variety of different applications. One such application is street lighting which still mostly uses very primitive methods of maintenance. The use...

  8. Vortex Cloud Street during AMTEX 75

    DEFF Research Database (Denmark)

    Jensen, Niels Otto; Agee, E. M.


    Strong northerly flow across Cheju Island, Korea, during the 1975 Air Mass Transformation Experiment (AMTEX 75) resulted in a pronounced vortex cloud street to the lee of the island on February 17 1975. This pattern has been studied and explained in terms of classical von Karman eddies shed...


    African Journals Online (AJOL)


    diet of people living in low- and middle-income countries ... market for SF consumers in Cape Town. However, most ... beverages prepared and/or sold by vendors and hawkers ... many street-food items sold are unhealthy ...... going children in lower-income groups, who may ... The dangers of regular consumption of sugar-.

  10. Opportunities and constraints facing informal street traders ...

    African Journals Online (AJOL)

    A small income and the limited ability of the government and the formal business sector to provide sufficient employment opportunities to people in the economically active age categories are two of the main reasons for informal trading in South African cities. As a result, the informal street trading sector plays an important ...

  11. The Earl Lee Street Art Campaign (United States)



    This article describes a catchy phrase with more to its meaning than first view. A slogan "All the girls love Earl Lee," appears in street art around the world. Earl Lee is a lovable, handsome man who owns the fictitious Earl Lube industries. Originally intended to bring a smile to people's faces at a time when there wasn't much to smile…

  12. Social Sustainability of Shopping Streets in Ankara

    Directory of Open Access Journals (Sweden)



    Full Text Available Shopping streets are integral parts of public spaces in traditional shopping areas of Central Business Districts (CBD. Furthermore, as modern shopping venues, shopping centers offer advantages for modern lifestyles with spacious shopping areas, variety of commercial and social activities, and economic value of their investments. These advantages act in favor of shopping centers and improve the level of shopping street social sustainability and its relevant concepts. The aim of this study is to analyze the main shopping streets of Ankara, using the concepts of social sustainability. In this study, these concepts, such as locality, identity, vitality, viability, sense of place, conviviality, meaning and local characteristics of the shopping streets are investigated. For the first time, the retail unit locations in Ankara, their brands and their business types, are illustrated on thematic land use maps using Geographical Information Systems (GIS software. Next, population activities and consumer spatial behavior are observed and marked on maps that are also referred to as social sustainability maps. The results of the study can be useful in formulating strategies within the framework of social sustainability, which is a relatively new concept.

  13. Turbulent ventilation of a street canyon

    DEFF Research Database (Denmark)

    Nielsen, Morten


    A selection of turbulence data corresponding to 185 days of field measurements has een analysed. The non-ideal building geometry influenced the circulation patterns in the street canyon and the largest average vertical velocities were observed in the wake of an unbroken line of buildings. The sta...

  14. Travel Time Estimation on Urban Street Segment

    Directory of Open Access Journals (Sweden)

    Jelena Kajalić


    Full Text Available Level of service (LOS is used as the main indicator of transport quality on urban roads and it is estimated based on the travel speed. The main objective of this study is to determine which of the existing models for travel speed calculation is most suitable for local conditions. The study uses actual data gathered in travel time survey on urban streets, recorded by applying second by second GPS data. The survey is limited to traffic flow in saturated conditions. The RMSE method (Root Mean Square Error is used for research results comparison with relevant models: Akcelik, HCM (Highway Capacity Manual, Singapore model and modified BPR (the Bureau of Public Roads function (Dowling - Skabardonis. The lowest deviation in local conditions for urban streets with standardized intersection distance (400-500 m is demonstrated by Akcelik model. However, for streets with lower signal density (<1 signal/km the correlation between speed and degree of saturation is best presented by HCM and Singapore model. According to test results, Akcelik model was adopted for travel speed estimation which can be the basis for determining the level of service in urban streets with standardized intersection distance and coordinated signal timing under local conditions.

  15. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren

    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage ...

  16. Clinical Correlates of Health Preference and Generic Health-Related Quality of Life in Patients with Colorectal Neoplasms


    Wong, Carlos K. H.; Lam, Cindy L. K.; Poon, Jensen T. C.; Kwong, Dora L. W.


    BACKGROUND: The aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients. METHODS: Five hundred and fifty-four CRN patients, inclusive of colorectal polyp or cancer, who attended the colorectal specialist outpatient clinic at Queen Mary Hospital in Hong Kong between October 2009 and July 2010, were included. Patients ...

  17. Religion, Spirituality, and Health: The Research and Clinical Implications (United States)

    Koenig, Harold G.


    This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard. PMID:23762764

  18. Role of Forensic Pathology in Clinical Practice and Public Health ...

    African Journals Online (AJOL)

    The request for and performance of autopsy have been on the decline despite its obvious merits to medical practice, the patients and public health. Several surveys have exposed some reasons for this decline. Method: This work is a review of the role of forensic pathology to medical practice and public health. The author ...

  19. School-Located Influenza Vaccination Clinics: Local Health Department Perspectives (United States)

    Ransom, James


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

  20. Clinical leadership in mental health nursing: the importance of a calm and confident approach. (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry


    Explore the perceptions of nurses working in mental health of effective clinical leadership. In-depth interviews were conducted with registered nurses employed in a mental health setting. Qualitative research using grounded theory. Remaining calm and confident in times of crisis and uncertainty was identified as one attribute of clinical leadership. Participants noted clinical leaders' demeanor during stressful or crisis situations, and their ability to manage unpredictable or unexpected clinical situations as contributing positively to clinical practice. Understanding these characteristics and how they can influence positive outcomes for clients is crucial in addressing the recruitment and retention challenges for the nursing workforce. © 2014 Wiley Periodicals, Inc.

  1. The importance of communication for clinical leaders in mental health nursing: the perspective of nurses working in mental health. (United States)

    Ennis, Gary; Happell, Brenda; Broadbent, Marc; Reid-Searl, Kerry


    Communication has been identified as an important attribute of clinical leadership in nursing. However, there is a paucity of research on its relevance in mental health nursing. This article presents the findings of a grounded theory informed study exploring the attributes and characteristics required for effective clinical leadership in mental health nursing, specifically the views of nurses working in mental health about the importance of effective communication in day to day clinical leadership. In-depth interviews were conducted to gain insight into the participants' experiences and views on clinical leadership in mental health nursing. The data that emerged from these interviews were constantly compared and reviewed, ensuring that any themes that emerged were based on the participants' own experiences and views. Participants recognized that effective communication was one of the attributes of effective clinical leadership and they considered communication as essential for successful working relationships and improved learning experiences for junior staff and students in mental health nursing. Four main themes emerged: choice of language; relationships; nonverbal communication, and listening and relevance. Participants identified that clinical leadership in mental health nursing requires effective communication skills, which enables the development of effective working relationships with others that allows them to contribute to the retention of staff, improved outcomes for clients, and the development of the profession.

  2. Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems (United States)

    Farri, Oladimeji Feyisetan


    Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

  3. Automated Methods to Extract Patient New Information from Clinical Notes in Electronic Health Record Systems (United States)

    Zhang, Rui


    The widespread adoption of Electronic Health Record (EHR) has resulted in rapid text proliferation within clinical care. Clinicians' use of copying and pasting functions in EHR systems further compounds this by creating a large amount of redundant clinical information in clinical documents. A mixture of redundant information (especially outdated…

  4. Consumer health information technology in an adult public health primary care clinic: a heart health education feasibility study. (United States)

    Gleason-Comstock, Julie A; Streater, Alicia; Jen, Kai-Lin Catherine; Artinian, Nancy T; Timmins, Jessica; Baker, Suzanne; Joshua, Bosede; Paranjpe, Aniruddha


    To explore the feasibility and short term outcomes of using an interactive kiosk integrated into office flow to deliver health information in a primary care clinic. Fifty-one adults with BMI ≥25 were randomly assigned to use a kiosk with attached devices to receive a six-week healthy eating/weight monitoring (intervention) or general health/BP monitoring (attention-control) program. Outcomes were measured at baseline, 8 weeks (post) and three month follow-up. Participants completed an average of 2.73 weekly sessions, with transportation and time given as limiting factors. They found the kiosk easy to use (97%), liked the touchscreen (94%), and would use the kiosk again (81%). Although there were no differences between groups, the 27 completing all assessments showed reduced weight (p=.02), and decreased systolic (p=.01) and diastolic BP (pinformation and self-monitoring. Multi-session educational content can provide beneficial short-term outcomes in overweight adults. A kiosk with attached peripherals in a clinic setting is a viable adjunct to provider education, particularly in medically underserved areas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. The Gap in Knowledge of Clinical Practice Guidelines by Mental Health Residents in Buenos Aires (Argentina

    Directory of Open Access Journals (Sweden)

    Javier Fabrissin


    Full Text Available The aim of this pilot study was to evaluate if the residents of psychiatry and clinical psychology from the city of Buenos Aires knew any of the existing mental health Clinical Practice and Treatment Guidelines (CPTGs. We asked residents their opinion about CPTGs and, also, if they followed their recommendations in clinical practice. We asked 59 mental health residents (28 physicians and 29 psychologists with different years of clinical training to fill a questionnaire to know their opinion about CPTGs and also if they follow the CPTG recommendations in their clinical practice. We found that 79.31% of residents did not know any CPTG. Eighty percent of the residents who did know any CPTG have a positive opinion about CPTGs. Finally, the American Psychiatric Association Guidelines were the most known CPTGs. The authors emphasize the need for a clinical guidelines diffusion policy in Buenos Aires city and particularly as a clinical and training resource for mental health residents.

  6. Streets? Where We're Going, We Don't Need Streets (United States)

    Bailey, J.


    In 2007 Google Street View started as a project to provide 360-degree imagery along streets, but in the decade since has evolved into a platform through which to explore everywhere from the slope of everest, to the middle of the Amazon rainforest to under the ocean. As camera technology has evolved it has also become a tool for ground truthing maps, and provided scientific observations, storytelling and education. The Google Street View "special collects" team has undertaken increasingly more challenging projects across 80+ countries and every continent. All of which culminated in possibly the most ambitious collection yet, the capture of Street View on board the International Space Station. Learn about the preparation and obstacles behind this and other special collects. Explore these datasets through both Google Earth and Google Expeditions VR, an educational tool to take students on virtual field trips using 360 degree imagery.

  7. Tobacco Taxation, Smuggling, and Street Tobacco Vendors in Eritrea

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

    The bulk of the smuggled cigarettes are sold by street vendors, many of them women and children, ... and its implications for government revenue;; identify the reasons why people sell on the streets; and, ... Agent(e) responsable du CRDI.

  8. Street youth in Colombia: lifestyle, attitudes and knowledge. (United States)

    Ruiz, J


    Gamines in Bogota, Colombia, are youths who live on the streets sometimes keeping loose family ties. They belong to informal gangs, use drugs, and survive by doing itinerant informal sector work, begging, and stealing. The New Life Program (NLP) of the Corporacion SOS Aldea de Ninos worked with three other agencies to investigate the lifestyle, attitudes, and knowledge of gamines about HIV/STDs for the purpose of designing AIDS/STD educational activities for the population. Focus group discussions and educational activities were conducted with 12 girls and 18 boys aged 14-25 years who had started living in NLP's shelter while working on the streets. Participants had spent an average of 7 years on the street typically from age 10. Concentrating primarily upon daily survival, these youths act on the basis of intuition and emotions. Verbal communication is essential to gain and maintain their trust. Although their sexual lives are influenced by the family of origin, institutions in which they have resided, and peers, and their daily lifestyles have much influence. Steady partners are sought for affection and romance, while sexual intercourse is had for pleasure and to satisfy biological need. Some homosexuality and prostitution are tolerated. Gangs also gang-rape and expel members thought to be traitors. The idea of birth control exists among the girls, but the boys overwhelmingly reject condom use. The boys got information on sex from prostitutes, erotic magazines, and adults, but girls rarely talk about sex. Many have had STDs and are generally aware about AIDS, but misinformed about transmission modes, symptoms, and treatment. The boys were especially negative about meeting a person with AIDS. Overall, the youths did not perceive themselves as being at risk for HIV infection. Participants also strongly distrusted the health system because many had been turned away for being dirty or received only callous treatment. The author concludes that we must acknowledge that

  9. Advancing LGBT Health Care Policies and Clinical Care Within a Large Academic Health Care System: A Case Study. (United States)

    Ruben, Mollie A; Shipherd, Jillian C; Topor, David; AhnAllen, Christopher G; Sloan, Colleen A; Walton, Heather M; Matza, Alexis R; Trezza, Glenn R


    Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.

  10. Injection safety knowledge and practices among clinical health care ...

    African Journals Online (AJOL)

    Injection safety is therefore critical in preventing occupational exposure and infection from blood borne pathogens, hence prevention is a vital part of any ... safety among clinical healthcare workers at the Garissa Provincial General Hospital.

  11. Air Pollution Modeling at Road Sides Using the Operational Street Pollution Model-A Case Study in Hanoi, Vietnam

    DEFF Research Database (Denmark)

    Hung, Ngo Tho; Ketzel, Matthias; Jensen, Steen Solvang


    In many metropolitan areas, traffic is the main source of air pollution. The high concentrations of pollutants in streets have the potential to affect human health. Therefore, estimation of air pollution at the street level is required for health impact assessment. This task has been carried out...... in many developed countries by a combination of air quality measurements and modeling. This study focuses on how to apply a dispersion model to cities in the developing world, where model input data and data from air quality monitoring stations are limited or of varying quality. This research uses...... the operational street pollution model (OSPM) developed by the National Environmental Research Institute in Denmark for a case study in Hanoi, the capital of Vietnam. OSPM predictions from five streets were evaluated against air pollution measurements of nitrogen oxides (NO), sulfur dioxide (SO2), carbon monoxide...

  12. Oral Health Status and Behaviour of Mauritians Visiting Private Dental Clinics (United States)

    Gunsam, P. Pugo; Banka, S.


    Purpose: This paper seeks to assess the oral health status and behaviour of a sample of the Mauritian population visiting private dental clinics. Design/methodology/approach: Oral health status was determined using the World Health Organization (Decayed, Missing, Filled Teeth (DMFT) index indicating the prevalence of caries, and factors associated…

  13. Infection with HIV and intestinal parasites among street dwellers in Gondar city, northwest Ethiopia. (United States)

    Moges, Feleke; Kebede, Yenew; Kassu, Afework; Degu, Getu; Tiruneh, Moges; Gedefaw, Molla


    In Ethiopia human immunodeficiency virus (HIV) infection is a major health and socioeconomic problem. Sex workers, youth, and mobile populations all show increasing prevalence of HIV. However, there is currently no information about the seroprevalence of HIV and the knowledge of HIV among street dwellers in the country. To fill this gap, 404 street dwellers residing in Gondar, northwest Ethiopia, were included in this cross-sectional study. Socio-demographic data, factors that prompted the subjects to become street dwellers, and their knowledge about HIV were all assessed using a structured questionnaire. Stool samples for diagnosis of intestinal parasites and venous blood for HIV antibody testing were collected and processed following standard procedures. Poverty-associated movement to urban areas in search of work was reported as a major factor that forced them to live in the streets, followed by divorce, family death, and addiction and peer pressure. One or more intestinal parasites were found in 67.6% of the street dwellers. Multiple parasitic infections were detected in 27.7%. The prevalence of HIV in the street dwellers was 6.9%. Fifty-nine (16.6%) participants responded that HIV can be transmitted by eating food together. Seventy-three (18%) believed an infected needle cannot transmit HIV, while 51 (12.6%) said HIV can be transmitted by hand shaking. One hundred ninety-two (47.5%) responded that antiretroviral therapy will not prolong the life of HIV-infected individuals. In summary, the prevalence of HIV and intestinal parasitic infection was quite high among street dwellers in Gondar. Therefore, strategies to control HIV and other infectious diseases should include this group, and regular mass deworming may help to reduce the burden of infection.

  14. Drug Use among Street Children in Tehran, Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Masoumeh eDejman


    Full Text Available Introduction and objective: Globally, children who work and live on the streets are at higher risk of undesired behavioral health outcomes, including increased drug use and abuse. Considering the rapid growth of this population in Iran and the lack of program planning that is partly due to a scarcity of research-based information, this study was conducted in 2013 to investigate drug use among street children in Tehran. Method: With a qualitative design, we conducted a Rapid Assessment and Response (RAS Survey of street children in Tehran, 2012-2013. Data were also obtained from ten focus group discussions with street children using semi-structured questionnaires and 27 in-depth interviews with key informants in governmental, non-governmental, and international organizations. Results: The variation in age at first use, type of drugs, and pattern of drug use were found based on ethnicity. Gypsy boys and girls reported consuming more alcohol than other groups. Drug use problems were commonly described among families of street children. Children whose parents had drug-use problems described using drugs earlier than other children. Informants reported that families with drug-related problems used children for procurement of drugs. Children themselves described using drugs to cope with stress, reduce physical and psychological stressors and problems such as fatigue, sadness, and pressure resulting from frequent failures in life. Conclusion: These results suggest that intervention and prevention programs dealing with drug use of street children in Iran should include family and peers when addressing drug use by street children.

