WorldWideScience

Sample records for sustaining soldier health

  1. Soldiers

    DEFF Research Database (Denmark)

    Lech, Marcel Lysgaard

    2017-01-01

    War, armies and soldiers were omnipresent in the ancient Greek society, and thus these phenomena are equally present in the worlds of ancient Greek comedy. However, the comic outlook on war differs from Old to New Comedy. While the citizen soldier remains the norm, but mainly at periphery of Old ...

  2. Multiple trauma and mental health in former Ugandan child soldiers.

    Science.gov (United States)

    Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Adam, Hubertus

    2010-10-01

    The present study examines the effect of war and domestic violence on the mental health of child soldiers in a sample consisting of 330 former Ugandan child soldiers (age: 11-17 years, female: 49%). All children had experienced at least 1 war-related event and 78% were additionally exposed to at least 1 incident of domestic violence. Prevalences of posttraumatic stress disorder and major depressive disorder were 33%, and 36%, respectively. Behavioral and emotional problems above clinical cutoff were measured in 61%. No gender differences were found regarding mental health outcomes. War experience and domestic violence were significantly associated with all mental health outcomes. The authors' findings point to the detrimental effects of domestic violence in addition to traumatizing war experiences in child soldiers.

  3. Health effects associated with geographical area of residence during the 1991 Gulf War: a comparative health study of Iraqi soldiers and civilians.

    Science.gov (United States)

    Jamil, Hikmet; Hamdan, Thamer A; Grzybowski, Mary; Arnetz, Bengt B

    2011-01-01

    Although Iraqis sustained the gravest exposure conditions during the 1991 Gulf War (GW), little is known about the possible relationship between environmental exposures during the GW and long-term health in Iraqis. To study the relationship between distance from Kuwait during the GW and somatic health among Iraqi Soldiers vs civilians. A survey questionnaire was distributed to a sample of 742 GW veterans and 413 civilians in Iraq. The odds ratios were calculated for somatic disorders as a function of distance from Kuwait during the GW, as well as a self-reported environmental exposure index. Soldiers reported a significantly higher prevalence of somatic disorders as compared to civilians. Soldiers closest to Kuwait reported significantly more somatic disorders as compared to Soldiers deployed further away from Kuwait. Iraqi GW veterans are at an increased risk of numerous somatic disorders. Soldiers are at an increased risk compared to civilians, suggesting that war-associated exposures are of etiologic relevance.

  4. The invisible soldiers: understanding how the life experiences of girl child soldiers impacts upon their health and rehabilitation needs.

    Science.gov (United States)

    Stevens, Amy Jane

    2014-05-01

    There are estimated 120,000 girl child soldiers worldwide. Recruitment makes girls vulnerable to the violence of war, torture, psychological trauma and sexual abuse with huge impact on their physical, mental and reproductive health. Despite this, girl soldiers often remain an invisible and marginalised group frequently neglected from disarmament, demobilisation and reintegration programmes. This is not just a local issue: with former child soldiers seeking asylum as refugees there is an increasing need for health workers in the destination countries to understand their health needs in order to inform appropriate holistic service provision. This review provides an overview of how the duties and life experiences of girl soldiers, including gender-specific abuses, impacts upon their health and concludes with a summary of recommendations as to how their rehabilitation needs can be addressed.

  5. A Prospective Cluster-Randomized Trial of Telehealth Coaching to Promote Bone Health and Nutrition in Deployed Soldiers

    Directory of Open Access Journals (Sweden)

    Mary S. McCarthy

    2014-12-01

    Full Text Available Findings from previous studies suggest that inadequate consumption of calcium and vitamin D and a decrease in exercise while deployed can be detrimental to bone health. This study enrolled 234 soldiers randomized to receive one-time nutrition and exercise education pre-deployment (n = 149, or telehealth coaching (n = 85, throughout the deployment cycle. Results suggest that online educational efforts may enhance sports activity, bone turnover, and vitamin D status. Improving vitamin D status and remaining active while deployed appears to sustain healthy bone density in young soldiers. Early and aggressive educational outreach to young adults may prevent chronic musculoskeletal conditions and disabling osteoporosis later in life.

  6. Sierra Leone's child soldiers: war exposures and mental health problems by gender.

    Science.gov (United States)

    Betancourt, Theresa S; Borisova, Ivelina I; de la Soudière, Marie; Williamson, John

    2011-07-01

    To examine associations between war experiences, mental health, and gender in a sample of male and female Sierra Leonean former child soldiers. A total of 273 former child soldiers (29% females) were assessed for depression and anxiety by using the Hopkins Symptoms Checklist, and for hostility, confidence, and prosocial attitudes by using an instrument developed for use with Sierra Leonean child soldiers. The former child soldiers had witnessed and perpetrated violence at largely comparable rates, although females experienced higher rates of rape (p child soldiers who lost caregivers were also more vulnerable to depression (p child soldiers. In our sample, female and male child soldiers experienced comparable levels of most war exposures. Female soldiers reported higher rates of rape and lower levels of adaptive outcomes. Toxic forms of violence (killing or injuring; rape) were associated with particularly poor outcomes. Although all boys and girls who experience rape and loss of caregivers are generally at risk for mental health problems, boys in our sample demonstrated increased vulnerability; these findings indicate a need for more inclusive mental health services. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health

    Science.gov (United States)

    Betancourt, Theresa S.; Brennan, Robert T.; Rubin-Smith, Julia; Fitzmaurice, Garrett M.; Gilman, Stephen E.

    2010-01-01

    Objective: To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method: Male and female former child soldiers (N = 260, aged 10 to 17 years at…

  8. Health and sustainability.

    Science.gov (United States)

    Kjӕrgård, Bente; Land, Birgit; Bransholm Pedersen, Kirsten

    2014-09-01

    In the present article, we explore how sustainable development strategies and health promotion strategies can be bridged. The concept of the 'duality of structure' is taken as our starting point for understanding the linkages between health promotion and sustainable development, and for uncovering the structural properties or conditions which either enable or constrain sustainable public health initiatives. We argue that strategies towards health promotion are not sufficiently integrated with strategies for sustainable development, and thus political strategies aimed at solving health problems or sustainability problems may cause new, undesired and unforeseen environmental or health problems. First, we explore how the relation between health and sustainability is articulated in international policy documents. Next, we develop a model for understanding the relation between health promotion and sustainability. Third, we use examples from agriculture and food production to illustrate that health and sustainability are mutually enabling and constraining. We conclude that while the renewed focus on food security and food inequalities has brought the health and sustainability dimensions of the food system onto the political agenda, the conceptualization of duality between health and sustainability could be a new platform for a critical and theoretical stance towards the market-oriented food system strategy. Thinking along the lines of duality means that the integration of health promotion strategies and sustainable development strategies cannot be based on an approach to integration in which either health or sustainability is given precedence over the other. From a duality perspective, integration means conceiving sustainability from a health perspective and health from a sustainability perspective. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Health and Sustainability

    DEFF Research Database (Denmark)

    Land, Birgit; Pedersen, Kirsten Bransholm; Kjærgård, Bente

    2014-01-01

    In the present article, we explore how sustainable development strategies and health promotion strategies can be bridged. The concept of the ‘duality of structure’ is taken as our starting point for understanding the linkages between health promotion and sustainable development, and for uncovering...... the structural properties or conditions which either enable or constrain sustainable public health initiatives. We argue that strategies towards health promotion are not sufficiently integrated with strategies for sustainable development, and thus political strategies aimed at solving health problems...... or sustainability problems may cause new, undesired and unforeseen environmental or health problems. First, we explore how the relation between health and sustainability is articulated in international policy documents. Next, we develop a model for understanding the relation between health promotion...

  10. Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns.

    Science.gov (United States)

    Douglas, Susan R; Vides de Andrade, Ana Regina; Boyd, Stephanie; Leslie, Melanie; Webb, Lynn; Davis, Lauren; Fraine, Melissa; Frazer, Nicole L; Hargraves, Ryan; Bickman, Leonard

    2016-07-01

    To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology. Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate). All Soldiers were eligible to participate and were blinded to provider training status. Immediately after screening encounters, providers reported on their identification of mental health concerns and Soldiers reported on provider communication behaviors resulting in 1,400 matched pairs. Electronic health records were also available for 26,005 Soldiers. The workshop was found to increase (1) providers' patient-centered communication behaviors as evaluated by Soldiers; (2) provider identification of Soldier mental health concerns; and (3), related health outcomes including provision of education and referral to a confidential counseling resource. Results are promising, but with small effect sizes and study limitations, further research is warranted. A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Postdeployment mental health screening: an application of the Soldier Adaptation Model.

    Science.gov (United States)

    Harmon, S Cory; Hoyt, Timothy V; Jones, Michael D; Etherage, Joseph R; Okiishi, John C

    2012-04-01

    The Global War on Terrorism and its corresponding frequent and long deployments have resulted in an increase in mental health concerns among active duty troops. To mitigate these impacts, the Department of Defense has implemented postdeployment screening initiatives designed to identify symptomatic soldiers and refer them for mental health care. Although the primary purpose of these screenings is to identify and provide assistance to individuals, macrolevel reporting of screening results for groups can assist Commanders, who are charged with ensuring the wellbeing of their soldiers, to make unit-level interventions. This study assesses the utility of a metatheory of occupational stress, the Soldier Adaptation Model, in organizing feedback information provided to Army Commanders on their units' postdeployment screening results. The results of a combat brigade of 2319 soldiers who completed post-deployment screening following return from Iraq were analyzed using Structural Equation Modeling to assess the Soldier Adaptation Model's use for macrolevel reporting. Results indicate the Soldier Adaptation Model did not strengthen the macrolevel reporting; however, alcohol use and reckless driving were found to mediate the relationship between combat exposure and numerous mental health symptoms and disorders (e.g., post-traumatic stress disorder, anger, depression, anxiety, etc.). Research and practice implications are discussed.

  12. Social Health and Sustainability

    DEFF Research Database (Denmark)

    Andersen, Heidi Lene

    2015-01-01

    Abstract: This article discusses how to accomplish a transition towards healthy and sustainable futures. Despite political statements and profound theoretical developments, little has happened in the field of practice. This article presents a number of problematics in the theoretical and conceptual...... development within the fields of sustainability and health promotion. With this objective in mind, this article seeks to find solutions to a question raised by the WHO health and sustainability researcher, Illona Kickbusch: ‘What conceptual framing and common language can help move a shared agenda forward...... departments. The article demonstrates that an action research approach including an Aristotelean phronetic perspective can be successful in integrating health and sustainability in research, as well as in practice. There are two main conclusions from the empirical case study. The first is that the common...

  13. The black soldier fly, Hermetia illucens - a promising source for sustainable production of proteins, lipids and bioactive substances.

    Science.gov (United States)

    Müller, Ariane; Wolf, Diana; Gutzeit, Herwig O

    2017-09-26

    The growing demand worldwide for proteins and lipids cannot be met by the intensive use of agricultural land currently available. Insect mass cultures as a source for proteins and lipids have been in focus for various reasons. An insect with many positive properties is the black soldier fly, Hermetia illucens, whose larvae could be used for the sustainable production of proteins and lipids. Furthermore, the larvae produce bioactive substances which could potentially be used for human and animal welfare.

  14. Who cares for former child soldiers? Mental health systems of care in Sierra Leone

    NARCIS (Netherlands)

    Song, S.; van den Brink, H.; de Jong, J.

    2013-01-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with

  15. Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War

    National Research Council Canada - National Science Library

    Milliken, CHarles S; Auchterlonie, Jennifer L; Hoge, Charles W

    2007-01-01

    Described the Department of Defense's (DoDs) screening efforts to identify mental health concerns among soldiers and Marines as they return from Iraq and Afghanistan using the Post-Deployment Health Assessment (PDHA...

  16. Mental Health among Former Child Soldiers and Never-Abducted Children in Northern Uganda

    Directory of Open Access Journals (Sweden)

    Ughetta Moscardino

    2012-01-01

    Full Text Available The present study aimed to evaluate posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems in former Ugandan child soldiers in comparison with civilian children living in the same conflict setting. Participants included 133 former child soldiers and 101 never-abducted children in northern Uganda, who were interviewed about exposure to traumatic war-related experiences, posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems. Results indicated that former child soldiers had experienced significantly more war-related traumatic events than nonabducted children, with 39.3% of girls having been forced to engage in sexual contact. Total scores on measures of PTSD symptoms, psychological distress, and emotional and behavioral problems were significantly higher among child soldiers compared to their never-abducted peers. Girls reported significantly more emotional and behavioral difficulties than boys. In never-abducted children, more mental health problems were associated with experiencing physical harm, witnessing the killings of other people, and being forced to engage in sexual contact.

  17. Mental health among former child soldiers and never-abducted children in northern Uganda.

    Science.gov (United States)

    Moscardino, Ughetta; Scrimin, Sara; Cadei, Francesca; Altoè, Gianmarco

    2012-01-01

    The present study aimed to evaluate posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems in former Ugandan child soldiers in comparison with civilian children living in the same conflict setting. Participants included 133 former child soldiers and 101 never-abducted children in northern Uganda, who were interviewed about exposure to traumatic war-related experiences, posttraumatic stress symptoms, psychological distress, and emotional and behavioral problems. Results indicated that former child soldiers had experienced significantly more war-related traumatic events than nonabducted children, with 39.3% of girls having been forced to engage in sexual contact. Total scores on measures of PTSD symptoms, psychological distress, and emotional and behavioral problems were significantly higher among child soldiers compared to their never-abducted peers. Girls reported significantly more emotional and behavioral difficulties than boys. In never-abducted children, more mental health problems were associated with experiencing physical harm, witnessing the killings of other people, and being forced to engage in sexual contact.

  18. Evaluation of Reproductive Health Training of Soldiers at the First Army of Turkish Armed Forces

    Directory of Open Access Journals (Sweden)

    Bilal Bakir

    2012-02-01

    Full Text Available The study has aimed to evaluate results of reproductive health training in the First army as a part the Reproductive Health Program of Turkish Armed Forces (TAF. Hard copies of training results from the a sample of 9 reproductive health classrooms between November 2006 and February 2007 have been collected and analyzed after entering in a SPSS file. A Pre-test and a post-test included the same 25 questions on RH issues were given to the soldiers. Total mean scores and scores for 5 modules of Sexual Health, Sexually Transmitted Infections (STIs, Contraceptives, Safe Motherhood, and Gender, were estimated. By deciding 60 as cutting point, achievement of soldiers was also evaluated. Total Pre and posttest mean scores were compared between groups according to the achievement, hometown, and region of residency, educational level, and marital status. Furthermore, Relative efficiency, Efficiency attributed to training course and Efficiency Ratio has been also calculated. The mean pre-test score of soldiers is 60.4 ± 21.0 and it has been significantly increased up to 82.8 ± 14.5 after the training course (p<0.05. This significant increase was also found for each of sub dimensions similar to total score (p<0.05. While 52.5 % of soldiers have been successful on pretest, this percent has been rise up to 93.1% for the post test (p<0.05.. The relative efficiency of intervention as 6.9, efficiency attributed to training as 40.6%, and efficiency ratio as 85.5% have been estimated. Involving in reproductive health training has improved soldiers� awareness particularly on women�s health. [TAF Prev Med Bull 2012; 11(1.000: 41-48

  19. Socioeconomic Status and Mental Health Service Use Among National Guard Soldiers.

    Science.gov (United States)

    Sripada, Rebecca K; Richards, Sarah K H; Rauch, Sheila A M; Walters, Heather M; Ganoczy, Dara; Bohnert, Kipling M; Gorman, Lisa A; Kees, Michelle; Blow, Adrian J; Valenstein, Marcia

    2015-09-01

    Convergent evidence suggests that low socioeconomic status (SES) may be related to reduced mental health service use. However, this relationship has not been tested in the National Guard (NG) population, in which the prevalence of mental health symptoms is high. Surveys were completed by 1,262 NG soldiers. SES was measured by education and income. Adjusted multivariable regression models assessed associations between SES, overall service use, and use of specific types of services. SES was not associated with overall use but was associated with use of certain types of services. Higher SES was associated with lower likelihood of psychotropic medication use (odds ratio=.83, 95% confidence interval=.72-.96), and higher SES strengthened the positive relationship between PTSD and use of individual therapy. Higher SES may increase the use of individual therapy among soldiers with PTSD. Barriers to care among individuals with low SES merit continued attention and outreach efforts.

  20. PTSD Trajectory, Co-morbidity, and Utilization of Mental Health Services among National Guard Soldiers

    Science.gov (United States)

    2014-09-01

    veterans. Sexual violence is commonly under-reported,27 and soldiers may be espe- cially concerned about stigma , fear of negative conse- quences, and...suicide ideation and attempts associated with adverse childhood experiences. Am J Public Health. 2008;98:946–952. 25. Koss MP, Gidycz CA, Wisniewski N...women compared a sample of male veterans with PTSD to a sample of female victims of childhood or adult sexual trauma with PTSD; the latter group

  1. Who cares for former child soldiers? Mental health systems of care in sierra leone.

    Science.gov (United States)

    J Song, Suzan; van den Brink, Helene; de Jong, Joop

    2013-10-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with participants from diverse sectors. Priorities of mental distress, substance abuse, and gender-based violence were common among FCS clients. Barriers were governmental support and communication with other providers. Perceived facilitators of care were primary- and secondary-level interventions. A public mental health model would feasibly build upon local, culturally embraced interventions, targeting local priorities and reducing barriers to care.

  2. Schools for health and sustainability

    DEFF Research Database (Denmark)

    Madsen, Katrine Dahl; Nordin, Lone Lindegard; Simovska, Venka

    2015-01-01

    in Denmark with its aims of ensuring overall school improvement, increasing pupil wellbeing and improving academic outcomes. Analysis of international policy documents, as well as of research literature in both fields, shows that school-based health education (HE) and education for sustainable development...... in this chapter focuses on a common tendency when health and sustainability education in schools are framed in national action plans: certain critical educational aspects are lost by narrowing the concepts of health and sustainability to fit particular school subjects (e.g. physical education or science......This chapter addresses the relationships between international and national (Danish) policies regarding sustainability and health promotion which have the potential to affect school-based health education/promotion and education for sustainable development. Based on policy mapping and analysis...

  3. Facilitating Soldier Receipt of Needed Mental Health Treatment

    Science.gov (United States)

    2014-11-01

    study and assigned two battalions to participate in the study. One of the battalions has more gender and MOS diversity. The PI met with the...of malingering, military-related be- liefs, leader and peer behaviors, and dishonesty on mental health assessments. Very little re- search has

  4. Facilitating Soldier Receipt of Needed Mental Health Treatment

    Science.gov (United States)

    2013-11-01

    Beliefs About Medications 1. The medications prescribed by mental health providers are usually addictive . (.705) 2. Ifl were to receive mental...deploymenL He ... wasn’t able to cope, but his outlet was the use of marijuana , primarily. It was one of those things that he just

  5. Facilitating Soldier Receipt of Needed Mental Health Treatment

    Science.gov (United States)

    2011-11-01

    experience of severe occupational hazards . In addition to the military, employees in other high stress occupations also experience mental health problems as...experienced by employees. Given the latter association, we argue that highly stressful events at work should be considered occupational hazards that...this latter area of research is that the use of EAPs may have more to do with reactions to non-work stressors than with the occupational hazards of

  6. Health-related quality of life in soldiers in Croatia: relationship with combat readiness and psychological dimensions.

    Science.gov (United States)

    Perić, Davorka; Plancak, Darije; Bulj, Martina; Tudor, Vedrana; Spalj, Stjepan

    2013-12-01

    Health status of soldiers affects their quality of life and combat readiness. The aim of the research was to explore the differences in health-related quality of life (HRQoL) between combat ready und unready soldiers and to what extent are clinically assessed combat readiness and psychological dimensions related to self-reported HRQoL. The study included 402 consecutively selected soldiers aged 21 to 54 (mean age 35.3 +/- 6.0) who were classified on the basis of a regular health examination as combat ready (N=327) and unready (N=75). HRQoL was assessed using the Short Form-8 Questionnaire and psychological dimensions using the Brief Symptom Inventory. There were no significant differences in physical and mental components of HRQoL between combat ready and unready soldiers. Clinically assessed combat readiness and psychological symptomatic dimensions were weak predictors of HRQoL. Higher intensity of psychoticism and less years in military service were the only significant predictor of higher physical component of HRQoL (p=0.027 and p=0.020, respectively) but accounted for low variability (each 1%). None variable was a predictor of mental component. In conclusion, clinically assessed combat readiness of soldiers and psychological symptomatic dimensions are poor predictors of HRQoL. HRQoL should be introduced in evaluation of combat readiness.

  7. Grief and physical health outcomes in U.S. soldiers returning from combat.

    Science.gov (United States)

    Toblin, Robin L; Riviere, Lyndon A; Thomas, Jeffrey L; Adler, Amy B; Kok, Brian C; Hoge, Charles W

    2012-02-01

    Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief. Infantry soldiers (n=1522) completed anonymous surveys using validated instruments six months following deployment in November-December 2008. Multiple logistic regression was used to assess the association of difficulty coping with grief and physical health. The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), and back pain (28.1%). Difficulty coping with grief over the death of someone close affected 21.3%. There was a dose-response relationship between level of difficulty coping with grief and principal physical health outcomes (psgrief significantly and uniquely contributed to a high somatic symptom score (adjusted odds ratio (AOR)=3.6), poor general health (AOR=2.0), missed work (AOR=1.7), medical utilization (AOR=1.5), difficulty carrying a heavy load (AOR=1.7), and difficulty performing physical training (AOR=1.6; all 95% confidence intervals>1). Data are cross-sectional and grief was measured with one item. Over 20% of soldiers reported difficulty coping with grief. This difficulty was significantly associated with physical health outcomes and occupational impairment. Clinicians should be aware of the unique role grief plays in post-deployment physical health when treating patients. Published by Elsevier B.V.

  8. Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medication, and Barriers to Care in the United States Military

    Science.gov (United States)

    2012-10-01

    treatment and etiology of psychological disorders relate to seeking professional help at a military mental health clinic and to general healthcare...beliefs about six different disorders or diseases (Cocaine Addiction, Mental Retardation , AIDS, Psychosis, Depression, and Cancer). The PDAQ has three...08-2-0702 TITLE: Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medication, and Barriers to Care in the United

  9. Towards Sustainable Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Mauro ROMANELLI

    2017-09-01

    Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

  10. Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal.

    Science.gov (United States)

    Kohrt, Brandon A; Jordans, Mark J D; Tol, Wietse A; Speckman, Rebecca A; Maharjan, Sujen M; Worthman, Carol M; Komproe, Ivan H

    2008-08-13

    Former child soldiers are considered in need of special mental health interventions. However, there is a lack of studies investigating the mental health of child soldiers compared with civilian children in armed conflicts. To compare the mental health status of former child soldiers with that of children who have never been conscripts of armed groups. Cross-sectional cohort study conducted in March and April 2007 in Nepal comparing the mental health of 141 former child soldiers and 141 never-conscripted children matched on age, sex, education, and ethnicity. Depression symptoms were assessed via the Depression Self Rating Scale, anxiety symptoms via the Screen for Child Anxiety Related Emotional Disorders, symptoms of posttraumatic stress disorder (PTSD) via the Child PTSD Symptom Scale, general psychological difficulties via the Strength and Difficulties Questionnaire, daily functioning via the Function Impairment tool, and exposure to traumatic events via the PTSD Traumatic Event Checklist of the Kiddie Schedule of Affective Disorders and Schizophrenia. Participants were a mean of 15.75 years old at the time of this study, and former child soldiers ranged in age from 5 to 16 years at the time of conscription. All participants experienced at least 1 type of trauma. The numbers of former child soldiers meeting symptom cutoff scores were 75 (53.2%) for depression, 65 (46.1%) for anxiety, 78 (55.3%) for PTSD, 55 (39.0%) for psychological difficulties, and 88 (62.4%) for function impairment. After adjusting for traumatic exposures and other covariates, former soldier status was significantly associated with depression (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.31-4.44) and PTSD among girls (OR, 6.80; 95% CI, 2.16-21.58), and PTSD among boys (OR, 3.81; 95% CI, 1.06-13.73) but was not associated with general psychological difficulties (OR, 2.08; 95% CI, 0.86-5.02), anxiety (OR, 1.63; 95% CI, 0.77-3.45), or function impairment (OR, 1.34; 95% CI, 0

  11. Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups

    OpenAIRE

    Brandon A. Kohrt; Yang, Minyoung; Rai, Sauharda; Bhardwaj, Anvita; Tol, Wietse A.; Jordans, Mark J. D.

    2016-01-01

    Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews were conducted with 258 former child soldiers wh...

  12. What Does Military Biomedical Research Contribute to Sustaining Soldier Performance in Cold Environments?

    Science.gov (United States)

    2005-12-01

    Energy Intake Detraining Overtraining Dehydration Hyponatremia Fatigue Traumatic Events Isolation New & Conflicting Roles Family Separation...the interactions of operational stressors, in part, because this is a relatively new frontier compared to all the studies of single isolated ...U.S. because of possible health risks. Other dietary solutions may be possible; a normal meal provides a thermic effect of its own, while

  13. Danish soldiers in Iraq

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Marott, Jacob Louis; Gyntelberg, Finn

    2011-01-01

    Using data from an occupational medical health surveillance program, we studied the associations between mental stressors and social support and the two outcome measures postdeployment psychological distress and multiple physical symptoms among Danish soldiers deployed to Iraq. The study was cross...... the assumption that other factors than combat exposure-psychosocial and cultural-are of importance in increasing psychological distress among soldiers deployed to Iraq. Additionally, we have shown that the reporting of multiple physical symptoms among the deployed soldiers is closely related to increased......-sectional and questionnaire-based with soldiers returning from the mission as the target group. Witnessing atrocities, fear of being physically harmed, feeling of insecurity, feeling of meaninglessness, and having been in touch with prisoners were associated with both outcome measures. In conclusion, our findings support...

  14. Barriers to initiating and continuing mental health treatment among soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

    Science.gov (United States)

    Naifeh, James A.; Colpe, CAPT Lisa J; Aliaga, Pablo A.; Sampson, Nancy A.; Heeringa, Steven G.; Stein, Murray B.; Ursano, Robert J.; Fullerton, Carol S.; Nock, Matthew K.; Schoenbaum, Michael; Zaslavsky, Alan M.; Kessler, Ronald C.

    2016-01-01

    U.S. Army soldiers with mental disorders report a variety of barriers to initiating and continuing treatment. Improved understanding of these barriers can help direct mental health services to soldiers in need. A representative sample of 5,428 nondeployed Regular Army soldiers participating in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) completed a self-administered questionnaire (SAQ) and consented to linking SAQ data with administrative records. We examined reported treatment barriers (perceived need, structural reasons, attitudinal reasons) among respondents with current DSM-IV mental disorders who either did not seek treatment in the past year (n=744) or discontinued treatment (n=145). 82.4% of soldiers who did not initiate treatment and 69.5% of those who discontinued treatment endorsed at least two barriers. 69.8% of never-treated soldiers reported no perceived need. Attitudinal reasons were cited more frequently than structural reasons among never-treated soldiers with perceived need (80.7% vs. 62.7%) and those who discontinued treatment (71.0% vs. 37.8%). Multivariate associations with socio-demographic, Army career, and mental health predictors varied across barrier categories. These findings suggest most soldiers with mental disorders do not believe they need treatment, and those who do typically face multiple attitudinal and, to a lesser extent, structural barriers. PMID:27612348

  15. Shadow Soldiering

    DEFF Research Database (Denmark)

    Mynster Christensen, Maya

    The thesis is an inquiry into what is at stake for a surplus population of militia soldiers in the aftermaths of the civil war in Sierra Leone. The analysis takes its point of departure in how militarised networks are transformed and gradualy morph into new constellations of soldiering. The central...... question the thesis pursues is how the processes of mobilisation connecting these constellations are facilitated, and how the constellations are constituted in the intersection between local and global formations. Shadow soldiering, it is argued, is not a phenomenon existing in parallel with...

  16. Passive acoustic monitoring of human physiology during activity indicates health and performance of soldiers and firefighters

    Science.gov (United States)

    Scanlon, Michael V.

    2003-04-01

    The Army Research Laboratory has developed a unique gel-coupled acoustic physiological monitoring sensor that has acoustic impedance properties similar to the skin. This facilitates the transmission of body sounds into the sensor pad, yet significantly repels ambient airborne noises due to an impedance mismatch. The sensor's sensitivity and bandwidth produce excellent signatures for detection and spectral analysis of diverse physiological events. Acoustic signal processing detects heartbeats, breaths, wheezes, coughs, blood pressure, activity, motion, and voice for communication and automatic speech recognition. The health and performance of soldiers, firefighters, and other first responders in strenuous and hazardous environments can be continuously and remotely monitored with body-worn acoustic sensors. Comfortable acoustic sensors can be in a helmet or in a strap around the neck, chest, and wrist. Noise-canceling sensor arrays help remove out-of-phase motion noise and enhance covariant physiology by using two acoustic sensors on the front sides of the neck and two additional acoustic sensors on each wrist. Pulse wave transit time between neck and wrist acoustic sensors will indicate systolic blood pressure. Larger torso-sized arrays can be used to acoustically inspect the lungs and heart, or built into beds for sleep monitoring. Acoustics is an excellent input for sensor fusion.

  17. Challenges in Sustaining Public Health Interventions

    Science.gov (United States)

    Altman, David G.

    2009-01-01

    Sustainability remains a key challenge in public health. The perspective article by Fagen and Flay adds to our understanding of technical factors associated with sustaining health interventions in schools. In this commentary, the Fagen and Flay article (2009) is considered within the broader literature on sustainability. By taking a broad view,…

  18. Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

    Science.gov (United States)

    Betancourt, Theresa S; Borisova, Ivelina; Williams, Timothy P; Meyers-Ohki, Sarah E; Rubin-Smith, Julia E; Annan, Jeannie; Kohrt, Brandon A

    2013-01-01

    This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR). According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and

  19. Postwar environment and long-term mental health problems in former child soldiers in Northern Uganda: the WAYS study.

    Science.gov (United States)

    Amone-P'Olak, Kennedy; Stochl, Jan; Ovuga, Emilio; Abbott, Rosemary; Meiser-Stedman, Richard; Croudace, Tim J; Jones, Peter B

    2014-05-01

    War experiences (WE) and postwar environments (PWE) are associated with mental ill-health. The present study aims to investigate the pathways from WE and PWE to mental ill-health and to define opportunities for intervention through analysis of the war-affected youths study (WAYS) cohort study. WAYS is an ongoing study of a large cohort of former child soldiers being conducted in Uganda. Mental health problems, subjective WE and PWE contexts were assessed by local adaptations of internationally developed measures for use with former child soldiers at least 6 years after the end of the war. Structural equation modeling was used to test two mediation hypotheses: (1) the 'trauma model' in which WE directly influence long-term mental health and (2) the 'psychosocial path' in which WE influence long-term mental health through PWE stressors. WE were linked to depression/anxiety (β=0.15 (95% CI 0.01 to 0.30)) through PWE (accounting for 44% of the variance in the relationship between these variables) and to conduct problems (β=0.23 (95% CI 0.03 to 0.43); (accounting for 89% of the variance, ie, near complete mediation)). The direct relation between WE and depression/anxiety attenuated but remained statistically significant. For conduct problems, the direct relationship was no longer significant after accounting for PWE. PWE are a key determinant of continued mental health problems in former child soldiers. Interventions to reduce long-term mental problems should address both PWE stressors (psychosocial model) and specialised mental healthcare (trauma model) and consider both models of intervention as complementary.

  20. Personal values in soldiers after military deployment: associations with mental health and resilience

    Directory of Open Access Journals (Sweden)

    Peter Zimmermann

    2014-05-01

    Full Text Available Background: After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Method: Schwartz's Portrait Values Questionnaire (PVQ, the Posttraumatic Stress Diagnostic Scale (PDS, and the 11-item version of the Resilience Scale (RS-11 were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated. Results: Logistic regression showed that the value types of hedonism (−, power (−, tradition (+, and universalism (+ were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Conclusions: Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.

  1. Personal values in soldiers after military deployment: associations with mental health and resilience

    Science.gov (United States)

    Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens T.; Backus, Johannes; Siegel, Stefan; Willmund, Gerd; Maercker, Andreas

    2014-01-01

    Background After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Method Schwartz’s Portrait Values Questionnaire (PVQ), the Posttraumatic Stress Diagnostic Scale (PDS), and the 11-item version of the Resilience Scale (RS-11) were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated). Results Logistic regression showed that the value types of hedonism (−), power (−), tradition (+), and universalism (+) were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Conclusions Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches. PMID:24808938

  2. The Impact of Sweat Calcium Loss on Bone Health in Soldiers: A Pilot Study

    Science.gov (United States)

    2013-02-06

    estradiol levels vary by the menstrual cycle phase for women. It does not appear that the reproductive axis was negatively impacted for any Soldier...disease No known family history of bone disease 93 89.42 Known family history of bone disease 11 10.58 History of stress fractures No...history stress fractures 79 75.96 Positive history of stress fractures 25 24.04 2. Body composition variables (Groups combined) Baseline

  3. Duality of Health Promotion and Sustainable Development

    DEFF Research Database (Denmark)

    Pedersen, Kirsten Bransholm; Land, Birgit; Kjærgård, Bente

    2015-01-01

    reduction and how these strategies affect the prospects for promoting health and sustainable food production and consumption. Danish food waste reduction strategies are used as examples with references to selected policy documents on food waste reduction strategies launched by international organisations...... sustainability and, vice versa, sustainability conditions health. Thus, to avoid unintended, negative effects the strategies directed towards sustainable development must be correlated with strategies for health promotion. The conceptual model is used to take a closer look at the complexities of food waste...... such as FAO, WHO, and the UN. We conclude that the strategies directed towards reducing food waste ignore the health and sustainability problems related to the oversupply of food. Neither do the Danish proponents of food waste reduction strategies explicitly articulate the built-in option to reduce the supply...