  15. POLICY EVALUATION OF RESTRUCTURING STREET VENDORS IN SURAKARTA CITY (Study of Street Vendors in Monument Park Banjarsari and Street Vendors in Manahan Stadium

    Directory of Open Access Journals (Sweden)

    Frahlevi Prajasari


    Full Text Available This study examined the policy evaluation of restructuring street vendors in Surakarta city. Street vendors represent the economic actors in the informal sector of urban economic activity. The government of City/District usually removes these street vendors by disguising this activity behind the reason of structuring, . The study used descriptive research with a qualitative approach. The relocation of street vendors in Surakarta City is orderly and smooth without violence which may impact badly on physic and material because the government of Surakarta City, especially Surakarta Mayor, uses persuasive approach. Notoharjo Market is a relocation place for street vendors at Banjarsari Monument Park. In the beginning, Notoharjo Market is crowded with buyers but current days, street vendors who occupy Notoharjo Market complain about lack of buyers. The lack of buyers at Notoharjo Market is because the facilities previously provided by the government of Surakarta City are not well maintained. The government of Surakarta City must listening all complains of street vendors for the smoothness and orderliness of trading activity of street vendors. Not only listening, but the government of Surakarta City also gives appropriate and best solution to street vendors such that street vendors feel comfort in selling and their income is better than before.

  16. Simplified Clinical Tools and Educational Outreach for Health Workers

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

    The training will focus on mid-level healthcare workers, that is, nurses, medical ... Registered Trustees of the Research for Equity and Community Health ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  17. The National Health Insurance, the decentralised clinical training ...

    African Journals Online (AJOL)

    studies, particularly those from Australia, Canada, and SA.[1-6] ... Gluckman's principles; therefore it is imperative to keep these in the forefront .... Digby A. Evidence, encounters and effects of South Africa's reforming Gluckman National Health.

  18. Socio - demographic characteristics of child street vendors in Nnewi ...

    African Journals Online (AJOL)

    Background: Involvement of children in street trading is inimical, contrary to the Rights of the Child, and threatens holistic child development. Objective: To describe the sociodemographic characteristics of child street vendors in Nnewi. Method: A cross-sectional questionnaire survey of children selling wares on the streets of ...

  19. Street Food Consumption and its associated socio-demographic ...

    African Journals Online (AJOL)

    Street Food Consumption and its associated socio-demographic factors in Oyo town, Nigeria. ... Abstract. Background: Contemporary life-styles have made street foods to be an important meal option in Nigeria. They contribute ... Nutrition education is suggested for people to make a better choice of nourishing street foods.

  20. An Art of Resistance: From the Street to the Classroom (United States)

    Chung, Sheng Kuan


    Rooted in graffiti culture and its attitude toward the world, street art is regarded as a postgraffiti movement. Street art encompasses a wide array of media and techniques, such as traditional spray-painted tags, stickers, stencils, posters, photocopies, murals, paper cutouts, mosaics, street installations, performances, and video projections…

  1. Socio-demographic characteristics of street children in rural ... - Ibadan

    African Journals Online (AJOL)

    15.0%), part-time driving (9.5%) and car washing (5.0%) were the commonest types of work. Of those still schooling, 41.6% had no form of part-time work on the streets. None of the street children lived on the street with 65% still living with parents.

  2. Evaluation of services of the integrative health clinic in Hong Kong. (United States)

    Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S


    (i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

  3. Clinical diagnosis of syphilis: a ten-year retrospective analysis in a South Australian urban sexual health clinic. (United States)

    Forrest, C E; Ward, A


    National notifications for infectious syphilis in Australia have increased in recent years. Outside of sexual health clinics, junior clinicians seldom encounter this disease in its infectious stage (primary, secondary and early latent). With such a variable clinical presentation, textbook teaching is no substitute for real-life experience. The importance of accurate classification and staging of disease is relevant to the risk of transmission and determines treatment duration. In this article, the authors review the clinical presentation of syphilis over ten years in an urban sexual health clinic with a focus on the clinical presentation and diagnosis of infectious syphilis, in particular secondary syphilis, compared with that outlined in the Australian National Notifiable Diseases Surveillance System guidelines. This retrospective review of all patients diagnosed with syphilis at an urban sexual health clinic showed that between 2005 and 2015, 226 cases of syphilis were diagnosed. Documentation of impression of clinical staging of disease was present in 46% of the cases. Seventeen of these cases were recorded as secondary syphilis. The criteria used by clinicians to diagnose the secondary syphilis cases were consistent with criteria defined by the Australian National Notifiable Diseases Surveillance System. All cases of secondary syphilis had at least one cutaneous manifestation of disease. The demographic of the cohort of syphilis cases was consistent with that recorded in the literature. This review showed that the clinician's diagnosis of secondary syphilis in this service is consistent with the National Notifiable Diseases Surveillance System guidelines. Continuing education of junior medical staff is important to facilitate diagnosis and improve documentation of clinical staging, minimise disease transmission and ensure appropriate treatment. © The Author(s) 2016.

  4. The Interplay between socioeconomic inequalities and clinical oral health. (United States)

    Steele, J; Shen, J; Tsakos, G; Fuller, E; Morris, S; Watt, R; Guarnizo-Herreño, C; Wildman, J


    Oral health inequalities associated with socioeconomic status are widely observed but may depend on the way that both oral health and socioeconomic status are measured. Our aim was to investigate inequalities using diverse indicators of oral health and 4 socioeconomic determinants, in the context of age and cohort. Multiple linear or logistic regressions were estimated for 7 oral health measures representing very different outcomes (2 caries prevalence measures, decayed/missing/filled teeth, 6-mm pockets, number of teeth, anterior spaces, and excellent oral health) against 4 socioeconomic measures (income, education, Index of Multiple Deprivation, and occupational social class) for adults aged ≥21 y in the 2009 UK Adult Dental Health Survey data set. Confounders were adjusted and marginal effects calculated. The results showed highly variable relationships for the different combinations of variables and that age group was critical, with different relationships at different ages. There were significant income inequalities in caries prevalence in the youngest age group, marginal effects of 0.10 to 0.18, representing a 10- to 18-percentage point increase in the probability of caries between the wealthiest and every other quintile, but there was not a clear gradient across the quintiles. With number of teeth as an outcome, there were significant income gradients after adjustment in older groups, up to 4.5 teeth (95% confidence interval, 2.2-6.8) between richest and poorest but none for the younger groups. For periodontal disease, income inequalities were mediated by other socioeconomic variables and smoking, while for anterior spaces, the relationships were age dependent and complex. In conclusion, oral health inequalities manifest in different ways in different age groups, representing age and cohort effects. Income sometimes has an independent relationship, but education and area of residence are also contributory. Appropriate choices of measures in relation to age

  5. [Conflicts of interests in clinical research in primary health care]. (United States)

    González-de Paz, L; Navarro-Rubio, M D; Sisó-Almirall, A


    Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. Health status measurement in COPD : the minimal clinically important difference of the clinical COPD questionnaire

    NARCIS (Netherlands)

    Kocks, J. W. H.; Tuinenga, M. G.; Uil, S. M.; van den Berg, J. W. K.; Stahl, E.; van der Molen, T.


    Background: Patient-reported outcomes ( PRO) questionnaires are being increasingly used in COPD clinical studies. The challenge facing investigators is to determine what change is significant, ie what is the minimal clinically important difference (MCID). This study aimed to identify the MCID for

  7. Electronic health record tools' support of nurses' clinical judgment and team communication. (United States)

    Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin


    Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

  8. Air Quality at Your Street

    DEFF Research Database (Denmark)

    Jensen, Steen Solvang; Becker, Thomas; Ketzel, Matthias

    Citizens are frequently concerned about the air quality where they live, where they go to work, where their children go to kindergarten or where they want to move to. Municipalities may also have an interest in location based air quality information e.g. in relation to screening of complaints from...... concerned citizents, or in the context of localization of institutions, etc. The purpose of the project ‘Air Quality at Your Street’ is to create interactive air quality maps on the internet using webGIS to illustrate the geographical variation of air quality in Denmark for selected health related air...... pollutants. The maps show annual means of NO2, PM2.5 or PM10 for 2012. The user interface presents modelled air quality data on a map where the user can select map view, pan, zoom in and out, etc. It is also possible to get the air quality for a particular address by entering a specific address. Air quality...

  9. A Study of Children's Geographic Access to Health Services (Health Care Centers and Clinical Laboratories in Kermanshah City, Iran

    Directory of Open Access Journals (Sweden)

    Sohyla Reshadat


    Full Text Available Background Given that the protection of children's health is of special importance due to their special age and physical conditions, the present study aimed to investigate the condition of children's Geographic access to health services (Health Centers and Clinical Laboratories in Kermanshah city, Iran. Materials and Methods: In this applied study, the research approach was descriptive-analytic using quantitative models in Geographic information system (GIS environment. The statistical population was the whole population of young girls aged 0-14 years old in Kermanshah, Iran. Moreover, to evaluate the spatial deployment pattern of health services and the correct and true access of this groupto such services, all data and information were collected through the Iranian Statistics Center and evaluated using the Arc-GIS Software. The latest published population statistics on the Population and Housing Census in 2011 were considered the basis for the analyses. Results: The results of the present study demonstrated that more than 40% and 60% of the young girls aged 0-14 years old in Kermanshah were deprived of proper access to health centers and clinical laboratories, respectively. In terms of the status of children’s access in the Second Scenario (access to health services by vehicles and during 5, 10, and 15 minutes, about 5.53%, 93.1% and 15.1% lacked access to health centers, respectively. In addition, in terms of the status of children’s access to clinical laboratories during 5, 10, and 15 minutes, 17.26%, 65.4% and 51% lacked access to clinical laboratories, respectively. Conclusion: The access of young girls aged 0-14 years old to health services in Kermanshah was undesirable in the access to health services through walking. Additionally, the access of this groupto health services in the access to health services by vehicles was far better than the first one.

  10. Willingness to Use Health Insurance at a Sexually Transmitted Disease Clinic: A Survey of Patients at 21 US Clinics. (United States)

    Pearson, William S; Cramer, Ryan; Tao, Guoyu; Leichliter, Jami S; Gift, Thomas L; Hoover, Karen W


    To survey patients of publicly funded sexually transmitted disease (STD) clinics across the United States about their willingness to use health insurance for their visit. In 2013, we identified STD clinics in 21 US metropolitan statistical areas with the highest rates of chlamydia, gonorrhea, and syphilis according to Centers for Disease Control and Prevention surveillance reports. Patients attending the identified STD clinics completed a total of 4364 surveys (response rate = 86.6%). Nearly half of the insured patients were willing to use their health insurance. Patients covered by government insurance were more likely to be willing to use their health insurance compared with those covered by private insurance (odds ratio [OR] =  3.60; 95% confidence interval [CI] = 2.79, 4.65), and patients covered by their parents' insurance were less likely to be willing to use their insurance compared with those covered by private insurance (OR = 0.72; 95% CI = 0.52, 1.00). Reasons for unwillingness to use insurance were privacy and out-of-pocket cost. Before full implementation of the Affordable Care Act, privacy and cost were barriers to using health insurance for STD services. Barriers to using health insurance for STD services could be reduced through addressing issues of stigma associated with STD care and considering alternative payment sources for STD services.

  11. Ecosystem Health Disorders - changing perspectives in clinical medicine and nutrition. (United States)

    Wahlqvist, Mark L


    The inseparability of people from their ecosystem without biological change is increasingly clear. The discrete species concept is becoming more an approximation as the interconnectedness of all things, animate and inanimate, becomes more apparent. Yet this was evident even to our earliest Homo Sapiens sapiens ancestors as they hunted and gathered from one locality to another and migrated across the globe. During a rather short 150-200,000 years of ancestral history, we have changed the aeons-old planet and our ecology with dubious sustainability. As we have changed the ecosystems of which we are a part, with their opportunities for shelter, rest, ambulation, discourse, food, recreation and their sensory inputs, we have changed our shared biology and our health prospects. The rate of ecosystem change has increased quantitatively and qualitatively and so will that of our health patterns, depending on our resilience and how linear, non-linear or fractal-like the linkage. Our health-associated ecosystem trajectories are uncertain. The interfaces between us and our environment are blurred, but comprise time, biorhythms, prokaryotic organisms, sensory (auditory, visual, tactile, taste and smell), conjoint movement, endocrine with various external hormonal through food and contaminants, the reflection of soil and rock composition in the microbes, plants, insects and animals that we eat (our biogeology) and much more. We have sought ways to optimise our health through highly anthropocentric means, which have proven inadequate. Accumulated ecosystem change may now overwhelm our health. On these accounts, more integrative approaches and partnerships for health care practice are required.

  12. Factor Structure of the WPPSI in Mental Health Clinic Settings. (United States)

    Haynes, Jack P.; Atkinson, David


    Factor-analyzed the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) scores of emotionally disturbed children (N=181). The results suggested that the structure of intelligence for emotionally disturbed children is similar to that for normal children. WPPSI profile analysis that uses subtest scores may be invalid in clinical settings.…

  13. Surrogate end points in clinical research: hazardous to your health. (United States)

    Grimes, David A; Schulz, Kenneth F


    Surrogate end points in clinical research pose real danger. A surrogate end point is an outcome measure, commonly a laboratory test, that substitutes for a clinical event of true importance. Resistance to activated protein C, for example, has been used as a surrogate for venous thrombosis in women using oral contraceptives. Other examples of inappropriate surrogate end points in contraception include the postcoital test instead of pregnancy to evaluate new spermicides, breakage and slippage instead of pregnancy to evaluate condoms, and bone mineral density instead of fracture to assess the safety of depo-medroxyprogesterone acetate. None of these markers captures the effect of the treatment on the true outcome. A valid surrogate end point must both correlate with and accurately predict the outcome of interest. Although many surrogate markers correlate with an outcome, few have been shown to capture the effect of a treatment (for example, oral contraceptives) on the outcome (venous thrombosis). As a result, thousands of useless and misleading reports on surrogate end points litter the medical literature. New drugs have been shown to benefit a surrogate marker, but, paradoxically, triple the risk of death. Thousands of patients have died needlessly because of reliance on invalid surrogate markers. Researchers should avoid surrogate end points unless they have been validated; that requires at least one well done trial using both the surrogate and true outcome. The clinical maxim that "a difference to be a difference must make a difference" applies to research as well. Clinical research should focus on outcomes that matter.

  14. Experiences of health science students during clinical placements at ...

    African Journals Online (AJOL)

    Inadequate supervision and inappropriate behaviours by supervisors were some of the challenges faced. Almost 89% used stress-relieving strategies such as focusing on why they were doing the clinical placement and the importance of successful completion. Ninety-one per cent had never used cannabis/mbanje but 41% ...

  15. Developing a Clinical Approach to Air Pollution and Cardiovascular Health. (United States)

    Hadley, Michael B; Baumgartner, Jill; Vedanthan, Rajesh


    Nearly 3 billion people are exposed to household air pollution emitted from inefficient cooking and heating stoves, and almost the entire global population is exposed to detectable levels of outdoor air pollution from traffic, industry, and other sources. Over 3 million people die annually of ischemic heart disease or stroke attributed to air pollution, more than from traditional cardiac risk factors such as obesity, diabetes mellitus, or smoking. Clinicians have a role to play in reducing the burden of pollution-attributable cardiovascular disease. However, there currently exists no clear clinical approach to this problem. Here, we provide a blueprint for an evidence-based clinical approach to assessing and mitigating cardiovascular risk from exposure to air pollution. We begin with a discussion of the global burden of pollution-attributable cardiovascular disease, including a review of the mechanisms by which particulate matter air pollution leads to cardiovascular outcomes. Next, we offer a simple patient-screening tool using known risk factors for pollution exposure. We then discuss approaches to quantifying air pollution exposures and cardiovascular risk, including the development of risk maps for clinical catchment areas. We review a collection of interventions for household and outdoor air pollution, which clinicians can tailor to patients and populations at risk. Finally, we identify future research needed to quantify pollution exposures and validate clinical interventions. Overall, we demonstrate that clinicians can be empowered to mitigate the global burden of cardiovascular disease attributable to air pollution. © 2018 American Heart Association, Inc.

  16. Competence of maternal and child health clinic workers in detecting ...

    African Journals Online (AJOL)

    Background: The MCH clinic workers in Somalia receive formal and in-service training to perform their professional duties. Their competence in the field was never examined. This study assessed their competencies in detecting malnourished children 5 years and below in Beledweyne. Objective: To assess the competence ...

  17. Adoption of health information technologies by physicians for clinical practice

    DEFF Research Database (Denmark)

    Villalba-Mora, Elena; Casas, Isabel; Lupiañez-Villanueva, Francisco


    OBJECTIVES: We investigated the level of adoption of Health Information Technologies (HIT) services, and the factors that influence this, amongst specialised and primary care physicians; in Andalusia, Spain. METHODS: We analysed the physicians' responses to an online survey. First, we performed...... Technologies: Electronic Health Records (EHR), ePrescription and patient management and telemedicine services. Results from an ordered logit model showed that the frequency of use of HIT is associated with the physicians' perceived usefulness. Lack of financing appeared as a common barrier to the adoption...

  18. Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic. (United States)

    Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole


    An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Keeping up appearances: Perceptions of street food safety in urban Kumasi, Ghana

    DEFF Research Database (Denmark)

    Rheinländer, Thilde; Olsen, Mette; Bakang, John Abubakar


    hygiene practices such as hand washing, cleaning of utensils, washing of raw vegetables, and quality of ingredients. Instead, four main food selection criteria could be identified and were related to (1) aesthetic appearance of food and food stand, (2) appearance of the food vendor, (3) interpersonal...... observations and several interviews were carried out with case vendors. In addition, street interviews and Focus Group Discussions were carried out with street food customers. The study found that although vendors and consumers demonstrated basic knowledge of food safety, the criteria did not emphasize basic......The growing street food sector in low-income countries offers easy access to inexpensive food as well as new job opportunities for urban residents. While this development is positive in many ways, it also presents new public health challenges for the urban population. Safe food hygiene is difficult...

  20. Geographies of exclusion: street drinking, gentrification and contests over public space. (United States)

    Pennay, Amy; Manton, Elizabeth; Savic, Michael


    Laws prohibiting the consumption of alcohol on the street have proliferated in Australia over the past 15 years. It is no coincidence that these laws have been implemented at the same time that significant advancements in urban renewal and gentrification have occurred in metropolitan cities. This paper draws on observational research as well as interviews and/or focus groups with street drinkers, residents and service providers (police, council workers, health workers and traders). Environmental economic and social changes that have occurred through gentrification are central to ongoing debates around the use of public space in urban areas. The geographical exclusion of street drinkers that has occurred as a result of these laws warrants the consideration of a more socially responsible strategy than the current legislative approach. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. The prostate health index selectively identifies clinically significant prostate cancer

    NARCIS (Netherlands)

    S. Loeb (Stacy); M.G. Sanda (Martin G.); D.L. Broyles (Dennis L.); S.S. Shin (Sanghyuk S.); C.H. Bangma (Chris); J.T. Wei (John T.); A.W. Partin (Alan W.); G.G. Klee (George); K.M. Slawin (Kevin M.); L.S. Marks (Leonard S.); R.H.N. van Schaik (Ron); D.W. Chan (Daniel); L. Sokoll (Lori); A.B. Cruz (Amabelle B.); I.A. Mizrahi (Isaac A.); W.J. Catalona (William)


    textabstractPurpose The Prostate Health Index (phi) is a new test combining total, free and [-2]proPSA into a single score. It was recently approved by the FDA and is now commercially available in the U.S., Europe and Australia. We investigate whether phi improves specificity for detecting

  2. Clinical Perspective Qualitative adolescent health research — focus ...

    African Journals Online (AJOL)

    This paper introduces nine steps that are recommended in conducting focus group discussions in rural communities and gives an example of how they can appropriately and fruitfully be employed in adolescent health behavioural research. The paper also reviewed issues related to methods of data collection, data analysis, ...

  3. Appointment Template Redesign in a Women's Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency. (United States)

    Huang, Y; Verduzco, S


    Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. This study was conducted in a Women's Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

  4. What are the effective ways to translate clinical leadership into health care quality improvement?

    Directory of Open Access Journals (Sweden)

    McSherry R


    Full Text Available Robert McSherry,1 Paddy Pearce2 1School of Health and Social Care, University of Teesside, Middlesbrough, 2PKP Consulting, Yarm, United Kingdom Abstract: The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor, along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not predefined roles but emerge from the complex clinical setting by gaining an acquired expertise and from how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognizing, influencing, and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for health care organizations in regard to creating organizational cultures where a duty of candor exists is not to reinvent the wheel by turning something that is simple into something complex, which can become confusing to health care workers, patients, and the public. By focusing on the clinical leader's role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting, and monitoring that this duty of candor happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks. Keywords: governance

  5. LES of flow in the street canyon (United States)

    Fuka, Vladimír; Brechler, Josef


    Results of computer simulation of flow over a series of street canyons are presented in this paper. The setup is adapted from an experimental study by [4] with two different shapes of buildings. The problem is simulated by an LES model CLMM (Charles University Large Eddy Microscale Model) and results are analysed using proper orthogonal decomposition and spectral analysis. The results in the channel (layout from the experiment) are compared with results with a free top boundary.

  6. Finding Street Gang Members on Twitter


    Balasuriya, Lakshika; Wijeratne, Sanjaya; Doran, Derek; Sheth, Amit


    Most street gang members use Twitter to intimidate others, to present outrageous images and statements to the world, and to share recent illegal activities. Their tweets may thus be useful to law enforcement agencies to discover clues about recent crimes or to anticipate ones that may occur. Finding these posts, however, requires a method to discover gang member Twitter profiles. This is a challenging task since gang members represent a very small population of the 320 million Twitter users. ...

  7. Hawadith Street Initiative: A unique Sudanese childhood charity experience. (United States)

    Ahmed, Awad Mohamed; A-Rahman, Nada Hassan Ahmed


    Due to escalating conflicts and resultant economic constraints, different social services in low income and low-middle income countries have witnessed a decline in its standards, and increase in the costs. This situation has led to emergence of large numbers of patients and their families who cannot afford the costs of health services provided by public hospitals. On this background, and the old heritage of the Sudanese to help the needy, the Hawadith Street Initiative (HSI) was established. Named after the street on which it was founded - which translates indirectly to "Accidents Lane", HSI was established in 2012 by a group of youths, most of them in their twenties of age, and recently graduated. The main activity of the initiative is helping the needy hospital patients, especially with regards to their treatment costs, in Khartoum and other cities in Sudan. Starting with recreational programs for cancer patients, and public campaigns for donation of blood, the initiative's youths changed their activities. Using the social media, Facebook, they adopted the strategy of communication with potential donors, after sending posts containing brief anonymous presentations and call of help for needy cases. Currently HSI includes more than 2000 volunteers in Khartoum and 17 other cities. The most important achievement of HSI is the establishment of an intensive care unit at a children hospital in Omdurman city costing 435,880 US dollars. HSI demonstrates the possibility of delivering great services with minimum resources, and constitutes a unique organization, worldwide, in a new wave of Internet-based initiatives.

  8. Prevalence and correlates of street racing among Ontario high school students. (United States)

    Vingilis, Evelyn; Smart, Reginald G; Mann, Robert E; Paglia-Boak, Angela; Stoduto, Gina; Adlaf, Edward M


    This study examined the prevalence and correlates of street racing among adolescents derived from the 2009 Ontario Student Drug Use and Health Survey (OSDUHS), an epidemiological survey of students in Ontario, Canada. The key response variable, self-reported street racing in past year, was examined in relation to grade level, rural/urban, school marks, cannabis use, drinking and driving, cannabis use and driving, and property, physical, drugs, and weapons delinquencies. All survey estimates were weighted, and variance and statistical tests were corrected for the complex sampling design. Of the 3053 9th- to 12th-graders (66% response rate), 5.6 percent of high-schoolers (an estimated 42,000 in the province) and (20.4% of grade 11 and 12 students with an advanced-level or full license) reported driving a car, truck, or sport utility vehicle (SUV) in a street race in the 12 months before the survey. Logistic regression analysis of the advanced-level or fully licensed students in grades 11 and 12 found that males compared to females and students in grade 11 compared to students in grade 12 had significantly higher adjusted odds of street racing. Supportive of problem behavior theory, students who reported property and drug delinquencies compared to students not engaging in these delinquencies also had significantly higher adjusted odds of street racing. This first population-based study in North America suggested that the prevalence of street racing at 1 in 5 of advanced or fully licensed high-schoolers in grades 11 and 12 poses significant public health concerns, especially related to the potential for unintentional injury.

  9. Innovation in Rehabilitation Services and Clinical Programs for Health Care

    Directory of Open Access Journals (Sweden)

    Asghar Dadkhah


    Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

  10. 75 FR 71744 - Fifth Street Finance Corp., et al.; Notice of Application (United States)


    ... Street Finance Corp., et al.; Notice of Application November 18, 2010. AGENCY: Securities and Exchange... Street Finance Corp. (``Fifth Street''), Fifth Street Management LLC, Fifth Street Mezzanine Partners IV... regulated as a business development company (``BDC'') under the Act. Fifth Street is a specialty finance...

  11. Self-Localization at Street Intersections. (United States)

    Fusco, Giovanni; Shen, Huiying; Coughlan, James M


    There is growing interest among smartphone users in the ability to determine their precise location in their environment for a variety of applications related to wayfinding, travel and shopping. While GPS provides valuable self-localization estimates, its accuracy is limited to approximately 10 meters in most urban locations. This paper focuses on the self-localization needs of blind or visually impaired travelers, who are faced with the challenge of negotiating street intersections. These travelers need more precise self-localization to help them align themselves properly to crosswalks, signal lights and other features such as walk light pushbuttons. We demonstrate a novel computer vision-based localization approach that is tailored to the street intersection domain. Unlike most work on computer vision-based localization techniques, which typically assume the presence of detailed, high-quality 3D models of urban environments, our technique harnesses the availability of simple, ubiquitous satellite imagery (e.g., Google Maps) to create simple maps of each intersection. Not only does this technique scale naturally to the great majority of street intersections in urban areas, but it has the added advantage of incorporating the specific metric information that blind or visually impaired travelers need, namely, the locations of intersection features such as crosswalks. Key to our approach is the integration of IMU (inertial measurement unit) information with geometric information obtained from image panorama stitchings. Finally, we evaluate the localization performance of our algorithm on a dataset of intersection panoramas, demonstrating the feasibility of our approach.

  12. Health Care Infrastructure for Financially Sustainable Clinical Genomics. (United States)

    Lennerz, Jochen K; McLaughlin, Heather M; Baron, Jason M; Rasmussen, David; Sumbada Shin, Meini; Berners-Lee, Nancy; Miller Batten, Julie; Swoboda, Kathryn J; Gala, Manish K; Winter, Harland S; Schmahmann, Jeremy D; Sweetser, David A; Boswell, Marianne; Pacula, Maciej; Stenzinger, Albrecht; Le, Long P; Hynes, William; Rehm, Heidi L; Klibanski, Anne; Black-Schaffer, Stephen W; Golden, Jeffrey A; Louis, David N; Weiss, Scott T; Iafrate, A John


    Next-generation sequencing has evolved technically and economically into the method of choice for interrogating the genome in cancer and inherited disorders. The introduction of procedural code sets for whole-exome and genome sequencing is a milestone toward financially sustainable clinical implementation; however, achieving reimbursement is currently a major challenge. As part of a prospective quality-improvement initiative to implement the new code sets, we adopted Agile, a development methodology originally devised in software development. We implemented eight functionally distinct modules (request review, cost estimation, preauthorization, accessioning, prebilling, testing, reporting, and reimbursement consultation) and obtained feedback via an anonymous survey. We managed 50 clinical requests (January to June 2015). The fraction of pursued-to-requested cases (n = 15/50; utilization management fraction, 0.3) aimed for a high rate of preauthorizations. In 13 of 15 patients the insurance plan required preauthorization, which we obtained in 70% and ultimately achieved reimbursement in 50%. Interoperability enabled assessment of 12 different combinations of modules that underline the importance of an adaptive workflow and policy tailoring to achieve higher yields of reimbursement. The survey confirmed a positive attitude toward self-organizing teams. We acknowledge the individuals and their interactions and termed the infrastructure: human pipeline. Nontechnical barriers currently are limiting the scope and availability of clinical genomic sequencing. The presented human pipeline is one approach toward long-term financial sustainability of clinical genomics. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  13. Transforming rural health systems through clinical academic leadership: lessons from South Africa. (United States)

    Doherty, J E; Couper, I D; Campbell, D; Walker, J


    Under-resourced and poorly managed rural health systems challenge the achievement of universal health coverage, and require innovative strategies worldwide to attract healthcare staff to rural areas. One such strategy is rural health training programs for health professionals. In addition, clinical leadership (for all categories of health professional) is a recognised prerequisite for substantial improvements in the quality of care in rural settings. Rural health training programs have been slow to develop in low- and middle-income countries (LMICs); and the impact of clinical leadership is under-researched in such settings. A 2012 conference in South Africa, with expert input from South Africa, Canada and Australia, discussed these issues and produced recommendations for change that will also be relevant in other LMICs. The two underpinning principles were that: rural clinical leadership (both academic and non-academic) is essential to developing and expanding rural training programs and improving care in LMICs; and leadership can be learned and should be taught. The three main sets of recommendations focused on supporting local rural clinical academic leaders; training health professionals for leadership roles in rural settings; and advancing the clinical academic leadership agenda through advocacy and research. By adopting the detailed recommendations, South Africa and other LMICs could energise management strategies, improve quality of care in rural settings and impact positively on rural health outcomes.

  14. Preceptors' perspectives of an integrated clinical learning model in a mental health environment. (United States)

    Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg


    Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting. © 2018 Australian College of Mental Health Nurses Inc.

  15. Health self-perception by dementia family caregivers: sociodemographic and clinical factors

    Directory of Open Access Journals (Sweden)

    Letice Ericeira Valente


    Full Text Available Caring for a demented family member has been associated with burden. Studies concerning health self-perception of family caregivers are still scarce. OBJECTIVE: To investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. METHOD: Dyads of dementia outpatients and family caregivers (n=137 were assessed with Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory and Clinical Dementia Rating. Caregivers answered Sociodemographic Questionnaire, Beck Depression and Anxiety Inventories, Zarit Burden Interview and Maslach Burnout Inventory. RESULTS: Caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. Logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. CONCLUSION: Aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. Evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health.

  16. Patients' Positive and Negative Responses to Reading Mental Health Clinical Notes Online. (United States)

    Denneson, Lauren M; Chen, Jason I; Pisciotta, Maura; Tuepker, Anais; Dobscha, Steven K


    This study describes responses to OpenNotes, clinical notes available online, among patients receiving mental health care and explores whether responses vary by patient demographic or clinical characteristics. Survey data from 178 veterans receiving mental health treatment at a large Veterans Affairs medical center included patient-reported health self-efficacy, health knowledge, alliance with clinicians, and negative emotional responses after reading OpenNotes. Health care data were extracted from the patient care database. Reading OpenNotes helped many participants feel in control of their health care (49%) and have more trust in clinicians (45%), although a few (8%) frequently felt upset after reading their notes. In multivariate models, posttraumatic stress disorder was associated with increased patient-clinician alliance (p=.046) but also with negative emotional responses (p<.01). Patients receiving mental health care frequently reported benefits from reading OpenNotes, yet some experienced negative responses.