  4. The Impact of Behavioral Health Issues on Soldiers Returning from Deployment -- Assessing the Programs for Reintegration of South Carolina National Guard Soldiers

    Science.gov (United States)

    2011-05-23

    home to begin a 30, 60, and 90-day cycle similar to the current system to ensure success in reintegration . Providing decompression immediately...and leads to a more successful transition into reintegration back into civilian life. A second recommendation is for the SCNG Family Programs to...RETURNING FROM DEPLOYMENT – ASSESSING THE PROGRAMS FOR REINTEGRATION OF SOUTH CAROLINA NATIONAL GUARD SOLDIERS BY COLONEL R. VAN MCCARTY United

  5. Health Systems Sustainability and Rare Diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; De Santis, Marta; Egle Gentile, Amalia; Taruscio, Domenica

    2017-01-01

    The paper is addressing aspects of health system sustainability for rare diseases in relation to the current economic crisis and equity concerns. It takes into account the results of the narrative review carried out in the framework of the Joint Action for Rare Diseases (Joint RD-Action) "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases", that identified networks as key factors for health systems sustainability for rare diseases. The legal framework of European Reference Networks and their added value is also presented. Networks play a relevant role for health systems sustainability, since they are based upon, pay special attention to and can intervene on health systems knowledge development, partnership, organizational structure, resources, leadership and governance. Moreover, sustainability of health systems can not be separated from the analysis of the context and the action on it, including fiscal equity. As a result of the financial crisis of 2008, cuts of public health-care budgets jeopardized health equity, since the least wealthy suffered from the greatest health effects. Moreover, austerity policies affected economic growth much more adversely than previously believed. Therefore, reducing public health expenditure not only is going to jeopardise citizens' health, but also to hamper fair and sustainable development.

  6. Pain-related psychological distress, self-rated health and significance of neuropathic pain in Danish soldiers injured in Afghanistan

    DEFF Research Database (Denmark)

    Duffy, J R; Warburg, Finn; Koelle, S-F T

    2015-01-01

    BACKGROUND: Pain and mental health concerns are prevalent among veterans. While the majority of research has focused on chronic pain as an entity, there has been little work directed towards investigating the role of neuropathic pain in relation to psychological comorbidity. As such, we...... hypothesised that participants with signs of neuropathic pain would report higher levels of psychological distress and diminished self-rated health compared to those without a neuropathic component. METHODS: A retrospective review of standardised questionnaires (PainDETECT Questionnaire, Post-traumatic Stress...... Disorder Checklist-Civilian, the Hospital Anxiety and Depression Scale, and EuroQOL Visual Analogue Scale) administered to injured soldiers. The participants were classified into three groups according to the PainDETECT questionnaire: non-neuropathic pain, possible neuropathic pain and definite neuropathic...

  7. Family as a Total Package: Restoring and Enhancing Psychological Health for Citizen Soldiers and Families (FAMPAC)

    Science.gov (United States)

    2015-07-12

    pulmonary disease nmlkj nmlkj nmlkj nmlkj B. Hypertension or high  blood  pressure nmlkj nmlkj nmlkj nmlkj C. Diabetes nmlkj nmlkj nmlkj nmlkj D. Respiratory...Page 30 Time 4 (T4) Soldier Interview 10_21_2011 10. …missing important  events at home such as  birthdays,  weddings ,  funerals, graduations, etc...disease nmlkj nmlkj nmlkj nmlkj B. Hypertension or high  blood  pressure nmlkj nmlkj nmlkj nmlkj C. Diabetes nmlkj nmlkj nmlkj nmlkj D. Respiratory

  8. Designing mental health interventions informed by child development and human biology theory: A social ecology intervention for child soldiers in Nepal

    OpenAIRE

    Kohrt, Brandon A.; Jordans, Mark J.D.; Koirala, Suraj; Worthman, Carol M.

    2014-01-01

    The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used t...

  9. Societal health and urban sustainability indicators

    Energy Technology Data Exchange (ETDEWEB)

    Petrich, C.H.; Tonn, B.E.

    1996-08-27

    Without the social will, no city can successfully Undertake the planning and programs necessary for meaningful progress toward sustainability. Social will derives from wellsprings of vital societal health. This paper presents an approach to helping cities in APEC member economies initiate a program for developing indicators of sustainability. Representative indicators of social capital and other aspects of civic engagement, as proxies for societal health, are presented.

  10. Does cynicism play a role in failure to obtain needed care? Mental health service utilization among returning U.S. National Guard soldiers.

    Science.gov (United States)

    Arbisi, Paul A; Rusch, Laura; Polusny, Melissa A; Thuras, Paul; Erbes, Christopher R

    2013-09-01

    In the present study, the authors examined cynicism, a trait associated with mistrust and a misanthropic world view, as an impediment to seeking needed mental health services among a group of National Guard Soldiers with diagnoses of anxiety, depression, or substance abuse or dependence after a combat deployment. On their return from deployment, 40 National Guard soldiers were assessed for self-stigma, current distress, attitudes toward mental health care, and psychiatric diagnoses. Eight and a half months later, mental health service utilization was evaluated. Cynicism assessed prior to deployment was associated with lower odds of utilizing mental health services independent of self-stigma and negative attitudes toward mental health care. Further, neither self-stigma nor attitudes toward mental health care predicted engaging in needed mental health care when cynicism was included in the model.

  11. Research Review: Psychosocial Adjustment and Mental Health in Former Child Soldiers--A Systematic Review of the Literature and Recommendations for Future Research

    Science.gov (United States)

    Betancourt, Theresa S.; Borisova, Ivelina; Williams, Timothy P.; Meyers-Ohki, Sarah E.; Rubin-Smith, Julia E.; Annan, Jeannie; Kohrt, Brandon A.

    2013-01-01

    Aims and scope: This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age less than 18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers. Methods: PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR,…

  12. Poorer Physical Health is Associated With Greater Mental Health Service Utilization in a Sample of Depressed U.S. Army National Guard Soldiers.

    Science.gov (United States)

    Levine, Debra S; Sripada, Rebecca K; Ganoczy, Dara; Walters, Heather; Gorman, Lisa A; Valenstein, Marcia

    2016-08-01

    Operation Iraqi Freedom/Operation Enduring Freedom service members returning from deployment suffer from high rates of depression and report low levels of physical functioning compared to age-adjusted norms. Treatment for depression may be limited in this group and there are few data on whether Veterans receive medication treatment versus psychotherapy. We assessed rates of depression, physical functioning, and treatment with either medication or psychotherapy among recently returning service members. Study participants were recruited from National Guard soldiers in a Midwestern state (n = 1,448). Logistic regression modeling was used to examine associations between physical health and odds of receiving different types of mental health treatment for depressed individuals (n = 299). 21% of soldiers reported significant depression and 44% of depressed service members reported poor physical health. Poorer physical health was associated with increased odds of any treatment (odds ratio: 1.27, confidence interval: 1.1-1.45) and medication treatment (odds ratio: 1.23, confidence interval: 1.08-1.40) but physical health was not associated with individual psychotherapy. Poor physical health is associated with increased likelihood of pharmacological but not individual psychotherapeutic treatment. Physical health problems may increase the need for depression care or increase contact with the medical system leading to higher levels of pharmacological treatment. Access to psychotherapy may need to be increased for Veterans with poor physical health. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  13. [Health and environmental governance for sustainable development].

    Science.gov (United States)

    Buss, Paulo Marchiori; Machado, Jorge Mesquita Huet; Gallo, Edmundo; Magalhães, Danielly de Paiva; Setti, Andréia Faraoni Freitas; Franco Netto, Francisco de Abreu; Buss, Daniel Forsin

    2012-06-01

    The United Nations Conference on Sustainable Development, Rio+20, will address the challenges for sustainable development (SD), 'green economy and poverty eradication' and the 'institutional structure of sustainable development'. Therefore it will address the governance needed to achieve such goals. This paper discusses the structure of global, regional and national governance of and for health and environment in the context of SD. Among other global actions, the Millenium Development Goals were a significant recent political effort, but despite its advances, it fails when ignores the structural causes of production and consumption patterns and the unequal distribution of power, which are responsible for inequities and impede true development. To achieve SD, proposals must avoid reductionism, advancing conceptually and methodologically to face the challenges of the socio-environmental determinants of health through intersectoral action, including social participation and all levels of government. It is paramount to continue the implementation of Agenda 21, to meet the MDGs and to create 'Sustainable Development Goals'. Regarding the health field, Rio+20 Summit must reassure the connection between health and sustainability - as a part of the Social pillar of sustainable development - inspiring politics and actions in multiple levels.

  14. Water Quality and Sustainable Environmental Health

    Science.gov (United States)

    Setegn, S. G.

    2014-12-01

    Lack of adequate safe water, the pollution of the aquatic environment and the mismanagement of resources are major causes of ill-health and mortality, particularly in the developing countries. In order to accommodate more growth, sustainable fresh water resource management will need to be included in future development plans. One of the major environmental issues of concern to policy-makers is the increased vulnerability of ground water quality. The main challenge for the sustainability of water resources is the control of water pollution. To understand the sustainability of the water resources, one needs to understand the impact of future land use and climate changes on the natural resources. Providing safe water and basic sanitation to meet the Millennium Development Goals will require substantial economic resources, sustainable technological solutions and courageous political will. A balanced approach to water resources exploitation for development, on the one hand, and controls for the protection of health, on the other, is required if the benefits of both are to be realized without avoidable detrimental effects manifesting themselves. Meeting the millennium development goals for water and sanitation in the next decade will require substantial economic resources, sustainable technological solutions and courageous political will. In addition to providing "improved" water and "basic" sanitation services, we must ensure that these services provide: safe drinking water, adequate quantities of water for health, hygiene, agriculture and development and sustainable sanitation approaches to protect health and the environment.

  15. Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

    Science.gov (United States)

    Kohrt, Brandon A; Yang, Minyoung; Rai, Sauharda; Bhardwaj, Anvita; Tol, Wietse A; Jordans, Mark J D

    2016-08-01

    Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews were conducted with 258 former child soldiers who participated in a communist (Maoist) revolution. Eighty percent of child soldiers joined 'voluntarily'. Girls were 2.07 times as likely to join voluntarily (95% CI, 1.03-4.16, p=0.04). Among girls, 51% reported joining voluntarily because of personal connections to people who were members of the armed group, compared to 22% of boys. Other reasons included escaping difficult life situations (36%), inability to achieve other goals in life (28%), and an appealing philosophy of the armed group (32%). Poor economic conditions were more frequently endorsed among boys (22%) than girls (10%). Voluntary conscription was associated with decreased risk for PTSD among boys but not for girls. Interventions to prevent voluntary association with armed groups could benefit from attending to difficulties in daily life, identifying non-violent paths to achieve life goals, and challenging the political philosophy of armed groups. Among boys, addressing economic risk factors may prevent recruitment, and prevention efforts for girls will need to address personal connections to armed groups, as it has important implications for preventing recruitment through new methods, such as social media.

  16. Effective and Sustainable Health Research Partnerships : a ...

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

    Effective and Sustainable Health Research Partnerships : a Collaborative Canada-South Project. IDRC frequently supports collaborative Canada-South research on subjects of vital interest to developing countries, such as health. This project is concerned with learning how to structure and manage Canada-South research ...

  17. Skin diseases in Turkish soldiers

    Directory of Open Access Journals (Sweden)

    Sezai Sasmaz

    2011-06-01

    Full Text Available This study aimed to determine the prevalence of skin diseases among soldiers who were assigned duties in Kahramanmaras, a province of east Mediterranean region of Turkey. One hundred eighty-eight soldiers were assessed for skin diseases by a complete dermatological examination and the findings were recorded to a form. Apart from the low number of older ones, the soldiers were of 20–22 years. The diagnosis of superficial fungal infections was made by the use of potassium hydroxide preparations in addition to clinical appearance. On completion of the study period, the data were evaluated, and patients were grouped. Pitted keratolysis was the primary dermatologic disease in 34.5% of the soldiers, 29.2% were diagnosed with oral candidiasis, and 25.5% suffered from tinea pedis. Among the soldiers suffering from a cutaneous disease, dyshidrotic eczema (18.6%, intertrigo (excluding candidal intertrigo (17%, acne (17%, seborrheic dermatitis (14.9%, plantar hyperkeratosis (14.3%, contact dermatitis (13.8%, and folliculitis (12.2% were the other most frequent dermatoses. Other less frequent dermatoses were asteatotic eczema, callus, onychomycosis, traumatic onychodystrophy, and so on. We conclude that the prevalence of skin diseases in soldiers is very high and is one of the major public health problems that have a significant burden on our nation.

  18. Community Health Global Network and Sustainable Development

    Directory of Open Access Journals (Sweden)

    Rebekah Young

    2016-01-01

    Full Text Available With the achievements, failures and passing of the Millennium Development Goals (MDG, the world has turned its eyes to the Sustainable Development Goals (SDG, designed to foster sustainable social, economic and environmental development over the next 15 years.(1 Community-led initiatives are increasingly being recognised as playing a key role in realising sustainable community development and in the aspirations of universal healthcare.(2 In many parts of the world, faith-based organisations are some of the main players in community-led development and health care.(3 Community Health Global Network (CHGN creates links between organisations, with the purpose being to encourage communities to recognise their assets and abilities, identify shared concerns and discover solutions together, in order to define and lead their futures in sustainable ways.(4 CHGN has facilitated the development of collaborative groups of health and development initiatives called ‘Clusters’ in several countries including India, Bangladesh, Kenya, Tanzania, Zambia and Myanmar. In March 2016 these Clusters met together in an International Forum, to share learnings, experiences, challenges, achievements and to encourage one another. Discussions held throughout the forum suggest that the CHGN model is helping to promote effective, sustainable development and health care provision on both a local and a global scale.

  19. [Environment, health and sustainable development].

    Science.gov (United States)

    Rattner, Henrique

    2009-01-01

    Environmental problems and their impact on health and welfare of the population, mainly the most deprived and excluded, from access to material and symbolic goods, provided only to a privileged minority, must be analyzed within the context of the global economic and financial crisis which swept the whole world since 2008. The collapse of the capitalist system and its negative impacts on production, income and employment provide evidence to the predatory nature of the underlying social and political relations which lead humanity to a catastrophic abyss whose consequences are felt on local, national and global levels. Appointing to the main aspects of environmental deterioration - greenhouse gases; pollution of rivers, lakes and oceans; the erosion and intoxication of soils; the lack of basic sanitation and fresh water supply in metropolitan areas, this essay refers to official health indicators published recently by the Ministry of Health of Brazil which documents destructive trends. Discussing the dysfunction and the paradoxes of capital accumulation the essay points out to the need for building a new development paradigm based on cooperation and solidarity; an equitable distribution of the social product and the reform of the political system leading from the present authoritarian patterns of social relations to a participative and a true democratic model.

  20. Engineering performant, innovative and sustainable health systems

    OpenAIRE

    Wouters, Raphael

    2016-01-01

    Background: In a time of growing health expenditures and inefficiencies, ageing populations, rise of chronic diseases, co-morbity and technical evolutions, there is a worldwide quest for performant, innovative and sustainable health systems that are, a.o. effective and cost-efficient, patient-centric and co-creative and able to deal with the growing society dynamics.Problem statement: Effectively implementing strategic initiatives that tackle these challenges appears a frightening task since ...

  1. Health care financing and the sustainability of health systems

    OpenAIRE

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-01-01

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to “traditional” issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a glo...

  2. INTERDEPENDENCE BETWEEN SUSTAINABLE DEVELOPMENT AND HUMAN HEALTH

    Directory of Open Access Journals (Sweden)

    Dorina MOCUTA

    2013-01-01

    Full Text Available Sustainable development in Romania can be achieved only through consensus orchestrated prioritizing people's attitudes and values. In order to achieve a maximum performance, cultural change must precede structural and functional changes, such an approach leading to a lasting transformation. Cultural change is not about social traditions, history, language, art, etc.., But those on the behavior, mentality, attitude towards work, economy and society. Sustainable development have to mean quality and achieve only limited natural capital, social and anthropogenic own or attracted. A drawing resources must be addressed by cost and their global rarity. Sustainable development for Romania, represents the effective management of resources in the national competitiveness and national foreign goods and services. Human health suppliers, health organizations that offer health services and those who need these services, meet on a market, called health services market, whose mechanism has features different from the other markets, not only from the point of view of the two forces, demand and supply, but also from the third party who pays. In the context of globalization, human development, defined as a process of people’s expanding possibilities to choose, cannot exist without an appropriate health. People often make choices in the economic, social and political fields, situated in the centre of development policies. From the human health perspective, attention is aimed at quality of the economic development, and not quantity, in three critical domains: expectation and quality of life, educational level and access to all the necessary economic resources in order to lead a decent life.

  3. Designing mental health interventions informed by child development and human biology theory: a social ecology intervention for child soldiers in Nepal.

    Science.gov (United States)

    Kohrt, Brandon A; Jordans, Mark J D; Koirala, Suraj; Worthman, Carol M

    2015-01-01

    The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used to illustrate the role of these concepts in intervention design and evaluation. Future directions and recommendations for applying human biology theory in pursuit of public mental health interventions are discussed. © 2014 Wiley Periodicals, Inc.

  4. Designing mental health interventions informed by child development and human biology theory: A social ecology intervention for child soldiers in Nepal

    Science.gov (United States)

    Kohrt, Brandon A.; Jordans, Mark J.D.; Koirala, Suraj; Worthman, Carol M.

    2017-01-01

    The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used to illustrate the role of these concepts in intervention design and evaluation. Future directions and recommendations for applying human biology theory in pursuit of public mental health interventions are discussed. PMID:25380194

  5. Correlation analysis of indicators of physical condition, health and physical fitness of soldiers involved in peacekeeping operations

    Directory of Open Access Journals (Sweden)

    S.S. Fedak

    2014-01-01

    Full Text Available Purpose: to identify the main physical qualities, which positively influence the physical state, health and military - professional career peacekeepers when performing tasks in different climatic conditions. Material : the study involved 98 military service under the contract the first age group (men. Analyzed contingent divided into groups according to climatic conditions of service: in the highlands - 37 person, in hot climates - 35 person, in towns and areas with limited space - 26 person. A correlation analysis between the results of running 100 meters, pulling, running 3 kilometre and indicators of the health and physical condition of the soldiers. Results : It was determined that the participation in peacekeeping missions in mountainous areas and in areas with a hot climate is the quality of the underlying physical endurance. With the participation in peacekeeping missions in populated areas and in areas with limited space - this is the strength and speed. Conclusions : on improving these physical qualities should focus during lessons in physical training of peacekeepers in the centers of immediate preparation for missions.

  6. Emphasizing Sustainable Health and Wellness in a Health Education Curriculum

    Science.gov (United States)

    Bajracharya, Srijana M.

    2009-01-01

    Environmental sustainability is the most visible recent global movement addressing the effect of human activities on the environment. Because of its effect on human health and well-being, it is imperative that the health education discipline begin to consider this topic as one of the important content areas. This paper provides a model for the…

  7. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

    2015-01-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

  8. Sustaining Soldier Health and Performance in Southwest Asia: Guidance for Small Unit Leaders

    Science.gov (United States)

    1994-10-01

    clothing is wet. The first signs of developing hypothermia mightinclude confusion, bizarre behavior and withdrawal from group interaction. Victims...good personal hygiene. Wash your hands to protect Yourself and others from infectious disease. Do not bathe, swim or wash clothes in local water such...Pirsian Gulf contain hazardous marine animals including sea snakes, poisonous jellyfish , and sea urchins. Diseases such as Brucellosis, Ŕ" fever, and

  9. Sustaining Soldier Health and Performance in the Former Republic of Yugoslavia. Guidance for Small Unit Leaders

    Science.gov (United States)

    1993-06-01

    bacteria , viruses and parasites. Contamination occurs because of improper water purification, inadequate cooking, handling, or storage of food and water, and...boots and the outermost clothing should be rel-ioved for sleeping. r. Use lip balm to prevent chapped and sunburned lips (Cold Climate Lipstick , Antichap

  10. Sustaining Soldier Health and Performance During Operation Support Hope: Guidance for Small Unit Leaders

    Science.gov (United States)

    1994-08-01

    FOOD & WATER CONSUMPTION 1. Problems with Food & Water Consumption Infectious diarrhea results from contamination of water and food by bacteria ...Cold Climate Lipstick , Antichap, NSN 6508-01-277-2903). 35 oy 3. First Aid for Cold Injuries a. For Chilblain and Trenchfoot, prevent further cold

  11. Sustainable development and quality health care.

    Science.gov (United States)

    1994-01-01

    On the occasion of Development Week in Canada, Dr. Remi Sogunro spoke in February, 1994, about the many achievements of quality primary health care and PLAN's strategy to achieve sustainability. In one generation, under-5 mortality has been cut by a third. Deaths from measles has been reduced from 2.5 million to 1 million a year. Skeletal deformities from polio also have been reduced from 1/2 million to less than 140,000. Despite all this, there is much more to be attained. 35,000 children under 5 die from preventable diseases every day in developing countries. The health community is working hard to address these silent emergencies. PLAN International's primary health care program targets the poor and undeserved populations where diseases are prevalent. The main focus of PLAN's programs are mothers and children who are most vulnerable to disease. Key interventions that PLAN gives priority to are childhood and maternal immunization programs, including pre- and post-natal care for mothers. Other interventions under PLAN's comprehensive primary health care program include: control of diarrheal diseases and acute respiratory infections, growth monitoring, nutrition and control of STDs and HIV/AIDS infection, water and sanitation, family planning information and educational services, and rehabilitation of the handicapped. "Go in search of people, begin with what they know, build on what they have," goes a Chinese proverb. This also summarizes PLAN's guiding principle for achieving sustainable development: the importance of investing in people. PLAN's programs in the field build partnerships and empower communities. PLAN's emphasis on institution-building and capacity-building with local institutions is an important part of organizational strategy to ensure sustained development. full text

  12. Health care financing and the sustainability of health systems.

    Science.gov (United States)

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-09-15

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

  13. Research Review: Psychosocial adjustment and mental health in former child soldiers – a systematic review of the literature and recommendations for future research

    Science.gov (United States)

    Betancourt, Theresa S.; Borisova, Ivelina; Williams, Timothy P.; Meyers-Ohki, Sarah E.; Rubin-Smith, Julia E.; Annan, Jeannie; Kohrt, Brandon A.

    2014-01-01

    Aims and scope This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the Systematic Assessment of Quality in Observational Research (SAQOR). Findings According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. Conclusions Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising

  14. Sustainable drugs and global health care

    Directory of Open Access Journals (Sweden)

    Geoffrey A. Cordell

    2009-01-01

    Full Text Available Each day, Earth's finite resources are being depleted for energy, for material goods, for transportation, for housing, and for drugs. As we evolve scientifically and technologically, and as the population of the world rapidly approaches 7 billion and beyond, among the many issues with which we are faced is the continued availability of drugs for future global health care. Medicinal agents are primarily derived from two sources, synthetic and natural, or in some cases, as semi-synthetic compounds, a mixture of the two. For the developed world, efforts have been initiated to make drug production "greener", with milder reagents, shorter reaction times, and more efficient processing, thereby using less energy, and reactions which are more atom efficient, and generate fewer by-products. However, most of the world's population uses plants, in either crude or extract form, for their primary health care. There is relatively little discussion as yet, about the long term effects of the current, non-sustainable harvesting methods for medicinal plants from the wild, which are depleting these critical resources without concurrent initiatives to commercialize their cultivation. To meet future public health care needs, a paradigm shift is required in order to adopt new approaches using contemporary technology which will result in drugs being regarded as a sustainable commodity, irrespective of their source. In this presentation, several approaches to enhancing and sustaining the availability of drugs, both synthetic and natural, will be discussed, including the use of vegetables as chemical reagents, and the deployment of integrated strategies involving information systems, biotechnology, nanotechnology, and detection techniques for the development of medicinal plants with enhanced levels of bioactive agents.

  15. A Coaching Intervention to Promote Nutrition and Bone Health in Deployed Soldiers

    Science.gov (United States)

    2015-03-13

    remainder influenced by hormonal status, diet, environmental factors, and exercise . The most important modifiable risk factors associated with bone density ...dietary and exercise contributions to bone health assessed before and after a 9-month deployment. Design/Methods: Prospective, longitudinal, cluster...randomized, controlled trial. Outcomes included anthropometrics, bone density , bone turnover, dietary intake, and frequency/ intensity of work, sport, and

  16. Rhesus factor modulation of effects of smoking and age on psychomotor performance, intelligence, personality profile, and health in Czech soldiers.

    Directory of Open Access Journals (Sweden)

    Jaroslav Flegr

    Full Text Available BACKGROUND: Rhesus-positive and rhesus-negative persons differ in the presence-absence of highly immunogenic RhD protein on the erythrocyte membrane. This protein is a component of NH(3 or CO(2 pump whose physiological role is unknown. Several recent studies have shown that RhD positivity protects against effects of latent toxoplasmosis on motor performance and personality. It is not known, however, whether the RhD phenotype modifies exclusively the response of the body to toxoplasmosis or whether it also influences effects of other factors. METHODOLOGY/PRINCIPAL FINDINGS: In the present cohort study, we searched for the effects of age and smoking on performance, intelligence, personality and self-estimated health and wellness in about 3800 draftees. We found that the positive effect of age on performance and intelligence was stronger in RhD-positive soldiers, while the negative effect of smoking on performance and intelligence was of similar size regardless of the RhD phenotype. The effect of age on four Cattell's personality factors, i.e., dominance (E, radicalism (Q(1, self-sentiment integration (Q(3, and ergic tension (Q(4, and on Cloninger's factor reward dependency (RD was stronger for RhD-negative than RhD-positive subjects, while the effect of smoking on the number of viral and bacterial diseases was about three times stronger for RhD-negative than RhD-positive subjects. CONCLUSIONS: RhD phenotype modulates the influence not only of latent toxoplasmosis, but also of at least two other potentially detrimental factors, age and smoking, on human behavior and physiology. The negative effect of smoking on health (estimated on the basis of the self-rated number of common viral and bacterial diseases in the past year was much stronger in RhD-negative than RhD-positive subjects. It is critically needed to confirm the differences in health response to smoking between RhD-positive and RhD-negative subjects by objective medical examination in

  17. Rhesus factor modulation of effects of smoking and age on psychomotor performance, intelligence, personality profile, and health in Czech soldiers.

    Science.gov (United States)

    Flegr, Jaroslav; Geryk, Jan; Volný, Jindra; Klose, Jiří; Cernochová, Dana

    2012-01-01

    Rhesus-positive and rhesus-negative persons differ in the presence-absence of highly immunogenic RhD protein on the erythrocyte membrane. This protein is a component of NH(3) or CO(2) pump whose physiological role is unknown. Several recent studies have shown that RhD positivity protects against effects of latent toxoplasmosis on motor performance and personality. It is not known, however, whether the RhD phenotype modifies exclusively the response of the body to toxoplasmosis or whether it also influences effects of other factors. In the present cohort study, we searched for the effects of age and smoking on performance, intelligence, personality and self-estimated health and wellness in about 3800 draftees. We found that the positive effect of age on performance and intelligence was stronger in RhD-positive soldiers, while the negative effect of smoking on performance and intelligence was of similar size regardless of the RhD phenotype. The effect of age on four Cattell's personality factors, i.e., dominance (E), radicalism (Q(1)), self-sentiment integration (Q(3)), and ergic tension (Q(4)), and on Cloninger's factor reward dependency (RD) was stronger for RhD-negative than RhD-positive subjects, while the effect of smoking on the number of viral and bacterial diseases was about three times stronger for RhD-negative than RhD-positive subjects. RhD phenotype modulates the influence not only of latent toxoplasmosis, but also of at least two other potentially detrimental factors, age and smoking, on human behavior and physiology. The negative effect of smoking on health (estimated on the basis of the self-rated number of common viral and bacterial diseases in the past year) was much stronger in RhD-negative than RhD-positive subjects. It is critically needed to confirm the differences in health response to smoking between RhD-positive and RhD-negative subjects by objective medical examination in future studies.

  18. Nursing students' attitudes towards sustainability and health care.

    Science.gov (United States)

    Richardson, Janet; Grose, Jane; O'Connor, Anita; Bradbury, Martyn; Kelsey, Janet; Doman, Maggie

    2015-06-17

    Aim To evaluate attitudes towards embedding sustainability and climate change in nursing curricula among nursing students, some of whom had participated in a sustainability and health skills session, and determine whether the session could improve knowledge of sustainability. Methods Three months after the sustainability session, students who had participated along with a sample of students who had not, completed a Sustainability Attitudes in Nursing Survey questionnaire. This investigated attitudes towards climate change and sustainability in nursing curricula and the costs of clinical and domestic waste disposal. Results Nursing students were positive about sustainability and climate change and its inclusion in the curriculum, irrespective of their participation in the sustainability scenario session. Participants in the sustainability session were more likely to identify correctly the cost of clinical waste disposal in the NHS. Conclusion The sustainability and health skills session has the potential to improve nursing students' knowledge of the cost of clinical waste disposal.

  19. Sustainable Health Development Becoming Agenda for Public Health Academia.

    Science.gov (United States)

    Takian, Amirhossein; Akbari-Sari, Ali

    2016-11-01

    Sustainable Development Goals (SDGs) aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development. To contribute to exploring to the academia's role in reaching SDGs, the 1(st) International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24-25 April 2016, in Tehran, Iran. In line with Goal 3 of SDGs: "ensure healthy lives and promote well-being for all at all ages", the conference discussed various aspects of Universal Health Coverage (UHC), as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs), and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential.

  20. THE EFFECT OF NUTRITION ON THE HEALTH STATUS OF SOLDIERS IN MISSIONS

    Directory of Open Access Journals (Sweden)

    Pavel Budinský

    2012-08-01

    Full Text Available The paper deals with the issue of the influence of soldiers’ nutrition in foreign missions on the contents of total cholesterol (TCH, triglyceride (TAG, glucose, and alanine aminotranferase (ALT. Combined rations consisting of the preparation of hot meals on a military base and combat rations of foodstuffs that provide soldier’s nutrition, in case of impossibility to deliver the hot meals, are an optimal solution. Adverse effect on consumption had psychosocial factors, i.e. eating in a hurry and stress, about the culture of eating it cannot be spoken at all. Air pollutants of chemical contamination and air contamination of the diet had a significant negative impact. The biochemical tests showed that the prolonged duration of the mission led to deterioration of health, especially in dislipidemic disorders. The increase in levels of TCH is particularly evident with the troops in the KFOR mission. The obtained values are characterized as an increased risk of acute cholesterolemia and are also enhanced by the low average age of evaluated group. The growing trend of increase in cholesterolemia is presented as a general phenomenon by foreign and domestic authors.

  1. Sustainable food systems for optimal planetary health.

    Science.gov (United States)

    Canavan, Chelsey R; Noor, Ramadhani A; Golden, Christopher D; Juma, Calestous; Fawzi, Wafaie

    2017-06-01

    Sustainable food systems are an important component of a planetary health strategy to reduce the threat of infectious disease, minimize environmental footprint and promote nutrition. Human population trends and dietary transition have led to growing demand for food and increasing production and consumption of meat, amid declining availability of arable land and water. The intensification of livestock production has serious environmental and infectious disease impacts. Land clearing for agriculture alters ecosystems, increases human-wildlife interactions and leads to disease proliferation. Context-specific interventions should be evaluated towards optimizing nutrition resilience, minimizing environmental footprint and reducing animal and human disease risk. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  2. The Comprehensive Soldier and Family Fitness Program Evaluation. Report 4. Evaluation of Resilience Training and Mental and Behavioral Health Outcomes

    Science.gov (United States)

    2013-04-01

    Prevention & Treatment, 5. No pagination specified. Casey, G. W., Jr. (2011). Comprehensive Soldier Fitness: A vision for psychological resilience in the...Alcohol-induced psychotic disorder with hallucinations 291.50 Alcohol-induced psychotic disorder with delusions 291.81 Alcohol withdrawal 291.89 Other...292.00 Drug withdrawal 292.11 Drug-induced psychotic disorder with delusions 292.12 Drug-induced psychotic disorder with hallucinations 292.81

  3. Sustaining universal health coverage: the interaction of social, political, and economic sustainability.

    Science.gov (United States)

    Borgonovi, Elio; Compagni, Amelia

    2013-01-01

    The sustainability of health care systems, particularly those supporting universal health care, is a matter of current discussion among policymakers and scholars. In this article, we summarize the controversies around the economic sustainability of health care. We attempt to extend the debate by including a more comprehensive conceptualization of sustainability in relation to health care systems and by examining the dimensions of social and political sustainability. In conclusion, we argue that policymakers when taking decisions around universal health care should carefully consider issues of social, political, and economic sustainability, their interaction, and often their inherent trade-offs. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Ecological Sustainability: What Role for Public Health Education?

    Directory of Open Access Journals (Sweden)

    Trish Gould

    2009-07-01

    Full Text Available This article explores the notion of ecological sustainability in the context of public health education and the contribution Universities can make in creating environments that include ecologically sustainable practices. It considers the important role of environmental health in building a sustainable future for the population as a central plank of public health. It presents the evidence for the need for comprehensive approaches to ecological sustainability within the University and offers suggestions about how this can take place. It concludes by arguing that to date there is a substantial gap between the rhetoric and the reality in the University context.

  5. Emerging sustainable/green cleaning products: health and environmental risks

    OpenAIRE

    Aydin, Mehmet Cihan; IŞIK, Ercan; Ulu, Ali Emre

    2016-01-01

    Sustainable development aims to bring a new perspective to our lives without compromising customer needs and quality. Along with sustainable development many innovative solutions came out. One of them is sustainable green cleaning products and techniques. Today, emissions from conventional cleaning products may cause severe health and environmental issues. Especially sick building syndromes such as eye, skin and respiratory irritations are main health effects of them. They may also contrib...

  6. Exploring Australian health promotion and environmental sustainability initiatives.

    Science.gov (United States)

    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health.

  7. Culture and Comorbidity: Intimate Partner Violence as a Common Risk Factor for Maternal Mental Illness and Reproductive Health Problems among Former Child Soldiers in Nepal.

    Science.gov (United States)

    Kohrt, Brandon A; Bourey, Christine

    2016-12-01

    Our objective was to elucidate how culture influences internal (psychological), external (social), institutional (structural), and health care (medical) processes, which, taken together, create differential risk of comorbidity across contexts. To develop a conceptual model, we conducted qualitative research with 13 female child soldiers in Nepal. Participants gave open-ended responses to intimate partner violence (IPV) vignettes (marital rape, emotional abuse, violence during pregnancy). Twelve participants (92%) endorsed personal responses (remaining silent, enduring violence, forgiving the husband). Twelve participants endorsed communication with one's husband. Only four participants (31%) sought family support, and three contacted police. Ultimately, 12 participants left the relationship, but the majority (nine) only left after the final IPV experience, which was preceded by prolonged psychological suffering and pregnancy endangerment. In conclusion, comorbidity risks are increased in cultural context that rely on individual or couples-only behavior, lack external social engagement, have weak law and justice institutions, and have limited health services. © 2016 by the American Anthropological Association.

  8. Linking health education and sustainability education in schools

    DEFF Research Database (Denmark)

    Madsen, Katrine Dahl; Nordin, Lone Lindegaard; Simovska, Venka

    2015-01-01

    This chapter addresses the relationship between international and national policies regarding sustainability and health promotion which have the potential to affect school-based health education/promotion and education for sustainable development in Denmark. Based on policy mapping and analysis...... education in Denmark with its aims of ensuring overall school improvement, increasing pupil wellbeing and improving academic outcomes. Analysis of international policy documents, as well as of research literature shows that school-based health education (HE) and education for sustainable development (ESD...... on the common tendency that when health and sustainability education in schools are framed in national action plans, certain critical educational aspects are lost by narrowing the concepts of health and sustainability to fit particular school subjects (e.g. physical education or science), and defining outcomes...

  9. A future task for Health Promotion research: Integration of Health Promotion and sustainable development

    DEFF Research Database (Denmark)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

    2017-01-01

    . Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired...

  10. Development of a culture of sustainability in health care organizations.

    Science.gov (United States)

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  11. Sustainability: Environmental Studies and Public Health

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2009-10-01

    Full Text Available This special issue ‘Sustainability: Environmental Studies and Public Health’ is part of the internationally leading 'International Journal of Environmental Research and Public Health’. I was invited to be the guest editor, and to oversee the refereeing process and subsequent selection of timely, relevant and high quality papers highlighting particularly novel aspects concerned with sustainability issues in environmental studies. [...

  12. Public health program capacity for sustainability: a new framework.

    Science.gov (United States)

    Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

    2013-02-01

    Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program's capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity-89% of the individual items composing the framework had specific support in the sustainability literature. The sustainability framework presented here suggests that a number of selected factors may be related to a program's ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing

  13. 59 Poverty Eradication and Sustainability of Healthful Living in Nigeria

    African Journals Online (AJOL)

    User

    2010-10-17

    Oct 17, 2010 ... health and wide spread of social economic gap between families. Key words: Poverty, Eradication, Sustainability, Healthful Living, Global. Spread .... rich, water and sanitation related diseases are a major cause of ill health ..... health care education, public utilities or transportation are privatized, and the.

  14. Child Soldiers: Are U.S. Military Members Prepared to Deal with the Threat?

    Science.gov (United States)

    2006-02-15

    Child soldiers are not a new phenomena for U.S. military forces, but they are an expanding problem that has implications for military training and...the mental health of U.S. troops. This paper examines the problem of child soldiers throughout the world and assesses current U.S. military policies and...practices regarding child soldiers . Specifically, the author describes the impact of child soldiers on the effectiveness of combat forces, the

  15. Patents for Soldiers

    Science.gov (United States)

    2016-06-10

    Soldier-inventors, although use of the title “Soldier” is not used. Instead, Soldiers are grouped into the tile of “government employees.”73 It notes...apparatus for object tracking via hyperspectral imagery Alan I. Kalb ARL 6 8,611,565 Microscale implementation of a bio- inspired acoustic ...94 8,746,124 Multi-axial explosive, laterally- shearing, tiled reactive mechanism--MAELSTRM Luis Miguel Acosta TACOM David L. Kuhn

  16. Emergent themes in the sustainability of primary health care innovation.

    Science.gov (United States)

    Sibthorpe, Beverly M; Glasgow, Nicholas J; Wells, Robert W

    2005-11-21

    A synthesis of the findings of the five studies of sustainability of primary health care innovation across six domains (political, institutional, financial, economic, client and workforce) yielded three main themes. These were: the importance of social relationships, networks and champions; the effect of political, financial and societal forces; and the motivation and capacity of agents within the system. The need for routine assessment of the sustainability of primary health care innovations is discussed. Given the dearth of literature on the sustainability of primary health care innovation, there is potential to develop a program of research directed towards a future synthesis of evidence.

  17. Self-reported load carriage injuries of military soldiers.

    Science.gov (United States)

    Orr, Robin Marc; Coyle, Julia; Johnston, Venerina; Pope, Rodney

    2017-06-01

    The aim of this study was to investigate whether occupational load carriage constitutes a significant source of injury to military soldiers. An online survey was sent to soldiers serving in specific Australian Army Corps known to experience the greatest occupational exposure to load carriage. Of the 338 respondents, 34% sustained at least one load carriage injury. Fifty-two per cent of those injured during initial training reported sustaining an additional load carriage injury. The majority of injuries (61%) were to the lower limbs with bones and joints the most frequently injured body structures (39%). Endurance marching (continuous marching as part of a physical training session) was the activity accounting for most (38%) injuries. Occupational load carriage is associated with military soldier injuries and, once injured, soldiers are at a high risk of future load carriage injury. The bodily sites and nature of self-reported injuries in this study are akin to those of formally reported injuries and those of other militaries.

  18. Soldier occupational load carriage: a narrative review of associated injuries.

    Science.gov (United States)

    Orr, Robin Marc; Pope, Rodney; Johnston, Venerina; Coyle, Julia

    2014-01-01

    This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage has the potential to cause injuries that impact on force generation and force sustainment. Through understanding the nature of these injuries targeted interventions, like improved physical conditioning and support to specialised organisations, can be employed.

  19. Social Ecology of Child Soldiers: Child, Family, and Community Determinants of Mental Health, Psychosocial Wellbeing, and Reintegration in Nepal

    Science.gov (United States)

    Kohrt, Brandon A.; Jordans, Mark J.D.; Tol, Wietse A.; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

    2013-01-01

    This study employs social ecology to evaluate psychosocial wellbeing in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Scale (CPSS), and locally developed measures of function impairment and reintegration. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted fewer reintegration supports. Ultimately, social ecology is well-suited to identify intervention foci across ecological levels, based on community differences in vulnerability and protective factors. PMID:21088102

  20. Conceptual model for partnership and sustainability in global health.

    Science.gov (United States)

    Leffers, Jeanne; Mitchell, Emma

    2011-01-01

    Although nursing has a long history of service to the global community, the profession lacks a theoretical and empirical base for nurses to frame their global practice. A study using grounded theory methodology to investigate partnership and sustainability for global health led to the development of a conceptual model. Interviews were conducted with 13 global health nurse experts. Themes from the interviews were: components for engagement, mutual goal setting, cultural bridging, collaboration, capacity building, leadership, partnership, ownership, and sustainability. Next, the identified themes were reviewed in the literature in order to evaluate their conceptual relationships. Finally, careful comparison of the interview transcripts and the supporting literature led to the Conceptual Framework for Partnership and Sustainability in Global Health Nursing. The model posits that engagement and partnership must precede any planning and intervention in order to create sustainable interventions. This conceptual framework will offer nurses important guidance for global health nursing practice. © 2010 Wiley Periodicals, Inc.

  1. Sustainability science: an integrated approach for health-programme planning.

    Science.gov (United States)

    Gruen, Russell L; Elliott, Julian H; Nolan, Monica L; Lawton, Paul D; Parkhill, Anne; McLaren, Cameron J; Lavis, John N

    2008-11-01

    Planning for programme sustainability is a key contributor to health and development, especially in low-income and middle-income countries. A consensus evidence-based operational framework would facilitate policy and research advances in understanding, measuring, and improving programme sustainability. We did a systematic review of both conceptual frameworks and empirical studies about health-programme sustainability. On the basis of the review, we propose that sustainable health programmes are regarded as complex systems that encompass programmes, health problems targeted by programmes, and programmes' drivers or key stakeholders, all of which interact dynamically within any given context. We show the usefulness of this approach with case studies drawn from the authors' experience.

  2. bayelsa, in search of a sustainable health financing scheme

    African Journals Online (AJOL)

    2016-08-19

    Aug 19, 2016 ... Conclusion: Although Bayelsa is a developing state, a sustainable health financing scheme will depend on a health system that ... tourism. To make the point clear, medical tourism is not mainly about travelling to see foreign doctors but essentially about the export of a state's health finances or finances that ...

  3. Consumer perception and trends about health and sustainability

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    2015-01-01

    Modern affluent societies encounter the challenge of the so-called obesity pandemic in terms of health, and the environmental strain of resource intensive production and consumption in terms of sustainability. Consumer’s role and the consumption side of the supply chain have been identified...... to be crucial in improving healthy choices and achieving sustainability goals, and both issues are increasingly discussed alongside each other. Arguments for why pursuing health and sustainability goals might entail challenges are presented, as well as arguments for why it might allow for synergies...

  4. Child soldiers and children associated with the fighting forces.

    Science.gov (United States)

    Uppard, Sarah

    2003-01-01

    Experience has shown that the breakdown of protective structures such as families and communities, particularly in times of conflict, leaves children vulnerable to recruitment into armed groups. These children are subject to gross violations of their human rights, such as the right to protection from harm, violence and abuse. At least 300,000 children are currently being used to fight in armed conflicts in over 30 countries across the world. Girls and boys are abducted, coerced or persuaded to join armed forces, often in brutal circumstances. These children are usually involved in internal conflicts, where poverty and exclusion leave very few other viable options--becoming soldiers may appear to be their only means of survival. Many, however, sustain physical injuries and permanent disabilities as a result of combat and it is impossible to know how many are killed. A large number encounter health problems such as sexually transmitted diseases, including HIV/AIDS. Lack of data on the health of child soldiers means that appropriate medical care and treatment may be inadequate or inaccessible, even during a planned demobilization. There is an urgent need for systematic research and data collection in order to better understand and provide for the healthcare of all children leaving armed groups.

  5. Sustaining organizational culture change in health systems.

    Science.gov (United States)

    Willis, Cameron David; Saul, Jessie; Bevan, Helen; Scheirer, Mary Ann; Best, Allan; Greenhalgh, Trisha; Mannion, Russell; Cornelissen, Evelyn; Howland, David; Jenkins, Emily; Bitz, Jennifer

    2016-01-01

    The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed leadership; promote staff engagement; create collaborative relationships; and continuously assess and learn from change. These principles interact with contextual elements such as local power distributions, pre-existing values and beliefs and readiness to engage. Mechanisms influencing how these principles sustain cultural change include activation of a shared sense of urgency and fostering flexible levels of engagement. The principles identified in this review, along with the contexts and mechanisms that influence their effectiveness, are useful domains for policy and practice leaders to explore when grappling with cultural change. These principles are sufficiently broad to allow local flexibilities in adoption and application. This is the first study to adopt a realist approach for understanding how changes in organizational culture may be sustained. Through doing so, this review highlights the broad principles by which organizational action may be organized within enabling contextual settings.

  6. Evaluating the Sustainability of School-Based Health Centers.

    Science.gov (United States)

    Navarro, Stephanie; Zirkle, Dorothy L; Barr, Donald A

    2017-01-01

    The United States is facing a surge in the number of school-based health centers (SBHCs) owing to their success in delivering positive health outcomes and increasing access to care. To preserve this success, experts have developed frameworks for creating sustainable SBHCs; however, little research has affirmed or added to these models. This research seeks to analyze elements of sustainability in a case study of three SBHCs in San Diego, California, with the purpose of creating a research-based framework of SBHC sustainability to supplement expertly derived models. Using a mixed methods study design, data were collected from interviews with SBHC stakeholders, observations in SBHCs, and SBHC budgets. A grounded theory qualitative analysis and a quantitative budget analysis were completed to develop a theoretical framework for the sustainability of SBHCs. Forty-one interviews were conducted, 6 hours of observations were completed, and 3 years of SBHC budgets were analyzed to identify care coordination, community buy-in, community awareness, and SBHC partner cooperation as key themes of sustainability promoting patient retention for sustainable billing and reimbursement levels. These findings highlight the unique ways in which SBHCs gain community buy-in and awareness by becoming trusted sources of comprehensive and coordinated care within communities and among vulnerable populations. Findings also support ideas from expert models of SBHC sustainability calling for well-defined and executed community partnerships and quality coordinated care in the procurement of sustainable SBHC funding.

  7. Transformation of Mental Health Care for U.S. Soldiers and Families During the Iraq and Afghanistan Wars: Where Science and Politics Intersect.

    Science.gov (United States)

    Hoge, Charles W; Ivany, Christopher G; Brusher, Edward A; Brown, Millard D; Shero, John C; Adler, Amy B; Warner, Christopher H; Orman, David T

    2016-04-01

    The cumulative strain of 14 years of war on service members, veterans, and their families, together with continuing global threats and the unique stresses of military service, are likely to be felt for years to come. Scientific as well as political factors have influenced how the military has addressed the mental health needs resulting from these wars. Two important differences between mental health care delivered during the Iraq and Afghanistan wars and previous wars are the degree to which research has directly informed care and the consolidated management of services. The U.S. Army Medical Command implemented programmatic changes to ensure delivery of high-quality standardized mental health services, including centralized workload management; consolidation of psychiatry, psychology, psychiatric nursing, and social work services under integrated behavioral health departments; creation of satellite mental health clinics embedded within brigade work areas; incorporation of mental health providers into primary care; routine mental health screening throughout soldiers' careers; standardization of clinical outcome measures; and improved services for family members. This transformation has been accompanied by reduction in psychiatric hospitalizations and improved continuity of care. Challenges remain, however, including continued underutilization of services by those most in need, problems with treatment of substance use disorders, overuse of opioid medications, concerns with the structure of care for chronic postdeployment (including postconcussion) symptoms, and ongoing questions concerning the causes of historically high suicide rates, efficacy of resilience training initiatives, and research priorities. It is critical to ensure that remaining gaps are addressed and that knowledge gained during these wars is retained and further evolved.

  8. An Informatics Approach to Establishing a Sustainable Public Health Community

    Science.gov (United States)

    Kriseman, Jeffrey Michael

    2012-01-01

    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  9. Strategies for sustainability and equity of prepayment health ...

    African Journals Online (AJOL)

    Background: Despite the long existence of community health insurance schemes (CHI) in Uganda, their numbers and coverage levels have remained small with limited accessibility by the poor. Objectives: To examine issues of equity and sustainability in CHI schemes, which are prerequisites to health sector financing.

  10. Design health village with the approach of sustainable architecture ...

    African Journals Online (AJOL)

    Create structures to increase user safety as well as attracting investment and making money the prevalence in different parts of the country can benefit. For people to have this design can be found in different locations accomplished and the success and benefits enjoyed it. Keywords: Health; city health; smart; sustainability ...

  11. Sustainability of the Health Management Information System in ...

    African Journals Online (AJOL)

    This study examines how Health Management Information Systems (HMIS) can be sustained in the Tanzanian context based on the experiences of Muheza and Kinondoni districts. Data for the study was collected using interviews, questionnares and document reviews. The findings show that the capability of a health facility ...

  12. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

    Science.gov (United States)

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

    2016-01-01

    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Sustainability Strategies for Regional Health Information Organization Startups

    DEFF Research Database (Denmark)

    Winkler, Till J.; Ozturk, Pinar; Brown, Carol V.

    2016-01-01

    HIOs that became operational during the SHIECAP grant period faced similar startup challenges, the two HIOs that demonstrated sustainability pursued distinct technology and sustainability strategies to develop HIE capabilities to fit their very different regional needs: an HIE capability to improve...... the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions: We propose two models of technology and sustainability strategies for developing bottom...

  14. Collaborative Research and Support of Fitzsimmons Army Medical Center Defense Women's Health Research Program Projects Relationships Between a Female Soldier's Military Occupational Specialty (MHOS) and Birth Outcomes

    National Research Council Canada - National Science Library

    Mulligan, Hugh

    1996-01-01

    ... and spontaneous abortion, small for gestational age, and preterm birth. This investigation found that pregnant soldiers who reside in the barracks demonstrated an unplanned pregnancy rate of 77.9 percent...

  15. CORYNEBACTERIUM TRIAD IN SOLDIERS

    Directory of Open Access Journals (Sweden)

    Brzeziński Piotr

    2010-07-01

    Full Text Available Background: Corynebacterial infection is a common condition in soldiers. Pitted keratolysis (PK, a bacterial infection confined to the plantar stratum corneum, does not severely impede patient activity but can be unpleasant and embarrassing because of its ‘‘rotten’’ odor. The incidence of PK in soldiers has been reported to be between 1,5% and 77.1%. Erythrasma is a superficial infection caused by Corynebacterium minutissimum and affects the major skin folds and the interdigital regions of the feet. It is characterized by erythematous, brown, scaly patches and maceration, and exhibits coral-red fluorescence under Wood light. Trichomycosis axillaris (TMA is caused by the Corynebacterium tenuis. Patients affected by trichomycosis axillaris present with complaints of a disagreeable underarm odor and a history of hyperhidrosis and poor hygiene. Examination reveals the underarm hair to be coated with black, yellow-white or reddish deposits.Objective: The aim of this study was to determine the frequency corynebacterium triad in soldiers (pitted keratolysis, erythrasma, trichomycosis axillarisMethods: The study involved 1694 men, soldiers in age about 23 years, (in period 5 months (-8-12.2008. 103 persons, whose dermatologic symptoms/changes were analysed, were qualified for the research. Reconnaissance put on base of characteristic clinical sign and under Wood light.Results: Incidence of PK observed at 103 patients (which make up 6,08% of 1694 soldiers. EA diagnosed at 15 soldiers (14,56% of 103 patients, and TMA was diagnosed of 3 patients (2,91% of 103 patients. The coexistence are summarized as follows: erythrasma and PK; 15 of 103 patients (14,56%, TMA and PK in 3 of 103 patients (2,91%. The coexistence of rythrasma, TMA, and PK was noted in 1 patients (0,97%.Conclusions: Corynebacterial infection is a common condition in soldiers. In most cases/most often development of PK is observed. Our results demonstrate that either erythrasma or TMA

  16. History at the intersection of disability and public health: the case of John Galsworthy and disabled soldiers of the First World War.

    Science.gov (United States)

    Reznick, Jeffrey S

    2011-01-01

    The author presented an earlier version of this historical article to the Disability Section of the American Public Health Association (November 2009). It is part of his ongoing research in the social and cultural history of medicine as the field intersects with the history of disability, veterans, and public health, as well as current issues that touch all of these areas. This article introduces readers to perspectives on disability held by the British novelist John Galsworthy (1867-1933), which he developed primarily through his philanthropic support for and his compositions about rehabilitation programs for British and American soldiers disabled in the First World War (1914-1918). Readers will learn that Galsworthy's perspectives are as much about his identity as an individual with disabilities as they are about men disabled in the "war to end all wars." The rediscovery of Galsworthy's experiences and words more than 90 years after the end of World War I reveals how history is present today at the intersection of disability and public health. Indeed, the story of Galsworthy ultimately seeking to forget his own experiences during the "Great War," as well as the very physical and psychological disability caused by that conflict, can inspire public health professionals and disability rights advocates today to remember-indeed, to advocate for-men and women who served in battle and have returned home to realize renewed health and social participation despite permanent physical and psychological wounds. Readers will note that language used throughout this article to describe disability is period-specific and therefore not keeping with current conventions. Published by Elsevier Inc.

  17. Leveraging best practices to promote health, safety, sustainability, and stewardship.

    Science.gov (United States)

    Weiss, Marjorie D

    2013-08-01

    Strategically leveraging health and safety initiatives with sustainability and stewardship helps organizations improve profitability and positively impact team member and customer attachment to the organization. Collective efficacy enhances the triple bottom line: healthy people, healthy planet, and healthy profits. The HS(3)™ Best Practice Exchanges group demonstrated that collective efficacy can leverage the social cohesion, communication channels, and activities within workplaces to promote a healthy, sustainable work culture. This in turn (1) protects the health and safety of workers, (2) preserves the natural environment, and (3) increases attachment to the organization. Community-based participatory research using the Attach21 survey assessed the progress of these companies in their efforts to integrate health, safety, sustainability, and stewardship. Monthly Best Practice Exchanges promoted collective efficacy by providing support, encouragement, and motivation to share and adopt new ideas. Copyright 2013, SLACK Incorporated.

  18. Soldier Quality of Life (Operational) and Readiness at Contingency Base Camps: Insights From Qualitative Interviews

    Science.gov (United States)

    2017-03-13

    the Army lacks data on the specific base camp capabilities that keep Soldiers ready across cognitive , physical, social, and emotional (CPSE...OPERATIONAL READINESS COGNITION SUSTAINABILITY MENTAL READINESS EXPEDITIONARY OPERATIONS EMOTIONS QUALITY OF LIFE...into four domains adapted from the Army Human Dimension Strategy: Cognitive , Physical, Social, and Emotional (CPSE). Soldiers also rated the severity

  19. Towards a Model of Sustainable Competitiveness of Health Organizations

    Directory of Open Access Journals (Sweden)

    Simona Catalina Stefan

    2016-05-01

    Full Text Available Over the last decades, around the world, the concept of competitiveness was long debated by economists (and others, widely used and even sometimes overused. Although at the theoretical level, a number of determinant factors of health care organizations’ competitiveness have been proposed, their diversity and the little empirical data available argues for the need to create and validate a model of competitiveness of health organizations. The purpose of this paper is (considering the theoretical approach to shape a model of sustainable competitiveness of health organizations. In this respect, a 51 item questionnaire was designed and applied on a sample of 291 respondents from 12 Romanian health organizations. The exploratory factor analysis undertaken recovered more than 69% of the common variability of the initial 51 variables and revealed four factors/dimensions of sustainable competitiveness of health organizations (Economic Dimension, Quality Dimension, Social Dimension, and Strategic Dimension. Among the results of the exploratory factor analysis is also the empirical evidence on the contribution of leadership and managerial processes to enhance the influence of all other factors/dimensions in increasing the sustainable competitiveness of health organizations, thus bringing into focus the concept of sustainable management and leadership. Being just in the exploratory phase of our research, the proposed model can, and should, be improved, thus opening up further research directions.

  20. Operationalising the health aspects of sustainable diets: a review.

    Science.gov (United States)

    Mertens, Elly; Van't Veer, Pieter; Hiddink, Gerrit J; Steijns, Jan Mjm; Kuijsten, Anneleen

    2017-03-01

    Shifting towards a more sustainable food consumption pattern is an important strategy to mitigate climate change. In the past decade, various studies have optimised environmentally sustainable diets using different methodological approaches. The aim of the present review was to categorise and summarise the different approaches to operationalise the health aspects of environmentally sustainable diets. Conventional keyword and reference searches were conducted in PubMed, Scopus, Web of Knowledge and CAB Abstracts. Inclusion criteria were: (i) English-language publication; (ii) published between 2005 and October 2015; (iii) dietary data collected for the diet as a whole at the national, household or individual level; (iv) comparison of the current diet with dietary scenarios; and (v) for results to consider the health aspect in some way. Consumer diets. Adult population. We reviewed forty-nine studies that combined the health and environmental aspects of consumer diets. Hereby, five approaches to operationalise the health aspect of the diet were identified: (i) food item replacements; (ii) dietary guidelines; (iii) dietary quality scores; (iv) diet modelling techniques; and (v) diet-related health impact analysis. Although the sustainability concept is increasingly popular and widely advocated by nutritional and environmental scientists, the journey towards designing sustainable diets for consumers has only just begun. In the context of operationalising the health aspects, diet modelling might be considered the preferred approach since it captures the complexity of the diet as a whole. For the future, we propose SHARP diets: environmentally Sustainable (S), Healthy (H), Affordable (A), Reliable (R) and Preferred from the consumer's perspective (P).

  1. Sustainable Technologies for the Health of All

    CERN Document Server

    Rodríguez, Tania; Marín, Carlos; Ruiz, Susana; Medina, Jorge; Vázquez, Haddid; Barreda, Maylen; Rojas, Rafael; Latin American Congress on Biomedical Engineering CLAIB

    2013-01-01

    This volume presents the proceedings of the CLAIB 2011, held in the Palacio de las Convenciones in Havana, Cuba, from 16 to 21 May 2011. The confernces of the American Congress of Biomedical Engineering are sponsored by the International Federation for Medical and Biological Engineering (IFMBE), Society for Engineering in Biology and Medicine (EMBS) and the Pan American Health Organization (PAHO), among other organizations and international agencies and bringing together scientists, academics and biomedical engineers in Latin America and other continents in an environment conducive to exchange and professional growth.

  2. [Health, environment and sustainable development in Mexico].

    Science.gov (United States)

    1998-09-01

    This article is based on "Salud, ambiente y desarrollo humano sostenible: el caso de México," a document prepared in June 1997 by the Comité Técnico Nacional para el Desarrollo Sostenible. It opens with information regarding the epidemiologic and demographic changes that have taken place in Mexico, such as the decrease in communicable diseases, the rise in noncommunicable diseases, and the less conspicuous increase in lesions resulting from accidents or acts of violence. This is followed by a discussion of priority problems and problems of lesser magnitude in environmental health, specifically those relating to water and air quality, as well as disposal of household and dangerous wastes. Finally, it proposes three areas of intervention in light of the structural problems detected: the absence of an integrated information system covering the area of health, environment, and development; the absence of channels of communication within and between institutions and sectors, and the lack of coordination in planning and implementing programs and actions in this field.

  3. Sustaining health promotion programs within sport and recreation organisations.

    Science.gov (United States)

    Casey, Meghan M; Payne, Warren R; Eime, Rochelle M; Brown, Sue J

    2009-01-01

    The involvement of the sport and recreation sector as a setting for health promotion is a new strategy implemented by health policy makers and strategic planners. Strategies to promote and sustain health promotion activities are important considering the risk that programs may cease after initial funding ends. This study explored the factors affecting the sustainability of a sport- and recreation-based health promotion program. A stratified sampling method was used to select four of the nine Regional Sports Assemblies (RSAs) that delivered a state-wide health promotion program funded by the Victorian Health Promotion Foundation in Australia. Data were collected from in-depth interviews with four Executive Officers (EOs) and focus group discussions with their Boards of Management. A sustainability checklist with pre-specified dimensions (e.g. organisational setting, broader community environment, and program design and implementation) guided data collection and analysis. The results showed that the organisational setting and the broader community environment supported program institutionalisation; whilst the design and implementation of the program worked against institutionalisation. The capacity of the organisations to generate new funds for the program was limited; the relationship between the central funding organisation and the Boards of Management was weak; and the program did not support the retention of staff. The engagement of sport and recreation organisations has potential to facilitate health promotion and public health. To enhance organisational capacity and achieve program sustainability, it is important that organisational processes, structures, and resources that support long-term health promotion practice are effectively and efficiently planned and managed.

  4. Neglecting legumes has compromised human health and sustainable food production.

    Science.gov (United States)

    Foyer, Christine H; Lam, Hon-Ming; Nguyen, Henry T; Siddique, Kadambot H M; Varshney, Rajeev K; Colmer, Timothy D; Cowling, Wallace; Bramley, Helen; Mori, Trevor A; Hodgson, Jonathan M; Cooper, James W; Miller, Anthony J; Kunert, Karl; Vorster, Juan; Cullis, Christopher; Ozga, Jocelyn A; Wahlqvist, Mark L; Liang, Yan; Shou, Huixia; Shi, Kai; Yu, Jingquan; Fodor, Nandor; Kaiser, Brent N; Wong, Fuk-Ling; Valliyodan, Babu; Considine, Michael J

    2016-08-02

    The United Nations declared 2016 as the International Year of Pulses (grain legumes) under the banner 'nutritious seeds for a sustainable future'. A second green revolution is required to ensure food and nutritional security in the face of global climate change. Grain legumes provide an unparalleled solution to this problem because of their inherent capacity for symbiotic atmospheric nitrogen fixation, which provides economically sustainable advantages for farming. In addition, a legume-rich diet has health benefits for humans and livestock alike. However, grain legumes form only a minor part of most current human diets, and legume crops are greatly under-used. Food security and soil fertility could be significantly improved by greater grain legume usage and increased improvement of a range of grain legumes. The current lack of coordinated focus on grain legumes has compromised human health, nutritional security and sustainable food production.

  5. The importance of mental health in the Sustainable Development Goals.

    Science.gov (United States)

    Votruba, Nicole; Thornicroft, Graham

    2015-02-01

    The United Nations' draft Sustainable Development Goals (SDGs) only briefly mention mental health. In the context of a growing burden of disease due to mental disorders and psychosocial disabilities, the inclusion of a clear mental health target and indicators in the SDGs will acknowledge the needs and rights of hundreds of millions of people. It will mobilise international funding and policy development, and support other SDGs; it will also strengthen mental health structures, governance and services in low- and middle-income countries. We argue that for a just, sustainable and inclusive post-2015 development agenda, it is vital that the United Nations includes a clear mental health target and indicators in the SDGs.

  6. Sustainable Livestock Production, Health, and Environment in the ...

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

    This project aims to promote evidence-based policies for improving livestock production, environmental sustainability, and health in the Bolivian Altiplano's rural communities. Traditional farming under threat in Bolivia Raising sheep and llamas is a fundamental economic activity that is threatened by current agricultural ...

  7. Opportunities and challenges within urban health and sustainable development

    DEFF Research Database (Denmark)

    Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen

    2017-01-01

    The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...

  8. Health in all policies in the partnership for sustainable development

    Directory of Open Access Journals (Sweden)

    Paulo M. Buss

    Full Text Available ABSTRACT This article analyzes the dynamic interaction between the Health in All Policies (HiAP agenda and the ongoing implementation of the 2030 Agenda for Sustainable Development. At the World Conference on Social Determinants of Health, held in Rio de Janeiro in October 2011, the Rio Political Declaration pledged to use HiAP as a mechanism to address health inequities. In 2014, the Ministers of Health of the Region of the Americas approved a regional Plan of Action of the Pan American Health Organization (PAHO that sought to call attention to the health consequences and benefits of policies and actions developed by other sectors. The HiAP approach seeks to integrate activities across the pillars of the sustainable development governance framework (economic, social, and environmental development. Advocates of the process are challenged to consider, using guiding questions outlined at the close of this article, how to pursue action at the country level and in what ways the HiAP approach can contribute to timely and effective implementation of the Sustainable Development Goals (SDGs. The authors propose that coordination between the 2030 Agenda and the regional Plan of Action on HiAP can make an important contribution to the implementation of both processes in the Region.

  9. Redefining public health leadership in the sustainable development goal era.

    Science.gov (United States)

    Reddy, K Srinath; Mathur, Manu Raj; Negi, Sagri; Krishna, Bhargav

    2017-06-01

    Adoption of the Sustainable Development Goals (SDGs) by member states of the United Nations (UN) has set a new agenda for public health action at national and global levels. The changed context calls for a reframing of what constitutes effective leadership in public health, through a construct that reflects the interdependence of leadership at multiple levels across the health system and its partners in other sectors. This is especially important in the context of Low and Middle Income Countries (LMICs) that are facing complex demographic and epidemiological transitions. The health system needs to exercise leadership that effectively mobilises all its resources for maximising health impact, and channels trans-disciplinary learning into well-coordinated multi-sectoral action on the wider determinants of health. Leadership is essential not only at the level of inspirational individuals who can create collective vision and commitment but also at the level of supportive institutions situated in or aligned to the health system. In turn, the health system as a whole has to exercise leadership that advances public health in the framework of sustainable development. This commentary examines the desirable attributes of effective leadership at each of these levels and explores the nature of their inter-dependence. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Sustaining health education research programs in Aboriginal communities.

    Science.gov (United States)

    Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

    2017-09-01

    Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

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

    Science.gov (United States)

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

    2015-06-01

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

  13. Prevalence and Screening of Mental Health Problems Among U.S. Combat Soldiers Pre- and Post- Deployment

    National Research Council Canada - National Science Library

    Hoge, Charles W; Wright, Kathleen; Bliese, Paul; Adler, Amy; Thomas, Jeffrey; Castro, Carl A; Milliken, Charles C

    2004-01-01

    ... mandated for troops returning from Afghanistan and Iraq. Despite these efforts, little research has been done to determine the prevalence of mental health problems among combat / operational units, the validity and benefits / risks of screening, or the optimal delivery of mental health services.

  14. Sustainable Development Goals: an opportunity for health in Africa?

    Science.gov (United States)

    Boidin, Bruno

    2017-01-01

    The purpose of this article is to examine to what extent the Sustainable Development Goals (SDGs) hold out new promises for health in Africa. Two significant shortcomings will have to be overcome. Application of a 'social determinants of health' approach is still woefully difficult in Africa due to the stronghold that international actors maintain over local governments. The persistence of a 'turnkey' concept of health policies is reflected in the coexistence of a disparate range of programmes and measures, often driven by the development partners. Thus the low level of institutional complementarities is a crucial issue in the effective implementation of the SDGs.