  17. Factors shaping effective utilization of health information technology in urban safety-net clinics. (United States)

    George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard


    Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

  18. Street Food Environment in Maputo (STOOD Map): a Cross-Sectional Study in Mozambique. (United States)

    Gelormini, Marcello; Damasceno, Albertino; Lopes, Simão António; Maló, Sérgio; Chongole, Célia; Muholove, Paulino; Casal, Susana; Pinho, Olívia; Moreira, Pedro; Padrão, Patrícia; Lunet, Nuno


    Street food represents a cultural, social, and economic phenomenon that is typical of urbanized areas, directly linked with a more sedentary lifestyle and providing a very accessible and inexpensive source of nutrition. Food advertising may contribute to shaping consumers' preferences and has the potential to drive the supply of specific foods. The purpose of this study is to characterize the street food offerings available to the urban population of Maputo, the capital city of Mozambique, and the billboard food advertising in the same setting. People selling ready-to-eat foods, beverages, or snacks from venues such as carts, trucks, stands, and a variety of improvised informal setups (eg, shopping carts, trunks of cars, sides of vans, blankets on the sidewalk, etc) will be identified in the district of KaMpfumu. We will gather information about the actual food being sold through direct observation and interviews to vendors, and from the billboard advertising in the same areas. A second phase of the research entails collecting food samples to be analyzed in a specialized laboratory. The street food environment will be characterized, overall and according to socioeconomic and physical characteristics of the neighborhood, using descriptive statistics and spatial analysis. The study protocol was approved by the National Committee for Bioethics for Health in Mozambique. Data collection, including the identification of street food vending sites and billboard advertising, started on October 20, 2014, and lasted for 1 month. The collection of food samples took place in December 2014, and the bromatological analyses are expected to be concluded in August 2015. The district of KaMpfumu is the wealthiest and most urbanized in Maputo, and it is the area with the highest concentration and variety of street food vendors. The expected results may yield important information to assess the nutritional environment and the characteristics of the foods to which a great majority of

  19. Ethics and the electronic health record in dental school clinics. (United States)

    Cederberg, Robert A; Valenza, John A


    Electronic health records (EHRs) are a major development in the practice of dentistry, and dental schools and dental curricula have benefitted from this technology. Patient data entry, storage, retrieval, transmission, and archiving have been streamlined, and the potential for teledentistry and improvement in epidemiological research is beginning to be realized. However, maintaining patient health information in an electronic form has also changed the environment in dental education, setting up potential ethical dilemmas for students and faculty members. The purpose of this article is to explore some of the ethical issues related to EHRs, the advantages and concerns related to the use of computers in the dental operatory, the impact of the EHR on the doctor-patient relationship, the introduction of web-based EHRs, the link between technology and ethics, and potential solutions for the management of ethical concerns related to EHRs in dental schools.

  20. Employment and risk of injection drug use initiation among street involved youth in Canadian setting. (United States)

    Richardson, Lindsey; DeBeck, Kora; Feng, Cindy; Kerr, Thomas; Wood, Evan


    Youth unemployment has been associated with labour market and health disparities. However, employment as a determinant of high-risk health behaviour among marginalized young people has not been well described. We sought to assess a potential relationship between employment status and initiation of intravenous drug use among a prospective cohort of street-involved youth. We followed injecting naïve youth in the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada, and employed Cox regression analyses to examine whether employment was associated with injection initiation. Among 422 injecting naïve youth recruited between September 2005 and November 2011, 77 participants transitioned from non-injection to injection drug use, for an incidence density of 10.3 (95% confidence interval [CI]: 8.0-12.6) per 100 person years. Results demonstrating that employment was inversely associated with injection initiation (adjusted hazard ratio: 0.53; 95% CI: 0.33-0.85) were robust to adjustment for a range of potential confounders. A lack of employment among street-involved youth was associated with the initiation of injection drug use, a practice that predisposes individuals to serious long-term health consequences. Future research should examine if reducing barriers to labour market involvement among street-involved youth prevents transitions into high-risk drug use. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. A Health Science Process Framework for Comprehensive Clinical Functional Assessment (United States)


    Adaptability Inventory-4 • Rancho Los Amigos Cognitive Scale - Inpatient • Rancho Los Amigos Cognitive Scale - Outpatient • Satisfaction with Life...and policies e580 Health services, systems and policies e585 Education and training services, systems and policies e590 Labour and employment services...consistently reported a high degree of satisfaction with the process, and demonstrated a high level of interest in the exercise. In conjunction with the

  2. A method of teaching clinical problem-solving skills to primary health ...

    African Journals Online (AJOL)


    Mar 14, 2009 ... was named the Diploma in Clinical Nursing Science, Health Assessment,. Treatment and ... Seeks relevant and discriminating physical signs to help confirm or refute working .... related to allergies e.g. pets, pollens, smoke.

  3. How to estimate the health benefits of additional research and changing clinical practice


    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire


    A simple extension of standard meta-analysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  4. How to estimate the health benefits of additional research and changing clinical practice


    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire


    A simple extension of standard metaanalysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  5. Addiction Competencies in the 2009 CACREP Clinical Mental Health Counseling Program Standards (United States)

    Lee, Tiffany K.; Craig, Stephen E.; Fetherson, Bianca T. L.; Simpson, C. Dennis


    The Council for Accreditation of Counseling and Related Educational Programs developed addiction competencies for clinical mental health counseling students. This article highlights these competencies, provides an overview of current addiction training, and describes methods to integrate addiction education into curricula.

  6. Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic. (United States)

    Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B


    The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

  7. What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform. (United States)

    Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto


    Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

  8. Service quality and clinical outcomes: an example from mental health rehabilitation services in England. (United States)

    Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael


    Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

  9. What are the effective ways to translate clinical leadership into health care quality improvement? (United States)

    McSherry, Robert; Pearce, Paddy


    The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor, along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not predefined roles but emerge from the complex clinical setting by gaining an acquired expertise and from how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognizing, influencing, and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for health care organizations in regard to creating organizational cultures where a duty of candor exists is not to reinvent the wheel by turning something that is simple into something complex, which can become confusing to health care workers, patients, and the public. By focusing on the clinical leader's role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting, and monitoring that this duty of candor happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks.

  10. Bronx Teens Connection's Clinic Linkage Model: Connecting Youth to Quality Sexual and Reproductive Health Care. (United States)

    O'Uhuru, Deborah J; Santiago, Vivian; Murray, Lauren E; Travers, Madeline; Bedell, Jane F


    Teen pregnancy and birth rates in the Bronx have been higher than in New York City, representing a longstanding health disparity. The New York City Department of Health and Mental Hygiene implemented a community-wide, multicomponent intervention to reduce unintended teen pregnancy, the Bronx Teens Connection. The Bronx Teens Connection Clinic Linkage Model sought to increase teens' access to and use of sexual and reproductive health care by increasing community partner capacity to link neighborhood clinics to youth-serving organizations, including schools. The Bronx Teens Connection Clinic Linkage Model used needs assessments, delineated the criteria for linkages, clarified roles and responsibilities of partners and staff, established trainings to support the staff engaged in linkage activities, and developed and used process evaluation methods. Early results demonstrated the strength and feasibility of the model over a 4-year period, with 31 linkages developed and maintained, over 11,300 contacts between clinic health educators and teens completed, and increasing adherence to the Centers for Disease Control and Prevention-defined clinical best practices for adolescent reproductive health. For those eight clinics that were able to provide data, there was a 25% increase in the number of teen clients seen over 4 years. There are many factors that relate to an increase in clinic utilization; some of this increase may have been a result of the linkages between schools and clinics. The Bronx Teens Connection Clinic Linkage Model is an explicit framework for clinical and youth-serving organizations seeking to establish formal linkage relationships that may be useful for other municipalities or organizations. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Women in Free Clinics: An Assessment of Health-Related Quality of Life for Prevention and Health Education. (United States)

    Kamimura, Akiko; Myers, Kyl; Ashby, Jeanie; Trinh, Ha Ngoc; Nourian, Maziar M; Reel, Justine J


    Understanding gender influences on health-related quality of life (HRQoL) is important to improve women's health when considering diseases that afflict women specifically. The target population of this study was uninsured female free clinic patients who are low socio-economic status and lack access to healthcare resources. Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. While approximately half of free clinic patients are women, there is a paucity of comprehensive health-related data for female free clinic patients. US born English, non-US born English, and Spanish speaking female free clinic patients completed a self-administered survey using a standardized women's HRQoL measure in Fall 2014 (N = 389). Female free clinic patients reported lower HRQoL on all aspects of women's health compared to the US baseline scores, and were less likely to utilize preventive care including: mammograms, Pap smear, and HPV vaccination compared to the US general population. Spanish speakers reported a higher percentage of having had mammography and Pap smear, and heard about HPV compared to the other two groups. US born English speakers reported lower levels of HRQoL in vasomotor symptoms and sleep symptoms, and the lowest percentage of breast health and Pap smear screenings compared to non-US born English and Spanish speakers. Non-US born English speakers reported higher preference for female physician compared to US born English speakers and Spanish speakers. Free clinic female patients need preventative interventions and educational opportunities to improve their overall HRQoL.

  12. Seniors' perspectives on care: a case study of the Alex Seniors health clinic, Calgary. (United States)

    Shaw, Marta; Rypien, Candace; Drummond, Neil; Harasym, Patricia; Nixon, Lara


    Primary care initiatives face an imperative to not only reduce barriers to care for their patients but also to uniquely accommodate the complex needs of at-risk patient populations. Patient-centered multidisciplinary care team models for primary care, like the Alex Seniors Clinic, are one approach for providing comprehensive care for marginalized seniors. The purpose of this qualitative study was to explore patient perspectives on the responsiveness of the Alex Seniors Clinic to their stated health needs. Themes reflected participants' perspectives on factors impacting their health needs as vulnerable seniors as well as on the measures that the Alex Seniors Clinic has taken to meet those needs. Factors impacting health included: the nature of their relationships to the physical environment in which they lived, the nature of the relationships they had to others in that environment, and independence and autonomy. Participants identified accessibility, respect and support, and advocacy as the ways in which the clinic was working to address those health needs. While respect and support, as well as advocacy, effectively addressed some patient needs, participants felt that accessibility problems continue to be health-related barriers for clinic patients. This may be due to the fact that issues of accessibility reflect larger community and social problems. Nevertheless, it is only through engaging the patient community for input on clinic approaches that an understanding can be gained of how closely a clinic's care goals are currently aligning with patient perspectives of the care and services they receive.

  13. Radiometric system for clinical applications in the National Health System

    International Nuclear Information System (INIS)

    Mesa Perez, G.; Arteche Diaz, R.; Camejo Batista, A.; Fonfria Bragado, C.


    In this paper it is presented the radiometric detection system SRNIC-02, manufactured at CEADEN. The system has three major components: a well-type Nal(TI) scintillator detector with its collimator, a measurement module, and the application software, which allows fixing the working parameters of the system, as well as the acquisition and processing of data. The system has two main applications in the National Health System, one for the quality control in Radiopharmacy, and in RIA/IRMA blood tests. There are 16 systems installed, in 13 provinces of the country up to this date. (Author)

  14. Clinical Trials in Dentistry: A Cross-sectional Analysis of World Health Organization-International Clinical Trial Registry Platform. (United States)

    Sivaramakrishnan, Gowri; Sridharan, Kannan


    Clinical trials are the back bone for evidence-based practice (EBP) and recently EBP has been considered the best source of treatment strategies available. Clinical trial registries serve as databases of clinical trials. As regards to dentistry in specific data on the number of clinical trials and their quality is lacking. Hence, the present study was envisaged. Clinical trials registered in WHO-ICTRP ( in dental specialties were considered. The details assessed from the collected trials include: Type of sponsors; Health condition; Recruitment status; Study design; randomization, method of randomization and allocation concealment; Single or multi-centric; Retrospective or prospective registration; and Publication status in case of completed studies. A total of 197 trials were identified. Maximum trials were from United States (n = 30) and United Kingdom (n = 38). Seventy six trials were registered in Clinical, 54 from International Standards of Reporting Clinical Trials, 13 each from Australia and New Zealand Trial Register and Iranian Registry of Clinical Trials, 10 from German Clinical Trial Registry, eight each from Brazilian Clinical Trial Registry and Nederland's Trial Register, seven from Japan Clinical Trial Registry, six from Clinical Trial Registry of India and two from Hong Kong Clinical Trial Registry. A total of 78.7% studies were investigator-initiated and 64% were completed while 3% were terminated. Nearly four-fifths of the registered trials (81.7%) were interventional studies of which randomized were the large majority (94.4%) with 63.2% being open label, 20.4% using single blinding technique and 16.4% were doubled blinded. The number, methodology and the characteristics of clinical trials in dentistry have been noted to be poor especially in terms of being conducted multi-centrically, employing blinding and the method for randomization and allocation concealment. More emphasis has to be

  15. Using a plant health system framework to assess plant clinic performance in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, Frank B.


    and expand, new analytical frameworks and tools are needed to identify factors influencing performance of services and systems in specific contexts, and to guide interventions. In this paper we apply a plant health system framework to assess plant clinic performance, using Uganda as a case study...... factors, influenced by basic operational and financial concerns, inter-institutional relations and public sector policies. Overall, there was a fairly close match between the plant health system attributes and plant clinic performance, suggesting that the framework can help explain system functioning....... A comparative study of plant clinics was carried out between July 2010 and September 2011 in the 12 districts where plant clinics were operating at that time. The framework enabled us to organise multiple issues and identify key features that affected the plant clinics. Clinic performance was, among other...

  16. Wiki Activities in Blended Learning for Health Professional Students: Enhancing Critical Thinking and Clinical Reasoning Skills (United States)

    Snodgrass, Suzanne


    Health professionals use critical thinking, a key problem solving skill, for clinical reasoning which is defined as the use of knowledge and reflective inquiry to diagnose a clinical problem. Teaching these skills in traditional settings with growing class sizes is challenging, and students increasingly expect learning that is flexible and…

  17. A decade of the International Journal of Clinical and Health Psychology (2001-2010

    Directory of Open Access Journals (Sweden)

    Izabela Zych


    and that the journal has published works of authors from 29 different countries. The highest percentages were found for ex post facto studies, works on test validation and adaptation and adult clinical samples. These results are in agreement with the journal's mission of promoting advancement in clinical and health psychology and show that it is a truly international journal.

  18. Financial Analysis of Behavioral Health Services in a Pediatric Endocrinology Clinic. (United States)

    Yarbro, Jessica L; Mehlenbeck, Robyn


    This article addresses a current need in psychological practice by describing a financially feasible model that moves toward integrated care of behavioral health services in a pediatric endocrinology clinic. Financial information (costs and revenue associated with behavioral health services) for the clinic, over an 18-month period (July 2012 to December 2013), was obtained through the hospital's financial department. The clinic meets one half day per week. Over the 18-month period, the behavioral health services generated a net gain of $3661.45 in the favor of the clinic. We determined that the psychologist and clinical psychology residents needed to see a total of four patients per half-day clinic for the clinic to "break-even." We describe one financially feasible way of integrating behavioral health services into a pediatric endocrinology clinic in the hope that this will be generalizable to other medical settings. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail:

  19. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases (United States)

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily


    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  20. Identifying mental health services in clinical genetic settings. (United States)

    Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D


    The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

  1. School-Based Health Clinics: An Analysis of the Johns Hopkins Study. Research Developments. (United States)

    Demsko, Tobin W.

    School-based health clinics, adolescent pregnancy prevention programs offering comprehensive health services, represent the latest initiative to reduce the incidence of teenage pregnancy. Researchers at Johns Hopkins University designed and administered a pregnancy prevention program which offered sexuality education and family planning services…

  2. 75 FR 47310 - Solicitation for Nominations for New Clinical Preventive Health Topics To Be Considered for... (United States)


    ... following set of criteria: Public health importance (burden of suffering, potential of preventive service to.../gynecology). c. Public health importance (burden of disease/suffering, potential of preventive service to... accomplishes these goals through scientific research and promotion of improvements in clinical practice...

  3. Use of Clinical Health Information Technology in Nursing Homes: Nursing Home Characteristics and Quality Measures (United States)

    Spinelli-Moraski, Carla


    This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to…

  4. Incidence of dog bite injuries and clinical rabies in a tertiary health ...

    African Journals Online (AJOL)

    Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.

  5. Public health nurses perception of clinical leadership in Ireland: narrative descriptions. (United States)

    Carney, Marie


    The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery. Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles. Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery. Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective. Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. RELEVANCE TO NURSE MANAGERS: Public health nurses are well placed to shape and influence health service culture through effective clinical leadership.

  6. Obstacles to Successful Implementation of eHealth Applications into Clinical Practice. (United States)

    Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W


    eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

  7. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study. (United States)

    Woods, Susan S; Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W Paul


    Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online. Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared

  8. Air quality considerations for stormwater green street design. (United States)

    Shaneyfelt, Kathryn M; Anderson, Andrew R; Kumar, Prashant; Hunt, William F


    Green streets are increasingly being used as a stormwater management strategy to mitigate stormwater runoff at its source while providing other environmental and societal benefits, including connecting pedestrians to the street. Simultaneously, human exposure to particulate matter from urban transportation is of major concern worldwide due to the proximity of pedestrians, drivers, and cyclists to the emission sources. Vegetation used for stormwater treatment can help designers limit the exposure of people to air pollutants. This goal can be achieved through the deliberate placement of green streets, along with strategic planting schemes that maximize pollutant dispersion. This communication presents general design considerations for green streets that combine stormwater management and air quality goals. There is currently limited guidance on designing green streets for air quality considerations; this is the first communication to offer suggestions and advice for the design of green stormwater streets in regards to their effects on air quality. Street characteristics including (1) the width to height ratio of the street to the buildings, (2) the type of trees and their location, and (3) any prevailing winds can have an impact on pollutant concentrations within the street and along sidewalks. Vegetation within stormwater control measures has the ability to reduce particulate matter concentrations; however, it must be carefully selected and placed within the green street to promote the dispersion of air flow. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Infant oral health care: An invaluable clinical intervention

    Directory of Open Access Journals (Sweden)

    Kanika Singh Dhull


    Full Text Available Dental assessments and evaluations for children during their 1st year of life have been recommended by the American Academy of Pediatric Dentistry and the American Association of Pediatrics. Early dental intervention evaluates a child's risk status based on parental interviews and oral examinations. These early screenings present an opportunity to educate parents about the medical, dental, and cost benefits of preventive rather than restorative care and may be more effective in reducing early childhood caries than traditional infectious disease models. A comprehensive infant oral care program includes: (1 risk assessments at regularly scheduled dental visits, (2 preventive treatments such as fluoride varnishes or sealants, (3 parental education on the correct methods to clean the baby's mouth, and (4 establishment of dental home and use of anticipatory guidance. The present article highlights the important guidelines of infant oral health care.