  15. Sustainable Development Goals for Monitoring Action to Improve Global Health.

    Science.gov (United States)

    Cesario, Sandra K

    2016-01-01

    Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  16. Pathway to Support the Sustainable National Health Information System

    Science.gov (United States)

    Sahavechaphan, Naiyana; Phengsuwan, Jedsada; U-Ruekolan, Suriya; Aroonrua, Kamron; Ponhan, Jukrapong; Harnsamut, Nattapon; Vannarat, Sornthep

    Heath information across geographically distributed healthcare centers has been recognized as an essential resource that drives an efficient national health-care plan. There is thus a need for the National Health Information System (NHIS) that provides the transparent and secure access to health information from different healthcare centers both on demand and in a time efficient manner. As healthiness is the ultimate goal of people and nation, we believe that the NHIS should be sustainable by taking the healthcare center and information consumer perspectives into account. Several issues in particular must be resolved altogether: (i) the diversity of health information structures among healthcare centers; (ii) the availability of health information sharing from healthcare centers; (iii) the efficient information access to various healthcare centers; and (iv) the privacy and privilege of heath information. To achieve the sustainable NHIS, this paper details our work which is divided into 3 main phases. Essentially, the first phase focuses on the application of metadata standard to enable the interoperability and usability of health information across healthcare centers. The second phase moves forward to make information sharing possible and to provide an efficient information access to a large number of healthcare centers. Finally, in the third phase, the privacy and privilege of health information is promoted with respect to access rights of information consumers.

  17. Sustainability in primary care and Mental Health Integration projects in Veterans Health Administration.

    Science.gov (United States)

    Ford, James H; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn

    2012-01-01

    To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change.

  18. Sustaining Engagements for Integrated Heat-Health Information Systems

    Science.gov (United States)

    Trtanj, J.

    2016-12-01

    Extreme heat events are on the rise, evidenced by the record breaking heat in the summer of 2016 in the US, increased heat-related death toll in south Asia, and projections from the Intergovernmental Panel on Climate Change. The impacts, responses and adaptation to extreme heat are inherently local or region in nature and require multisector engagement to manage current and future heat risks. Understanding the character of the information demand, who needs it, when and how it is needed, how it is used, and the remaining research questions, requires sustained engagement of multiple science and decision making communities. The construct of Integrated Information Systems provides the framework that sustains this dialogue, supports the production of useful information, and the translation of knowledge to action. The National Integrated Heat Health Information System (NIHHIS), a multi-agency collaboration, working at state, local and international levels, designed to facilitate an integrated approach to providing a suite of decision support services that reduce heat-related illness and death. NIHHIS sustains engagement across the public health, emergency management, disaster risk reduction, planning, housing, communication, climate, weather and other science communities. This presentation will highlight NIHHS sustained engagements in the Rio Grande Bravo region, other NIHHIS pilots, and international efforts building on the NIHHIS framework. NIHHIS, launched by the National Oceanic and Atmospheric Administration and the Centers for Disease Control and Prevention in 2015, now has over eight Federal partners and a burgeoning mix of pilots, projects and partners at state, local and international levels.

  19. Nanomaterials Nexus in Environmental, Human Health, and Sustainability

    Science.gov (United States)

    Vaseashta, A.

    Three interconnected and underpinning aspects of nanotechnology viz.: environment, human health, and sustainability are discussed. Sustainable development using nanomaterials by employing responsible manufacturing, principles of “green chemistry” by drastically reducing waste discharge and emission by-products; generation and storage of energy; development of lightweight yet mechanically strong components; development of bio-degradable goods — for medicine, waste disposal, containers, etc. and to monitor, detect, and remediate the environmental pollution are discussed. A brief discussion of fate and transport of nanomaterials in air, water, and soil; life-cycle analysis, and methodologies to conduct risk-assessment in the context of source reduction and conservation is introduced. It is expected that such emerging and potentially transformative studies will make a major contribution to improving the quality of the life of citizens worldwide, in particular in sectors such as environment and health care.

  20. INFORMATION SOCIETY AND FINANCIAL SUSTAINABILITY OF THE ROMANIAN HEALTH SYSTEM

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    TATIANA BOGDAN

    2016-06-01

    Full Text Available The financial sustainability of the health systems often reveals the ability of policy makers to finance healthcare in the face of growing cost pressures, with populations ageing, new technologies and increased patient expectations for healthcare coverage and quality. Thus, the healthcare systems need to reinvent themselves by using innovative financing mechanisms coupled with electronic information and communication systems, while offering greater transparency, flexibility and choice and increasing access to the services available. The paper analyses the healthcare financing models: the national health system, the social insurance or the private insurance model so that the Romanian health care reform should preserve the best elements of its existing system while selectively adapt techniques and processes that seemed to have been successful in other countries. Moreover, the application of information and communication technologies – eHealth offers new possibilities for improving almost every aspect of healthcare, from making medical systems more powerful and responsive to providing better health information to all.

  1. Sustainable Health Development Goals (SHDG): breaking down the walls.

    Science.gov (United States)

    Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

    2015-01-01

    The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.

  2. Textbook of Military Medicine. Part 3. Disease and the Environment. Volume 2. Occupational Health. The Soldier and the Industrial Base

    Science.gov (United States)

    1993-01-01

    of leoipardi/.e their health if tile%- had, or were being its kind in American industry. This policy. i% hich treated for, syphilis ." (Because syphilis ...levels greater than 100 pg/ weeks gestational age, although the fetus remains dL classic lead colic may develop. Lead colic is char- somewhat sensitive

  3. Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military

    Science.gov (United States)

    2014-08-01

    psychotherapy. Scale items were derived via confirmatory factor analysis of (n = 232) participants enrolled in the Collaborative Care for Anxiety and Panic (CCAP...for anxiety and depression are highly addictive . Rate how each of the possible concerns might affect your decision to receive mental health counseling...anxiety and depression do not help a person cope better. 6. Most medications for anxiety and depression are highly addictive . Strongly Strongly DISAGREE

  4. Majors in mental health nursing: issues of sustainability and commitment.

    Science.gov (United States)

    Happell, Brenda; McAllister, Margaret; Gaskin, Cadeyrn J

    2015-01-01

    Major streams in mental health nursing in undergraduate nursing programs were introduced in Australia as a strategy to address current and projected workforce shortages. Of the 14 programs originally planned or implemented, only five are continuing. A qualitative exploratory study was conducted involving in-depth interviews with representatives of universities that had ceased the major streams or abandoned plans to introduce them. Significant themes from interview material on abandoned programs were efficient use of resources, expertise, and problems with registration. On the programs now terminated significant themes were viability and commitment to mental health nursing. These findings suggest demonstrable and sustainable commitment to mental health nursing is a precursor to success of major streams and advancement of the mental health nursing specialty. © 2014 Wiley Periodicals, Inc.

  5. Tracking health-related Sustainable Development Goals (SDGs in Nepal

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    Meghnath Dhimal

    2017-07-01

    Full Text Available Sustainable Development Goals (SDGs comprise of 17 goals and 169 targets. All SDGs are interlinked to produce synergetic eff ects and emphasize health in all policies. Among the 17 Goals, Goal 3 has a central focus on health, which is underpinned by 13 targets. The other 16 goals are also directly or indirectly related to health and will contribute to achieving the associated targets for Goal 3. The ambitious SDG agenda and their progress can be tracked by measuring numerous goals, targets, and indicators. The main objective of this paper is to provide an overview about how health- related SDGs and their targets and indicators are being tracked in the national context of Nepal. Adequate investment in research for knowledge generation, capacity building and innovation, and continous research communication among policy makers, researchers and external development partners will contribute to tracking the progress of SDGs in Nepal.

  6. Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

    Science.gov (United States)

    Cluver, Lucie D; Orkin, F Mark; Meinck, Franziska; Boyes, Mark E; Yakubovich, Alexa R; Sherr, Lorraine

    2016-01-01

    The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. We conducted a longitudinal survey of adolescents (10-18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision) and 'care' (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.

  7. Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

    Directory of Open Access Journals (Sweden)

    Lucie D Cluver

    Full Text Available The first policy action outlined in the Sustainable Development Goals (SDGs is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa.We conducted a longitudinal survey of adolescents (10-18 years between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision and 'care' (psychosocial support social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models.Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger; SDG 3 (AIDS, tuberculosis, mental health and substance abuse; SDG 4 (educational access; SDG 5 (sexual exploitation, sexual and reproductive health; and SDG 16 (violence perpetration. For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens.National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.

  8. The sustainable farm families project: changing attitudes to health.

    Science.gov (United States)

    Brumby, Susan A; Willder, Stuart J; Martin, John

    2009-01-01

    Farm health and safety has historically focussed on strategies such as injury prevention, safety audits and fulfilling legislative responsibilities. However, farmer injuries mask deeper health issues including higher rates of cancer, suicides, cardiovascular disease and stress. The relationship between occupational health and safety and farm family health has not been fully investigated. The Sustainable Farm Families (SFF) project attempts to make this connection in order to address premature death, morbidity and injury on Australian farms. The SFF project illustrates how increasing health literacy through education and physical assessment can lead to improved health and knowledge outcomes for farm families. The SFF project focuses on the human resource in the triple bottom line and is working with farmers, families, industry and universities to collaboratively assess and promote improvement in the health and wellbeing of farm families. Based on a model of extension that engages farm families as active learners where they commit to healthy living and safe working practices, the SFF project is proving to be an effective model for engaging communities in learning and change. Health education and information is delivered to farm men and women aged 18 to 75 years using a workshop format. Pre- and post-knowledge surveys, annual physical assessments and focus group discussions form the methodological context for the research over a three-year intervention. This article discusses the progress of the research outlining the design of the SFF project, the delivery and extension processes used to engage 321 farm families from within a broadacre and dairy-farming family sample. The article presents key learnings on intersectoral collaboration, engaging farmers and families in health, and the future for this project extending into agricultural industries across the nation. Key results reveal that health issues do exist in farming families and are often underreported by family

  9. A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

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    Kanellopoulos Dimitros

    2011-12-01

    Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

  10. Can We Improve Training for Health Professionals to Sustain Local Health Development?

    Science.gov (United States)

    King, Stephen

    2016-01-01

    Can we improve training for health professionals? We explore specific variables that need to be accounted for to achieve sustainable local health development through training. A problem-based approach with appreciation of the need for making changes is suggested as the only authentic basis for training. PMID:28090174

  11. Health-Related Education for Sustainability: Public Health Workforce Needs and the Role of Higher Education

    Science.gov (United States)

    Patrick, Rebecca; Kingsley, Jonathan; Capetola, Teresa

    2016-01-01

    Public health practitioners have important roles to play in addressing environmental sustainability imperatives that have an impact on human health. Yet, to date, the extent to which practitioners are willing and able to address these issues is an understudied subject. This article draws on the findings of two qualitative studies involving 49…

  12. Health Policy Brief: Global Mental Health and the United Nations' Sustainable Development Goals.

    Science.gov (United States)

    Cratsley, Kelso; Mackey, Tim K

    2018-01-25

    Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013-2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN's 2030 Agenda for Sustainable Development (United Nations, 2015). The WHO's Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN's Sustainable Development Goals include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Social ecology interventions for post-traumatic stress disorder: what can we learn from child soldiers?

    Science.gov (United States)

    Kohrt, Brandon

    2013-09-01

    Research with child soldiers is crucial to improving mental health services after war. This research also can illuminate innovative approaches to treating post-traumatic stress disorder (PTSD) among adult soldiers, veterans and other trauma survivors in high-income countries. A key contribution is the role of social ecology for trauma-healing interventions.

  14. Child Soldiers: Children Associated with Fighting Forces.

    Science.gov (United States)

    Song, Suzan J; de Jong, Joop

    2015-10-01

    Around the world, there are an estimated 300,000 to 500,000 children involved in armed conflict. Children can be abducted into a fighting force to fight or serve as sex slaves. Child soldiers have depression, anxiety, and posttraumatic stress symptoms; however, evidence is mixed because of methodologic limitations. Various mental health interventions have been tried, with promising results. Child and adolescent psychiatrists are uniquely trained in understanding and assisting youth to heal from such extraordinary experiences. A public health paradigm could include interventions that are based on a comprehensive assessment of interweaving developmental, biological, psychological, and sociocultural factors. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Linking Environmental Sustainability, Health, and Safety Data in Health Care: A Research Roadmap.

    Science.gov (United States)

    Kaplan, Susan B; Forst, Linda

    2017-08-01

    Limited but growing evidence demonstrates that environmental sustainability in the health-care sector can improve worker and patient health and safety. Yet these connections are not appreciated or understood by decision makers in health-care organizations or oversight agencies. Several studies demonstrate improvements in quality of care, staff satisfaction, and work productivity related to environmental improvements in the health-care sector. A pilot study conducted by the authors found that already-collected data could be used to evaluate impacts of environmental sustainability initiatives on worker and patient health and safety, yet few hospitals do so. Future research should include a policy analysis of laws that could drive efforts to integrate these areas, elucidation of organizational models that promote sharing of environmental and health and safety data, and development of tools and methods to enable systematic linkage and evaluation of these data to expand the evidence base and improve the hospital environment.

  16. Behaviour change for better health: nutrition, hygiene and sustainability.

    Science.gov (United States)

    Newson, Rachel S; Lion, Rene; Crawford, Robert J; Curtis, Valerie; Elmadfa, Ibrahim; Feunekes, Gerda I J; Hicks, Cheryl; van Liere, Marti; Lowe, C Fergus; Meijer, Gert W; Pradeep, B V; Reddy, K Srinath; Sidibe, Myriam; Uauy, Ricardo

    2013-01-01

    As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes - particularly in developing and emerging countries - imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public-private partnerships.

  17. Medicine 'misuse': Implications for health and environmental sustainability.

    Science.gov (United States)

    Thomas, Felicity; Depledge, Michael

    2015-10-01

    Recent decades have witnessed a global rise in the use of medical pharmaceuticals to combat disease. However, estimates suggest that over half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them as directed. Bringing together research from across the medical, natural and social sciences, this paper considers what we know about the causes, impacts and implications of medicine misuse in relation to health, the sustainable use of pharmaceuticals and their unintended effects in the environment. We suggest that greater insight and understanding of medicine misuse can be gained by integrating the biomedical-focused approaches used in public health with approaches that consider the social and environmental determinants of medical prescribing and consuming practices. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Global health governance in the sustainable development goals: Is it grounded in the right to health?

    Science.gov (United States)

    Van de Pas, Remco; Hill, Peter S; Hammonds, Rachel; Ooms, Gorik; Forman, Lisa; Waris, Attiya; Brolan, Claire E; McKee, Martin; Sridhar, Devi

    2017-01-01

    This paper explores the extent to which global health governance - in the context of the early implementation of the Sustainable Development Goals is grounded in the right to health. The essential components of the right to health in relation to global health are unpacked. Four essential functions of the global health system are assessed from a normative, rights-based, analysis on how each of these governance functions should operate. These essential functions are: the production of global public goods, the management of externalities across countries, the mobilization of global solidarity, and stewardship. The paper maps the current reality of global health governance now that the post-2015 Sustainable Development Goals are beginning to be implemented. In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state. In practice, there is a governance gap between the human rights framework and practices in global health and development policies. This gap can be explained by the political determinants of health that shape the governance of these global policies. Current representations of the right to health in the Sustainable Development Goals are insufficient and superficial, because they do not explicitly link commitments or right to health discourse to binding treaty obligations for duty-bearing nation states or entitlements by people. If global health policy is to meaningfully contribute to the realization of the right to health and to rights based global health governance then future iterations of global health policy must bridge this gap. This includes scholarship and policy debate on the structure, politics, and agency to overcome existing global health injustices.

  19. Global Mental Health: sharing and synthesizing knowledge for sustainable development.

    Science.gov (United States)

    O'Donnell, K; O'Donnell, M Lewis

    2016-01-01

    Global mental health (GMH) is a growing domain with an increasing capacity to positively impact the world community's efforts for sustainable development and wellbeing. Sharing and synthesizing GMH and multi-sectoral knowledge, the focus of this paper, is an important way to support these global efforts. This paper consolidates some of the most recent and relevant 'context resources' [global multi-sector (GMS) materials, emphasizing world reports on major issues] and 'core resources' (GMH materials, including newsletters, texts, conferences, training, etc.). In addition to offering a guided index of materials, it presents an orientation framework (global integration) to help make important information as accessible and useful as possible. Mental health colleagues are encouraged to stay current in GMH and global issues, to engage in the emerging agendas for sustainable development and wellbeing, and to intentionally connect and contribute across sectors. Colleagues in all sectors are encouraged to do likewise, and to take advantage of the wealth of shared and synthesized knowledge in the GMH domain, such as the materials featured in this paper.

  20. THEORETICAL FOUNDATIONS OF SUSTAINABLE DEVELOPMENT IN THE HEALTH SECTOR OF UKRAINE

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    Liliia Savchuk

    2017-08-01

    Full Text Available This article aims at deepening the theoretical foundations of the development of the health sector in the conditions of realization of the strategy of sustainable development of the state. Summarizes the notional and terminological apparatus of the modern economic science of health. Clarified categories “human health”, “public health”, “health”, “healthcare”, “health”, “development”, “sustainable development”. Introduced the concept of “sustainable development of the health sector”. The article generalises theoretical approaches to understanding issues in health care. Key words: health, human health, sustainable development, services.

  1. Growing up in armed groups: trauma and aggression among child soldiers in DR Congo

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    Katharin Hermenau

    2013-11-01

    Full Text Available Background: Child soldiers are often both victims and perpetrators of horrendous acts of violence. Research with former child soldiers has consistently shown that exposure to violence is linked to trauma-related disorders and that living in a violent environment is correlated with enhanced levels of aggression. Objective: To gain more insight into the experiences and the mental health status of former child soldiers, we conducted a survey with N=200 former child soldiers and adult combatants in the DR Congo. Methods: We conducted semi-structured interviews concerning military experiences, experienced and perpetrated violence, and mental health. Results: Former child soldiers reported more experienced and perpetrated violence, a greater severity of trauma-related suffering, as well as higher appetitive aggression than adult ex-combatants. Appetitive aggression was related to more perpetrated violence, higher military ranks, voluntary recruitment and higher rates of reenlistments in former child soldiers. Conclusions: Our results indicate that growing up in an armed group is related to higher levels of trauma-related disorders and aggressive behavior. This may explain the challenge of reintegrating former child soldiers. It is thus important to consider mental health problems, particularly trauma-related disorders and aggressive behavior, of former child soldiers for designing adequate reintegration programs.

  2. Growing up in armed groups: trauma and aggression among child soldiers in DR Congo.

    Science.gov (United States)

    Hermenau, Katharin; Hecker, Tobias; Maedl, Anna; Schauer, Maggie; Elbert, Thomas

    2013-01-01

    Child soldiers are often both victims and perpetrators of horrendous acts of violence. Research with former child soldiers has consistently shown that exposure to violence is linked to trauma-related disorders and that living in a violent environment is correlated with enhanced levels of aggression. To gain more insight into the experiences and the mental health status of former child soldiers, we conducted a survey with N=200 former child soldiers and adult combatants in the DR Congo. We conducted semi-structured interviews concerning military experiences, experienced and perpetrated violence, and mental health. Former child soldiers reported more experienced and perpetrated violence, a greater severity of trauma-related suffering, as well as higher appetitive aggression than adult ex-combatants. Appetitive aggression was related to more perpetrated violence, higher military ranks, voluntary recruitment and higher rates of reenlistments in former child soldiers. Our results indicate that growing up in an armed group is related to higher levels of trauma-related disorders and aggressive behavior. This may explain the challenge of reintegrating former child soldiers. It is thus important to consider mental health problems, particularly trauma-related disorders and aggressive behavior, of former child soldiers for designing adequate reintegration programs.

  3. The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care.

    Science.gov (United States)

    Shelton, Rachel C; Cooper, Brittany Rhoades; Stirman, Shannon Wiltsey

    2018-01-12

    There is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented. This review critically examines and discusses conceptual and methodological issues in studying sustainability, summarizes the multilevel factors that have been found to influence the sustainability of interventions in a range of public health and health care settings, and highlights key areas for future research. Expected final online publication date for the Annual Review of Public Health Volume 39 is April 1, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  4. Reintegration of child soldiers in Burundi: a tracer study

    Science.gov (United States)

    2012-01-01

    Background Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare. Methods This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06); immediately afterwards (T2; 2006–07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators. Results Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the outcome indicators. Socio-economic functioning was negatively related with depression- and, health complaints and positively with intervention satisfaction. Conclusion The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program. PMID:23095403

  5. Reintegration of child soldiers in Burundi: a tracer study.

    Science.gov (United States)

    Jordans, Mark J D; Komproe, Ivan H; Tol, Wietse A; Ndayisaba, Aline; Nisabwe, Theodora; Kohrt, Brandon A

    2012-10-25

    Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare. This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005-06); immediately afterwards (T2; 2006-07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators. Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the outcome indicators. Socio-economic functioning was negatively related with depression- and, health complaints and positively with intervention satisfaction. The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program.

  6. Reintegration of child soldiers in Burundi: a tracer study

    Directory of Open Access Journals (Sweden)

    Jordans Mark JD

    2012-10-01

    Full Text Available Abstract Background Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare. Methods This tracer study was conducted among former child soldiers (N=452 and never-recruited peers (N=191 who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06; immediately afterwards (T2; 2006–07; and at present (T3; 2010. Participants also rated present functional impairment and mental health indicators. Results Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the outcome indicators. Socio-economic functioning was negatively related with depression- and, health complaints and positively with intervention satisfaction. Conclusion The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program.

  7. Integrated Systems Health Management for Sustainable Habitats (Using Sustainability Base as a Testbed)

    Science.gov (United States)

    Martin, Rodney A.

    2017-01-01

    Habitation systems provide a safe place for astronauts to live and work in space and on planetary surfaces. They enable crews to live and work safely in deep space, and include integrated life support systems, radiation protection, fire safety, and systems to reduce logistics and the need for resupply missions. Innovative health management technologies are needed in order to increase the safety and mission-effectiveness for future space habitats on other planets, asteroids, or lunar surfaces. For example, off-nominal or failure conditions occurring in safety-critical life support systems may need to be addressed quickly by the habitat crew without extensive technical support from Earth due to communication delays. If the crew in the habitat must manage, plan and operate much of the mission themselves, operations support must be migrated from Earth to the habitat. Enabling monitoring, tracking, and management capabilities on-board the habitat and related EVA platforms for a small crew to use will require significant automation and decision support software.Traditional caution and warning systems are typically triggered by out-of-bounds sensor values, but can be enhanced by including machine learning and data mining techniques. These methods aim to reveal latent, unknown conditions while still retaining and improving the ability to provide highly accurate alerts for known issues. A few of these techniques will briefly described, along with performance targets for known faults and failures. Specific system health management capabilities required for habitat system elements (environmental control and life support systems, etc.) may include relevant subsystems such as water recycling systems, photovoltaic systems, electrical power systems, and environmental monitoring systems. Sustainability Base, the agency's flagship LEED-platinum certified green building acts as a living laboratory for testing advanced information and sustainable technologies that provides an

  8. The combat soldier.

    Science.gov (United States)

    Artiss, Kenneth L

    2010-04-01

    The Gulf War illness (GWI) problem is seen as a postwar syndrome related to veteran discontent rather than as a new phenomenon. It is here proposed that application of social psychiatric thinking and workers' compensation experience can help in understanding the problem. Social psychiatry has been neglected in the training of so many psychiatrists that many of them fail to understand the Army as a community and to recognize that a community's parts may develop symptom neuroses. Most psychiatrists, however, do know that a symptom neurosis will not disappear until it no longer serves its purposes. The young soldier may know that he is being trained for combat duty but manages to distance himself from the terrible realities of military combat by creating a psychic reality that protects him. Social psychiatric emphasis is used to describe his response when brought face to face with himself as a combatant with overwhelming responsibilities and genuine lethal danger. The brilliance and relevance of social thinking is demonstrated by examples from the works of Gustave LeBon and Georg Simmel so that its application to present--and future--military problems may be brought into focus.

  9. Plant nutrition for sustainable development and global health.

    Science.gov (United States)

    White, P J; Brown, P H

    2010-06-01

    Plants require at least 14 mineral elements for their nutrition. These include the macronutrients nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg) and sulphur (S) and the micronutrients chlorine (Cl), boron (B), iron (Fe), manganese (Mn), copper (Cu), zinc (Zn), nickel (Ni) and molybdenum (Mo). These are generally obtained from the soil. Crop production is often limited by low phytoavailability of essential mineral elements and/or the presence of excessive concentrations of potentially toxic mineral elements, such as sodium (Na), Cl, B, Fe, Mn and aluminium (Al), in the soil solution. This article provides the context for a Special Issue of the Annals of Botany on 'Plant Nutrition for Sustainable Development and Global Health'. It provides an introduction to plant mineral nutrition and explains how mineral elements are taken up by roots and distributed within plants. It introduces the concept of the ionome (the elemental composition of a subcellular structure, cell, tissue or organism), and observes that the activities of key transport proteins determine species-specific, tissue and cellular ionomes. It then describes how current research is addressing the problems of mineral toxicities in agricultural soils to provide food security and the optimization of fertilizer applications for economic and environmental sustainability. It concludes with a perspective on how agriculture can produce edible crops that contribute sufficient mineral elements for adequate animal and human nutrition.

  10. Behaviour change for better health: nutrition, hygiene and sustainability

    Science.gov (United States)

    2013-01-01

    As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled ‘Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability’. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today’s environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes – particularly in developing and emerging countries – imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public

  11. Sustainable Organic Farming For Environmental Health A Social Development Model

    Directory of Open Access Journals (Sweden)

    Ijun Rijwan Susanto

    2015-05-01

    Full Text Available ABSTRACT In this study the researcher attempted 1 to understand the basic features of organic farming in The Paguyuban Pasundans Cianjur 2 to describe and understand how the stakeholders were are able to internalize the challenges of organic farming on their lived experiences in the community 3 to describe and understand how the stakeholders were are able to internalize and applied the values of benefits of organic farming in support of environmental health on their lived experiences in the community 4 The purpose was to describe and understand how the stakeholders who are able to articulate their ideas regarding the model of sustainable organic farming 5 The Policy Recommendation for Organic Farming. The researcher employed triangulation thorough finding that provides breadth and depth to an investigation offering researchers a more accurate picture of the phenomenon. In the implementation of triangulation researchers conducted several interviews to get saturation. After completion of the interview results are written compiled and shown to the participants to check every statement by every participant. In addition researchers also checked the relevant documents and direct observation in the field The participants of this study were the stakeholders namely 1 The leader of Paguyuban Pasundans Organic Farmer Cianjur PPOFC 2 Members of Paguyuban Pasundans Organic FarmersCianjur 3 Leader of NGO 4 Government officials of agriculture 5 Business of organic food 6 and Consumer of organic food. Generally the findings of the study revealed the following 1 PPOFC began to see the reality as the impact of modern agriculture showed in fertility problems due to contaminated soil by residues of agricultural chemicals such as chemical fertilizers and chemical pesticides. So he wants to restore the soil fertility through environmentally friendly of farming practices 2 the challenges of organic farming on their lived experiences in the community farmers did not

  12. Multi-functional roles of a soldier-specific volatile as a worker arrestant, primer pheromone and an antimicrobial agent in a termite.

    Science.gov (United States)

    Mitaka, Yuki; Mori, Naoki; Matsuura, Kenji

    2017-07-26

    Division of labour in eusocial insects is characterized by efficient communication systems based on pheromones. Among such insects, termites have evolved specialized sterile defenders, called soldiers. Because they are incapable of feeding themselves, it has been suggested that soldiers are sustained by workers and emit the pheromone arresting workers. However, such a soldier pheromone has not been identified in any termite species, and the details of the soldier-worker interaction remain to be explored. Here, we identified a soldier-specific volatile sesquiterpene as a worker arrestant, which also acts as a primer pheromone regulating soldier differentiation and fungistatic agent in a termite Reticulitermes speratus Chemical analyses revealed that (-)-β-elemene is the major component of soldier extract, and its authentic standard exhibited arrestant activity to workers and inhibited the differentiation from workers to soldiers. This compound also showed fungistatic activity against entomopathogenic fungi. These suggest that (-)-β-elemene secreted by soldiers acts not only as a worker arrestant but also as one component of inhibitory primer pheromone and an anti-pathogenic agent. Our study provides novel evidence supporting the multi-functionality of termite soldier pheromone and provides new insights into the role of soldiers and the evolutionary mechanisms of pheromone compounds. © 2017 The Author(s).

  13. Mapping of Policies Shaping the Agenda within Health and Sustainability Education

    DEFF Research Database (Denmark)

    Madsen, Katrine Dahl; Simovska, Venka

    This paper maps the key international and national policy documents influencing work with health education/promotion and education for sustainable development within primary and lower secondary education in Denmark. This mapping will provide the foundation for further analysis of: - the ways...... in which the concepts of health and sustainability are articulated, with particular focus on stated aims, strategies and competences required for health promotion and sustainable development - the relevance of the above-mentioned conceptualizations for school-based health education/promotion and education...... for sustainable development - the transformation processes which take place when international/national policies are interpreted and put into practice at municipal and school levels...

  14. The Dark Side of Comprehensive Soldier Fitness

    Science.gov (United States)

    Eidelson, Roy; Pilisuk, Marc; Soldz, Stephen

    2011-01-01

    Comprehensive Soldier Fitness (CSF), the focus of the January 2011 special issue of the "American Psychologist," is a $125 million resilience training initiative designed to reduce and prevent the adverse psychological consequences of combat for soldiers and veterans. These are worthy goals. Soldiers and veterans deserve the best care possible,…

  15. Perception and practice of contraception among male soldiers in ...

    African Journals Online (AJOL)

    Background: There is a popular belief among the general population that Nigerian soldiers tend to have large families but this has not been substantiated with evidence-based research. The Nigerian military health authority implements femaletargetted contraception strategies, with less focus on their husbands; who are the ...

  16. Comprehensive Soldier Fitness: Building Resilience in a Challenging Institutional Context

    Science.gov (United States)

    Cornum, Rhonda; Matthews, Michael D.; Seligman, Martin E. P.

    2011-01-01

    The Comprehensive Soldier Fitness (CSF) program is designed to increase psychological strength and positive performance and to reduce the incidence of maladaptive responses of the entire U.S. Army. Based on the principles of positive psychology, CSF is a historically unique approach to behavioral health in a large (1.1 million members)…

  17. City networks collaboration and planning for health and sustainability

    CERN Document Server

    Migdalas, Athanasios; Rassia, Stamatina; Pardalos, Panos

    2017-01-01

    Sustainable development within urban and rural areas, transportation systems, logistics, supply chain management, urban health, social services, and architectural design are taken into consideration in the cohesive network models provided in this book. The ideas, methods, and models presented consider city landscapes and quality of life conditions based on mathematical network models and optimization. Interdisciplinary Works from prominent researchers in mathematical modeling, optimization, architecture, engineering, and physics are featured in this volume to promote health and well-being through design.   Specific topics include: -          Current technology that form the basis of future living in smart cities -          Interdisciplinary design and networking of large-scale urban systems  -          Network communication and route traffic optimization -          Carbon dioxide emission reduction -          Closed-loop logistics chain management and operation ...

  18. Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

    2015-04-29

    The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

  19. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    Science.gov (United States)

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  20. Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to Afghanistan.

    Science.gov (United States)

    Taal, Elisabeth Liesbeth M; Vermetten, Eric; van Schaik, Digna Anneke J F; Leenstra, Tjalling

    2014-01-01

    Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel. We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61-2.11] in the first and 1.28 [1.09-1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02-3.32] and 1.74 [1.30-2.32]) and of anxiety disorders (2.22 [1.52-3.25] and 2.28 [1.50-3.45]) including posttraumatic stress disorder (5.15 [2.55-10.40] and 5.28 [2.42-11.50]), but not of mood disorders (1.33 [0.90-1.97] and 1.11 [0.68-1.82]), was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84-2.47] and 1.40 [1.18-1.67]). Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never deployed to Afghanistan. These observations underscore the need for an adequate mental

  1. Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to Afghanistan

    Directory of Open Access Journals (Sweden)

    Elisabeth (Liesbeth M. Taal

    2014-08-01

    Full Text Available Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS of military deployed to Afghanistan to that of non-deployed military personnel. Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed, who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR, adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32] and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45] including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50], but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82], was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]. Conclusions: Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never

  2. Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal.

    Science.gov (United States)

    Kohrt, Brandon A; Jordans, Mark J D; Tol, Wietse A; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

    2010-11-01

    This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted lack of reintegration supports. Ultimately, social ecology is well suited to identify intervention foci across ecological levels based on community differences in vulnerability and protective factors.

  3. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    Science.gov (United States)

    Sandifer, P. A.; Trtanj, J.; Collier, T. K.

    2012-12-01

    Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and

  4. Searching for sustainability within public health policy: insights from an injury prevention perspective.

    Science.gov (United States)

    Errington, Gail; Evans, Catrin; Watson, Michael C

    2017-04-01

    Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. A content review of global and UK national public health policies (1981-2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Forty-nine policies were reviewed. The term 'sustain', or its derivatives, featured in 36 (73%) of these. Its' use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its' conceptualization varied according to individual interpretation. Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes.

  5. Soldier Dimensions and Operational Readiness in U.S. Army Forces Deployed to Kosovo

    National Research Council Canada - National Science Library

    Castro, Carl

    1999-01-01

    .... In a recent study of U.S. Army units deployed to Kosovo in support of a multinational peacekeeping mission, soldier attitudes and health were surveyed on site, mid-way during a 6-month deployment...

  6. Caffeine use among active duty US Army soldiers.

    Science.gov (United States)

    Lieberman, Harris R; Stavinoha, Trisha; McGraw, Susan; White, Alan; Hadden, Louise; Marriott, Bernadette P

    2012-06-01

    Eighty-percent of the US adult population regularly consumes caffeine, but limited information is available on the extent and patterns of use. Caffeine use is a public health issue and its risks and benefits are regularly considered in scientific literature and the lay media. Recently, new caffeine-containing products have been introduced and are widely available on Army bases and are added to rations to maintain cognitive performance. This study surveyed caffeine consumption and demographic characteristics in 990 US Army soldiers. Data were weighted by age, sex, rank, and Special Forces status. Total caffeine intake and intake from specific products were estimated. Logistic regression was used to examine relationships between caffeine use and soldier demographic and lifestyle characteristics. Eighty-two percent of soldiers consumed caffeine at least once a week. Mean daily caffeine consumption was 285 mg/day (347 mg/day among regular caffeine consumers). Male soldiers consumed, on average, 303 mg/day and females 163 mg/day (regular consumers: 365 mg/day for male soldiers, 216 mg/day for female soldiers). Coffee was the main source of caffeine intake. Among young males, energy drinks were the largest source of caffeine intake, but their intake was not greater than older males. Regression analysis indicated an association of higher caffeine intake with male sex, white race, and tobacco use (Pcaffeine in levels accepted as safe, but some consume greater quantities than recommended, although definitive information on safe upper limits of caffeine intake is not available. Labels of caffeine-containing products should provide caffeine content so individuals can make informed decisions. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. Health system strengthening: prospects and threats for its sustainability on the global health policy agenda.

    Science.gov (United States)

    Naimoli, Joseph F; Saxena, Sweta; Hatt, Laurel E; Yarrow, Kristina M; White, Trenton M; Ifafore-Calfee, Temitayo

    2018-01-01

    In 2013, Hafner and Shiffman applied Kingdon's public policy process model to explain the emergence of global attention to health system strengthening (HSS). They questioned, however, HSS's sustainability on the global health policy agenda, citing various concerns. Guided by the Grindle and Thomas interactive model of policy implementation, we advance and elaborate a proposition: a confluence of developments will contribute to maintaining HSS's prominent place on the agenda until at least 2030. Those developments include (1) technical, managerial, financial, and political responses to unpredictable public health crises that imperil the routine functioning of health systems, such as the 2014-2015 Ebola virus disease (Ebola) epidemic in West Africa; (2) similar responses to non-crisis situations requiring fully engaged, robust health systems, such as the pursuit of the new Sustainable Development Goal for health (SDG3); and (3) increased availability of new knowledge about system change at macro, meso, and micro levels and its effects on people's health and well-being. To gauge the accuracy of our proposition, we carried out a speculative assessment of credible threats to our premise by discussing all of the Hafner-Shiffman concerns. We conclude that (1) the components of our proposition and other forces that have the potential to promote continuing attention to HSS are of sufficient strength to counteract these concerns, and (2) prospective monitoring of HSS agenda status and further research on agenda sustainability can increase confidence in our threat assessment. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Soldier Quality of Life Assessment

    Science.gov (United States)

    2016-09-01

    the attribute set every possible condition that one might encounter on a base camp. For example, during survey administration some Soldiers commented...access equipment for group sports, such as volleyball, basketball, and football . The levels of this attribute were:  No (reference)  Yes The...CO Commanding Officer DCE Discrete Choice Experiment DFAC Dining Facilities Administration Center DP Duty Position FOB Forward

  9. Supporting Structures for Education for Sustainable Development and School-Based Health Promotion

    Science.gov (United States)

    Madsen, Katrine Dahl; Nordin, Lone Lindegaard; Simovska, Venka

    2016-01-01

    The article aims to explore the following question: "How is education for sustainable development and health education in schools approached and contextualized at a municipal level, and what contradictions and tensions might local structures imply for sustainable health promoting school development?" Based on interviews with key agents…

  10. Supporting structures for education for sustainable development and school-based health promotion

    DEFF Research Database (Denmark)

    Madsen, Katrine Dahl; Nordin, Lone Lindegard; Simovska, Venka

    2016-01-01

    The article aims to explore the following question: How is education for sustainable development and health education in schools approached and contextualized at a municipal level, and what contradictions and tensions might local structures imply for sustainable health promoting school developmen...

  11. Integrating Health and Sustainability: The Higher Education Sector as a Timely Catalyst

    Science.gov (United States)

    Orme, J.; Dooris, M.

    2010-01-01

    Higher education is an influential sector with enormous potential to impact positively on health and sustainability. The purpose of this paper was to explore its emergent role as a key setting for promoting health and sustainability and for addressing their challenges in an integrated and coherent way. Acknowledging both the relative narrowness of…

  12. Holistic and sustainable health improvement: the contribution of the settings-based approach to health promotion.

    Science.gov (United States)

    Dooris, Mark

    2009-01-01

    Highlighting the need for holistic and sustainable health improvement, this paper starts by reviewing the origins, history and conceptualization of the settings approach to health promotion. It then takes stock of current practice both internationally and nationally, noting its continuing importance worldwide and its inconsistent profile and utilization across the four UK countries. It goes on to explore the applicability and future development of settings-based health promotion in relation to three key issues: inequalities and inclusion; place-shaping and systems-based responses to complex problems. Concluding that the settings approach remains highly relevant to 21st century public health, the paper calls on the new "Royal" to provide much-needed leadership, thereby placing settings-based health promotion firmly on the national agenda across the whole of the UK.

  13. The Sustainable Development Goals and the Global Health Security Agenda: exploring synergies for a sustainable and resilient world.

    Science.gov (United States)

    Bali, Sulzhan; Taaffe, Jessica

    2017-02-07

    Both the Sustainable Development Goals (SDGs) and the Global Health Security Agenda (GHSA) represent bold initiatives to address systematically gaps in previous efforts to assure that societies can be resilient when confronted with potentially overwhelming threats to health. Despite their obvious differences, and differing criticisms of both, they shift away from vertical (problem- or disease-specific) to horizontal (comprehensive) solutions. Despite the comprehensiveness of the SDGs, they lack a specific target for global health security. The GHSA focuses primarily on infectious diseases and neglects non-communicable diseases and socioeconomic drivers of health. Even though each agenda has limitations and unique challenges, they are complementary. We discuss ways to understand and implement the two agendas synergistically to hasten progress toward a more sustainable and resilient world.

  14. The Sustainable Development Goals and the Global Health Security Agenda: exploring synergies for a sustainable and resilient world.

    Science.gov (United States)

    Bali, Sulzhan; Taaffe, Jessica

    2017-05-01

    Both the Sustainable Development Goals (SDGs) and the Global Health Security Agenda (GHSA) represent bold initiatives to address systematically gaps in previous efforts to assure that societies can be resilient when confronted with potentially overwhelming threats to health. Despite their obvious differences, and differing criticisms of both, they shift away from vertical (problem- or disease-specific) to horizontal (comprehensive) solutions. Despite the comprehensiveness of the SDGs, they lack a specific target for global health security. The GHSA focuses primarily on infectious diseases and neglects non-communicable diseases and socioeconomic drivers of health. Even though each agenda has limitations and unique challenges, they are complementary. We discuss ways to understand and implement the two agendas synergistically to hasten progress toward a more sustainable and resilient world.

  15. Nursing's leadership in positioning human health at the core of urban sustainability.

    Science.gov (United States)

    St Pierre Schneider, Barbara; Menzel, Nancy; Clark, Michele; York, Nancy; Candela, Lori; Xu, Yu

    2009-01-01

    The United Nations predicts that by 2050 nearly three fourths of the world's population will live in urban areas, including cities. People are attracted to cities because these urban areas offer diverse opportunities, including the availability of goods and services and a higher quality of life. Cities, however, may not be sustainable with this population boom. To address sustainability, urban developers and engineers are building green structures, and businesses are creating products that are safe for the environment. Additionally, efforts are needed to place human health at the core of urban sustainability. Without human health, cities will not survive for future generations. Nursing is the discipline that can place human health in this position. Nursing's initiatives throughout history are efforts of sustainability-improving human health within the physical, economic, and social environments. Therefore, nursing must take a leadership role to ensure that human health is at the core of urban sustainability.

  16. [Promoting health in vulnerable communities: social technologies for poverty reduction and sustainable development].

    Science.gov (United States)

    Oliveira, Elenilda Farias de; Jesus, Viviane Silva de; Siqueira, Samylla Maira Costa; Alves, Thais de Andrade; Santos, Ivana Mota Dos; Camargo, Climene Laura de

    2015-01-01

    To report the experience of implementing social technologies in vulnerable communities to foster individual and community potential for health promotion, poverty reduction and sustainable development. The experience reports were collected from July 2010 to June 2015 with 200 individuals residing in vulnerable communities, in Bahia, Brazil. The experiences were reported in stages: 1) Awareness and diagnostics; 2) Workshops on different subjects; 3) Deployment of social technologies. The participants were notified of the importance of sustainable development and the environmental and health conditions were diagnosed. Actions for sustainable development were planned, with the implementation of acoustic artefacts (natural fibres) and experimental kitchens (homemade sweets). Considering that health comprises actions that promote the quality of life, the use of social technologies favoured health promotion because they stimulated the potential of the participants. It also allowed the diversification of the community's income source and sustainable development, which reduces poverty and fosters sustainability, quality of life and health promotion.

  17. Indicators linking health and sustainability in the post-2015 development agenda.

    Science.gov (United States)

    Dora, Carlos; Haines, Andy; Balbus, John; Fletcher, Elaine; Adair-Rohani, Heather; Alabaster, Graham; Hossain, Rifat; de Onis, Mercedes; Branca, Francesco; Neira, Maria

    2015-01-24

    The UN-led discussion about the post-2015 sustainable development agenda provides an opportunity to develop indicators and targets that show the importance of health as a precondition for and an outcome of policies to promote sustainable development. Health as a precondition for development has received considerable attention in terms of achievement of health-related Millennium Development Goals (MDGs), addressing growing challenges of non-communicable diseases, and ensuring universal health coverage. Much less attention has been devoted to health as an outcome of sustainable development and to indicators that show both changes in exposure to health-related risks and progress towards environmental sustainability. We present a rationale and methods for the selection of health-related indicators to measure progress of post-2015 development goals in non-health sectors. The proposed indicators show the ancillary benefits to health and health equity (co-benefits) of sustainable development policies, particularly those to reduce greenhouse gas emissions and increase resilience to environmental change. We use illustrative examples from four thematic areas: cities, food and agriculture, energy, and water and sanitation. Embedding of a range of health-related indicators in the post-2015 goals can help to raise awareness of the probable health gains from sustainable development policies, thus making them more attractive to decision makers and more likely to be implemented than before. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Fostering the future of health promotion as seen through the 'Message from Youth Delegates on Health Promotion and Sustainable Development'.

    Science.gov (United States)

    Rodgers, Sara

    2017-03-01

    The World Health Organization 9th Global Conference on Health Promotion presented us with the Shanghai Declaration for promoting health in the 2030 Agenda for Sustainable Development. At the same time, the participants of the conference symposium, 'How can youth become future leaders in delivering on the 2030 Agenda for Sustainable Development?' produced the 'Message from Youth Delegates on Health Promotion and Sustainable Development' as its complement. This 'Message from Youth Delegates' outlined pledges of young leaders in health promotion and proposed the necessary steps to ensure the future of health promotion includes more meaningful participation by young people. In order to fulfil the newest promises of the Shanghai Declaration and the past promises of the Ottawa Charter for Health Promotion, we must think to close the divides between generations of health promoters and move forward on actions designed to develop the best possible future leaders for the field of global health. (Global Health Promotion, 2017; 24(1): 62-65).

  19. STRATEGIC MANAGEMENT OF BIOCHEMICAL AND BIOPHYSICAL CONTROL STRUCTURES AND SUSTAINABILITY HEALTH ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Ioana-Andreea, MARINESCU

    2014-11-01

    Full Text Available Scientific Investigation of sustainability sanitary herein, matters to a define the structure of the health sector; b knowing the contents of the local health systems, c to obtain information about the properties and characteristics associated with health in Romania; d obtaining views on the mission, objectives, goals and targets pursued by health services; e scheduling results, effects and positive consequences among human communities to ensure sustainable health in the framework of sustainable development of the country and, last but not least; f it is intended to measure people's participation and the rule management process, based on biochemical and biophysical control structures. Mainly, it is considered that the sustainability and health have depicted conceptual content that must be secured effectively recovered, concrete operational activities of health systems in laboratories and hospitals.

  20. An Agenda for Research on the Sustainability of Public Health Programs

    Science.gov (United States)

    Dearing, James W.

    2011-01-01

    Funders of programs in public health and community health are increasingly concerned about the sustainability of changes they initiate. Despite a recent increase in sustainability research and evaluation, this literature has not developed a widely used paradigm for conducting research that can accumulate into generalizable findings. We provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection. We suggest viewing sustainability research as a further stage in the translation or dissemination of research-based interventions into practice. This perspective emphasizes ongoing relationships with earlier stages of a broader diffusion framework, including adoption and implementation processes. PMID:21940916

  1. Health promotion and sustainability programmes in Australia: barriers and enablers to evaluation.

    Science.gov (United States)

    Patrick, Rebecca; Kingsley, Jonathan

    2017-08-01

    In an era characterised by the adverse impacts of climate change and environmental degradation, health promotion programmes are beginning to actively link human health with environmental sustainability imperatives. This paper draws on a study of health promotion and sustainability programmes in Australia, providing insights to evaluation approaches being used and barriers and enablers to these evaluations. The study was based on a multi-strategy research involving both quantitative and qualitative methods. Health promotion practitioners explained through surveys and semi-structured interviews that they focused on five overarching health and sustainability programme types (healthy and sustainable food, active transport, energy efficiency, contact with nature, and capacity building). Various evaluation methods and indicators (health, social, environmental, economic and demographic) were identified as being valuable for monitoring and evaluating health and sustainability programmes. Findings identified several evaluation enablers such as successful community engagement, knowledge of health and sustainability issues and programme champions, whereas barriers included resource constraints and competing interests. This paper highlights the need for ecological models and evaluation tools to support the design and monitoring of health promotion and sustainability programmes.

  2. Developing and implementing health and sustainability guidelines for institutional food service.

    Science.gov (United States)

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

    2012-05-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

  3. Sustainability considerations for health research and analytic data infrastructures.

    Science.gov (United States)

    Wilcox, Adam; Randhawa, Gurvaneet; Embi, Peter; Cao, Hui; Kuperman, Gilad J

    2014-01-01

    The United States has made recent large investments in creating data infrastructures to support the important goals of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER), with still more investment planned. These initial investments, while critical to the creation of the infrastructures, are not expected to sustain them much beyond the initial development. To provide the maximum benefit, the infrastructures need to be sustained through innovative financing models while providing value to PCOR and CER researchers. Based on our experience with creating flexible sustainability strategies (i.e., strategies that are adaptive to the different characteristics and opportunities of a resource or infrastructure), we define specific factors that are important considerations in developing a sustainability strategy. These factors include assets, expansion, complexity, and stakeholders. Each factor is described, with examples of how it is applied. These factors are dimensions of variation in different resources, to which a sustainability strategy should adapt. We also identify specific important considerations for maintaining an infrastructure, so that the long-term intended benefits can be realized. These observations are presented as lessons learned, to be applied to other sustainability efforts. We define the lessons learned, relating them to the defined sustainability factors as interactions between factors. Using perspectives and experiences from a diverse group of experts, we define broad characteristics of sustainability strategies and important observations, which can vary for different projects. Other descriptions of adaptive, flexible, and successful models of collaboration between stakeholders and data infrastructures can expand this framework by identifying other factors for sustainability, and give more concrete directions on how sustainability can be best achieved.

  4. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    Science.gov (United States)

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Evaluation of health determinants for sustaining workability in aging US workforce.

    Science.gov (United States)

    Vatsalya, Vatsalya; Karch, Robert

    2013-08-01

    Growth of older population in United States requires multi-generational evaluation to characterize health measures for sustaining workability. Investigation of measures that working population would need and use with their work-life in an attempt to stay healthy and fit, could potentially reveal significant association that could extend workability and enhance work productivity such as performance, presenteeism, job satisfaction. Evaluation with selective longitudinal health profiling; employment prerequisites; socio-economic and psychological scales could characterize health measures significantly associated with work sustainability. Such health measures could potentially be employed by US working population early in their life and occupation to sustain and improve workability in their later epoch.

  6. Energy, Transportation, Air Quality, Climate Change, Health Nexus: Sustainable Energy is Good for Our Health

    Directory of Open Access Journals (Sweden)

    Larry E. Erickson

    2017-02-01

    Full Text Available The Paris Agreement on Climate Change has the potential to improve air quality and human health by encouraging the electrification of transportation and a transition from coal to sustainable energy. There will be human health benefits from reducing combustion emissions in all parts of the world. Solar powered charging infrastructure for electric vehicles adds renewable energy to generate electricity, shaded parking, and a needed charging infrastructure for electric vehicles that will reduce range anxiety. The costs of wind power, solar panels, and batteries are falling because of technological progress, magnitude of commercial activity, production experience, and competition associated with new trillion dollar markets. These energy and transportation transitions can have a very positive impact on health. The energy, transportation, air quality, climate change, health nexus may benefit from additional progress in developing solar powered charging infrastructure.

  7. Predictors of Saudi nursing students' attitudes towards environment and sustainability in health care.

    Science.gov (United States)

    Cruz, J P; Alshammari, F; Felicilda-Reynaldo, R F D

    2018-02-09

    This study aimed to investigate the predictors of Saudi nursing students' attitudes towards the environment and sustainability in health care. With rising temperature and decreasing annual rainfall, Saudi Arabia is threatened by the harmful effects of climate change on its population. In response to these threats, the Ministry of Health adapted sustainable development and environmental preservation in their National E-Health strategy. To implement these policies successfully, healthcare practitioners should be educated on how climate change could impact human health negatively. A secondary analysis of 280 questionnaires from baccalaureate nursing students of a university in Hail City, Saudi Arabia, was completed. The New Ecological Paradigm (NEP) Scale and Sustainability Attitudes in Nursing Survey 2 (SANS-2) were used to investigate the predictors of student attitudes towards the environment and sustainable development in health care. The NEP score indicated moderate pro-environment attitudes, whereas the SANS-2 mean score showed very positive attitudes towards sustainability in health care. Learning about the environment and related issues in the nursing programme, raising climate change awareness and attending environment-related seminars and training positively influenced the environmental and sustainability attitudes of nursing students. Saudi nursing students moderately manifested pro-environment attitudes but exhibited extremely positive attitudes towards sustainability in health care. The results support the need to strengthen the education of nursing students about environmental and sustainability concepts and the inclusion of these topics in the nursing curricula. The study underscores the critical role of enriching the awareness of nursing students on environmental issues and concerns and sustainability in health care. The findings of this study can support the inclusion of course contents, which deal specifically with environmental health and

  8. The Program Sustainability Assessment Tool: a new instrument for public health programs.

    Science.gov (United States)

    Luke, Douglas A; Calhoun, Annaliese; Robichaux, Christopher B; Elliott, Michael B; Moreland-Russell, Sarah

    2014-01-23

    Public health programs can deliver benefits only if they are able to sustain programs, policies, and activities over time. Although numerous sustainability frameworks and models have been developed, there are almost no assessment tools that have demonstrated reliability or validity or have been widely disseminated. We present the Program Sustainability Assessment Tool (PSAT), a new and reliable instrument for assessing the capacity for program sustainability of various public health and other programs. A measurement development study was conducted to assess the reliability of the PSAT. Program managers and staff (n = 592) representing 252 public health programs used the PSAT to rate the sustainability of their program. State and community-level programs participated, representing 4 types of chronic disease programs: tobacco control, diabetes, obesity prevention, and oral health. The final version of the PSAT contains 40 items, spread across 8 sustainability domains, with 5 items per domain. Confirmatory factor analysis shows good fit of the data with the 8 sustainability domains. The subscales have excellent internal consistency; the average Cronbach's α is 0.88, ranging from 0.79 to 0.92. Preliminary validation analyses suggest that PSAT scores are related to important program and organizational characteristics. The PSAT is a new and reliable assessment instrument that can be used to measure a public health program's capacity for sustainability. The tool is designed to be used by researchers, evaluators, program managers, and staff for large and small public health programs.

  9. Using sustainability as a collaboration magnet to encourage multi-sector collaborations for health.

    Science.gov (United States)

    Khayatzadeh-Mahani, Akram; Labonté, Ronald; Ruckert, Arne; de Leeuw, Evelyne

    2017-03-01

    The World Health Organization Commission on Social Determinants of Health (SDH) places great emphasis on the role of multi-sector collaboration in addressing SDH. Despite this emphasis on this need, there is surprisingly little evidence for this to advance health equity goals. One way to encourage more successful multi-sector collaborations is anchoring SDH discourse around 'sustainability', subordinating within it the ethical and empirical importance of 'levelling up'. Sustainability, in contrast to health equity, has recently proved to be an effective collaboration magnet. The recent adoption of the Sustainable Development Goals (SDGs) provides an opportunity for novel ways of ideationally re-framing SDH discussions through the notion of sustainability. The 2030 Agenda for the SDGs calls for greater policy coherence across sectors to advance on the goals and targets. The expectation is that diverse sectors are more likely and willing to collaborate with each other around the SDGs, the core idea of which is 'sustainability'.

  10. Measuring sustainability within the Veterans Administration Mental Health System Redesign initiative.

    Science.gov (United States)

    Ford, James H; Krahn, Dean; Wise, Meg; Oliver, Karen Anderson

    2011-01-01

    To examine how attributes affecting sustainability differ across Veterans Health Administration organizational components and by staff characteristics. Surveys of 870 change team members and 50 staff interviews within the Veterans Affairs' Mental Health System Redesign initiative. A 1-way ANOVA with a Tukey post hoc test examined differences in sustainability by Veteran Integrated Service Networks, job classification, and tenure from staff survey data of the Sustainability Index. Qualitative interviews used an iterative process to identify "a priori" and "in vivo" themes. A simple stepwise linear regression explored predictors of sustainability. Sustainability differed across Veteran Integrated Service Networks and staff tenure. Job classification differences existed for the following: (1) benefits and credibility of the change and (2) staff involvement and attitudes toward change. Sustainability barriers were staff and institutional resistance and nonsupportive leadership. Facilitators were commitment to veterans, strong leadership, and use of quality improvement tools. Sustainability predictors were outcomes tracking, regular reporting, and use of Plan, Do, Study, Adjust cycles. Creating homogeneous implementation and sustainability processes across a national health system is difficult. Despite the Veterans Affairs' best evidence-based implementation efforts, there was significant variance. Locally tailored interventions might better support sustainability than "one-size-fits-all" approaches. Further research is needed to understand how participation in a quality improvement collaborative affects sustainability.

  11. [Political ecology, ecological economics, and public health: interfaces for the sustainability of development and health promotion].

    Science.gov (United States)

    Porto, Marcelo Firpo; Martinez-Alier, Joan

    2007-01-01

    This article proposes to focus contributions from political ecology and ecological economics to the field of collective health with a view towards integrating the discussions around health promotion, socio-environmental sustainability, and development. Ecological economics is a recent interdisciplinary field that combines economists and other professionals from the social, human, and life sciences. The field has developed new concepts and methodologies that seek to grasp the relationship between the economy and ecological and social processes such as social metabolism and metabolic profile, thereby interrelating economic, material, and energy flows and producing indicators and indexes for (un)sustainability. Meanwhile, political ecology approaches ecological issues and socio-environmental conflicts based on the economic and power dynamics characterizing modern societies. Collective health and the discussions on health promotion can expand our understanding of territory, communities, and the role of science and institutions based on the contributions of political ecology and ecological economics in analyzing development models and the distributive and socio-environmental conflicts generated by them.

  12. Seeking consensus on universal health coverage indicators in the sustainable development goals.

    Science.gov (United States)

    Reddock, Jennifer

    2017-01-01

    There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

  13. Sustainable care improvement programs supported by undergraduate health care education

    NARCIS (Netherlands)

    C.H.M. Smits (Carolien); A. Harps (Annelies); A.M.V. Stoopendaal (Annemiek); A.M. Kamper (Ad); M.M.H. Strating (Mathilde); R.A. Bal (Roland)

    2017-01-01

    markdownabstractBackground: The Care for Better Region program was developed to achieve sustainable care improvement focusing onfall prevention. Key ingredients involved improvement teams developing and implementing a falls reduction plan, PracticeDevelopment; facilitation of

  14. Management and Leadership Approaches to Health Promotion and Sustainable Workplaces: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Andrea Eriksson

    2017-05-01

    Full Text Available Whole-system approaches linking workplace health promotion to the development of a sustainable working life have been advocated. The aim of this scoping review was to map out if and how whole-system approaches to workplace health promotion with a focus on management, leadership, and economic efficiency have been used in Nordic health promotion research. In addition, we wanted to investigate, in depth, if and how management and/or leadership approaches related to sustainable workplaces are addressed. Eighty-three articles were included in an analysis of the studies’ aims and content, research design, and country. For a further in-depth qualitative content analysis we excluded 63 articles in which management and/or leadership were only one of several factors studied. In the in-depth analysis of the 20 remaining studies, four main categories connected to sustainable workplaces emerged: studies including a whole system understanding; studies examining success factors for the implementation of workplace health promotion; studies using sustainability for framing the study; and studies highlighting health risks with an explicit economic focus. Aspects of sustainability were, in most articles, only included for framing the importance of the studies, and only few studies addressed aspects of sustainable workplaces from the perspective of a whole-system approach. Implications from this scoping review are that future Nordic workplace health promotion research needs to integrate health promotion and economic efficiency to a greater extent, in order to contribute to societal effectiveness and sustainability.

  15. Psychosocial factors related to returning to work in U.S. Army Soldiers.

    Science.gov (United States)

    Julian, Christopher H; Valente, Juliana M

    2015-01-01

    Work provides daily structure, physical and mental activity, interpersonal contact, social status, self-esteem, respect of others, and the ability to use acquired skills. Wounded, ill, or injured soldiers are often removed from duty and assigned or attached to a Warrior Transition Unit during medical and rehabilitation management. Separation from meaningful employment can lead to negative physical and behavioral health outcomes that may impact an active duty soldier's ability to resume work. This cross-sectional study explored the Model of Human Occupation (MOHO) psychosocial factors of Personal Causation, Values, Interests, Roles, Habits, and Perceptions of Environment related to returning to work in US Army Soldiers in a Warrior Transition Unit (WTU) at a large military medical center. Single data collection sessions were held for 34 soldiers using the following instruments: a demographic and work status questionnaire, the Role Checklist, and the Worker Role Interview (WRI). Descriptive statistics, Chi-square analysis, and the Mann Whitney U test were used to analyze the results. Analysis revealed that one WRI item related to Personal Causation and three items related to Roles and Habits were supportive factors for successfully returning to employment among soldiers that were working or engaged in returning to work. There are significant differences among psychosocial factors related to returning to work between soldiers who are currently working or have returned to work and those who have not. Longitudinal studies could help to clarify how these factors augment a soldier's rehabilitation at a WTU.

  16. Training Dismounted Soldiers in Virtual Environments: Enhancing Configuration Learning

    National Research Council Canada - National Science Library

    Witmer, Bob

    2000-01-01

    ...) has conducted research in using virtual environments (VE) to train dismounted soldiers. While showing that some dismounted soldiers skills can be trained in VE, the research has also identified problems in using VE for soldier training...

  17. Ecological footprint as an indicator of sustainability at Lisbon School of Health Technology, Portugal

    OpenAIRE

    de Francisco, Sara; Costa, Gonçalo; Manteigas, Vítor

    2014-01-01

    Higher education institutions, has an active role in the development of a sustainable future and for this reason, it is essential that they became environmentally sustainable institutions, applying methods such as the Ecological Footprint analysis. This study intent is to strengthen the potential of the ecological footprint as an indicator of the sustainability of students of Lisbon School of Health Technology, and identify the relationship between the ecological footprint and the different s...

  18. Heavy context dependence --- decisions of underground soldiers

    CERN Document Server

    Kułakowski, K; Krawczyk, M J

    2015-01-01

    An attempt is made to simulate the disclosure of underground soldiers in terms of theory of networks. The coupling mechanism between the network nodes is the possibility that a disclosed soldier is going to disclose also his acquaintances. We calculate the fraction of disclosed soldiers as dependent on the fraction of those who, once disclosed, reveal also their colleagues. The simulation is immersed in the historical context of the Polish Home Army under the communist rule in 1946-49.

  19. How Thailand's greater convergence created sustainable funding for emerging health priorities caused by globalization.

    Science.gov (United States)

    Charoenca, Naowarut; Kungskulniti, Nipapun; Mock, Jeremiah; Hamann, Stephen; Vathesatogkit, Prakit

    2015-01-01

    Global health is shifting gradually from a limited focus on individual communicable disease goals to the formulation of broader sustainable health development goals. A major impediment to this shift is that most low- and middle-income countries (LMICs) have not established adequate sustainable funding for health promotion and health infrastructure. In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. We analyzed the progression of tobacco control and health promotion policies over the past three decades within the wider political-economic and sociocultural context. We constructed a parallel longitudinal analysis of statistical data on one emerging priority - road accidents - to determine whether policy shifts resulted in reduced injuries, hospitalizations and deaths. In Thailand, the convergence of priorities among national interest groups for sustainable health development created an opportunity to use domestic tax policy and to create a semi-autonomous foundation (ThaiHealth) to address a range of pressing health priorities, including programs that substantially reduced road accidents. Thailand's strategic process to develop a domestic mechanism for sustainable funding for health may provide LMICs with a roadmap to address emerging health priorities, especially those caused by modernization and globalization.

  20. [Ecosystemic and communicative approaches in the implementation of territorial agendas for sustainable development and health promotion].

    Science.gov (United States)

    Gallo, Edmundo; Setti, Andréia Faraoni Freitas

    2012-06-01

    This paper analyzes the sustainability of ecosystemic and communicative approaches in terms of strategic planning for the implementation of territorial agendas that seek to integrate the principles of Sustainable Development and Health Promotion. It takes the Sustainable Development and Health Promotion project: Implementation of the Healthy Cities Agenda integrated with Agenda 21 in Traditional Communities of Protected Areas of the Bocaina Region" as a point of reference. It involves action-research that strives to contribute to the promotion of quality of life by means of the implementation of a participative strategic agenda and the promotion of mutual economic sustainability. The work seeks to build theoretical/practical bridges between the approaches and the methodologies and technologies used, assessing their consistency and effectiveness in relation to the principles of sustainable development and health promotion, especially in the empowerment of the local population and the broadening of the autonomy of the community.

  1. Selection of sustainability indicators for health services in challenging environments: balancing scientific approach with political engagement.

    Science.gov (United States)

    Blanchet, Karl; Girois, Susan

    2013-06-01

    Sustainability evaluation has become a key component of international health. However, evaluators have faced a number of challenges linked to the lack of consensus on the meaning of the concept of "sustainability". This paper aims to describe a methodology, the Sustainability Analysis Process, based on several conceptual frameworks and tested in five different countries in the physical rehabilitation sector. The methodology consists of five successive steps: (i) overview of the context; (ii) system boundary; (iii) consensus vision of sustainability, and derivation of stakeholder perspectives; (iv) selection of sustainability indicators and characterization and analysis of local system sustainability; and (v) verification and modification. The paper also discusses the place of the evaluator and researcher in the process: the methodology aims to help evaluators objectively measure the level of sustainability of a health system with the challenge of dealing with a subjective notion, the concept of sustainability, and a diversity of actors. The Sustainability Analysis Process also aims to capture the dynamics of systems by repeating the process on a regular basis. The methodology highlights the need for evaluators build consensus amongst stakeholders on a common vision of the future of a health system. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Study of smoking habit among soldiers in Cairo Security Forces Hospital

    Directory of Open Access Journals (Sweden)

    Adel Mahmoud Khattab

    2017-04-01

    Conclusions: Cigarette smoking is a common habit among soldiers and it starts in a relatively young age mainly due to social influence. Respiratory and gastrointestinal symptoms are the most frequent encountered complaints among soldiers. Main causes that led them to try quitting were health concerns and financial issues; as most of them spend a considerable percentage of their monthly income to obtain cigarettes. Unfortunately there was no organized positive support to help the quitters.

  3. Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts.

    Science.gov (United States)

    Ursano, Robert J; Kessler, Ronald C; Naifeh, James A; Herberman Mash, Holly; Fullerton, Carol S; Bliese, Paul D; Zaslavsky, Alan M; Ng, Tsz Hin Hinz; Aliaga, Pablo A; Wynn, Gary H; Dinh, Hieu M; McCarroll, James E; Sampson, Nancy A; Kao, Tzu-Cheg; Schoenbaum, Michael; Heeringa, Steven G; Stein, Murray B

    2017-09-01

    Mental health of soldiers is adversely affected by the death and injury of other unit members, but whether risk of suicide attempt is influenced by previous suicide attempts in a soldier's unit is unknown. To examine whether a soldier's risk of suicide attempt is influenced by previous suicide attempts in that soldier's unit. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS), this study identified person-month records for all active-duty, regular US Army, enlisted soldiers who attempted suicide from January 1, 2004, through December 31, 2009 (n = 9650), and an equal-probability sample of control person-months (n = 153 528). Data analysis was performed from August 8, 2016, to April 10, 2017. Logistic regression analyses examined the number of past-year suicide attempts in a soldier's unit as a predictor of subsequent suicide attempt, controlling for sociodemographic features, service-related characteristics, prior mental health diagnosis, and other unit variables, including suicide-, combat-, and unintentional injury-related unit deaths. The study also examined whether the influence of previous unit suicide attempts varied by military occupational specialty (MOS) and unit size. Of the final analytic sample of 9512 enlisted soldiers who attempted suicide and 151 526 control person-months, most were male (86.4%), 29 years or younger (68.4%), younger than 21 years when entering the army (62.2%), white (59.8%), high school educated (76.6%), and currently married (54.8%). In adjusted models, soldiers were more likely to attempt suicide if 1 or more suicide attempts occurred in their unit during the past year (odds ratios [ORs], 1.4-2.3; P attempts increased. The odds of suicide attempt among soldiers in a unit with 5 or more past-year attempts was more than twice that of soldiers in a unit with no previous attempts (OR, 2.3; 95% CI, 2.1-2.6). The association of previous unit suicide attempts with subsequent

  4. Communicable disease control programmes and health systems: an analytical approach to sustainability.

    Science.gov (United States)

    Shigayeva, Altynay; Coker, Richard J

    2015-04-01

    There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  5. Making mental health an integral part of sustainable development: the contribution of a social determinants framework.