  10. The Effects of Peer Education on The Behaviors Regarding HIV/AIDS Transmission Prevention Among Street Children in Bandung City

    Directory of Open Access Journals (Sweden)

    Lia Meilianingsih


    Full Text Available All adolescents are vulnerable to HIV/AIDS, including street children. The behaviors of street children are much influenced by their peers. Peer education can enhance knowledge, attitudes, beliefs, and skills and empower children to be responsible for protecting the health of themselves and their peers (Wahyuni, 2012. This study aims to determine the effects of peer health education on the HIV/AIDS Preventive Behaviors of Street Children in Bandung City in 2015. The research employed a quasi-experimental method with the pre-post-test control group design. The sample was 26 people for the treatment group and 26 people for the control group, respectively, taken with purposive sampling technique. Interventions began with peer educator training and then the peer educators provided health education on HIV/AIDS transmission prevention through small group discussions for 2 days. The data in this study were not normally distributed. The paired or dependent data were analyzed using the Wilcoxon test, while the unpaired or independent data using Mann-Whitney test. The results of the research show that peer health education had effects on the knowledge and attitudes of the street children (p values 0.00 and 0.00, respectively; however, there was no effect of peer health education on the actions regarding HIV/AIDS transmission prevention among the street children (p value 0.09. Hence, it is advisable to conduct health promotion with peer health education method in an effort of increasing knowledge and attitudes regarding HIV/AIDS transmission prevention among street children that is sustainable and integrated with the existing programs at puskesmas (Community Health Center.

  11. Adolescent postabortion groups: risk reduction in a school-based health clinic. (United States)

    Daly, Joan Ziegler; Ziegler, Robert; Goldstein, Donna J


    A short-term postabortion group for adolescents was developed. Three groups were conducted in an adolescent mental health clinic within an urban high school-based health clinic. The clinical group experiences offered the adolescents an opportunity to integrate the experience of pregnancy and the abortion decision into their lives. At follow up, adolescents who participated in th postabortion counseling group indicated that they chose and used a method of birth control, did not repeat an unplanned pregnancy, and remained in high school.

  12. Social and structural barriers to housing among street-involved youth who use illicit drugs. (United States)

    Krüsi, Andrea; Fast, Danya; Small, Will; Wood, Evan; Kerr, Thomas


    In Canada, approximately 150,000 youth live on the street. Street-involvement and homelessness have been associated with various health risks, including increased substance use, blood-borne infections and sexually transmitted diseases. We undertook a qualitative study to better understand the social and structural barriers street-involved youth who use illicit drugs encounter when seeking housing. We conducted 38 semi-structured interviews with street-involved youth in Vancouver, Canada from May to October 2008. Interviewees were recruited from the At-risk Youth Study (ARYS) cohort, which follows youth aged 14 to 26 who have experience with illicit drug use. All interviews were thematically analyzed, with particular emphasis on participants' perspectives regarding their housing situation and their experiences seeking housing. Many street-involved youth reported feeling unsupported in their efforts to find housing. For the majority of youth, existing abstinence-focused shelters did not constitute a viable option and, as a result, many felt excluded from these facilities. Many youth identified inflexible shelter rules and a lack of privacy as outweighing the benefits of sleeping indoors. Single-room occupancy hotels (SROs) were reported to be the only affordable housing options, as many landlords would not rent to youth on welfare. Many youth reported resisting moving to SROs as they viewed them as unsafe and as giving up hope for a return to mainstream society. The findings of the present study shed light on the social and structural barriers street-involved youth face in attaining housing and challenge the popular view of youth homelessness constituting a lifestyle choice. Our findings point to the need for housing strategies that include safe, low threshold, harm reduction focused housing options for youth who engage in illicit substance use.

  13. Healthy by Design: Using a Gender Focus to Influence Complete Streets Policy. (United States)

    Keippel, April Ennis; Henderson, Melissa A; Golbeck, Amanda L; Gallup, TommiLee; Duin, Diane K; Hayes, Stephen; Alexander, Stephanie; Ciemins, Elizabeth L


    Public health leaders in Yellowstone County, Montana, formed an alliance to address community-wide issues. One such issue is Complete Streets, with its vision of safe streets for all. This case study focuses on development and adoption of a Complete Streets policy. It examines how a community coalition, Healthy By Design, infused a gender focus into the policymaking process. An incremental and nonlinear policymaking process was aided by a focus on gender and health equity. The focus on a large constituency helped to frame advocacy in terms of a broad population's needs, not just special interests. The city council unanimously adopted a Complete Streets resolution, informed by a gender lens. Healthy By Design further used gender information to successfully mobilize the community in response to threats of repeal of the policy, and then influenced the adoption of a revised policy. Policies developed with a focus on equity, including gender equity, may have broader impact on the community. Such policies may pave the way for future policies that seek to transform gender norms toward building a healthier community for all residents. Published by Elsevier Inc.

  14. Risk factors in street food practices in developing countries: A review

    Directory of Open Access Journals (Sweden)

    Buliyaminu Adegbemiro Alimi


    Full Text Available Street food trading solves major social and economic problems in developing countries through the provision of ready-made meals at relatively inexpensive prices and employment for teeming rural and urban populace along its value chain. However, due to informal nature of the enterprise, the activities of the practitioners are not regulated. This gives ample room for unwholesome practices. The results are the risks such activities pose to the health and safety of practitioners along the value chain. This review paper, a summary of literature reports on risk factors in street food trade in developing countries and recommended safety intervention, is written with the hope of providing global baseline for intervention to ensure safe food practices. Adoption of safety approaches that permeates the entire chain of street food business from good agricultural practices through hazard analysis critical control points strategy to good hygiene practices by farmers, vendors and consumers would significantly reduce risks in street food consumption. Above all, active collaboration of all stakeholders toward the strengthening and proper enforcement of public health policies to ensure safe practices and engender safer and healthier society is recommended.

  15. An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention. (United States)

    Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard


    Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.

  16. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney


    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  17. Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies. (United States)

    Anderson, James W; Nunnelley, Paige A


    To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, prayer in four studies (P value, P prayer (P prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

  18. Evaluation of a hand hygiene campaign in outpatient health care clinics. (United States)

    Kukanich, Kate Stenske; Kaur, Ramandeep; Freeman, Lisa C; Powell, Douglas A


    To improve hand hygiene in two outpatient health care clinics through the introduction of a gel sanitizer and an informational poster. In this interventional study, health care workers at two outpatient clinics were observed for frequency of hand hygiene (attempts versus opportunities). Gel sanitizer and informational posters were introduced together as an intervention. Direct observation of the frequency of hand hygiene was performed during baseline, intervention, and follow-up. A poststudy survey of health care workers was also distributed and collected. In both clinics, the frequency of hand hygiene was poor at baseline (11% and 21%) but improved significantly after intervention (36% and 54%) and was maintained through the follow-up period (32% and 51%). Throughout the study, postcontact hand hygiene was observed significantly more often than precontact hand hygiene. In both clinics, health care workers reported a preference for soap and water; yet observations showed that when the intervention made gel sanitizer available, sanitizer use predominated. Fifty percent of the surveyed health care workers considered the introduction of gel sanitizer to be an effective motivating tool for improving hand hygiene. Hand hygiene performance by health care workers in outpatient clinics may be improved through promoting the use of gel sanitizer and using informational posters. Compared with surveys, direct observation by trained observers may provide more accurate information about worker preferences for hand hygiene tools.

  19. Processo saúde-doença ligado à sexualidade de meninas que vivem na rua El proceso salud-enfermedad de la sexualidad de niñas que viven en la calle Health-sickness-process linked to sexuality of street girls

    Directory of Open Access Journals (Sweden)

    Romeu Gomes


    Full Text Available O artigo consiste num recorte de uma pesquisa que aborda a relação entre prostituição infantil, processo saúde-doença ligado à sexualidade, e violência, configurada no ambiente de meninas que vivem na rua. Neste trabalho são apresentados apenas os resultados sobre o processo saúde-doença ligado à sexualidade revelados na fala das meninas. Após considerações. básicas sobre a pesquisa e sobre a sexualidade em geral, as meninas estudadas são situadas em seu cenário social. Dentro deste cenário, analisa-se os dados sobre a sexualidade. A partir desta análise, conclui-se que, entre outros aspectos, a interdisciplinaridade é necessária para a Saúde Pública abordar a temática aqui apresentada.El presente artículo es parte de una pesquisa acerca la relación entre prostitución infantil, proceso salud-enfermedad de la sexualidad y violencia, presentada en el ambiente de niñas que viven en la calle, En este trabajo son presentados solamente los resultados acerca de el proceso salud-enfermedad de la sexualidad revelados en las palabras de las niñas. Después de las consideraciones esenciales acerca de la investigación y acerca de la sexualidad en general, las niñas son caracterizadas en su escenario social. En este escenario, se hace un análisis de los datos acerca de la sexualidad. Con apoyo en este análisis, se concluye que, entre otros aspectos, que la interdisciplinariedad es imprescindible para que la Salud Pública pueda abordar el tema de este artículo.This article is a part of a research focusing on the relationship among child-prostitution, health-sickness-process linked to sexuality and violence; the three categories found in the environment of street girls. This paper, however, only deals with health-sickness-process linked to sexuality revealed by the girls themselves. After the considerations about the research as a whole and about sexuality in general, the street girls are characterized in their social

  20. Mobile phone based clinical microscopy for global health applications.

    Directory of Open Access Journals (Sweden)

    David N Breslauer

    Full Text Available Light microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases. In many regions of the world, however, the required equipment is either unavailable or insufficiently portable, and operators may not possess adequate training to make full use of the images obtained. Counterintuitively, these same regions are often well served by mobile phone networks, suggesting the possibility of leveraging portable, camera-enabled mobile phones for diagnostic imaging and telemedicine. Toward this end we have built a mobile phone-mounted light microscope and demonstrated its potential for clinical use by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with LED excitation. In all cases resolution exceeded that necessary to detect blood cell and microorganism morphology, and with the tuberculosis samples we took further advantage of the digitized images to demonstrate automated bacillus counting via image analysis software. We expect such a telemedicine system for global healthcare via mobile phone -- offering inexpensive brightfield and fluorescence microscopy integrated with automated image analysis -- to provide an important tool for disease diagnosis and screening, particularly in the developing world and rural areas where laboratory facilities are scarce but mobile phone infrastructure is extensive.

  1. Vermeer's The Little Street: a precise location

    Directory of Open Access Journals (Sweden)

    Frans Grijzenhout


    Full Text Available In the autumn of 2015, Frans Grijzenhout published his sensational findings regarding the likely location of Johannes Vermeer’s ‘little street’ (The Little Street. After consulting a variety of sources, including the ‘The Ledger of Dredging of the Canals in the Town of Delft’ from 1666–1667, he had reached the conclusion that the famous painting by Vermeer must have been based on the houses and two intervening passageways that in Vermeer’s day stood on Vlamingstraat, an unassuming canal in the eastern part of Delft, where numbers 40 and 42 stand today. He had also ascertained that one of Vermeer’s aunts, Ariaentgen Claes van der Minne, was the occupant of 42 Vlamingstraat at that time. Several authors have since produced material indicating that Vermeer painted the right-hand house in Little Street ‘from life’: the house was, it now appears, observed and reproduced in meticulous detail. The same can now be confirmed for other aspects, such as the colour used for the painted shutters and the recesses for wind hooks in the sill of the window of the righthand house. Philip Steadman has rightly pointed to an apparent discrepancy of four feet (c. 1.25 m. between the details in the aforementioned ‘Ledger of the Dredging of the Canals in the Town of Delft’ and the actual spatial situation at 40 Vlamingstraat. This difference can be traced back to the fact that the gateway provided access to both front and back houses. Accordingly, the owners of both front and back houses would have been taxed on the width (four feet of the passageway. Given what we know about the meticulous precision with which the Ledger was compiled in the case of 42 Vlamingstraat, it is inconceivable that the authors of the register for number 40 should have made a mistake. A spatial rendering based on an earlier perspective study of The Little Street, corresponds surprisingly well, and in some respects in detail, with the cadastral and other information we

  2. Experience from mental health clinics held during medical service camps in Fiji. (United States)

    Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir


    We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  3. Is it just religious practice? Exploring patients' reasons for choosing a faith-based primary health clinic over their local public sector primary health clinic. (United States)

    Porter, James D; Bresick, Graham


    Person-centred, re-engineered primary health care (PHC) is a national and global priority. Faith-based health care is a significant provider of PHC in sub-Saharan Africa, but there is limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa. The primary objective was to determine and explore the reasons for patient choice of a faith-based primary care clinic over their local public sector primary care clinic, and secondarily to determine to what extent these reasons were influenced by demography. The study was conducted at Jubilee Health Centre (JHC), a faith-based primary care clinic attached to Jubilee Community Church in Cape Town, South Africa. Focus groups, using the nominal group technique, were conducted with JHC patients and used to generate ranked reasons for attending the clinic. These were collated into the top 15 reasons and incorporated into a quantitative questionnaire which was administered to adult patients attending JHC. A total of 164 patients were surveyed (a response rate of 92.4%) of which 68.3% were female and 57.9% from the Democratic Republic of the Congo (DRC). Of patients surveyed, 98.2% chose to attend JHC because 'the staff treat me with respect', 96.3% because 'the staff are friendly' and 96.3% because 'the staff take time to listen to me'. The reason 'it is a Christian clinic' was chosen by 70.1% of patients. 'The staff speak my home language' was given as a reason by 61.1% of DRC patients and 37.1% of South African patients. 'The clinic is close to me' was chosen by 66.6% of Muslims and 40.8% of Christians. Patients chose to attend JHC (a faith-based primary care clinic) because of the quality of care received. They emphasised the staff-patient relationship and patient-centredness rather than the clinic's religious practices (prayer with patients). These findings may be important in informing efforts to improve public sector primary care.

  4. Federated querying architecture with clinical & translational health IT application. (United States)

    Livne, Oren E; Schultz, N Dustin; Narus, Scott P


    We present a software architecture that federates data from multiple heterogeneous health informatics data sources owned by multiple organizations. The architecture builds upon state-of-the-art open-source Java and XML frameworks in innovative ways. It consists of (a) federated query engine, which manages federated queries and result set aggregation via a patient identification service; and (b) data source facades, which translate the physical data models into a common model on-the-fly and handle large result set streaming. System modules are connected via reusable Apache Camel integration routes and deployed to an OSGi enterprise service bus. We present an application of our architecture that allows users to construct queries via the i2b2 web front-end, and federates patient data from the University of Utah Enterprise Data Warehouse and the Utah Population database. Our system can be easily adopted, extended and integrated with existing SOA Healthcare and HL7 frameworks such as i2b2 and caGrid.

  5. The gut microbiota and host health: a new clinical frontier. (United States)

    Marchesi, Julian R; Adams, David H; Fava, Francesca; Hermes, Gerben D A; Hirschfield, Gideon M; Hold, Georgina; Quraishi, Mohammed Nabil; Kinross, James; Smidt, Hauke; Tuohy, Kieran M; Thomas, Linda V; Zoetendal, Erwin G; Hart, Ailsa


    Over the last 10-15 years, our understanding of the composition and functions of the human gut microbiota has increased exponentially. To a large extent, this has been due to new 'omic' technologies that have facilitated large-scale analysis of the genetic and metabolic profile of this microbial community, revealing it to be comparable in influence to a new organ in the body and offering the possibility of a new route for therapeutic intervention. Moreover, it might be more accurate to think of it like an immune system: a collection of cells that work in unison with the host and that can promote health but sometimes initiate disease. This review gives an update on the current knowledge in the area of gut disorders, in particular metabolic syndrome and obesity-related disease, liver disease, IBD and colorectal cancer. The potential of manipulating the gut microbiota in these disorders is assessed, with an examination of the latest and most relevant evidence relating to antibiotics, probiotics, prebiotics, polyphenols and faecal microbiota transplantation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  6. Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing. (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry


    Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.