    Science.gov (United States)

    De Silva, M J

    2015-04-01

    There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.

  6. Short-term and sustained effects of a health system strengthening ...

    African Journals Online (AJOL)

    There is a need to develop reproducible interventions that reinforce the implementation of these guidelines and assess their effect and sustainability. Objectives. To assess the short-term and sustained effects of a health system strengthening intervention on mortality attributable to SAM in two hospitals located in the Eastern ...

  7. Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

    Science.gov (United States)

    Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

    2017-02-01

    The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. What pre-deployment and early post-deployment factors predict health function after combat deployment?: a prospective longitudinal study of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) soldiers

    OpenAIRE

    McAndrew, Lisa M; D?Andrea, Elizabeth; Lu, Shou-En; Abbi, Bhavna; Yan, Grace W.; Engel, Charles; Quigley, Karen S.

    2013-01-01

    Background Physical and mental function are strong indicators of disability and mortality. OEF/OIF Veterans returning from deployment have been found to have poorer function than soldiers who have not deployed; however the reasons for this are unknown. Methods A prospective cohort of 790 soldiers was assessed both pre- and immediately after deployment to determine predictors of physical and mental function after war. Results On average, OEF/OIF Veterans showed significant declines in both phy...

  9. A Systematic Review of the Literature on the Sustainability of Community Health Collaboratives.

    Science.gov (United States)

    Hearld, Larry R; Bleser, William K; Alexander, Jeffrey A; Wolf, Laura J

    2016-04-01

    Recent interest in community health collaboratives has been driven by the potential of these types of organizations to solve complex health problems at the local level by bringing together stakeholders that have traditionally operated independently, and often at cross-purposes. Much of the work that is central to the mission of collaboratives can take years to reach fruition, however, and there are a number of challenges to sustaining their activities. In this article, we systematically reviewed the theoretical and empirical literature on health care collaborative sustainability, focusing on definitions and antecedents of sustainability. Given the diversity and fragmentation of this literature, we used this review as a foundation to develop a synthesized definition, conceptual groups of antecedents, and potential research propositions to help guide future research, planning, and practice of sustainable community health collaboratives. © The Author(s) 2015.

  10. High prevalence of syphilis among demobilized child soldiers in Eastern Congo: a cross-sectional study.

    Science.gov (United States)

    Senga, Raphael Kabangwa; Lutala, Prosper Mukobelwa

    2011-09-06

    Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined the prevalence of syphilis among young demobilized soldiers. Screening of syphilis using the rapid plasma reagin test and the Treponema pallidum hemagglutination assay was conducted in three transit sites of soldier reintegration in 2005. The Fisher Exact probability test was used to compare results. The prevalence of syphilis was found to be 3.4%, with almost equal distribution in respect to sex, location. Syphilis continues to be highly prevalent in demobilized child soldiers in Eastern Congo. Syphilis screening tests are recommended.

  11. High prevalence of syphilis among demobilized child soldiers in Eastern Congo: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lutala Prosper

    2011-09-01

    Full Text Available Abstract Background Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined the prevalence of syphilis among young demobilized soldiers. Methods Screening of syphilis using the rapid plasma reagin test and the Treponema pallidum hemagglutination assay was conducted in three transit sites of soldier reintegration in 2005. The Fisher Exact probability test was used to compare results. Results The prevalence of syphilis was found to be 3.4%, with almost equal distribution in respect to sex, location. Conclusion Syphilis continues to be highly prevalent in demobilized child soldiers in Eastern Congo. Syphilis screening tests are recommended.

  12. A Fourteen Year Follow-Up Study of Health Promoting Schools in Norway: Principals` Perceptions of Conditions Influencing Sustainability

    OpenAIRE

    Tjomsland, Hege Eikeland; Larsen, Torill Marie Bogsnes; Viig, Nina Grieg; Wold, Bente

    2009-01-01

    In this study, we examined the sustainability of health-promoting practices in Norwegian schools that were enrolled in the European Network of Health-Promoting Schools from 1993 to 2003. The research questions were: How do the principals perceive that health-promoting practices have been sustained in the schools following the schools' membership of the health-promoting schools network? In what way is school leadership related to the sustainability of health promotion? The study draws on quali...

  13. Mobile Healthcare Applications and Gamification for Sustained Health Maintenance

    Directory of Open Access Journals (Sweden)

    Changjun Lee

    2017-05-01

    Full Text Available This paper examines how gamification affects user intention to use mobile healthcare applications (mHealth and how the effect of gamification works differently according to health status, age, and gender. We use data from a mobile survey conducted by a Korean representative survey agency. We estimate the effect of gamification on user intention to use mobile healthcare applications based on a structural equation model and examine the moderating effects of self-reported health status, age, and gender. We find that gamification is effective in increasing user intention to use mHealth, especially in the healthy and younger groups. These findings suggest that mHealth, with the gamification factor, would encourage healthy (but lack exercise people as well as unhealthy people to maintain their health status, and thus the mHealth developers need to consider the gamification factor when they develop mHealth services for healthy people.

  14. Sustainable health information exchanges: the role of institutional factors

    National Research Council Canada - National Science Library

    Frankel, Meir; Chinitz, David; Salzberg, Claudia A; Reichman, Katriel

    2013-01-01

    ... United States.In Israel, the vertically integrated Clalit health services developed a different solution for HIE than was developed in the non-vertically integrated Maccabi and Meuhedet health funds...

  15. Soldier motivation – different or similar?

    DEFF Research Database (Denmark)

    Brænder, Morten; Andersen, Lotte Bøgh

    Recent research in military sociology has shown that in addition to their strong peer motivation modern soldiers are oriented toward contributing to society. It has not, however, been tested how soldier motivation differs from the motivation of other citizens in this respect. In this paper......, by means of public service motivation, a concept developed within the public administration literature, we compare soldier and civilian motivation. The contribution of this paper is an analysis of whether and how Danish combat soldiers differs from other Danes in regard to public service motivation? Using...... to the representativity of the military. If soldiers are less empathetic than other citizens, it might amplify differences between armed forces and society, making the individual’s transition from the one to the other even more difficult....

  16. Consumer response to health and environmental sustainability information regarding seafood consumption.

    Science.gov (United States)

    Jacobs, Silke; Sioen, Isabelle; Marques, António; Verbeke, Wim

    2018-02-01

    Seafood consumption has an impact on both consumers' health and on the marine environment, making the integration of health and sustainability aspects in information and recommendation messages for consumers highly topical. This study presents the results of a consumer study in terms of the impact of exposure to a message about health and sustainability aspects of seafood on 986 participants from Belgium and Portugal. Possible drivers for behavioural change regarding seafood consumption frequency and sustainable seafood buying frequency are studied following exposure to the message. Initial behaviour emerges as the most important factor triggering a change in the intention to consume seafood twice per week and a change in the intention to buy sustainable seafood. A higher health benefit perception resulted in an increased intention to consume seafood twice per week. Attitude towards the message and the option to optimise consumers' choice of seafood species favouring sustainability were significant determinants of change in the intention to buy sustainable seafood. Different stakeholders may take the results of this communication strategy into account and, consequently, contribute to a seafood supply and related communication that supports public health and the marine environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Whatever happened to the soldiers?

    DEFF Research Database (Denmark)

    Poulsen, Dorthe Varning; Stigsdotter, Ulrika K.; Refshauge, Anne Dahl

    2015-01-01

    and status of practice and research concerning NAT for veterans with post-traumatic stress disorder (PTSD). The systematic review included a seven-step literature search. Relevant data sources were scrutinized in order to retrieve literature meeting the predefined inclusion criteria. Due to the limited......Nature-assisted therapy (NAT) has become more common and recognized in both practice and research. The literature often describes how NAT gradually emerged in the UK and the US offering rehabilitation of soldiers suffering from traumatic experiences after active service in WW I and WW II. The main...

  18. Leveraging design thinking to build sustainable mobile health systems.

    Science.gov (United States)

    Eckman, Molly; Gorski, Irena; Mehta, Khanjan

    Mobile health, or mHealth, technology has the potential to improve health care access in the developing world. However, the majority of mHealth projects do not expand beyond the pilot stage. A core reason why is because they do not account for the individual needs and wants of those involved. A collaborative approach is needed to integrate the perspectives of all stakeholders into the design and operation of mHealth endeavours. Design thinking is a methodology used to develop and evaluate novel concepts for systems. With roots in participatory processes and self-determined pathways, design thinking provides a compelling framework to understand and apply the needs of diverse stakeholders to mHealth project development through a highly iterative process. The methodology presented in this article provides a structured approach to apply design thinking principles to assess the feasibility of novel mHealth endeavours during early conceptualisation.

  19. Sustainability of health information systems: a three-country qualitative study in southern Africa.

    Science.gov (United States)

    Moucheraud, Corrina; Schwitters, Amee; Boudreaux, Chantelle; Giles, Denise; Kilmarx, Peter H; Ntolo, Ntolo; Bangani, Zwashe; St Louis, Michael E; Bossert, Thomas J

    2017-01-10

    Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern. This analysis explores the potential sustainability of EHIS investments in Malawi, Zambia and Zimbabwe, originally supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR). Using a framework based on sustainability theories from the health systems literature, this analysis employs a qualitative case study methodology to highlight factors that may increase the likelihood that donor-supported initiatives will continue after the original support is modified or ends. Findings highlight commonalities around possible determinants of sustainability. The study found that there is great optimism about the potential for EHIS, but the perceived risks may result in hesitancy to transition completely and parallel use of paper-based systems. Full stakeholder engagement is likely to be crucial for sustainability, as well as integration with other activities within the health system and those funded by development partners. The literature suggests that a sustainable system has clearly-defined goals around which stakeholders can rally, but this has not been achieved in the systems studied. The study also found that technical resource constraints - affecting system usage, maintenance, upgrades and repairs - may limit EHIS sustainability even if these other pillars were addressed. The sustainability of EHIS faces many challenges, which could be addressed through systems' technical design, stakeholder

  20. A study of project management knowledge and sustainable outcomes in Thailand’s reproductive health projects

    OpenAIRE

    Dumrak, Jantanee; Barroudi, Bassam; Pullen, Stephen

    2015-01-01

    In Thailand, numerous reproductive health projects funded by both national and international agencies have been established in an attempt to mitigate reproductive health problems. Solving problems on reproductive health projects that only have temporary funding requires effective project management that hopefully leads to better long-term desired outcomes. This paper identifies the association between collaborative reproductive health (CRH) project management and sustainable outcomes. The Gui...

  1. How do small rural primary health care services sustain themselves in a constantly changing health system environment?

    Science.gov (United States)

    Buykx, Penny; Humphreys, John S; Tham, Rachel; Kinsman, Leigh; Wakerman, John; Asaid, Adel; Tuohey, Kathy

    2012-03-26

    The ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS) located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups) and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure. Four years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified. This evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.

  2. Continuing Medical Education via Telemedicine and Sustainable Improvements to Health.

    Science.gov (United States)

    Wang, Fuhmei

    2016-01-01

    Background. This research aims to investigate the quantitative relationship between telemedicine and online continuing medical education (CME) and to find the optimal CME lectures to be delivered via telemedicine to improve the population's health status. Objective. This study examines the following: (1) What factors foster learning processes in CME via telemedicine? (2) What is the possible role of online CME in health improvement? And (3) How optimal learning processes can be integrated with various health services? Methods. By applying telemedicine experiences in Taiwan over the period 1995-2004, this study uses panel data and the method of ordinary least squares to embed an adequate set of phenomena affecting the provision of online CME lectures versus health status. Results. Analytical results find that a nonlinear online CME-health nexus exists. Increases in the provision of online CME lectures are associated with health improvements. However, after the optimum has been reached, greater provision of online CME lectures may be associated with decreasing population health. Conclusion. Health attainment could be partially viewed as being determined by the achievement of the appropriately providing online CME lectures. This study has evaluated the population's health outcomes and responded to the currently inadequate provision of online CME lectures via telemedicine.

  3. Machismo sustains health and illness beliefs of Mexican American men.

    Science.gov (United States)

    Sobralske, Mary

    2006-08-01

    To inform nurse practitioners (NPs) about Mexican American men's health and illness beliefs and the ways in which these are influenced by their masculine identity and how they view themselves as men in their culture. The data sources used were based on a selected review of the literature about Mexican American men's health and illness beliefs and the concept of machismo. Several studies, including the author's study on Mexican American men's healthcare-seeking beliefs and behaviors and experience in providing primary health care to men across cultures, contributed new data. The meaning of manhood in the Mexican American culture is critical in understanding how men perceive health and illness and what they do when they are ill. Machismo enhances men's awareness of their health because they have to be healthy to be good fathers, husbands, brothers, sons, workers, and community members. Pain and disability are motivating factors in finding ways to regain their health. Men's health beliefs across cultures need further investigation by nurse researchers and NPs. How culture influences healthcare delivery to men should be better understood. If NPs are aware of men's views on masculinity, they are better prepared to understand and assist men in becoming more aware of their health status and to seek health care when appropriate.

  4. Sustaining librarian vitality: embedded librarianship model for health sciences libraries.

    Science.gov (United States)

    Wu, Lin; Mi, Misa

    2013-01-01

    With biomedical information widely accessible from anywhere at any time, health sciences libraries have become less centralized, and they are challenged to stay relevant and vital to the mission and strategic goals of their home institution. One solution is to embed librarians at strategic points in health professions' education, research, and patient care. This article discusses a proposed five-level model of embedded librarianship within the context of health sciences libraries and describes different roles, knowledge, and skills desirable for health sciences librarians working as embedded librarians.

  5. Exploring Community Health through the Sustainable Livelihoods Framework

    Science.gov (United States)

    Barnidge, Ellen K.; Baker, Elizabeth A.; Motton, Freda; Fitzgerald, Teresa; Rose, Frank

    2011-01-01

    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The…

  6. Sustainable implementation of e-health enabled interdisciplinary collaboration

    NARCIS (Netherlands)

    Keijser, Wouter Alexander; Smits, Jacco Gerardus Wilhelmus Leonardus; Penterman, Lisanne; Wilderom, Celeste P.M.

    2016-01-01

    Introduction: Integrated care can prosper from e-health solutions that hold a vast potential for increasing effective information sharing and communication: collaboration. This is in particular the case in the care for elder persons: a growing population often in need of a variety of care, health

  7. Using Drama to Promote Sustainable Health among Rural Folk in ...

    African Journals Online (AJOL)

    The conclusion reached is that access to good health is one of the most serious challenges faced by women in third world countries. Hence, the article suggests, among other things, to improve maternal health, policymakers and planners should utilize alternative approaches which create avenues for public communication ...

  8. The role of work ability and health on sustaining employability

    NARCIS (Netherlands)

    T.I.J. van den Berg (Tilja)

    2010-01-01

    textabstractThis thesis aimed to contribute to the understanding of the role of decreased work ability and ill health on work participation and work performance of older workers. The longitudinal study on the role of four different health measures on exit from paid employment among workers aged 50

  9. Soldiers' personal technologies on deployment and at home.

    Science.gov (United States)

    Bush, Nigel E; Fullerton, Nicole; Crumpton, Rosa; Metzger-Abamukong, Melinda; Fantelli, Emily

    2012-05-01

    Personal technologies such as smartphones, computers, and gaming devices, are ubiquitous in the civilian world. Consequently they represent ideal vehicles for disseminating psychological and other health resources and interventions. However, almost nothing is known about personal technology use in the U.S. military. We conducted the most comprehensive survey to date of the use, availability, and need for personal technologies by U.S. military service members. Our survey asked detailed questions about computers and the Internet, phones and smartphones, other mobile or portable technologies, gaming devices, and TV and video media used during deployment and at permanent duty station or home. We collected data by paper-and-pencil survey in 2010 and 2011 from 331 active Army service members at a processing and registration center in a large military installation in the western United States. Two cohorts were surveyed: Soldiers who had previously been deployed to a warzone and soldiers who had never been deployed. We measured high rates of personal technology use by service members at home across all popular electronic media. Soldiers at home essentially resembled civilian consumers in their use of popular technologies. Some technologies, including the Internet, gaming, and TV, were widespread on deployment. Others, most notably cellphones, were more restricted by availability, connectivity, opportunity, and military regulation in the warzone. Results will enable researchers and technology developers target their efforts on the most promising and popular technologies for psychological health in the military.

  10. Photonovels: an innovative approach to address health disparities and sustainability.

    Science.gov (United States)

    McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A

    2014-09-01

    Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.

  11. A theory of how rural health services contribute to community sustainability.

    Science.gov (United States)

    Farmer, Jane; Prior, Maria; Taylor, Judy

    2012-11-01

    Study and opinion suggest that health services play a significant role in supporting the social fabric of fragile rural communities. We draw on empirical evidence about the added-value contributions of health services to communities and unite it with theory of capitals to propose a theoretical model depicting how rural health services contribute to community sustainability. While providing an analytical framework, the paper also points to construction of a measurement tool for enabling planners to measure the contributions of diverse sectors to community sustainability and predict or measure the impact of changes to models of service delivery on the future of rural communities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Measuring the health-related Sustainable Development Goals in 188 countries

    DEFF Research Database (Denmark)

    Truelsen, Thomas Clement; Christensen, Hanne Krarup

    2016-01-01

    BACKGROUND: In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases......, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve...

  13. Enacting sustainable school-based health initiatives: a communication-centered approach to policy and practice.

    Science.gov (United States)

    LeGreco, Marianne; Canary, Heather E

    2011-03-01

    Communication plays an important role in all aspects of the development and use of policy. We present a communication-centered perspective on the processes of enacting public health policies. Our proposed conceptual framework comprises 4 communication frames: orientation, amplification, implementation, and integration. Empirical examples from 2 longitudinal studies of school-based health policies show how each frame includes different communication processes that enable sustainable public health policy practices in school-based health initiatives. These 4 frames provide unique insight into the capacity of school-based public health policy to engage youths, parents, and a broader community of stakeholders. Communication is often included as an element of health policy; however, our framework demonstrates the importance of communication as a pivotal resource in sustaining changes in public health practices.

  14. Civil society: the catalyst for ensuring health in the age of sustainable development.

    Science.gov (United States)

    Smith, Julia; Buse, Kent; Gordon, Case

    2016-07-16

    Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

  15. International institutions, global health initiatives and the challenge of sustainability: lessons from the Brazilian AIDS programme.

    Science.gov (United States)

    Le Loup, G; Fleury, S; Camargo, K; Larouzé, B

    2010-01-01

    The sustainability of successful public health programmes remains a challenge in low and middle income settings. These programmes are often subjected to mobilization-demobilization cycle. Indeed, political and organizational factors are of major importance to ensure this sustainability. The cooperation between the World Bank and the Brazilian AIDS programme highlights the role of international institutions and global health initiatives (GHI), not only to scale up programmes but also to guarantee their stability and sustainability, at a time when advocacy is diminishing and vertical programmes are integrated within health systems. This role is critical at the local level, particularly when economic crisis may hamper the future of public health programmes. Political and organizational evolution should be monitored and warnings should trigger interventions of GHI before the decline of these programmes.

  16. United Nations Sustainable Development Goals: Promoting Health and Well-Being through Physical Education Partnerships

    Science.gov (United States)

    Lynch, Timothy

    2016-01-01

    This paper shares a health and wellbeing partnership, modelling implementation of physical education (PE) advocated by the United Nations (UN). The Sustainable Development Goals (SDGs) exemplifies global efforts towards equality, specifically Goal 3 and 4 address health and wellbeing. The purpose of this paper is to provide insights into cross…

  17. How can health remain central post-2015 in a sustainable development paradigm?

    Science.gov (United States)

    2014-01-01

    In two years, the uncompleted tasks of the Millennium Development Goals will be merged with the agenda articulated in the 2012 United Nations Conference on Sustainable Development. This process will seek to integrate economic development (including the elimination of extreme poverty), social inclusion, environmental sustainability, and good governance into a combined sustainable development agenda. The first phase of consultation for the post-2015 Sustainable Development Goals reached completion in the May 2013 report to the Secretary-General of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda. Health did well out of the Millennium Development Goal (MDG) process, but the global context and framing of the new agenda is substantially different, and health advocates cannot automatically assume the same prominence. This paper argues that to remain central to continuing negotiations and the future implementation, four strategic shifts are urgently required. Advocates need to reframe health from the poverty reduction focus of the MDGs to embrace the social sustainability paradigm that underpins the new goals. Second, health advocates need to speak—and listen—to the whole sustainable development agenda, and assert health in every theme and every relevant policy, something that is not yet happening in current thematic debates. Third, we need to construct goals that will be truly “universal”, that will engage every nation—a significant re-orientation from the focus on low-income countries of the MDGs. And finally, health advocates need to overtly explore what global governance structures will be needed to finance and implement these universal Sustainable Development Goals. PMID:24708779

  18. Occupational safety and health, green chemistry, and sustainability: a review of areas of convergence.

    Science.gov (United States)

    Schulte, Paul A; McKernan, Lauralynn T; Heidel, Donna S; Okun, Andrea H; Dotson, Gary Scott; Lentz, Thomas J; Geraci, Charles L; Heckel, Pamela E; Branche, Christine M

    2013-04-15

    With increasing numbers and quantities of chemicals in commerce and use, scientific attention continues to focus on the environmental and public health consequences of chemical production processes and exposures. Concerns about environmental stewardship have been gaining broader traction through emphases on sustainability and "green chemistry" principles. Occupational safety and health has not been fully promoted as a component of environmental sustainability. However, there is a natural convergence of green chemistry/sustainability and occupational safety and health efforts. Addressing both together can have a synergistic effect. Failure to promote this convergence could lead to increasing worker hazards and lack of support for sustainability efforts. The National Institute for Occupational Safety and Health has made a concerted effort involving multiple stakeholders to anticipate and identify potential hazards associated with sustainable practices and green jobs for workers. Examples of potential hazards are presented in case studies with suggested solutions such as implementing the hierarchy of controls and prevention through design principles in green chemistry and green building practices. Practical considerations and strategies for green chemistry, and environmental stewardship could benefit from the incorporation of occupational safety and health concepts which in turn protect affected workers.

  19. Sustainable watersheds: integrating ecosystem services and public health

    National Research Council Canada - National Science Library

    Jordan, Stephen J; Benson, William H

    2015-01-01

    ...) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health...

  20. Sustainable Watersheds: Integrating Ecosystem Services and Public Health

    National Research Council Canada - National Science Library

    Stephen J Jordan; William H Benson

    2015-01-01

    ...) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health...

  1. Health Care Infrastructure for Financially Sustainable Clinical Genomics.

    Science.gov (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

    2016-09-01

    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.

  2. Contributions of national and global health estimates to monitoring health-related sustainable development goals.

    Science.gov (United States)

    Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

    2016-01-01

    The millennium development goals triggered an increased demand for data on child and maternal mortalities for monitoring progress. With the advent of the sustainable development goals and growing evidence of an epidemiological transition toward non-communicable diseases, policymakers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper discusses lessons learned from Thailand's burden of disease (BOD) study on capacity development on NHEs and discusses the contributions and limitations of GHEs in informing policies at the country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and subnational levels. Initially, the quality of cause-of-death reporting in death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This method helped to improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the Global Burden of Disease 2010 study estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and an effective interface between researchers and decision-makers contribute to enhanced country policy responses, whereas subnational data are intended to be used by various subnational partners. Although GHEs contribute to benchmarking country achievement compared with global health

  3. Building sustainable health and education partnerships: stories from local communities.

    Science.gov (United States)

    Blank, Martin J

    2015-11-01

    Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. © 2015 Institute for Educational Leadership. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

  4. Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations?

    Science.gov (United States)

    Macpherson, Cheryl C; Hill, Jonathan

    2017-12-01

    Climate change threatens health, health care, and the industries and resources upon which these depend. The growing prevalence and severity of its health consequences and economic costs are alarming health professionals and organizations as their professional obligations, grounded in the core value of health, include protecting against these harms. One means of fulfilling these obligations is to lead or support sustainability initiatives that are built upon current, reliable, accurate, and unbiased evidence and collaboratively tailored to meet specific needs and respond to specific contexts. We consider why and how health professionals and organizations should lead or support such initiatives. © 2017 American Medical Association. All Rights Reserved.

  5. India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

    Science.gov (United States)

    Narayana, Muttur Ranganathan

    2016-12-01

    India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public

  6. European Health Examination Survey--towards a sustainable monitoring system.

    Science.gov (United States)

    Tolonen, Hanna; Koponen, Päivikki; Mindell, Jennifer; Männistö, Satu; Kuulasmaa, Kari

    2014-04-01

    Health examination surveys (HESs), including both questionnaire and physical measurements, and in most cases also collection of biological samples, can provide objective health indicators. This information complements data from health interview surveys and administrative registers, and is important for evidence-based planning of health policies and prevention activities. HESs are valuable data sources for research. The first national HESs in Europe were conducted in the late 1950s and early 1960s. They have recently been carried out in an increasing number of countries, but there has been no joint standardization between the countries. The European Health Examination Survey Pilot Project was conducted in 2009-2012. The European Health Examination Survey Pilot Reference Centre was established and pilot surveys were conducted in 12 countries.  European standardized protocols for key measurements on main chronic disease risk factors (height, weight, waist circumference, blood pressure, blood lipids and fasting glucose or HbA1c) were prepared. European-level training and external quality assessment were organized. Although the level of earlier experience, infrastructures, economic status and cultural settings varied between the pilot countries, it was possible to standardize measurements of HESs across the populations. Obtaining high participation rates was challenging.  HESs provide high-quality and representative population data to support policy decisions and research. For future national HESs, centralized coordination, training and external quality assessment are needed to ensure comparability of the results. Further studies on effects of different survey methods on comparability of the results and on recruitment and motivation of survey participants are needed.

  7. Sustainable practice change: Professionals' experiences with a multisectoral child health promotion programme in Sweden

    Directory of Open Access Journals (Sweden)

    Mogren Ingrid

    2011-03-01

    Full Text Available Abstract Background New methods for prevention and health promotion and are constantly evolving; however, positive outcomes will only emerge if these methods are fully adopted and sustainable in practice. To date, limited attention has been given to sustainability of health promotion efforts. This study aimed to explore facilitators, barriers, and requirements for sustainability as experienced by professionals two years after finalizing the development and implementation of a multisectoral child health promotion programme in Sweden (the Salut programme. Initiated in 2005, the programme uses a 'Salutogenesis' approach to support health-promoting activities in health care, social services, and schools. Methods All professionals involved in the Salut Programme's pilot areas were interviewed between May and September 2009, approximately two years after the intervention package was established and implemented. Participants (n = 23 were midwives, child health nurses, dental hygienists/dental nurses, and pre-school teachers. Transcribed data underwent qualitative content analysis to illuminate perceived facilitators, barriers, and requirements for programme sustainability. Results The programme was described as sustainable at most sites, except in child health care. The perception of facilitators, barriers, and requirements were largely shared across sectors. Facilitators included being actively involved in intervention development and small-scale testing, personal values corresponding to programme intentions, regular meetings, working close with collaborators, using manuals and a clear programme branding. Existing or potential barriers included insufficient managerial involvement and support and perceived constraints regarding time and resources. In dental health care, barriers also included conflicting incentives for performance. Many facilitators and barriers identified by participants also reflected their perceptions of more general and forthcoming

  8. Testing time for sustainability and health: striving for inclusive rationality in project appraisal.

    Science.gov (United States)

    Barton, Hugh; Grant, Marcus

    2008-05-01

    There is a widespread recognition that cities, towns and villages have become increasingly dependent on motorized transport and a car-based land-use pattern. This has led to a series of unintended consequences--in particular, a lack of regular exercise, the decline of local communities and excessive greenhouse gas emissions--ith huge long-term impacts on health and wellbeing. Official policies are trying to change the trend, with much rhetoric about 'sustainable development' and 'sustainable communities'. Yet many of the decision processes that control change in the built environment have not caught up with the new agenda. This paper is concerned with the way in which new development proposals are tested for their health and sustainability credentials. It reviews the theory and practice in this field, with a particular focus on environmental impact analysis and health impact assessment. It identifies the relative strengths and weaknesses of these tools, examining the degree to which they are systematic in their approach to health and sustainability, and include all those who have a legitimate interest in the outcomes. Then a new technique--Spectrum appraisal--is presented. Spectrum is a logical and very practical process that facilitates consensus-building and creativity in decision-making. Practical applications show how the technique can be used to help ensure a healthier, more sustainable urban environment.

  9. Sustainability of green jobs in Portugal: a methodological approach using occupational health indicators.

    Science.gov (United States)

    Moreira, Sandra; Vasconcelos, Lia; Silva Santos, Carlos

    2017-09-28

    This study aimed to develop a methodological tool to analyze and monitor the green jobs in the context of Occupational Health and Safety. A literature review in combination with an investigation of Occupational Health Indicators was performed. The resulting tool of Occupational Health Indicators was based on the existing information of "Single Report" and was validated by national's experts. The tool brings together 40 Occupational Health Indicators in four key fields established by World Health Organization in their conceptual framework "Health indicators of sustainable jobs." The tool proposed allows for assessing if the green jobs enabled to follow the principles and requirements of Occupational Health Indicators and if these jobs are as good for the environment as for the workers' health, so if they can be considered quality jobs. This shows that Occupational Health Indicators are indispensable for the assessment of the sustainability of green jobs and should be taken into account in the definition and evaluation of policies and strategies of the sustainable development.

  10. Protecting the planet and its people: how do interventions to promote environmental sustainability and occupational safety and health overlap?

    Science.gov (United States)

    Cunningham, Thomas R; Galloway-Williams, Neville; Geller, E Scott

    2010-10-01

    The challenges of both occupational safety and health and environmental sustainability require large-scale behavior change for meaningful improvements to occur. Environmental sustainability, or the 'green movement' has received far more attention recently, and certain strategies and recommendations from interventions designed for promoting pro-environmental behaviors may inform efforts to intervene on critical behaviors for improving occupational safety and health. A survey of the literature regarding behavioral interventions for both environmental sustainability and occupational safety and health was conducted. Several theoretical approaches are reviewed, and successful approaches from each domain are identified, as well as parallel challenges and points for crossover. Recommendations are provided for adapting environmental sustainability intervention approaches for occupational safety and health applications. Safety and health leaders may achieve sustainable improvements in worker safety and health by harnessing the momentum of the green movement and adapting successful intervention approaches from the environmental sustainability domain. Published by Elsevier Ltd.

  11. SUSTAINABLE DEVELOPMENT IN PUBLIC HEALTH IN THE SOUTH MUNTENIA REGION AND SOUTH WEST OLTENIA REGION

    Directory of Open Access Journals (Sweden)

    Georgiana Melania COSTAICHE

    2014-04-01

    Full Text Available The purpose of this paper is to highlight sustainable development in terms of health in two development regions of Romania, the South Muntenia region and South West Oltenia region. “Sustainable development is development which aims to meet the needs of the present without compromising the ability of future generations to meet their own needs”. Sustainable development objectives can not be achieved in conditions of ill health, and health is maintained in a functional and a healthy environment. To highlight the evolution of public health in the two regions for regional development and related counties, we used indicators of sustainable development in Romania, based on data provided by the Romanian Statistical Yearbooks for 2011, 2012 and 2013. Indicators used to assess health development in the two regions are: The mortality rate, the infant mortality rate, natural growth rate, hospital beds (per 1,000 inhabitants, population/doctor (per 1000 inhabitants. Research methods applied are clues fixed base and chain base. Factors that increase the mortality rate are represented by a larger proportion of the elderly population, origin, given that rural health services are weak comparing to urban areas.

  12. Design for sustainable development : environmental management and safety and health

    NARCIS (Netherlands)

    Zwetsloot, G.; Bos, J.

    1998-01-01

    This is a report on the EU's environmental management and audit scheme and its interaction with the management of safety and health. The focus is on the interactions at company and at policy level. To illustrate the relevance of the interactions at company level, the Annex includes five case studies

  13. 262 Using Drama to Promote Sustainable Health among Rural Folk ...

    African Journals Online (AJOL)

    need for facility based delivery as against home based delivery. Using Ikyaan and Amua communities in ... this misconception was corrected. The conclusion reached is that access to good health is one of the most ..... given, begins to see that reality is not a closed world from which there can be no exit; and perceives his ...

  14. Sustainable Health Development Goals (SHDG): breaking down the ...

    African Journals Online (AJOL)

    The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year.

  15. Sustainable Livestock Production, Health, and Environment in the ...

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

    However, animal disease, including the high prevalence of sarcocystosis in llamas, is limiting the program's potential. Local farmers are abandoning the traditional mixed llama-sheep production. Evaluating risks and options The project will address important knowledge gaps associated with local livestock health and public ...

  16. Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi's Health System Strengthening Grants.

    Science.gov (United States)

    Mimche, Honoré; Squires, Ellen; Miangotar, Yodé; Mokdad, Ali; El Bcheraoui, Charbel

    2017-12-22

    Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi's HSS grants, we investigated the factors, events, and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes, and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. We conducted two retrospective independent evaluations of Gavi's HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent, and hindered the sustainability of the implemented activities and gains achieved. Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation towards procurements and service provision, and leaving both countries without solid exit plans to maintain the results gained. To increase the efficiency and sustainability of Gavi's HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  17. Paediatrics and the doctor-soldier.

    Science.gov (United States)

    Pearn, John H

    2012-08-01

    Sick and injured children, like combatants wounded by shot and shell in war, are disproportionately represented in the tallies of both man-made and national disasters. Paediatricians have a particularly proud heritage of military service, a nexus dating in Australia from the early 19th century. This paper traces this link between service to children in peacetime and the care of servicemen, women and children in times of war and disaster. The extraordinary record of Australian 'paediatric' doctors who also served in the Gallipoli Campaign (1915) is documented as an illustration of this duality. Paediatricians who serve in the Defence Reserves and in civilian non-government organisations which respond to disasters and civil wars have special credentials in their advocacy for the protection of children enmeshed in conflict or disaster. Such applies particularly to the banning of the recruitment and use of child soldiers; support for children caught up in refugee and illegal immigrant confrontations; and continued advocacy for greater international compliance with the Ottawa Convention to ban the use of anti-personnel landmines. Volunteering for such service must occur in cold 'down time', ensuring that paediatricians are trained in disaster and conflict response, when such challenges inevitably confront the paediatricians of the future. © 2012 The Author. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Immersive Simulation Training for the Dismounted Soldier

    National Research Council Canada - National Science Library

    Knerr, Bruce W

    2007-01-01

    A study was conducted to document the need for immersive dismounted virtual Soldier and leader training and the available research evidence regarding the effectiveness of virtual training for training...

  19. Can Suicide Tries Spread Among Soldiers?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_167432.html Can Suicide Tries Spread Among Soldiers? Increased risk seen within ... if another member of their unit has attempted suicide in the previous year. In fact, the researchers ...

  20. Child Soldiers: Tropes of Innocence and Terror

    Directory of Open Access Journals (Sweden)

    David Rosen

    2013-10-01

    Full Text Available The story of child soldiers in the Western imagination is a story of symbolic reversals. Where the image of the child soldier once denoted public virtue and the nobility of sacrifice, it now stands for virtually everything that is wrong with war. Children were frequently present in the military through much of the 19th century (Aries 1962, p. 193. But by the middle of the 19th century, most Western nations had begun to reduce or eliminate the presence of children in their armed forces. The change was slow and erratic, however, so that even during World War I the heroic and patriotic child soldier, typically a boy sailor or soldier, remained a central image in the ideology of war and conflict (Conley 2009.

  1. Does sustained participation in an online health community affect sentiment?

    Science.gov (United States)

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie

    2014-01-01

    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members' behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members.

  2. Innovation sustainability in challenging health-care contexts: embedding clinically led change in routine practice.

    Science.gov (United States)

    Martin, Graham P; Weaver, Simon; Currie, Graeme; Finn, Rachael; McDonald, Ruth

    2012-11-01

    The need for organizational innovation as a means of improving health-care quality and containing costs is widely recognized, but while a growing body of research has improved knowledge of implementation, very little has considered the challenges involved in sustaining change - especially organizational change led 'bottom-up' by frontline clinicians. This study addresses this lacuna, taking a longitudinal, qualitative case-study approach to understanding the paths to sustainability of four organizational innovations. It highlights the importance of the interaction between organizational context, nature of the innovation and strategies deployed in achieving sustainability. It discusses how positional influence of service leads, complexity of innovation, networks of support, embedding in existing systems, and proactive responses to changing circumstances can interact to sustain change. In the absence of cast-iron evidence of effectiveness, wider notions of value may be successfully invoked to sustain innovation. Sustainability requires continuing effort through time, rather than representing a final state to be achieved. Our study offers new insights into the process of sustainability of organizational change, and elucidates the complement of strategies needed to make bottom-up change last in challenging contexts replete with competing priorities.

  3. Soldier Readiness: Insights from Qualitative Interviews

    Science.gov (United States)

    2018-01-10

    situations that require creative thinking and strong problem solving skills. In addition to their intellectual capacity, they must also be able to meet...Described by Soldiers related to this theme: • smart, technically proficient, intelligent • creative thinker, resourceful, problem solver, adaptable...taught in a traditional classroom setting (e.g. with PowerPoint slides). – The primary means by which Soldiers gain social and emotional skills is by

  4. Headgear system development for the dismounted soldier

    Science.gov (United States)

    Ferrin, Frank J.

    1996-06-01

    Headgear systems for the dismounted soldier are being developed that will provide an extensive set of new capabilites on the battlefield. These systems provide dramatically enhanced audio and visual information flow to and from the soldier. Integrated/modular headgear components include a miniature helmet mounted high resolution display, an advanced intensified night sensor, a head orientation sensor, advanced signal processing electronics, a helmet mounted radio antenna, in addition to new ballistic protection and helmet suspension and communication components.

  5. Enhancing learning, innovation, adaptation, and sustainability in health care organizations: the ELIAS performance management framework.

    Science.gov (United States)

    Persaud, D David

    2014-01-01

    The development of sustainable health care organizations that provide high-quality accessible care is a topic of intense interest. This article provides a practical performance management framework that can be utilized to develop sustainable health care organizations. It is a cyclical 5-step process that is premised on accountability, performance management, and learning practices that are the foundation for a continuous process of measurement, disconfirmation, contextualization, implementation, and routinization This results in the enhancement of learning, innovation, adaptation, and sustainability (ELIAS). Important considerations such as recognizing that health care organizations are complex adaptive systems and the presence of a dynamic learning culture are necessary contextual factors that maximize the effectiveness of the proposed framework. Importantly, the ELIAS framework utilizes data that are already being collected by health care organizations for accountability, improvement, evaluation, and strategic purposes. Therefore, the benefit of the framework, when used as outlined, would be to enhance the chances of health care organizations achieving the goals of ongoing adaptation and sustainability, by design, rather than by chance.

  6. The Comprehensive Soldier Fitness Program Evaluation. Report 3: Longitudinal Analysis of the Impact of Master Resilience Training on Self-Reported Resilience and Psychological Health Data

    Science.gov (United States)

    2011-12-01

    psychoeducational program . Journal of Traumatic Stress, 20, 505-515. Greenberg, N., Langston, V., Fear, N. T., Jones, M., & Wessely, S. (2009). An... psychoeducational program designed to increase resilience led to improved mental health among British Royal Navy personnel. Cohn and Pakenham (2008...Finally, Gould, Greenberg, and Hetherton (2007) found that a psychoeducational program geared toward understanding symptoms of stress reactions

  7. Sustainable diets: The interaction between food industry, nutrition, health and the environment.

    Science.gov (United States)

    Alsaffar, Ayten Aylin

    2016-03-01

    Everyday great amounts of food are produced, processed, transported by the food industry and consumed by us and these activities have direct impact on our health and the environment. The current food system has started causing strain on the Earth's natural resources and that is why sustainable food production systems are needed. This review article discusses the need for sustainable diets by exploring the interactions between the food industry, nutrition, health and the environment, which are strongly interconnected. The most common environmental issues in the food industry are related to food processing loss, food wastage and packaging; energy efficiency; transportation of foods; water consumption and waste management. Among the foods produced and processed, meat and meat products have the greatest environmental impact followed by the dairy products. Our eating patterns impact the environment, but the environment can impact dietary choices as well. The foods and drinks we consume may also affect our health. A healthy and sustainable diet would minimise the consumption of energy-dense and highly processed and packaged foods, include less animal-derived foods and more plant-based foods and encourage people not to exceed the recommended daily energy intake. Sustainable diets contribute to food and nutrition security, have low environmental impacts and promote healthy life for present and future generations. There is an urgent need to develop and promote strategies for sustainable diets; and governments, United Nations agencies, civil society, research organisations and the food industry should work together in achieving this. © The Author(s) 2016.

  8. Children of former child soldiers and never-conscripted civilians: a preliminary intergenerational study in Burundi

    NARCIS (Netherlands)

    Song, S.; de Jong, J.; O'Hara, R.; Koopman, C.

    2013-01-01

    Studies around the world show that former child soldiers (FCSs) have mental health strengths and limitations, and highlight the important role of families and communities in reintegration to society. However, there are limited data that examine the mental health risks and protective factors of the

  9. Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.

    Science.gov (United States)

    Desmond, Sharon

    2017-03-02

    The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

  10. Correlates of the sustainability of community-based heart health promotion interventions.

    Science.gov (United States)

    O'Loughlin, J; Renaud, L; Richard, L; Gomez, L S; Paradis, G

    1998-01-01

    This study investigated factors related to the perceived sustainability of 189 heart health promotion interventions initiated by a public health department or research initiative and implemented in a variety of organizations across Canada. Data were collected in a telephone survey of key informants from schools, restaurants, grocery stores, health care facilities, and sports facilities that had implemented a heart health promotion intervention (risk factor screening, courses for smoking cessation, healthy eating or physical activity, support groups to promote healthy lifestyles, environmental modification, dissemination of information) in the past 8 years. Overall, 43.6% of 189 interventions were perceived to be very permanent, 34.8% were somewhat permanent, and 21.5% were not permanent. Independent correlates of perceived sustainability included intervention used no paid staff (odds ratio (OR) 95% confidence interval (95% Cl) = 3.7 (1.8, 7.5)), intervention was modified during implementation (OR (95% Cl) = 2.7 (1.4, 5.0)), there was a good fit between the local provider and the intervention (OR (95% Cl) = 2.4 (1.2, 5.0)), and there was the presence of a program champion (OR (95% Cl) = 2.3 (1.2, 4.4)). Consideration of these factors by health promotion program planners could increase the potential for sustainability of health promotion interventions implemented in the community. Copyright 1998 American Health Foundation and Academic Press.

  11. Sustainability at the Edge of Chaos: Its Limits and Possibilities in Public Health

    Directory of Open Access Journals (Sweden)

    Christopher G. Hudson

    2013-01-01

    Full Text Available This paper critically reviews the expanding literature on applications of sustainability to healthcare policy and planning. It argues that the concept has been overgeneralized and has become a buzzword masking disparate agendas. It ignores the insights of the newest generation of systems theory on complex systems on the ubiquity of far-from-equilibrium conditions. Yet, a central meaning often ascribed to sustainability is the level continuation of healthcare programs and their institutionalization. Sustainability is only coherent in health care when it is more narrowly delimited to involve public health and treated as only one of several evaluative criteria that informs not only the continuation of programs but more often their expansion or contraction as needs dynamically change.

  12. Determining business models for financial sustainability in regional health information organizations: a literature review.

    Science.gov (United States)

    Maffei, Roxana; Dunn, Kim

    2008-11-06

    While the promise and enthusiasm for regional health information organizations (RHIOs) are immense, a significant issue regarding this type of health information exchange, (HIE) remains unclear: financial sustainability. As of today, there is a clear lack of concrete business models implemented in RHIOs' projects. The purpose of this study is to conduct a literature review of the current state of RHIOs adaptation and implementation of business models for successful financial sustainability, as well as evaluate existing RHIOs financial situation to determine and recommend best models for economic uphold. This literature review will be the starting point for thorough analysis and understanding of the economic factors required for RHIOs to generate a return on investment (ROI) and become self-sustainable.

  13. Sustainability at the Edge of Chaos: Its Limits and Possibilities in Public Health

    Science.gov (United States)

    Hudson, Christopher G.; Vissing, Yvonne M.

    2013-01-01

    This paper critically reviews the expanding literature on applications of sustainability to healthcare policy and planning. It argues that the concept has been overgeneralized and has become a buzzword masking disparate agendas. It ignores the insights of the newest generation of systems theory on complex systems on the ubiquity of far-from-equilibrium conditions. Yet, a central meaning often ascribed to sustainability is the level continuation of healthcare programs and their institutionalization. Sustainability is only coherent in health care when it is more narrowly delimited to involve public health and treated as only one of several evaluative criteria that informs not only the continuation of programs but more often their expansion or contraction as needs dynamically change. PMID:24058914

  14. [Health and the green economy: challenges for sustainable development and the eradication of poverty].

    Science.gov (United States)

    Gallo, Edmundo; Setti, Andréia Faraoni Freitas; Magalhães, Danielly de Paiva; Machado, Jorge Mesquita Huet; Buss, Daniel Forsin; Franco Netto, Francisco de Abreu; Buss, Paulo Marchiori

    2012-06-01

    In a scenario where ecosystemic services are being eroded and there is high social inequity, a new model of development is necessary, namely one capable of promoting social development with a reduction of its ecological footprint. The 'Green Economy' model is one of the proposed models. This paper seeks to analyze the environmental, social and individual impacts on human health in the context of a 'brown economy', and discusses the contributions of a green economy on the promotion of equity and health. The assumption is that economic development and environmental sustainability are not incompatible and both contribute to the eradication of poverty. The transition to a sustainable economy depends on political decisions, and transcends technological developments. Above all, it should instigate new models of production, consumption and social organization, which promote socio-environmental justice, encouraging social participation and democratic forms of governance to define a solid agenda for the implementation of sustainable development and mechanisms to implement them at all levels.

  15. The Drive towards Sustainable Health Systems Needs an Alignment: Where are the Innovations in Health Systems Planning?

    Science.gov (United States)

    Murphy, Gail Tomblin; Birch, Stephen; MacKenzie, Adrian; Rigby, Janet; Purkis, Mary Ellen

    2017-01-01

    Clarifying the healthcare innovation agenda is critical in order to advance the impact of system innovations. As part of this agenda-setting it is important to address the four conditions within which innovations can enhance system sustainability: 1) the innovation agenda reflects and is aligned with healthcare objectives and policy; 2) planning methodologies for services, workforce and funding are aligned with healthcare objectives and policy; 3) innovations in services are accommodated in systems through innovations in policy, planning and funding; and 4) innovations are systematically monitored and evaluated. In order to illustrate these conditions, the authors present a case study of an evaluation of one Canadian Health Authority's efforts to transform healthcare delivery. This case study reveals that aligning innovations in policy, planning, funding and health services is critical to transforming health systems and that, in the absence of such alignment, sustainable health systems are difficult to achieve.

  16. Making Travel to Cuba Work for Health and Sustainable Development.

    Science.gov (United States)

    Gorry, Conner

    2017-01-01

    In 2015, a record-breaking 3.5 million visitors-1 million from Canada alone-traveled to Cuba to explore its history, culture, natural splendor, and visit family. That same year, US President Barack Obama relaxed travel restrictions, giving general authorization for a dozen categories of legal travel by US citizens and residents. As a result, US visitors to the island ballooned by 80% between January 2015 and June 2016. And the numbers keep growing: the latest data show that foreign arrivals reached 4 million in 2016.[1] The surge in visitors highlights the potential negative impact of tourism on a developing country's infrastructure, environment, cultural patrimony and local economy-all considered important social determinants of health.

  17. The new United Nations approach to sustainable development post-2015: Findings from four overviews of systematic reviews on interventions for sustainable development and health.

    Science.gov (United States)

    Galvão, Luiz A C; Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Câmara, Volney Magalhães; Luiz, Ronir Raggio; Becerra-Posada, Francisco

    2016-03-01

    Objective To identify reported interventions that facilitate sustainable development and have had a positive impact on health in four areas: sustainable food production; sustainable energy use; sustainable jobs ("decent work"); and prevention of toxic exposure to chemicals. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted of at least 14 databases and 8 websites for each of the four overviews, using pre-defined protocols, including clear inclusion criteria. To qualify as "sustainable," interventions needed to aim (explicitly or implicitly) to positively impact at least two dimensions of the integrated framework for sustainable development and had to include measures of health impact. Results In total, 47 systematic reviews and 10 economic evaluations met the inclusion criteria. The most promising interventions, such as agricultural policies, were identified for each of the four topics. While the evidence for the interventions is not strong because of the limited number of studies, there is no evidence of a definite negative impact on health. The only possible exception is that of taxes and subsidies-though this intervention also has the potential to be pro-equity with higher relative impacts for lower income groups. Conclusions The evidence found for effective interventions is useful for guiding countries toward the best options for non-health sector interventions that can positively impact health. This overviews shows that intersectoral work benefits every sector involved.

  18. Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review.

    Science.gov (United States)

    Kiberu, Vincent M; Mars, Maurice; Scott, Richard E

    2017-05-29

    Most developing countries, including Uganda, have embraced the use of e-Health and m-Health applications as a means to improve primary healthcare delivery and public health for their populace. In Uganda, the growth in the information and communications technology industry has benefited the rural communities and also created opportunities for new innovations, and their application into healthcare has reported positive results, especially in the areas of disease control and prevention through disease surveillance. However, most are mere proof-of-concepts, only demonstrated in use within a small context and lack sustainability. This study reviews the literature to understand e-Health's current implementation status within Uganda and documents the barriers and opportunities to sustainable e-Health intervention programmes in Uganda. A structured literature review of e-Health in Uganda was undertaken between May and December 2015 and was complemented with hand searching and a document review of grey literature in the form of policy documents and reports obtained online or from the Ministry of Health's Resource Centre. The searches identified a total of 293 resources of which 48 articles met the inclusion criteria of being in English and describing e-Health implementation in Uganda. These were included in the study and were examined in detail. Uganda has trialled several e-Health and m-Health solutions to address healthcare challenges. Most were donor funded, operated in silos and lacked sustainability. Various barriers have been identified. Evidence has shown that e-Health implementations in Uganda have lacked prior planning stages that the literature notes as essential, for example strategy and need readiness assessment. Future research should address these shortcomings prior to introduction of e-Health innovations.

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

    Science.gov (United States)

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

    2016-01-01

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

  20. From the Earth Summit to Rio+20: integration of health and sustainable development.

    Science.gov (United States)

    Haines, Andy; Alleyne, George; Kickbusch, Ilona; Dora, Carlos

    2012-06-09

    In 2012, world leaders will meet at the Rio+20 conference to advance sustainable development--20 years after the Earth Summit that resulted in agreement on important principles but insufficient action. Many of the development goals have not been achieved partly because social (including health), economic, and environmental priorities have not been addressed in an integrated manner. Adverse trends have been reported in many key environmental indicators that have worsened since the Earth Summit. Substantial economic growth has occurred in many regions but nevertheless has not benefited many populations of low income and those that have been marginalised, and has resulted in growing inequities. Variable progress in health has been made, and inequities are persistent. Improved health contributes to development and is underpinned by ecosystem stability and equitable economic progress. Implementation of policies that both improve health and promote sustainable development is urgently needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. [Health system sustainability from a network perspective: a proposal to optimize healthy habits and social support].

    Science.gov (United States)

    Marqués Sánchez, Pilar; Fernández Peña, Rosario; Cabrera León, Andrés; Muñoz Doyague, María F; Llopis Cañameras, Jaime; Arias Ramos, Natalia

    2013-01-01

    The search of new health management formulas focused to give wide services is one of the priorities of our present health policies. Those formulas examine the optimization of the links between the main actors involved in public health, ie, users, professionals, local socio-political and corporate agents. This paper is aimed to introduce the Social Network Analysis as a method for analyzing, measuring and interpreting those connections. The knowledge of people's relationships (what is called social networks) in the field of public health is becoming increasingly important at an international level. In fact, countries such as UK, Netherlands, Italy, Australia and U.S. are looking formulas to apply this knowledge to their health departments. With this work we show the utility of the ARS on topics related to sustainability of the health system, particularly those related with health habits and social support, topics included in the 2020 health strategies that underline the importance of the collaborative aspects in networks.

  2. The Objective Force Soldier/Soldier Team. Volume II - The Science and Technology Challenges

    Science.gov (United States)

    2001-11-01

    solutions to achieve this goal. Weight-2 2 Weight Panel Panel Participants Mark Hofmann, Chair (ASB) Tony Tether, (ASB) Michael Krause (ASB) Don Wajda ...Mr. Ed Doucette U.S. Army Natick Soldier Center Mr. Don Woodbury DARPA Mr. Donald Wajda U.S. Army Natick Soldier Center Staff

  3. Millimeter-wave soldier-to-soldier communications for covert battlefield operations

    NARCIS (Netherlands)

    Cotton, Simon L.; Scanlon, W.G.; Madahar, Bhopinder K.

    2009-01-01

    Mobile ad hoc networking of dismounted combat personnel is expected to play an important role in the future of network-centric operations. High-speed, short-range, soldier-to-soldier wireless communications will be required to relay information on situational awareness, tactical instructions, and

  4. Understanding sustainable diets: a descriptive analysis of the determinants and processes that influence diets and their impact on health, food security, and environmental sustainability.

    Science.gov (United States)

    Johnston, Jessica L; Fanzo, Jessica C; Cogill, Bruce

    2014-07-01

    The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a "better" way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of "sustainability" of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system. © 2014 American Society for Nutrition.

  5. "It's All About Ben10[TM]": Children's Play, Health and Sustainability Decisions in the Early Years

    Science.gov (United States)

    Edwards, S.; Skouteris, H.; Rutherford, L.; Cutter-Mackenzie, A.

    2013-01-01

    In today's fast food, fast-paced consumer society, too few questions are asked about the influence of digital media on young children's health and sustainability choices, and indeed how such choices are expressed in children's play (and early childhood classrooms). By interviewing children and parents, and using such data to prompt teacher…

  6. An application of the global sustainable tourism criteria in health tourism

    Science.gov (United States)

    Robert S. Bristow; Wen-Tsann Yang; Mei-Tsen. Lu

    2010-01-01

    Tourism is an important element of the global economy. Yet for the tourism industry to grow and prosper, there is a need to protect local environmental and social well-being. Sustainable tourism seeks a compromise between growth and protection. Today, health tourism is a multi-billion dollar industry tied to individuals' travel overseas for inexpensive and timely...

  7. The self-regulatory function of anticipated pride and guilt in sustainable and health consumption

    NARCIS (Netherlands)

    Onwezen, M.C.; Bartels, J.; Antonides, G.

    2014-01-01

    Although individuals generally value health and sustainability, they do not always behave in a manner that is consistent with their standards. The current study examines whether attitudes and social norms (i.e., descriptive and injunctive norms) can evoke anticipated pride and guilt, which, in turn,

  8. An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity.

    Science.gov (United States)

    Bentley, Michael

    2014-09-01

    The environmental determinants of public health and social equity present many challenges to a sustainable urbanism-climate change, water shortages and oil dependency to name a few. There are many pathways from urban environments to human health. Numerous links have been described but some underlying mechanisms behind these relationships are less understood. Combining theory and methods is a way of understanding and explaining how the underlying structures of urban environments relate to public health and social equity. This paper proposes a model for an ecological public health, which can be used to explore these relationships. Four principles of an ecological public health-conviviality, equity, sustainability and global responsibility-are used to derive theoretical concepts that can inform ecological public health thinking, which, among other things, provides a way of exploring the underlying mechanisms that link urban environments to public health and social equity. Theories of more-than-human agency inform ways of living together (conviviality) in urban areas. Political ecology links the equity concerns about environmental and social justice. Resilience thinking offers a better way of coming to grips with sustainability. Integrating ecological ethics into public health considers the global consequences of local urban living and thus attends to global responsibility. This way of looking at the relationships between urban environments, public health and social equity answers the call to craft an ecological public health for the twenty-first century by re-imagining public health in a way that acknowledges humans as part of the ecosystem, not separate from it, though not central to it. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Evaluation of health determinants for sustaining workability in aging US workforce

    OpenAIRE

    Vatsalya, Vatsalya; Karch, Robert

    2013-01-01

    Growth of older population in United States requires multi-generational evaluation to characterize health measures for sustaining workability. Investigation of measures that working population would need and use with their work-life in an attempt to stay healthy and fit, could potentially reveal significant association that could extend workability and enhance work productivity such as performance, presenteeism, job satisfaction. Evaluation with selective longitudinal health profiling; employ...

  10. Finding Sustainability: University-community collaborations focused on arts in health

    Directory of Open Access Journals (Sweden)

    Mike White

    2011-11-01

    Full Text Available This article describes a number of community-based arts in health projects in schools and disadvantaged communities in Northern England that connect with the interdisciplinary research interests of the Centre for Medical Humanities at Durham University (www.dur.ac.uk/cmh. It examines issues about what makes for sustainability in both practice and research of arts in health when operating from a university base and stresses the importance of relationship-based work in health promotion interventions in communities. It attempts to set arts development work in the policy context of how community health has been addressed over the last decade. It provides both practical and metaphorical illustrations of how community cohesion and emotional literacy can be developed and recognised in schools and communities when supported by ethnographic research that is underpinned by theories of social capital, resilience and participatory arts practice. The significance that the artwork can attain as a social gift, with a special meaning for its creators, is examined from an anthropological perspective. Looking historically and comparatively at some longitudinal projects in community-based arts in health, the article assesses what makes for both success and failure in practice, and looks particularly at the significance of the arts in helping to deliver strategies for improving child health and education. In a strategic development context, explanation is given of several strands of university-community collaboration in arts in health, with interlinked project examples drawn from Tyneside and West Yorkshire. Finally, the article looks at the prospects for sustaining arts in health within the coming transfer of the public health function to local government. Keywords Sustainability, arts in community health, resilience, child mental health, social capital

  11. Developing and sustaining adolescent-friendly health services: A multiple case study from Ecuador and Peru.

    Science.gov (United States)

    Goicolea, Isabel; Coe, Anna-Britt; San Sebastián, Miguel; Hurtig, Anna-Karin

    2017-08-01

    Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries - Peru and Ecuador - introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities' transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.

  12. The World Summit on Sustainable Development: reaffirming the centrality of health

    Directory of Open Access Journals (Sweden)

    von Schirnding Yasmin

    2005-05-01

    Full Text Available Abstract The World Summit on Sustainable Development (WSSD was held in Johannesburg in 2002 to review progress since the Rio conference in 1992, and to agree a new global deal on sustainable development. Unlike its predecessor, it was primarily concerned with implementation rather than with new treaties and targets, although a number of new targets were agreed, for example one on sanitation. Failure to agree a target on renewable energy was regarded as a major disappointment of the conference. While relatively modest in its achievements, and with difficulties in achieving consensus in key areas such as energy, trade, finance and globalisation, WSSD nevertheless succeeded in placing sustainable development back on the political agenda, giving new impetus, in particular to the environment and development needs of Africa, with a strong focus on local issues like household energy, water and sanitation. Health was singled out as one of five priority areas, along with water, energy, agriculture and biodiversity, and was devoted a separate chapter in the resulting Plan of Implementation, which highlighted a range of environmental health issues as well as issues relating to health services, communicable and non-communicable diseases. A number of new partnerships were formed at WSSD, including the Healthy Environments for Children Alliance (HECA launched by WHO, which will form an important platform for implementation. The Commission on Sustainable Development has been designated main responsibility for monitoring and follow up, with its programme of work reorganised to focus on thematic clusters of issues. From the perspective of health, WSSD must be seen as a reaffirmation of the central place of health on the sustainable development agenda, and in the broader context of a process which began in Rio and was given added impetus with the Monterrey Financing for Development conference and the World Trade Organisation meeting held in Doha. Translating

  13. The importance of leadership in Soldiers' nutritional behaviors: results from the Soldier Fueling Initiative program evaluation.

    Science.gov (United States)

    Jackson, Theresa K; Cable, Sonya J; Jin, Wana K; Robinson, Ayanna; Dennis, Sabriya D; Vo, Linda T; Prosser, Trish J; Rawlings, Jess A

    2013-01-01

    Improving Soldiers' nutritional habits continues to be a concern of the US Army, especially amidst increasing obesity and high injury rates. This study examines leadership influence on nutritional behaviors within the context of the Soldier Fueling Initiative, a program providing nutrition education and improved dining facility menus to Soldiers in Basic Combat Training (BCT) and Advanced Individual Training (AIT). A mixed methods design using surveys (N=486) and focus groups (N=112) was used to collect data at Fort Jackson, SC, and Fort Eustis, VA, in 2011. Survey results showed 75% of Soldiers in BCT believed their drill sergeant was helpful in making performance-enhancing food choices, and 86% agreed their drill sergeant believed it is important to eat for performance. Soldiers in AIT perceived their cadre as less helpful than their BCT drill sergeants and agreed less frequently that the AIT cadre believed it was important to eat for performance (Pnutritional attitudes and behaviors in both BCT and AIT. Focus groups revealed 5 key themes related to cadre influence and nutrition behavior (listed in order of most to least frequent): (1) cadre influence food choices through consequences related to selection, (2) cadre teach Soldiers how to eat, (3) cadre rush Soldiers to eat quickly to return to training, (4) cadre influence choice through example but often do not make healthy choices, and (5) cadre have no influence on food choices. Leaders influence most Soldiers' nutrition practices within the training environment, particularly within BCT. Given that leader influence can impact Soldiers' attitudes and behaviors, it is critical that military leaders become knowledgeable about optimal nutrition practices to disseminate appropriate information to their Soldiers, avoid reprimand associated with trainees' food choices, reinforce key messages associated with nutrition programming, and lead by example in their own food choices.

  14. Accelerating Digital Mental Health Research From Early Design and Creation to Successful Implementation and Sustainment.

    Science.gov (United States)

    Mohr, David C; Lyon, Aaron R; Lattie, Emily G; Reddy, Madhu; Schueller, Stephen M

    2017-05-10

    Mental health problems are common and pose a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. The great majority of people experience barriers that prevent access to treatment, aggravated by a lack of mental health specialists. Digital mental health is potentially useful in meeting the treatment needs of large numbers of people. A growing number of efficacy trials have shown strong outcomes for digital mental health treatments. Yet despite their positive findings, there are very few examples of successful implementations and many failures. Although the research-to-practice gap is not unique to digital mental health, the inclusion of technology poses unique challenges. We outline some of the reasons for this gap and propose a collection of methods that can result in sustainable digital mental health interventions. These methods draw from human-computer interaction and implementation science and are integrated into an Accelerated Creation-to-Sustainment (ACTS) model. The ACTS model uses an iterative process that includes 2 basic functions (design and evaluate) across 3 general phases (Create, Trial, and Sustain). The ultimate goal in using the ACTS model is to produce a functioning technology-enabled service (TES) that is sustainable in a real-world treatment setting. We emphasize the importance of the service component because evidence from both research and practice has suggested that human touch is a critical ingredient in the most efficacious and used digital mental health treatments. The Create phase results in at least a minimally viable TES and an implementation blueprint. The Trial phase requires evaluation of both effectiveness and implementation while allowing optimization and continuous quality improvement of the TES and implementation plan. Finally, the Sustainment phase involves the withdrawal of research or donor support, while leaving a functioning, continuously improving TES in place. The ACTS model is a step

  15. Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review

    Directory of Open Access Journals (Sweden)

    Vincent M. Kiberu

    2017-01-01

    Full Text Available Background: Most developing countries, including Uganda, have embraced the use of e-Health and m-Health applications as a means to improve primary healthcare delivery and public health for their populace. In Uganda, the growth in the information and communications technology industry has benefited the rural communities and also created opportunities for new innovations, and their application into healthcare has reported positive results, especially in the areas of disease control and prevention through disease surveillance. However, most are mere proof-of-concepts, only demonstrated in use within a small context and lack sustainability. This study reviews the literature to understand e-Health’s current implementation status within Uganda and documents the barriers and opportunities to sustainable e-Health intervention programmes in Uganda.Methods: A structured literature review of e-Health in Uganda was undertaken between May and December 2015 and was complemented with hand searching and a document review of grey literature in the form of policy documents and reports obtained online or from the Ministry of Health’s Resource Centre.Results: The searches identified a total of 293 resources of which 48 articles met the inclusion criteria of being in English and describing e-Health implementation in Uganda. These were included in the study and were examined in detail.Conclusion: Uganda has trialled several e-Health and m-Health solutions to address healthcare challenges. Most were donor funded, operated in silos and lacked sustainability. Various barriers have been identified. Evidence has shown that e-Health implementations in Uganda have lacked prior planning stages that the literature notes as essential, for example strategy and need readiness assessment. Future research should address these shortcomings prior to introduction of e-Health innovations.

  16. The Significance of "Participation" as an Educational Ideal in Education for Sustainable Development and Health Education in Schools

    Science.gov (United States)

    Andreasen Lysgaard, Jonas; Simovska, Venka

    2016-01-01

    This article examines the significance of the concept of participation for teacher meaning-making processes in education for sustainable development and health education. In Scandinavian public schools, education for sustainable development and health education focus on a wide palette of societal problems rather than on narrow curricula. Drawing…

  17. Determining business models for financial sustainability in regional health information organizations (RHIOs): a review.

    Science.gov (United States)

    Maffei, Roxana; Burciago, Daniel; Dunn, Kim

    2009-10-01

    Regional health information organizations (RHIOs) have the potential to alleviate today's health care problems by granting providers access to a supported body of clinical information for all patients in a given region. While the promise of and enthusiasm for RHIOs is immense, the issue of their financial sustainability remains unclear. It has been said that the business model supporting a regional or national health information network is as essential, if not more essential, than the technology that makes it feasible. Currently, there is a clear lack of concrete business models implemented in RHIOs' projects. This article reports the results of a literature review of the current status of the adaptation and implementation of business models by RHIOs for successful financial sustainability. Based on the review, this article also attempts to evaluate the existing financial situation of RHIOs to determine and recommend the best models of economic sustainability. Significant findings include RHIOs' present financial environment, planning, and self-sustainability methods. Future studies will be needed as RHIOs continue to grow and move toward the implementation phase of their development.