  7. Towards integration of health economics into medical education and clinical practice in Saudi Arabia. (United States)

    Da'ar, Omar B; Al Shehri, Ali M


    In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

  8. Impact and user satisfaction of a clinical information portal embedded in an electronic health record. (United States)

    Tannery, Nancy H; Epstein, Barbara A; Wessel, Charles B; Yarger, Frances; LaDue, John; Klem, Mary Lou


    In 2008, a clinical information tool was developed and embedded in the electronic health record system of an academic medical center. In 2009, the initial information tool, Clinical-e, was superseded by a portal called Clinical Focus, with a single search box enabling a federated search of selected online information resources. To measure the usefulness and impact of Clinical Focus, a survey was used to gather feedback about users' experience with this clinical resource. The survey determined what type of clinicians were using this tool and assessed user satisfaction and perceived impact on patient care decision making. Initial survey results suggest the majority of respondents found Clinical Focus easy to navigate, the content easy to read, and the retrieved information relevant and complete. The majority would recommend Clinical Focus to their colleagues. Results indicate that this tool is a promising area for future development.

  9. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren


    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...

  10. Politicians, Managers, and Street-Level Bureaucrats

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren


    This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...





    The issue represents the analysis of the fundamentals and world-wide best practices of controlling street dog population in Moscow and other global cities. Actions proposed to improve the strategy of managing free-ranging dogs in Moscow.Some reasons of increase in number of stray dogs and “pet overpopulation” ware studied. There are ecological types of stray dogs characterized the types of running wild of dogs and foraging (food procurement) strategy of animals.The analysis of the basic princ...

  12. Potential reductions of street solids and phosphorus in urban watersheds from street cleaning, Cambridge, Massachusetts, 2009-11 (United States)

    Sorenson, Jason R.


    Material accumulating and washing off urban street surfaces and ultimately into stormwater drainage systems represents a substantial nonpoint source of solids, phosphorus, and other constituent loading to waterways in urban areas. Cost and lack of usable space limit the type and number of structural stormwater source controls available to municipalities and other public managers. Non-structural source controls such as street cleaning are commonly used by cities and towns for construction, maintenance and aesthetics, and may reduce contaminant loading to waterways. Effectiveness of street cleaning is highly variable and potential improvements to water quality are not fully understood. In 2009, the U.S. Geological Survey, in cooperation with the Massachusetts Department of Environmental Protection, the U.S. Environmental Protection Agency, and the city of Cambridge, Massachusetts, and initiated a study to better understand the physical and chemical nature of the organic and inorganic solid material on street surfaces, evaluate the performance of a street cleaner at removing street solids, and make use of the Source Loading and Management Model (SLAMM) to estimate potential reductions in solid and phosphorus loading to the lower Charles River from various street-cleaning technologies and frequencies. Average yield of material on streets collected between May and December 2010, was determined to be about 740 pounds per curb-mile on streets in multifamily land use and about 522 pounds per curb-mile on commercial land-use streets. At the end-of-winter in March 2011, about 2,609 and 4,788 pounds per curb-mile on average were collected from streets in multifamily and commercial land-use types, respectively. About 86 percent of the total street-solid yield from multifamily and commercial land-use streets was greater than or equal to 0.125 millimeters in diameter (or very fine sand). Observations of street-solid distribution across the entire street width indicated that as

  13. Feasibility of Automatic Extraction of Electronic Health Data to Evaluate a Status Epilepticus Clinical Protocol. (United States)

    Hafeez, Baria; Paolicchi, Juliann; Pon, Steven; Howell, Joy D; Grinspan, Zachary M


    Status epilepticus is a common neurologic emergency in children. Pediatric medical centers often develop protocols to standardize care. Widespread adoption of electronic health records by hospitals affords the opportunity for clinicians to rapidly, and electronically evaluate protocol adherence. We reviewed the clinical data of a small sample of 7 children with status epilepticus, in order to (1) qualitatively determine the feasibility of automated data extraction and (2) demonstrate a timeline-style visualization of each patient's first 24 hours of care. Qualitatively, our observations indicate that most clinical data are well labeled in structured fields within the electronic health record, though some important information, particularly electroencephalography (EEG) data, may require manual abstraction. We conclude that a visualization that clarifies a patient's clinical course can be automatically created using the patient's electronic clinical data, supplemented with some manually abstracted data. Future work could use this timeline to evaluate adherence to status epilepticus clinical protocols. © The Author(s) 2015.

  14. Acupuncture and women's health: an overview of the role of acupuncture and its clinical management in women's reproductive health

    Directory of Open Access Journals (Sweden)

    Cochrane S


    Full Text Available Suzanne Cochrane,1 Caroline A Smith,2 Alphia Possamai-Inesedy,3 Alan Bensoussan2 1School of Science and Health, 2Centre for Complementary Medicine Research, 3School of Social Sciences and Psychology, University of Western Sydney – Campbelltown Campus, Penrith, NSW, Australia Background: Acupuncture and other modalities of Chinese/East Asian medicine have been used to treat women's health for many centuries. Gynecology specialties focus particularly on menstrual and reproductive disorders. Both the adoption of the use of acupuncture outside Asia, and the incorporation of scientific analysis in Asia have challenged biomedical conceptions of what can be achieved with this treatment method. The scale of research activity in relation to acupuncture and women's health has increased over the last 20 years. Objective: This review aims to explore the research evidence in relation to acupuncture use for women's reproductive disorders, focusing on both clinical findings and experimental research on acupuncture's mechanisms of action in relation to women's health. Methods: A narrative literature search was undertaken using searches of electronic databases and manual searches of journals and textbooks. The search included all literature published prior to June 2013. The literature was assessed as to the nature of the study it was reporting and findings synthesized into a commentary. Results: For acupuncture's mechanism of action the search resulted in 114 relevant documents; in relation to clinical reports on the use of acupuncture for women's health 204 documents were found and assessed. Conclusion: There is preliminary data indicating acupuncture may improve menstrual health and coping for women experiencing delays falling pregnant. There is experimental data showing that acupuncture can influence female reproductive functioning, although the actual mechanisms involved are not yet clarified. Further well-conducted clinical research would benefit our

  15. A social work study on family patterns and street children

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani


    Full Text Available This paper presents a social work study on relationship between various family characteristics and street children in rural area as well as city of Esfahan, Iran. The proposed study selects a sample of 150 street children, 75 from city and 75 from rural area, and using some statistical tests verifies the effects of three factors including family income, place of residency and family size on street children. The results indicate that the city residence had more street children than rural residence did. In addition, there was a meaningful difference between the number of street children in low-income families and high-income families. Finally, the survey results indicate that big size families more likely suffered from street children than low size families did.

  16. [Street social education: historical, political and pedagogical bases]. (United States)

    de Oliveira, Walter Ferreira


    This work is about street social education as a pedagogical system that started in Latin America in the late 1970s, as the street population formed mostly by children and adolescents called for attention. The first street social educators were 'pastoral' agents working at the praça da Sé a place with large numbers of street children in São Paulo. Based on the Liberation Theology and on the pedagogies developed by Paulo Freire, Celestine Freinet, Anton Makarenko, and Emília Ferreiro, the street educators developed a conceptual field and participated in the promulgation of the 1988 Federal Constitution, particularly by writing and introducing the 'Estatuto da Criança e do Adolescente' (the 'Child and Adolescent Statute'). Street social education is currently latent and suffering the consequences of program discontinuity caused by successive changes of government. It is, therefore important to know the conceptual proposals.

  17. Whose Bay Street? Competing Narratives of Nassau's City Centre

    Directory of Open Access Journals (Sweden)

    Nona Patara Martin


    Full Text Available Bay Street has always been at the centre of commercial, cultural and political life in the Bahama Islands. It also acts as a gateway for millions of tourists who come to Nassau, the Bahamian capital, via cruise ships every year. Not surprisingly, Bahamians and non-Bahamians have widely divergent impressions of Bay Street. The need to accommodate the tourists who are critical to the Bahamian economy has meant that Bay Street, despite its deep social significance for Bahamians, has increasingly become a tourist space. With reference to the ‘sense of place’ and place attachment literature, this paper traces the transformation of Bay Street and attempts to tease out the most obvious tensions between the Bay Street that Bahamians experience and Bay Street as a port of call.

  18. Digital health promotion in sexual health clinics: results of a feasibility trial of the Men’s Safer Sex website

    Directory of Open Access Journals (Sweden)

    Julia V Bailey


    The best way to assess the impact of the MenSS website was by recording STI diagnoses from clinical records. Response rates for the online questionnaire were poor despite offers of incentives. There were many challenges to conducting an online trial of a sexual health website including ethical committee concerns about email content, poor reliability of trial-related software, balancing data protection and security protocols against ease of access for participants, barriers to patient access to IT in NHS clinics, and trying to ensure that participants engage with a digital intervention for long enough. Whilst digital interventions have great potential for health promotion, we encountered significant obstacles to online research, and to implementation of an IDI in an NHS clinical setting.

  19. The on-street parking premium and car drivers' choice between street and garage parking

    NARCIS (Netherlands)

    Kobus, M.B.W.; Gutierrez Puigarnau, E.; Rietveld, P.; van Ommeren, J.N.


    We introduce a methodology to estimate the effect of parking prices on car drivers' choice between street and garage parking. Our key identifying assumption is that the marginal benefit of parking duration does not depend on this choice. The endogeneity of parking duration is acknowledged in the

  20. The Ballet of the Streets: Teaching about Cities at Street Level (United States)

    McGuire, Patrick A.; Spates, James L.


    The urban scholar Jane Jacobs once described city life as "the ballet of the streets." In more than a quarter century of joint teaching, the authors have used Jacobs' metaphor to help their students understand that cities are living organisms created and maintained, for good or ill, by the people who live and work in them. At heart their…

  1. Health status in routine clinical practice: validity of the clinical COPD questionnaire at the individual patient level

    Directory of Open Access Journals (Sweden)

    de Vos Barbara


    Full Text Available Abstract Background There is a growing interest to use health status or disease control questionnaires in routine clinical practice. However, the validity of most questionnaires is established using techniques developed for group level validation. This study examines a new method, using patient interviews, to validate a short health status questionnaire, the Clinical COPD Questionnaire (CCQ, at the individual patient level. Methods Patients with COPD who visited an outpatient clinic completed the CCQ before the consultation, and the specialist physician completed it after the consultation. After the consultation all patients had a semi-structured in-depth interview. The patients' CCQ scores were compared with those of the treating clinician, and with mean scores from 5 clinicians from a pool of 20 who scored the CCQ after reading the transcript of the in-depth interviews only. Agreement was assessed using Lin's concordance correlation coefficient (CCC, and Blant and Altman plots. Interviews with patients with low agreement were reviewed for possible explanations. Results A total of 44 COPD patients (32 male, mean age 66 years, FEV1 45% of predicted participated. Agreement between the patients' CCQ scores and those of the treating clinicians (CCC = 0.87 and the mean score of the reviewing clinicians (CCC = 0.86 was very high. No systematic error was detected. No explanation for individuals with low agreement was found. Conclusion The validity of the CCQ on the individual patient level, as assessed by these methods, is good. Individual health status assessment with the CCQ is therefore sufficiently accurate to be used in routine clinical practice.

  2. Implications of Nursing Clinical Practice to The Student’s Spiritual Health

    Directory of Open Access Journals (Sweden)

    Bhandesa Asthadi Mahendra


    Full Text Available This study aimed to clarify the implications of Nursing Clinical Practice (PLKK to the spiritual health of STIKES Bali students. This study employed purposive sampling method to determine the number of respondents. To conduct this study, the fourth grade of nursing students were recruited as the sample with total number 136 respondents. A questionnaire about spirituality from World Health Organization (WHO was used in this study as the instrument. In addition, the data were analysed by using quantitative descriptive technique. The result showed that 50.0% of students had a very good spiritual health, 42.6% had good spiritual health, 6.6% had moderate spiritual health, and 0.7 % had poor spiritual health. It can be interpreted that spiritual health of nursing students of STIKES Bali is good after conducting Nursing Clinical Practice. Thus, this study can be concluded that Nursing Clinical Practice has implication to the ability of students to love themselves and others meaningfully as the evidence of students’ spiritual health.

  3. Socioeconomic and clinical factors associated with caregivers' perceptions of children's oral health in Brazil. (United States)

    Piovesan, Chaiana; Marquezan, Macela; Kramer, Paulo F; Bönecker, Marcelo; Ardenghi, Thiago M


    We assessed how socioeconomic and clinical conditions could affect parents' perceptions of their child's oral health. A cross-sectional study was conducted in a sample of 455 children, aged 1-5 years, representative of Santa Maria, a southern city in Brazil. Participants were randomly selected among children attending a National Day of Children's Vaccination. Clinical examinations provided information on the prevalence of caries, dental trauma, and occlusion. The caregivers' perception of children's oral health and socioeconomic status were assessed by means of a questionnaire. A Poisson regression model using robust variance (Prevalence ratio: PR; 95% CI, P ≤ 0.05) was performed to assess the association between the predictor variables and outcomes. Parents were more likely to rate their child's oral health as 'poor' if the former earned a lower income and the latter had anterior open bite and dental caries. Parents of black children with anterior open bite and dental caries were more likely to rate their child's oral health as 'worse than that of other children'. Clinical and socioeconomic characteristics are significantly associated with parents' perceptions of their child's oral health. Understanding the caregivers' perceptions of children's oral health and the factors affecting this could be useful in the planning of public health polices, in view of the inequity in the oral health pattern. © 2010 John Wiley & Sons A/S.

  4. [Addictive behavior of street children: interculturation and resilience]. (United States)

    Kommegne, T; Denoux, P; Bernoussi, A; Njiengwe, E F


    This research belongs to a more comprehensive study on the care of street children in Cameroon. The idea is to develop an analysis of the street pathology where symptoms such as addictive behavior and drug addiction can be found. Beside HIV AIDS, addictive behaviors are the main risk factors that many professionals have to face with while dealing with the street problems today. Through an intercultural approach, we examined the practices of addictive typology, their initiatory role and their function in the integration of the street system. We also analysed their importance in the survival strategies. After an overview of theoretical controversies that feed the debate on addictions, we questioned the impact of these practices on the street career through the prism of general theory of addictions, particularly the hedonic management model. Addiction helps to resist adversity, it helps to desist and then to begin a harmonious neo development despite the horrors of the street experience. We undertook a quantitative and qualitative study on a sample of 148 street children. We proposed to 128 of them a questionnaire focused on addictive behaviors and survival strategies in the street context. We notably evaluated the street career of 24 of them, using interviews and standardized tests to assess self-esteem (Coopersmith's SEI) frustration tolerance (Rosenweig's P-F) and self-efficacy (Sherer's SE Scale) in order to measure the impact of addictive behaviors on the resilience process. We found that the street career is essentially traumatic, and that addictive behaviors involving various integration strategies are strongly linked to the interculturation process through the identity strategies and the intercultural competences. Addiction itself is not significantly related to self-esteem issues but strongly impacts on self-efficacy and the ability to tolerate frustration. They allow the street children to withstand the street adversity but are a real obstacle to their

  5. Trees in the city: valuing street trees in Portland, Oregon (United States)

    G.H. Donovan; D.T. Butry


    We use a hedonic price model to simultaneously estimate the effects of street trees on the sales price and the time-on-market (TOM) of houses in Portland. Oregon. On average, street trees add $8,870 to sales price and reduce TOM by 1.7 days. In addition, we found that the benefits of street trees spill over to neighboring houses. Because the provision and maintenance...

  6. Playing With the City: Street Art and Videogames


    Vazques Marquez, Israel; Pajares Tosca, Susana


    In this paper we introduce and describe the phenomenon of videogame street art as a specific kind of street art. We consider its materiality and significance, and conceptualize it in the light of a double manifestation of play: the playful appropriation of the city by the artist and the fact that street art encapsulates the act of playing videogames in a visual form. Digital play spills out of our computer screens and occupies the urban space with the explicit intention of involving spectator...

  7. Assessment of volatile organic compounds and particulate matter in a dental clinic and health risks to clinic personnel. (United States)

    Hong, Yu-Jue; Huang, Yen-Ching; Lee, I-Long; Chiang, Che-Ming; Lin, Chitsan; Jeng, Hueiwang Anna


    This study was conducted to assess (1) levels of volatile organic compounds (VOCs) and particulate matter (PM) in a dental clinic in southern Taiwan and (2) dental care personnel's health risks associated with due to chronic exposure to VOCs. An automatic, continuous sampling system and a multi-gas monitor were employed to quantify the air pollutants, along with environmental comfort factors, including temperature, CO2, and relative humidity at six sampling sites in the clinic over eight days. Specific VOC compounds were identified and their concentrations were quantified. Both non-carcinogenic and carcinogenic VOC compounds were assessed based on the US Environmental Protection Agency's Principles of Health Risk Assessment in terms of whether those indoor air pollutants increased health risks for the full-time dental care professionals at the clinic. Increased levels of VOCs were recorded during business hours and exceeded limits recommended by the Taiwan Environmental Protection Agency. A total of 68 VOC compounds were identified in the study area. Methylene methacrylate (2.8 ppm) and acetone (0.176 ppm) were the only two non-carcinogenic compounds that posed increased risks for human health, yielding hazard indexes of 16.4 and 4.1, respectively. None of the carcinogenic compounds increased cancer risk. All detected PM10 levels ranged from 20 to 150 μg/m(3), which met the Taiwan EPA and international limits. The average PM10 level during business hours was significantly higher than that during non-business hours (P = 0.04). Improved ventilation capacity in the air conditioning system was recommended to reduce VOCs and PM levels.

  8. The effect of urban street gang densities on small area homicide incidence in a large metropolitan county, 1994-2002. (United States)

    Robinson, Paul L; Boscardin, W John; George, Sheba M; Teklehaimanot, Senait; Heslin, Kevin C; Bluthenthal, Ricky N


    The presence of street gangs has been hypothesized as influencing overall levels of violence in urban communities through a process of gun-drug diffusion and cross-type homicide. This effect is said to act independently of other known correlates of violence, i.e., neighborhood poverty. To test this hypothesis, we independently assessed the impact of population exposure to local street gang densities on 8-year homicide rates in small areas of Los Angeles County, California. Homicide data from the Los Angeles County Coroners Office were analyzed with original field survey data on street gang locations, while controlling for the established covariates of community homicide rates. Bivariate and multivariate regression analyses explicated strong relationships between homicide rates, gang density, race/ethnicity, and socioeconomic structure. Street gang densities alone had cumulative effects on small area homicide rates. Local gang densities, along with high school dropout rates, high unemployment rates, racial and ethnic concentration, and higher population densities, together explained 90% of the variation in local 8-year homicide rates. Several other commonly considered covariates were insignificant in the model. Urban environments with higher densities of street gangs exhibited higher overall homicide rates, independent of other community covariates of homicide. The unique nature of street gang killings and their greater potential to influence future local rates of violence suggests that more direct public health interventions are needed alongside traditional criminal justice mechanisms to combat urban violence and homicides.

  9. Outcomes for street children and youth under multidisciplinary care in a drop-in centre in Tegucigalpa, Honduras. (United States)

    Souza, Renato; Porten, Klaudia; Nicholas, Sarala; Grais, Rebecca


    There is little evidence to describe the feasibility and outcomes of services for the care of street children and youth in low-income countries. To describe the outcomes of a multidisciplinary case management approach delivered in a drop-in centre for street children and youth. A longitudinal study of street children and youth followed in an urban drop-in centre. Four hundred (400) street children and youth received a multidisciplinary case management therapeutic package based on the community reinforcement approach. The main outcomes were changes in psychological distress, substance abuse and social situation scores. The median follow-up time for the cohort was 18 months. There were reductions in the levels of psychological distress (p = 0.0001) and substance abuse (p ≤ 0.0001) in the cohort as well as an improvement in the social situation of street children and youth (p = 0.0001). There was a main effect of gender (p street situations in developing countries should target both their health and social needs.

  10. Moving the Barricades to Physical Activity: A Qualitative Analysis of Open Streets Initiatives Across the United States. (United States)

    Eyler, Amy A; Hipp, J Aaron; Lokuta, Julie


    Ciclovía, or Open Streets initiatives, are events where streets are opened for physical activity and closed to motorized traffic. Although the initiatives are gaining popularity in the United States, little is known about planning and implementing them. The goals of this paper are to explore the development and implementation of Open Streets initiatives and make recommendations for increasing the capacity of organizers to enhance initiative success. Phenomenology with qualitative analysis of structured interviews was used. Study setting was urban and suburban communities in the United States. Study participants were organizers of Open Streets initiatives in U.S. cities. Using a list of 47 events held in 2011, 27 lead organizers were interviewed by telephone about planning, implementation, and lessons learned. The interviews were digitally recorded and transcribed. A phenomenologic approach was used, an initial coding tool was developed after reviewing a sample of transcripts, and constant comparative coding methodology was applied. Themes and subthemes were generated from codes. The most common reasons for initiation were to highlight or improve health and transportation. Most initiatives aimed to reach the general population, but some targeted families, children, or specific neighborhoods. Getting people to understand the concept of Open Streets was an important challenge. Other challenges included lack of funding and personnel, and complex logistics. These initiatives democratize public space for citizens while promoting physical activity, social connectedness, and other broad agendas. There are opportunities for the research community to contribute to the expanse and sustainability of Open Streets, particularly in evaluation and dissemination.

  11. Beyond information retrieval and electronic health record use: competencies in clinical informatics for medical education

    Directory of Open Access Journals (Sweden)

    Hersh WR


    Full Text Available William R Hersh,1 Paul N Gorman,1 Frances E Biagioli,2 Vishnu Mohan,1 Jeffrey A Gold,3 George C Mejicano4 1Department of Medical Informatics and Clinical Epidemiology, 2Department of Family Medicine, 3Department of Medicine, 4School of Medicine, Oregon Health & Science University, Portland, OR, USA Abstract: Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area. Keywords: curriculum transformation, clinical decision support, patient safety, health care quality, patient engagement

  12. Measuring outcomes of a pharmacist-run travel health clinic located in an independent community pharmacy. (United States)

    Hess, Karl M; Dai, Chih-Wei; Garner, Brian; Law, Anandi V

    To describe the acceptance and refusal rates of travel-related vaccine and medication recommendations in a pharmacist-run travel health clinic, to evaluate the change in patient understanding of travel-related issues, to determine patient satisfaction with this clinic, and to determine factors influencing both patient acceptance and satisfaction. Southern California (Claremont) between July 2007 and October 2008. Hendricks Pharmacy is an independently owned community pharmacy that is part of the Good Neighbor Pharmacy Provider Network. The pharmacy offers a range of services including home delivery, compounding, and blood glucose, blood pressure, and cholesterol screenings. Comprehensive pharmacist-run travel health clinic. Patient acceptance and refusal rates of pharmacist-made recommendations, changes in patient understanding of travel-related issues resulting from pharmacist counseling, and patient satisfaction with this travel health clinic. In a sample of 283 patients, overall patient acceptance of pharmacist-made recommendations was 84.7%. The primary reason for patient refusal of a recommendation was self-perceived low risk for infection. A subsample of patients (n = 82) completing a patient satisfaction survey found that 96% were satisfied with their overall visit. Patient satisfaction with the clinic and pharmacist services was correlated with overall patient acceptance. The high rate of patient acceptance and satisfaction with this clinic supports adoption of pharmacists as nontraditional providers of travel health services.

  13. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network. (United States)

    Wright, Adam; Sittig, Dean F


    In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

  14. Machine Learning Approaches for Detecting Diabetic Retinopathy from Clinical and Public Health Records. (United States)

    Ogunyemi, Omolola; Kermah, Dulcie


    Annual eye examinations are recommended for diabetic patients in order to detect diabetic retinopathy and other eye conditions that arise from diabetes. Medically underserved urban communities in the US have annual screening rates that are much lower than the national average and could benefit from informatics approaches to identify unscreened patients most at risk of developing retinopathy. Using clinical data from urban safety net clinics as well as public health data from the CDC's National Health and Nutrition Examination Survey, we examined different machine learning approaches for predicting retinopathy from clinical or public health data. All datasets utilized exhibited a class imbalance. Classifiers learned on the clinical data were modestly predictive of retinopathy with the best model having an AUC of 0.72, sensitivity of 69.2% and specificity of 55.9%. Classifiers learned on public health data were not predictive of retinopathy. Successful approaches to detecting latent retinopathy using machine learning could help safety net and other clinics identify unscreened patients who are most at risk of developing retinopathy and the use of ensemble classifiers on clinical data shows promise for this purpose.

  15. Patterns of health service utilization at a medical school clinic in Ghana. (United States)

    Yawson, A E; Malm, K L; Adu, A A; Wontumi, G-M; Biritwum, R B


    The University of Ghana Medical School (UGMS) Clinic provides healthcare service which is free at point of service to students, staff, retired staff and dependents of staff of the College of Health Sciences. However, since 1983, no in-depth review of health service provision or utilization has been undertaken. This study reviewed client characteristics, utilization and disease patterns at the clinic and also compared the disease patterns to that of other primary health facilities nationwide. This was an analytical cross-sectional study undertaken at the UGMS clinic in Korle-Bu. It was a retrospective review of records of all clients attending the facility from January 2002 to December, 2004. More males than females attended the clinic and majority (63.9%) of clients were between 15-44 years (median age was 26 years). Dependents of staff constituted the highest attendants (41%) to the clinic. Among staff, junior staffs were in the majority. Malaria, respiratory tract infection and musculoskeletal pain were the most common conditions seen. Overall, 83% of clients were treated and discharged per visit without the need for review visits. Dependents of staff used the facility the most and they live in many different part of the city of Accra, and to ask them to attend the clinic for care is not efficient. It will be better to provide or supplement their securing of insurance so that they could access health care close to their homes and save time and attention to students and staff.

  16. A work-based learning approach for clinical support workers on mental health inpatient wards. (United States)

    Kemp, Philip; Gilding, Moorene; Seewooruttun, Khooseal; Walsh, Hannah


    Background With a rise in the number of unqualified staff providing health and social care, and reports raising concerns about the quality of care provided, there is a need to address the learning needs of clinical support workers. This article describes a qualitative evaluation of a service improvement project that involved a work-based learning approach for clinical support workers on mental health inpatient wards. Aim To investigate and identify insights in relation to the content and process of learning using a work-based learning approach for clinical support workers. Method This was a qualitative evaluation of a service improvement project involving 25 clinical support workers at the seven mental health inpatient units in South London and Maudsley NHS Foundation Trust. Three clinical skills tutors were appointed to develop, implement and evaluate the work-based learning approach. Four sources of data were used to evaluate this approach, including reflective journals, qualitative responses to questionnaires, three focus groups involving the clinical support workers and a group interview involving the clinical skills tutors. Data were analysed using thematic analysis. Findings The work-based learning approach was highly valued by the clinical support workers and enhanced learning in practice. Face-to-face learning in practice helped the clinical support workers to develop practice skills and reflective learning skills. Insights relating to the role of clinical support workers were also identified, including the benefits of face-to-face supervision in practice, particularly in relation to the interpersonal aspects of care. Conclusion A work-based learning approach has the potential to enhance care delivery by meeting the learning needs of clinical support workers and enabling them to apply learning to practice. Care providers should consider how the work-based learning approach can be used on a systematic, organisation-wide basis in the context of budgetary

  17. The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students. (United States)

    Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy


    To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning

  18. On the escape of pollutants from urban street canyons

    Energy Technology Data Exchange (ETDEWEB)

    Baik, J.J.; Kim, J.J. [Kwangju Inst. of Science and Technology (Korea). Dept. of Environmental Science and Engineering


    Pollutant transport from urban street canyons is numerically investigated using a two-dimensional flow and dispersion model. The ambient wind blows perpendicular to the street and passive pollutants are released at the street level. Results from the control experiment with a street aspect ratio of 1 show that at the roof level of the street canyon, the vertical turbulent flux of pollutants is upward everywhere and the vertical flux of pollutants by mean flow is upward or downward. The horizontally integrated vertical flux of pollutants by mean flow at the roof level of the street canyon is downward and its magnitude is much smaller than that by turbulent process. These results indicate that pollutants escape from the street canyon mainly by turbulent process and that the net effect of mean flow is to make some escaped pollutants reenter the street canyon. Further experiments with different inflow turbulence intensities, inflow wind speeds, and street aspect ratio confirm the findings from the control experiment. In the case of two isolated buildings, the horizontally integrated vertical flux of pollutants by mean flow is upward due to flow separation but the other main results are the same as those from the control experiment. (author)

  19. Into a Mapping of Copenhagen Street Lighting 2014

    DEFF Research Database (Denmark)

    Bülow, Katja; Asp, Claus; Kongshaug, Jesper

    LED lighting is a new lighting component in urban Spaces. How does LED lighting change the visual experience of a street, how did it use to be and how will it become? The book presents a mapping method in which an overview map of light sources in the Copenhagen streets is combined with a video...... recording and a series of photos from a route, whick goes through different city parts and types of streets. The mapping is done in the crucial changing fase, in which the street lighting in Copenhagen is a mix of previously used light sources and LED....

  20. Targeting mental health care attributes by diagnosis and clinical stage: the views of youth mental health clinicians. (United States)

    Hamilton, Matthew P; Hetrick, Sarah E; Mihalopoulos, Cathrine; Baker, David; Browne, Vivienne; Chanen, Andrew M; Pennell, Kerryn; Purcell, Rosemary; Stavely, Heather; McGorry, Patrick D


    To explore the potential utility of clinical stage and mental disorder categories as a basis for determining which attributes of youth mental health care should be offered to which groups of young people. In June 2017, we conducted an online survey of youth mental health clinicians that collected information on the participants' background and areas of expertise, then presented vignettes describing young people with different stages of six mental disorders (disorder-based vignettes were matched to participants' area of expertise). For each vignette, participants were asked to give a quantitative estimate of the proportion of young people with similar mental health problems they thought would clinically benefit from each of twelve attributes of mental health care (other than pharmacological or individual psychological therapies). Survey results were analysed as independent, disorder-based samples, using standard statistical tests of significance, and as a stratified sample using mixed-effects models. A total of 412 clinicians working in 32 countries participated in both parts of the survey. Respondents represented a broad range of clinical disciplines, settings and areas of expertise. Their estimated proportions of young people who would benefit from the mental health care attributes varied by clinical stage and disorder (eg, a mean of 93% [interquartile range (IQR), 90%-100%] of young people with Stage 2 psychosis were estimated to benefit from case management with a multidisciplinary team; while only 15% [IQR, 1%-25%] of young people with Stage 1b generalised anxiety disorder were estimated to benefit from collection and processing of biological samples). Neither the background of the respondents nor the sex of the characters in the vignettes significantly influenced the results. A combination of clinical stage and disorder information might be an appropriate basis for ensuring that the right attributes of early intervention mental health care are provided to the

  1. The structure of mental health research: networks of influence among psychiatry and clinical psychology journals. (United States)

    Haslam, N; Lusher, D


    Psychiatry and clinical psychology are the two dominant disciplines in mental health research, but the structure of scientific influence and information flow within and between them has never been mapped. Citations among 96 of the highest impact psychiatry and clinical psychology journals were examined, based on 10 052 articles published in 2008. Network analysis explored patterns of influence between journal clusters. Psychiatry journals tended to have greater influence than clinical psychology journals, and their influence was asymmetrical: clinical psychology journals cited psychiatry journals at a much higher rate than the reverse. Eight journal clusters were found, most dominated by a single discipline. Their citation network revealed an influential central cluster of 'core psychiatry' journals that had close affinities with a 'psychopharmacology' cluster. A group of 'core clinical psychology' journals was linked to a 'behavior therapy' cluster but both were subordinate to psychiatry journals. Clinical psychology journals were less integrated than psychiatry journals, and 'health psychology/behavioral medicine' and 'neuropsychology' clusters were relatively peripheral to the network. Scientific publication in the mental health field is largely organized along disciplinary lines, and is to some degree hierarchical, with clinical psychology journals tending to be structurally subordinate to psychiatry journals.

  2. Interoperability of clinical decision-support systems and electronic health records using archetypes: a case study in clinical trial eligibility. (United States)

    Marcos, Mar; Maldonado, Jose A; Martínez-Salvador, Begoña; Boscá, Diego; Robles, Montserrat


    Clinical decision-support systems (CDSSs) comprise systems as diverse as sophisticated platforms to store and manage clinical data, tools to alert clinicians of problematic situations, or decision-making tools to assist clinicians. Irrespective of the kind of decision-support task CDSSs should be smoothly integrated within the clinical information system, interacting with other components, in particular with the electronic health record (EHR). However, despite decades of developments, most CDSSs lack interoperability features. We deal with the interoperability problem of CDSSs and EHRs by exploiting the dual-model methodology. This methodology distinguishes a reference model and archetypes. A reference model is represented by a stable and small object-oriented model that describes the generic properties of health record information. For their part, archetypes are reusable and domain-specific definitions of clinical concepts in the form of structured and constrained combinations of the entities of the reference model. We rely on archetypes to make the CDSS compatible with EHRs from different institutions. Concretely, we use archetypes for modelling the clinical concepts that the CDSS requires, in conjunction with a series of knowledge-intensive mappings relating the archetypes to the data sources (EHR and/or other archetypes) they depend on. We introduce a comprehensive approach, including a set of tools as well as methodological guidelines, to deal with the interoperability of CDSSs and EHRs based on archetypes. Archetypes are used to build a conceptual layer of the kind of a virtual health record (VHR) over the EHR whose contents need to be integrated and used in the CDSS, associating them with structural and terminology-based semantics. Subsequently, the archetypes are mapped to the EHR by means of an expressive mapping language and specific-purpose tools. We also describe a case study where the tools and methodology have been employed in a CDSS to support

  3. Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics. (United States)

    Yano, Elizabeth M; Goldzweig, Caroline; Canelo, Ismelda; Washington, Donna L


    In response to concerns about the availability and quality of women's health services in Department of Veterans Affairs (VA) medical centers in the early 1990s, Congress approved landmark legislation earmarking funds to enhance women's health services. A portion of the appropriation was used to launch Comprehensive Women's Health Centers as exemplars for the development of VA women's health care throughout the system. We report on the diffusion and characteristics of VA women's health clinics (WHCs) 10 years later. In 2001, we surveyed the senior women's health clinician at each VA medical center serving > or =400 women veterans (83% response rate) regarding their internal organizational characteristics in relation to factors associated with organizational innovation (centralization, complexity, formalization, interconnectedness, organizational slack, size). We evaluated the comparability of WHCs (n = 66) with characteristics of the original comprehensive women's health centers (CWHCs; n = 8). Gender-specific service availability in WHCs was comparable to that of CWHCs with important exceptions in mental health, mammography and osteoporosis management. WHCs were less likely to have same-gender providers (p business case for managers faced with small female patient caseloads.

  4. The scope and impact of mobile health clinics in the United States: a literature review. (United States)

    Yu, Stephanie W Y; Hill, Caterina; Ricks, Mariesa L; Bennet, Jennifer; Oriol, Nancy E


    As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs. Many illnesses disproportionately affect certain populations, due to disparities in healthcare access and social determinants of health. These disparities represent a key area to target in order to better our nation's overall health and decrease healthcare expenditures. It is thus imperative for policymakers and health professionals to develop innovative interventions that sustainably manage chronic diseases, promote preventative health, and improve outcomes among communities disenfranchised from traditional healthcare as well as among the general population. This article examines the available literature on Mobile Health Clinics (MHCs) and the role that they currently play in the U.S. healthcare system. Based on a search in the PubMed database and data from the online collaborative research network of mobile clinics , the authors evaluated 51 articles with evidence on the strengths and weaknesses of the mobile health sector in the United States. Current literature supports that MHCs are successful in reaching vulnerable populations, by delivering services directly at the curbside in communities of need and flexibly adapting their services based on the changing needs of the target community. As a link between clinical and community settings, MHCs address both medical and social determinants of health, tackling health issues on a community-wide level. Furthermore, evidence suggest that MHCs produce significant cost savings and represent a cost-effective care delivery model that improves health outcomes in underserved groups. Even though MHCs can fulfill many goals and mandates in alignment with our national priorities and have the potential to help combat some of the largest healthcare challenges of this era, there

  5. Comparison of 5 health care professionals’ratings of the clinical significance of drug related problems

    DEFF Research Database (Denmark)

    Villesen, Christine; Hojsted, Jette; Kjeldsen, Lene Juel


    to a mutual agreement on the level of clinical significance. However, to what degree does the panel agree?Purpose To compare the agreement between different health care professionals who have evaluated the clinical significance of DRPs.Materials and methods DRPs were identified in 30 comprehensive medicines...... reviews conducted by a clinical pharmacist. Two hospital pharmacists, a general practitioner and two specialists in pain management from hospital care (the Panel) evaluated each DRP considering the potential clinical outcome for the patient. The DRPs were rated either nil, low, minor, moderate or highly...... clinically significant. Agreement was analysed using Kappa statistics. A Kappa value of 0.8 to 1.0 indicated nearly perfect agreement between ratings of the Panel members.Results The Panel rated 45 percent of the total 162 DRPs as of moderate clinical significance. However, the overall kappa score was 0...

  6. Smart street lighting : The advantages of LED street lighting and a smart control system in Uppsala municipality


    Sjöberg, Inga; Gidén Hember, Amanda; Wallerström, Carolina


    The purpose of this bachelor thesis is to examine how LED street lights and a smart street light control system can reduce the energy consumption, costs and in extension the CO2 equivalents in a geographically delimited area. In 2015 the municipality of Sala installed LED armatures connected to a smart control system in the whole municipality. The smart control system enables for instance adjustment of the light intensity at specific times during the day and a supervision of the street light ...

  7. Development of an online clinical trial recruitment portal for the NIHR mental health BRC. (United States)

    Markham, Sarah


    In order to test whether or not new treatments for mental health disorders help patients get better according to clinician/patient selected criteria, it is often necessary to test them on patients under safe, carefully monitored conditions called clinical trials. It is necessary to find enough patients to take part in a clinical trial so that the results of the trial are reliable. The NIHR Mental Health BRC (here after abbreviated to BRC) is a centre for research in London which seeks to find out better ways to treat patients with mental health difficulties. The BRC has experienced problems trying to find sufficient numbers of patients to participate in its clinical trials as it appears that insufficient patients were being told by their doctor about opportunities to participate in clinical research. In order to help the BRC find enough patients to volunteer to take part in its clinical trials, the author (a patient representative) of this article and a clinical researcher in the nearby Institute of Psychiatry, Psychology and Neuroscience (IoPPN) decided to work together to try to find the best way to let patients know more about what clinical trials are, what it is like to take part in them and which clinical trials are seeking patients to take part. The author and researcher used a report by the Association of Medical Research Charities (AMRC) on patient difficulties in finding clinical trials to take part in, and the recommendations it made, to guide them in building a website to give such patients the information on clinical trials they wanted (including clinical trials run by the BRC). The author and researcher also asked patients, carers, staff at the IoPPN and BRC what they thought of the website and how to make it better. They used the ideas, suggestions and criticisms to improve the website. The author and researcher also asked mental health charities and research organisations if they would advertise the final version of this website on their own websites

  8. Model for teaching population health and community-based care across diverse clinical experiences. (United States)

    Van Dyk, Elizabeth J; Valentine-Maher, Sarah K; Tracy, Janet P


    The pillars constructivist model is designed to offer a unifying clinical paradigm to support consistent learning opportunities across diverse configurations of community and public health clinical sites. Thirty-six students and six faculty members participated in a mixed methods evaluation to assess the model after its inaugural semester of implementation. The evaluation methods included a rating scale that measures the model's ability to provide consistent learning opportunities at both population health and direct care sites, a case study to measure student growth within the five conceptual pillars, and a faculty focus group. Results revealed that the model served as an effective means of clinical education to support the use of multiple, small-scale public health sites. Although measurements of student growth within the pillars are inconclusive, the findings suggest efficacy. The authors recommend the continued use of the pillars constructivist model in baccalaureate programs, with further study of the author-designed evaluation tools. Copyright 2015, SLACK Incorporated.

  9. Emotional health: on the applicability of affective science to the integration of clinical psychology

    Directory of Open Access Journals (Sweden)

    Ewa Trzebińska


    Full Text Available The aim of the article is to outline the concept of emotional health and its integrative potential in the field of clinical psychology. It is a well-known fact that the transdiagnostic approach and psychotherapy integration – the two most influential integrative movements in clinical psychology – search for a sound conceptual foundation of the efforts to organize a plethora of theories and data relating to the psychological aspects of physical and mental health. Following a short presentation of general discrepancies afflicting clinical psychology and the main ideas of both the transdiagnostic approach and psychotherapy integration, the notion of emotional health is introduced and its unifying convenience, as well as limitations, is discussed.

  10. Simulating the impacts of on-street vehicle parking on traffic operations on urban streets using cellular automation (United States)

    Chen, Jingxu; Li, Zhibin; Jiang, Hang; Zhu, Senlai; Wang, Wei


    In recent years, many bicycle lanes on urban streets are replaced with vehicle parking places. Spaces for bicycle riding are reduced, resulting in changes in bicycle and vehicle operational features. The objective of this study is to estimate the impacts of on-street parking on heterogeneous traffic operation on urban streets. A cellular automaton (CA) model is developed and calibrated to simulate bicycle lane-changing on streets with on-street parking. Two types of street segments with different bicycle lane width are considered. From the simulation, two types of conflicts between bicycles and vehicles are identified which are frictional conflicts and blocking conflicts. Factors affecting the frequency of conflicts are also identified. Based on the results, vehicle delay is estimated for various traffic situations considering the range of occupancy levels for on-street parking. Later, a numerical network example is analyzed to estimate the network impact of on-street parking on traffic assignment and operation. Findings of the study are helpful to policies and design regarding on-street vehicle parking to improve the efficiency of traffic operations.

  11. Socio-demographic and behavioural characteristics of illegal motorcycle street racers in Malaysia

    Directory of Open Access Journals (Sweden)

    Wong Li Ping


    Full Text Available Abstract Background This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the "Mat Rempit". Methods Street outreach interviewer-administered surveys were conducted from June 2008 to January 2009 in this multi-state study. Results A total of 2022 participants were surveyed, the mean ± SD age of the participants was 20.5 ± 3.4 years (age range: 12 to 35 years. Mean duration of street racing was 2.65(SD ± 1.77 years (range: 2 months to 12 years, with 50.1% and 35.8% reporting stunt riding and alcohol drinking while racing, respectively. With regard to risk behaviours, cigarette smoking was highly prevalent among the study participants (78.3%, followed by alcohol drinking (27.8% and recreational drug use (18.8%. Participants scored high on the masculinity scale (15.7 ± 4.0 out of 21.0. The results of the logistic regression analysis showed that socio-demographic variables, risk behaviour and masculinity scores were associated with racing frequency. Conclusion Given these associations, tailoring family-centered interventions to the needs of the lower socio-economic groups and interventions recognizing the negative consequences of health risk behaviours related to street racing as an expression of traditional masculinity should be emphasized.

  12. Socio-demographic and behavioural characteristics of illegal motorcycle street racers in Malaysia. (United States)

    Wong, Li Ping


    This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the "Mat Rempit". Street outreach interviewer-administered surveys were conducted from June 2008 to January 2009 in this multi-state study. A total of 2022 participants were surveyed, the mean ± SD age of the participants was 20.5 ± 3.4 years (age range: 12 to 35 years). Mean duration of street racing was 2.65(SD ± 1.77) years (range: 2 months to 12 years), with 50.1% and 35.8% reporting stunt riding and alcohol drinking while racing, respectively. With regard to risk behaviours, cigarette smoking was highly prevalent among the study participants (78.3%), followed by alcohol drinking (27.8%) and recreational drug use (18.8%). Participants scored high on the masculinity scale (15.7 ± 4.0 out of 21.0). The results of the logistic regression analysis showed that socio-demographic variables, risk behaviour and masculinity scores were associated with racing frequency. Given these associations, tailoring family-centered interventions to the needs of the lower socio-economic groups and interventions recognizing the negative consequences of health risk behaviours related to street racing as an expression of traditional masculinity should be emphasized.

  13. Heavy metals assessment in the hair of street children by INAA method, Isfahan

    International Nuclear Information System (INIS)

    Khadijeh Rezaee Ebrahim Saraee; Gharipour, M.M.


    The street children phenomenon is an increasing problem in most cities of the world including Isfahan, which is a fast growing town. The number of street children with the growth of the town is increased. It is therefore important to have baseline data on their health problems. Hair element analysis remains an important tool in the nutritional and environmental assessment of them. A measurement of the elemental concentration in recently-grown hair provides an integrated view of the element status in the follicular cells and their blood supply, unaffected by short term fluctuations in the nutrient intake of the subject. This study aimed to assess heavy metals concentrations in the hair of street children in Isfahan using neutron activation analysis method. The concentration of heavy metals (Cu, Cr, Fe, Hg, Mn, and Zn) of 17 Iranian street children (Isfahan) was examined. Data analysis found that different profiles of the concentrations of Cr, Hg, Mn, and Zn were seen in each sample. These results were discussed with reference to show of environmental effects. (author)

  14. Design and analysis of a health care clinic for homeless people using simulations. (United States)

    Reynolds, Jared; Zeng, Zhen; Li, Jingshan; Chiang, Shu-Yin


    Improving quality of care is important in health care management. For health care clinics, reducing patient waiting time and improving throughput with efficient utilization of the workforce are important issues to achieve better quality of care. This paper seeks to introduce a simulation study on design and analysis of a health clinic for homeless patients in Lexington, Kentucky, USA. Using the simulation model, the patient flow of the clinic and analyze quality of care for different staffing levels is simulated. In addition, the dependence of distributions on service times is investigated. Moreover, the impact of service time variability on quality of care (e.g. patient waiting time) is analyzed. The necessary staffing level and utilizations to reduce patient waiting times and improve throughput to achieve better quality of care are obtained. In addition, it is shown that the system performance is primarily dependent on the mean and coefficients of variation, rather than a complete distribution, of service times. In addition, a piece-wise linear approximation formula is proposed so that patient waiting time in the clinic can be estimated for any variability with only two simulations. The simulation method may need long model development time and long simulation executing time for complex systems. The quality of care delivery in a health care clinic can be evaluated using simulations. The results presented in the paper provide an easier approach for medical practitioners to evaluate different scenarios, examine needed resources, and carry out what-if analysis to predictthe impact of any changes in the system, to determine an optimal system configuration. The paper shows that such models provide a quantitative tool for clinic operations and management to achieve better care quality. Moreover, it can be easily adapted to model other health care facilities, such as hospitals, emergency rooms, operating rooms, supply chain in health care industry.

  15. Barriers to using eHealth data for clinical performance feedback in Malawi: A case study. (United States)

    Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S


    Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive

  16. Air quality considerations for stormwater green street design

    International Nuclear Information System (INIS)

    Shaneyfelt, Kathryn M.; Anderson, Andrew R.; Kumar, Prashant; Hunt, William F.


    Green streets are increasingly being used as a stormwater management strategy to mitigate stormwater runoff at its source while providing other environmental and societal benefits, including connecting pedestrians to the street. Simultaneously, human exposure to particulate matter from urban transportation is of major concern worldwide due to the proximity of pedestrians, drivers, and cyclists to the emission sources. Vegetation used for stormwater treatment can help designers limit the exposure of people to air pollutants. This goal can be achieved through the deliberate placement of green streets, along with strategic planting schemes that maximize pollutant dispersion. This communication presents general design considerations for green streets that combine stormwater management and air quality goals. There is currently limited guidance on designing green streets for air quality considerations; this is the first communication to offer suggestions and advice for the design of green stormwater streets in regards to their effects on air quality. Street characteristics including (1) the width to height ratio of the street to the buildings, (2) the type of trees and their location, and (3) any prevailing winds can have an impact on pollutant concentrations within the street and along sidewalks. Vegetation within stormwater control measures has the ability to reduce particulate matter concentrations; however, it must be carefully selected and placed within the green street to promote the dispersion of air flow. - Highlights: • Green streets can be used for both stormwater and air quality management. • Design considerations must be made to minimize human exposure to air pollutants. • Urban vegetation can improve air quality with careful selection and placement.

  17. Street Choice Logit Model for Visitors in Shopping Districts

    Directory of Open Access Journals (Sweden)

    Ko Kawada


    Full Text Available In this study, we propose two models for predicting people’s activity. The first model is the pedestrian distribution prediction (or postdiction model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation. The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that “have more shops, and are wider and lower”. In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive and CARS (negative. Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive.

  18. Street Choice Logit Model for Visitors in Shopping Districts (United States)

    Kawada, Ko; Yamada, Takashi; Kishimoto, Tatsuya


    In this study, we propose two models for predicting people’s activity. The first model is the pedestrian distribution prediction (or postdiction) model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation). The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that “have more shops, and are wider and lower”. In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive) and CARS (negative). Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive). PMID:25379274

  19. Expanding the scope and relevance of health interventions: Moving beyond clinical trials and behavior change models

    Directory of Open Access Journals (Sweden)

    Khary K. Rigg


    Full Text Available An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.

  20. SANDS: an architecture for clinical decision support in a National Health Information Network. (United States)

    Wright, Adam; Sittig, Dean F


    A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.