  18. Population, sexual and reproductive health, rights and sustainable development: forging a common agenda.

    Science.gov (United States)

    Newman, Karen; Fisher, Sarah; Mayhew, Susannah; Stephenson, Judith

    2014-05-01

    This article suggests that sexual and reproductive health and rights activists seeking to influence the post-2015 international development paradigm must work with sustainable development advocates concerned with a range of issues, including climate change, environmental issues, and food and water security, and that a way of building bridges with these communities is to demonstrate how sexual and reproductive health and rights are relevant for these issues. An understanding of population dynamics, including urbanization and migration, as well as population growth, can help to clarify these links. This article therefore suggests that whether or not sexual and reproductive health and rights activists can overcome resistance to discussing "population", become more knowledgeable about other sustainable development issues, and work with others in those fields to advance the global sustainable development agenda are crucial questions for the coming months. The article also contends that it is possible to care about population dynamics (including ageing and problems faced by countries with a high proportion of young people) and care about human rights at the same time. It expresses concern that, if sexual and reproductive health and rights advocates do not participate in the population dynamics discourse, the field will be left free for those for whom respecting and protecting rights may be less of a priority. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  19. Mental disorders by draftees and soldiers at the military service

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2003-06-01

    Full Text Available The army training presents a very stressful life event that may lead to several mental disorders. Therefore it is important to establish good screening methods to identify people that are prone to propulsive reactions and autoaggressive behaviour. I have analysed the data from the sample of 1032 draftees from the Maribor's county in regard of different mental disorders that were established by the screening and examinations of our health care professionals. Besides I have analysed the data from 71 soldiers that were already serving the military service and were urgently send to the psychiatric ambulatory care unit because of different mental health problems. Between all draftees there were only 471 (45,6 % fully capable for military duty, 180 were partially capable and from them only 5 because of mental health problems, 164 were temporary rejected for the army service and from them 43 because of mental health problems and 97 were rejected, 72 of them because of different mental disorders. The most frequent reason for rejection or limitation of the capability for military service were personality disorders in 56,7 % of cases. In the sample of soldiers already on duty the frequency of personality disorders was even higher, 74,6 %. From this sample the most frequent personality disorder was dissocial (41,5 %. Therefore we should add the inventory for personality disorders assessment to the psychological screening of draftees.

  20. Suboptimal Nutritional Characteristics in Male and Female Soldiers Compared to Sports Nutrition Guidelines.

    Science.gov (United States)

    Beals, Kim; Darnell, Matthew E; Lovalekar, Mita; Baker, Rachel A; Nagai, Takashi; San-Adams, Thida; Wirt, Michael D

    2015-12-01

    The purpose of this study was to evaluate the nutrient intake of male and female Soldiers in the 101 st Airborne Division (Air Assault) compared to sports nutrition standards for athletes, and to identify suboptimal eating characteristics that may impair physical performance and jeopardize military readiness. Male and female Soldiers from the 101 st Airborne Division (Air Assault) completed a 24-hour dietary recall and nutrition history questionnaire before anthropometric and body composition measurements were taken. Compared to sports nutrition guidelines, Soldiers of the 101 st under consume carbohydrates (males: 3.9 ± 2.0 vs. 5.0 g/kg, p < 0.001; females: 4.0 ± 2.1 vs. 5.0 g/kg, p = 0.001), male Soldiers eat too much fat (32.4% of kcal vs. <30% of kcal, p = 0.000) and saturated fat (males: 10.5 ± 3.9% of kcal vs. 10.0% of kcal, p = 0.044), and both males and females follow a meal pattern that may not optimize energy availability throughout the day. Eating too much fat and under fueling carbohydrate may negatively impact the adaptations to physical training and compromise overall health. Although Soldiers continue to participate in arduous training programs, future research should be aimed at determining the energy and macronutrient needs to fuel and recover from specific types of military training. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  1. Characteristics of the suicidal soldier in the Israeli Defense Force-a review of literature.

    Science.gov (United States)

    Shelef, Leah; Laur, Lucian; Fruchter, Eyal

    2015-01-01

    Suicide is the third leading cause of death among adolescents in most Western world countries. Similar findings have been reported among adolescents in Israel (including the Israeli army) in times of peace; nonetheless, suicide rate has decreased significantly in recent years. In Israel, IDF service is mandatory and adolescents are obligated to serve by law. Therefore, the IDF is responsible under state and moral law to care for the physical and mental health of its soldiers. Additionally, there is an understanding that the Israeli soldiers represent a mentally healthy population as prior to their enlistment they undergo a series of tests and evaluations to determine their suitability for service. The IDF is one of the few organizations in the world that is comprised of the majority of a country's healthy adolescent population. International literature defines this population (i.e., the adolescent population) as having the highest risk of suicidality. Moreover, the risk of suicide increases in the face of two additional circumstances within the context of military service: the army service as a stressor and the availability of weapons. The IDF invests significant resources in delineating the characteristics of suicidal soldiers, realizing its importance for suicide prevention during military service. This article reviews studies regarding complete suicide cases of Israeli soldiers in the aim of characterising a 'suicidal soldier's profile' to inform better screening and prevention policies.

  2. Creating Flexible and Sustainable Work Models for Academic Obstetrician-Gynecologists Engaged in Global Health Work.

    Science.gov (United States)

    Molina, Rose; Boatin, Adeline; Farid, Huma; Luckett, Rebecca; Neo, Dayna; Ricciotti, Hope; Scott, Jennifer

    2017-10-01

    To describe various work models for obstetrics and gynecology global health faculty affiliated with academic medical centers and to identify barriers and opportunities for pursuing global health work. A mixed-methods study was conducted in 2016 among obstetrics and gynecology faculty and leaders from seven academic medical institutions in Boston, Massachusetts. Global health faculty members were invited to complete an online survey about their work models and to participate in semistructured interviews about barriers and facilitators of these models. Department chairs and residency directors were asked to participate in interviews. The survey response rate among faculty was 65.6% (21/32), of which 76.2% (16/21) completed an interview. Five department leaders (45.5% [5/11]) participated in an interview. Faculty described a range of work models with varied time and compensation, but only one third reported contracted time for global health work. The most common barriers to global health work were financial constraints, time limitations, lack of mentorship, need for specialized training, and maintenance of clinical skills. Career satisfaction, creating value for the obstetrics and gynecology department, and work model flexibility were the most important facilitators of sustainable global health careers. The study identified challenges and opportunities to creating flexible and sustainable work models for academic obstetrics and gynecology clinicians engaged in global health work. Additional research and innovation are needed to identify work models that allow for sustainable careers in global women's health. There are opportunities to create professional standards and models for academic global health work in the obstetrics and gynecology specialty.

  3. Health in the sustainable development goals: ready for a paradigm shift?

    Science.gov (United States)

    Buse, Kent; Hawkes, Sarah

    2015-03-21

    The Millennium Development Goals (MDGs) galvanized attention, resources and accountability on a small number of health concerns of low- and middle-income countries with unprecedented results. The international community is presently developing a set of Sustainable Development Goals as the successor framework to the MDGs. This review examines the evidence base for the current health-related proposals in relation to disease burden and the technical and political feasibility of interventions to achieve the targets. In contrast to the MDGs, the proposed health agenda aspires to be universally applicable to all countries and is appropriately broad in encompassing both communicable and non-communicable diseases as well as emerging burdens from, among other things, road traffic accidents and pollution.We argue that success in realizing the agenda requires a paradigm shift in the way we address global health to surmount five challenges: 1) ensuring leadership for intersectoral coherence and coordination on the structural (including social, economic, political and legal) drivers of health; 2) shifting the focus from treatment to prevention through locally-led, politically-smart approaches to a far broader agenda; 3) identifying effective means to tackle the commercial determinants of ill-health; 4) further integrating rights-based approaches; and 5) enhancing civic engagement and ensuring accountability. We are concerned that neither the international community nor the global health community truly appreciates the extent of the shift required to implement this health agenda which is a critical determinant of sustainable development.

  4. Understanding Sustainable Diets: A Descriptive Analysis of the Determinants and Processes That Influence Diets and Their Impact on Health, Food Security, and Environmental Sustainability123

    Science.gov (United States)

    Johnston, Jessica L.; Fanzo, Jessica C.; Cogill, Bruce

    2014-01-01

    The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a “better” way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of “sustainability” of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system. PMID:25022991

  5. Zinc: An Essential Trace Element with Potential Benefits to Soldiers

    National Research Council Canada - National Science Library

    McClung, James P; Scrimgeour, Angus G

    2005-01-01

    .... This review highlights the importance of adequate zinc nutrition to soldiers and discusses the potential benefits of supplemental zinc to protect soldiers against a number of diseases currently affecting them, including diarrhea, respiratory diseases, malaria, and leishmaniasis.

  6. The challenges to performance and sustaining mutual health organisations/health institutions: an exploratory study in Ghana.

    Science.gov (United States)

    Adomah-Afari, Augustine

    2015-01-01

    The purpose of this paper is to explore challenges to the performance and sustainability of mutual health organisations (MHOs) and health institutions towards enhancing access to quality health care (HC) in Ghana. Data were gathered through interviews and documentary review. Problems with late release of reimbursement funds for discharging with claims by the central government has impacted heavily on the financial and strategic management and decision-making processes of the MHOs and health institutions. The lack of in-depth analysis of the financial viability of the MHOs; and the limited number of schemes selected. Recommends the need to ensure prompt release of reimbursement funds by government to enable the MHOs to reimburse claims to health institutions. There is a perceived tension between the MHOs and HC institutions due to late release of reimbursement funds by the government. Contributes to understanding of how the NHI Act influences the operations of MHOs and health institutions towards increasing access to quality HC and financing.

  7. Women in WAR and peace – reflections on gender and the role of female soldiers in MINUSMA, MALI

    DEFF Research Database (Denmark)

    Haugegaard, Rikke

    Active involvement of women is key to sustainable and inclusive peace. Despite efforts to increase the deployment of female soldiers, the United Nations peacekeeping mission in Mali (MINUSMA) remains dominated by men. A focus on the operational relevance of gender integration and building...

  8. Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

    Science.gov (United States)

    Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

    2015-09-01

    Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

  9. [Research Networks in Public Health: Requirements for Sustainability and Effectiveness - a Sociological Perspective].

    Science.gov (United States)

    Pfaff, Holger; Ohlmeier, Silke

    2017-11-01

    The Public Health White Paper draws up a vision of public health as a living, decentralized network that can help improve the health of the population in a sustained fashion. However, the central question remains open as to which prerequisites public health networks should fulfill in order to be effective in the long term. The aim of this paper is to provide a sociological view of the issue and offer some discussion ideas. Parsons' structural functionalism leads to the thesis that science networks in public health require structures that ensure that the 4 basic functions of viable social networks - (1) adaptation, (2) goal attainment, (3) integration and (4) latent pattern maintenance - are fulfilled. On this theoretical basis, suggestions are made to establish functional formal structures in public health networks. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Perceptions and Attitudes of Female Soldiers Toward Physical Performance and Fitness Standards in Soldiers.

    Science.gov (United States)

    Vaara, Jani P; Viskari, Jarmo; Kyröläinen, Heikki; Santtila, Matti

    2016-10-01

    No previous studies have investigated attitudes of the female soldiers toward physical fitness tests and physical performance requirements. The purpose of the present study was to investigate how military personnel group, age, physical fitness, and body composition are associated with female soldiers' attitudes toward fitness tests and requirements. A survey was conducted for 362 voluntary female soldiers. 76 % of them answered that the current fitness requirements are not too demanding, and 56 to 76% thought that the minimum requirements are at appropriate level for females. Nearly half (48%) of the female soldiers reported that it creates inequality when there are the same fitness standards for both genders. 12 % of the studied females had experienced bullying and 24% had experienced discrimination because of their physical fitness. Noncommissioned officers, older soldiers, overweight soldiers, and those with lower fitness thought more often that the physical fitness requirements are too high for female soldiers (p < 0.05). Lower fitness and overweight were associated with higher prevalence of being bullied and experiences of discrimination because of physical fitness (p < 0.05). The results suggest that there might be a need for a better communication about fitness requirements and targeted interventions for better integration of women in military environment. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  11. The photovoltaic industry on the path to a sustainable future--environmental and occupational health issues.

    Science.gov (United States)

    Bakhiyi, Bouchra; Labrèche, France; Zayed, Joseph

    2014-12-01

    As it supplies solar power, a priori considered harmless for the environment and human health compared with fossil fuels, the photovoltaic (PV) industry seems to contribute optimally to reduce greenhouse gas emissions and, overall, to sustainable development. However, considering the forecast for rapid growth, its use of potentially toxic substances and manufacturing processes presenting health and safety problems may jeopardize its benefits. This paper aims to establish a profile of the PV industry in order to determine current and emerging environmental and health concerns. A review of PV system life cycle assessments, in light of the current state of the industry and its developmental prospects, reveals information deficits concerning some sensitive life cycle indicators and environmental impacts, together with incomplete information on toxicological data and studies of workers' exposure to different chemical and physical hazards. Although solar panel installation is generally considered relatively safe, the occupational health concerns related to the growing number of hazardous materials handled in the PV industry warrants an all-inclusive occupational health and safety approach in order to achieve an optimal equilibrium with sustainability. To prevent eco-health problems from offsetting the benefits currently offered by the PV industry, manufacturers should cooperate actively with workers, researchers and government agencies toward improved and more transparent research, the adoption of specific and stricter regulations, the implementation of preventive risk management of occupational health and safety and, lastly, greater responsibilization toward PV systems from their design until their end of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. A study of project management knowledge and sustainable outcomes in Thailand’s reproductive health projects

    Directory of Open Access Journals (Sweden)

    Jantanee Dumrak

    2015-05-01

    Full Text Available In Thailand, numerous reproductive health projects funded by both national and international agencies have been established in an attempt to mitigate reproductive health problems. Solving problems on reproductive health projects that only have temporary funding requires effective project management that hopefully leads to better long-term desired outcomes. This paper identifies the association between collaborative reproductive health (CRH project management and sustainable outcomes. The Guide to the Project Management Body of Knowledge (PMBOK® Guide is employed to benchmark project management practices on four CRH projects in Thailand. The research methodology presented in this paper comprises of content analysis and questionnaire survey. It is evident that limited use of certain project management knowledge areas (PMKAs affects CRH project implementation and success. The association between the use of PMKAs and sustainable outcomes on these projects is also presented. Scope, integration and quality management were found to be the most influential PMKAs for sustainable outcomes on CRH projects. Nevertheless, the projects showed a shortage of project management processes for PMKAs that were required to attain the outcomes.

  13. Developing Sustainable Cancer Education Programs: Training Public Health Students to Deliver Cancer 101 in Puerto Rico.

    Science.gov (United States)

    Rivera, Y M; Moreno, L; Briant, K J; Vélez, H; Jiménez, J C; Torres, J; Vadaparampil, S T; Muñoz-Antonia, T; Quinn, G P

    2018-02-01

    The use of promotores to educate Hispanic communities about different health topics has been proven successful, albeit with limitations in program sustainability. The goal of this study was to develop a sustainable train-the-trainer model to train graduate public health (PH) students to disseminate cancer education among communities in Puerto Rico (PR). Graduate students (n = 32) from Ponce Health Sciences University's (PHSU) PH program participated in a 2-day Cáncer 101 training, where they learned how to deliver nine cancer modules to the community. Cancer knowledge was assessed before and after the training via 54 items measuring discussed concepts. Participants also assessed the training's effectiveness by completing a training evaluation informed by social cognitive theory (SCT) constructs of self-efficacy, outcome expectations, facilitation, and observational learning. Participants were mainly female (78.1 %), 26.7 ± 3.9 years old, and enrolled in a Masters-level program (81.3 %). Participants reported an average 11.38-point increase in cancer knowledge after attending the training [t(31) = 14.88, p reporting satisfactory comments in the open-ended responses and high scores on measured SCT constructs. The Cáncer 101 training program effectively prepared students to deliver cancer education to local communities. Training graduate PH students to educate communities about health issues is an innovative, and potentially sustainable, way to reach underserved populations.

  14. Development of transdisciplinarity among students placed with a sustainability for health research project.

    Science.gov (United States)

    Orozco, Fadya; Cole, Donald C

    2008-12-01

    Transdisciplinary education on sustainability for health has been primarily developed in high-income countries, yet the need in countries with limited research and human resource investments remains urgent. Little empiric documentation of the facilitators and barriers to transdisciplinary learning in such countries has been described. We assessed transdisciplinary learning among students of different disciplines collaborating with an Ecuadorian sustainability for health research project. Six undergraduate students from four different disciplinary backgrounds were incorporated through work-study agreements with provincial university academic supervisors. Learning was fostered and monitored through participant observations by a field supervisor. Students' learning was evaluated through subsequent in-depth interviews and visualization methods. Academic supervisor key informant and co-investigator observations aided triangulation. Qualitative data were analyzed using indicators of transdisciplinary thinking. Principal factors facilitating transdisciplinary learning were interaction with social actors, the integration of work with other disciplines, the use of alternative research techniques and methods, and the constant support of the field supervisor. Inhibiting factors included the existence of rigid academic rules, lack of training of the academic supervisors in diverse research methods, and social pressures to implement unidisciplinary foci. At the end of their link with the project, students had developed both cognitive outcomes and attitudinal values relevant to sustainable development for health. In countries with limited investments in research and human resources development, transdisciplinary approaches with social actors and engaged researchers can sensitize new professionals training in traditional academic contexts to the ecological-social-health problems faced by poor majorities and encourage their subsequent work on sustainability for human health.

  15. Food system sustainability for health and well-being of Indigenous Peoples.

    Science.gov (United States)

    Kuhnlein, Harriet V

    2015-09-01

    To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions. Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries. The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas. Leaders of the Indigenous Peoples' case studies, their communities and their academic partners. Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples. Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

  16. Streamflow conditions along Soldier Creek, Northeast Kansas

    Science.gov (United States)

    Juracek, Kyle E.

    2017-11-14

    The availability of adequate water to meet the present (2017) and future needs of humans, fish, and wildlife is a fundamental issue for the Prairie Band Potawatomi Nation in northeast Kansas. Because Soldier Creek flows through the Prairie Band Potawatomi Nation Reservation, it is an important tribal resource. An understanding of historical Soldier Creek streamflow conditions is required for the effective management of tribal water resources, including drought contingency planning. Historical data for six selected U.S. Geological Survey (USGS) streamgages along Soldier Creek were used in an assessment of streamflow characteristics and trends by Juracek (2017). Streamflow data for the period of record at each streamgage were used to compute annual mean streamflow, annual mean base flow, mean monthly flow, annual peak flow, and annual minimum flow. Results of the assessment are summarized in this fact sheet.

  17. Sustainability and scalability of a volunteer-based primary care intervention (Health TAPESTRY): a mixed-methods analysis.

    Science.gov (United States)

    Kastner, Monika; Sayal, Radha; Oliver, Doug; Straus, Sharon E; Dolovich, Lisa

    2017-08-01

    Chronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team. Health TAPESTRY was implemented, pilot tested, and evaluated in a randomized controlled trial (analysis underway). Knowledge translation (KT) interventions such as Health TAPESTRY should involve an investigation of their sustainability and scalability determinants to inform further implementation. However, this is seldom considered in research or considered early enough, so the objectives of this study were to assess the sustainability and scalability potential of Health TAPESTRY from the perspective of the team who developed and pilot-tested it. Our objectives were addressed using a sequential mixed-methods approach involving the administration of a validated, sustainability survey developed by the National Health Service (NHS) to all members of the Health TAPESTRY team who were actively involved in the development, implementation and pilot evaluation of the intervention (Phase 1: n = 38). Mean sustainability scores were calculated to identify the best potential for improvement across sustainability factors. Phase 2 was a qualitative study of interviews with purposively selected Health TAPESTRY team members to gain a more in-depth understanding of the factors that influence the sustainability and scalability Health TAPESTRY. Two independent reviewers coded transcribed interviews and completed a multi-step thematic analysis. Outcomes were participant perceptions of the determinants influencing the sustainability and scalability of Health TAPESTRY. Twenty

  18. Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?

    Directory of Open Access Journals (Sweden)

    Lisa Forman

    2015-12-01

    Full Text Available While the right to health is increasingly referenced in Sustainable Development Goal (SDG discussions, its contribution to global health and development remains subject to considerable debate. This hypothesis explores the potential influence of the right to health on the formulation of health goals in 4 major SDG reports. We analyse these reports through a social constructivist lens which views the use of rights rhetoric as an important indicator of the extent to which a norm is being adopted and/or internalized. Our analysis seeks to assess the influence of this language on goals chosen, and to consider accordingly the potential for rights discourse to promote more equitable global health policy in the future.

  19. Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?

    Science.gov (United States)

    Forman, Lisa; Ooms, Gorik; Brolan, Claire E

    2015-09-29

    While the right to health is increasingly referenced in Sustainable Development Goal (SDG) discussions, its contribution to global health and development remains subject to considerable debate. This hypothesis explores the potential influence of the right to health on the formulation of health goals in 4 major SDG reports. We analyse these reports through a social constructivist lens which views the use of rights rhetoric as an important indicator of the extent to which a norm is being adopted and/or internalized. Our analysis seeks to assess the influence of this language on goals chosen, and to consider accordingly the potential for rights discourse to promote more equitable global health policy in the future. © 2015 by Kerman University of Medical Sciences.

  20. Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development.

    Science.gov (United States)

    Pantyley, Viktoriya

    2017-09-21

    The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.

  1. [Efficiency indicators to contribute to sustainability of health services in Spain].

    Science.gov (United States)

    García, E I; Mira Solves, J J; Guilabert Mora, M

    2014-01-01

    Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability. We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated. Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management. The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  2. Squaring the circle: health as a bridge to global solidarity in the Sustainable Development Goals.

    Science.gov (United States)

    Williams, B; Taylor, S

    2017-05-01

    The Sustainable Development Goals (SDGs), launched in September 2015 to follow on from the Millennium Development Goals, require action by all countries. The new goals range from traditional areas of health and education to a newer focus on global trade and environmental protection. We discuss how all countries can be incentivised to engage and commit and argue that thoughtful target-setting and benchmarking, a more aggressive focus on equity and an emphasis on the interdependence of health and non-health development goals are key to meaningful progress. Fundamental shared values and aspirations around health, and in particular child health, within SDG3 may, we argue, offer a platform on which to build genuine global solidarity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Community-based health information technology alliances: potential predictors of early sustainability.

    Science.gov (United States)

    Kern, Lisa M; Wilcox, Adam B; Shapiro, Jason; Yoon-Flannery, Kahyun; Abramson, Erika; Barron, Yolanda; Kaushal, Rainu

    2011-04-01

    To determine potential predictors of sustainability among community-based organizations that are implementing health information technology (HIT) with health information exchange, in a state with significant funding of such organizations. A longitudinal cohort study of community-based organizations funded through the first phase of the $440 million Healthcare Efficiency and Affordability Law for New Yorkers program. We administered a baseline telephone survey in January and February 2007, using a novel instrument with open-ended questions, and collected follow-up data from the New York State Department of Health regarding subsequent funding awarded in March 2008. We used logistic regression to determine associations between 18 organizational characteristics and subsequent funding. All 26 organizations (100%) responded. Having the alliance led by a health information organization (odds ratio [OR] 11.4, P = .01) and having performed a community-based needs assessment (OR 5.1, P = .08) increased the unadjusted odds of subsequent funding. Having the intervention target the long-term care setting (OR 0.14, P = .03) decreased the unadjusted odds of subsequent funding. In the multivariate model, having the alliance led by a health information organization, rather than a healthcare organization, increased the odds of subsequent funding (adjusted OR 6.4; 95% confidence interval 0.8, 52.6; P = .08). Results from this longitudinal study suggest that both health information organizations and healthcare organizations are needed for sustainable HIT transformation.

  4. [Sustainability and excellence of the Catalan health system. New paradigms, challenges and responses].

    Science.gov (United States)

    Fernández i Alegre, Roser; Argenter i Giralt, Miquel; Rodríguez i Guasch, Xavier

    2015-11-01

    The aim of a health system and the priority of any government is to anticipate problems before they appear, provide an innovative response to these new needs and healthcare models, improve access of the general public and patients to health care, especially care for the most vulnerable groups, improve healthcare results and implement the structural reforms necessary to maintain a viable and sustainable quality public healthcare system for everyone. In the current environment, health systems are facing new economic, demographic, care, social, technological and political paradigms to which health policy must respond. Faced with these challenges, health systems, especially in the case of Catalonia, are challenged to take decisions on how best to approach the implementation of structural reform designed to facilitate the necessary economic and fiscal sustainability in the service of fresh and innovative health policies and patient-centred care within a system marked by excellence and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  5. The impact of healthcare on the environment: improving sustainability in the health service.

    Science.gov (United States)

    Fitzpatrick, Jane

    As the largest employer in the UK, the NHS has a duty to contribute to sustainability in the UK and minimise the impact of healthcare provision on the environment. Nurses also have a responsibility to ensure their practice makes the best use of resources. This article discusses initiatives aimed at supporting organisations and individuals in reducing the negative impact of healthcare on the environment and on human health and wellbeing.

  6. Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development

    Directory of Open Access Journals (Sweden)

    Viktoriya Pantyley

    2017-09-01

    In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.

  7. Searching for the Right to Health in the Sustainable Development Agenda

    Science.gov (United States)

    Hawkes, Sarah; Buse, Kent

    2016-01-01

    The United Nations (UN) Sustainable Development Agenda offers an opportunity to realise the right to health for all. The Agenda’s "interlinked and integrated" Sustainable Development Goals (SDGs) provide the prospect of focusing attention and mobilising resources not just for the provision of health services through universal health coverage (UHC), but also for addressing the underlying social, structural, and political determinants of illness and health inequity. However, achieving the goals’ promises will require new mechanisms for inter-sectoral coordination and action, enhanced instruments for rational priority-setting that involve affected population groups, and new approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas. In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a health-promoting and health protecting environment for each and every one of us. We argue that realizing the right to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments, not least those outlined in other goals, and pursue complementary openings in the Agenda – from inclusive policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind. PMID:27239885

  8. THE CARE OF PERSONAL HEALTH AS A PART OF SUSTAINABLE HEALTHCARE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Kalina Peycheva

    2017-06-01

    Full Text Available Active participation and personal responsibility of patients for their own health are necessary to realise the idea of the sustainable development of health care. Aim: To study the readiness of patients to take personal responsibility for their health. Material and Methods:A questionnaire was prepared for the purposes of the study.The methods utilised were a direct individual anonymous questionnaire, statistical – descriptive, analytical (hi – square. The answers were examined and statistically processed according to age, gender and education level of the participants. Results: 1. 92,7 % of those between 18-24 years old answered, that the decision to change their lifestyle in order to prevent disease, depend on the deprivation they have to suffer. 2. Only ¼ are responsible for their health, while the ones who know they have to do it, but they do not are 12,2%. 3. University graduates pay more attention and take more care for their health. 4. Lack of time is the primary reason patients cite for not taking care of their health. 5. Few could read the labels – only 9,6%. The remaining over 90 % do not understand the labels. 6. Gender wise – women are more responsible and have higher health education. Conclusions: The lack of health education and care, using the lack of time as an excuse, as well as the reluctance to compromise and deprivation for health’s sake, demonstrate the lack of sustainability of health care system with respect to health education and promotion.

  9. Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

    Science.gov (United States)

    Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

    2016-10-18

    Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions

  10. Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow.

    Science.gov (United States)

    Saadatian-Elahi, Mitra; Bloom, David; Plotkin, Stanley; Picot, Valentina; Louis, Jacques; Watson, Michael

    2017-01-01

    Vaccination is a complex ecosystem with several components that interact with one another and with the environment. Today's vaccine ecosystem is defined by the pursuit of polio eradication, the drive to get as many of the new vaccines to as many people as possible and the research and development against immunologically challenging diseases. Despite these successes, vaccine ecosystem is facing keys issues with regard to supply/distribution and cost/profitability asymmetry that risk slowing its global growth. The conference "Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow" held in Annecy-France (January 19-21, 2015) took stock of the health of today's vaccination ecosystem and its ability to reliably and sustainably supply high-quality vaccines while investing in tomorrow's needed innovation. Small and decreasing numbers of suppliers/manufacturing facilities; paucity of research-driven companies; regulatory pressures; market uncertainties; political prioritization; anti-vaccine movements/complacency; and technological and programmatic issues were acknowledged as the major challenges that could weaken today's vaccination ecosystem. The expert panel discussed also drivers and barriers to a sustainable vaccination ecosystem; the metrics of a vaccination ecosystem; and what should be added, removed, increased, or reduced to maintain the health of the vaccination ecosystem.

  11. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    Science.gov (United States)

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-04

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Verma, Pooja; Moran, John W

    2014-01-01

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

  13. Fair equality of opportunity critically reexamined: the family and the sustainability of health care systems.

    Science.gov (United States)

    Engelhardt, H Tristram

    2012-12-01

    A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls's original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy.

  14. [The economic-financial sustainability of the Family Health Strategy in large municipalities].

    Science.gov (United States)

    Portela, Gustavo Zoio; Ribeiro, José Mendes

    2011-03-01

    The universalization of basic care and commitment budget of the Ministry of Health with the Family Health Strategy (ESF) through new systematic financing incentives have been highlighted in the Brazilian health policy scenario. One of the great problems observed is the expansion of the strategy for large urban centres. This paper studies the economic-financial sustainability of ESF in Brazilian municipalities of more than 100 thousand inhabitants according to some selected indicators, considering the geographical region to which they belong, their population size and participation in Project for the Expansion and Consolidation Family Health (Proesf). Municipalities belonging to the Southeast region, more developed of the country, have on average better economic-financial performance, but lower average values of coverage of ESF. Municipalities from the North and Northeast, with the lowest average for economic-financial sustainability indicators, were the ones that made more effort to developments in the period. Thus, we observed the dynamics between bigger fiscal capacity and budgetary commitment with the Health Sector for biggest municipalities and in more economically developed regions, and greater vulnerability and dependence of federative transferences for municipalities with less people, in less developed areas.

  15. The Land Warrior Soldier System: A Case Study for the Acquisition of Soldier Systems

    Science.gov (United States)

    2008-12-01

    302 Figure 112. Italian Soldier Wearing the “Soldato Futuro ”................................................305 Figure 113. Belgian...military has implemented the “Soldato Futuro ” soldier modernization program; this involves two phases, the second phase consisting of three prototype...operational test and evaluation phase. Currently, Italy’s Soldato Futuro program is in the second phase of a 304 three-month series of tests

  16. After The Demonstration: What States Sustained After the End of Federal Grants to Improve Children's Health Care Quality.

    Science.gov (United States)

    Ireys, Henry T; Brach, Cindy; Anglin, Grace; Devers, Kelly J; Burton, Rachel

    2018-02-01

    Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program's legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children's health care provided through Medicaid and CHIP. As part of the program's multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states' CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects' intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state's Medicaid environment, implementation partners' resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states' CHIPRA quality demonstration projects provides insight into the fates of the "promising ideas" that the grant program was designed to examine. As a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children.

  17. Seasonality and dietary requirements: will eating seasonal food contribute to health and environmental sustainability?

    Science.gov (United States)

    Macdiarmid, Jennie I

    2014-08-01

    Eating more seasonal food is one proposal for moving towards more sustainable consumption patterns, based on the assumption that it could reduce the environmental impact of the diet. The aim of the present paper is to consider the implications of eating seasonal food on the different elements of sustainability (i.e. health, economics, society), not just the environment. Seasonality can be defined as either globally seasonal (i.e. produced in the natural production season but consumed anywhere in the world) or locally seasonal (i.e. produced in the natural production season and consumed within the same climatic zone). The environmental, health, economic and societal impact varies by the definition used. Global seasonality has the nutritional benefit of providing a more varied and consistent supply of fresh produce year round, but this increases demand for foods that in turn can have a high environmental cost in the country of production (e.g. water stress, land use change with loss of biodiversity). Greenhouse gas emissions of globally seasonal food are not necessarily higher than food produced locally as it depends more on the production system used than transportation. Eating more seasonal food, however, is only one element of a sustainable diet and should not overshadow some of the potentially more difficult dietary behaviours to change that could have greater environmental and health benefits (e.g. reducing overconsumption or meat consumption). For future guidelines for sustainable diets to be realistic they will need to take into account modern lifestyles, cultural and social expectations in the current food environment.

  18. Adapting to the health impacts of climate change in a sustainable manner.

    Science.gov (United States)

    Hoy, Damian; Roth, Adam; Lepers, Christelle; Durham, Jo; Bell, Johann; Durand, Alexis; Lal, Padma Narsey; Souares, Yvan

    2014-12-11

    The climate is changing and this poses significant threats to human health. Climate change is one of the greatest challenges facing Pacific Island countries and territories due to their unique geophysical features, and their social, economic and cultural characteristics. The Pacific region also faces challenges with widely dispersed populations, limited resources and fragmented health systems. Over the past few years, there has been a substantial increase in international aid for health activities aimed at adapting to the threats of climate change. This funding needs to be used strategically to ensure an effective approach to reducing the health risk from climate change. Respecting the principles of development effectiveness will result in more effective and sustainable adaptation, in particular, 1) processes should be owned and driven by local communities, 2) investments should be aligned with existing national priorities and policies, and 3) existing systems must not be ignored, but rather expanded upon and reinforced.

  19. The medium-term sustainability of organisational innovations in the national health service.

    Science.gov (United States)

    Martin, Graham P; Currie, Graeme; Finn, Rachael; McDonald, Ruth

    2011-03-14

    There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Through comparison and contrast across four sites, each

  20. The medium-term sustainability of organisational innovations in the national health service

    Directory of Open Access Journals (Sweden)

    Finn Rachael

    2011-03-01

    Full Text Available Abstract Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion

  1. Deployments, Stress, and Soldiers' Academic Performance

    Science.gov (United States)

    Perot, Mindy

    2012-01-01

    This study focused on identifying whether certain factors affected the academic performance of Soldiers attending an Army educational institution. Academic performance was measured by the grade percentile average of the participant upon the completion of their course of enrollment. Factors that were considered within the study through…

  2. DUSTY WARRIORS: MODERN SOLDIERS AT WAR

    African Journals Online (AJOL)

    hennie

    From a recruitment and training perspective, so it appears, the going is increasingly difficult and often at odds with a civil society not always holding the military in high esteem and portraying traits which are even more ... boredom, high intensity battles, and even the aloofness of the soldiers at times to what was going on ...

  3. Child Soldiers Initiative | IDRC - International Development ...

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

    The involvement of children in fighting forces continues to be widespread, undercutting security and blocking development in many fragile states. Failure ... The project will include field testing promising techniques in an existing child soldier recruitment situation. ... Driving vaccine innovations to improve lives and livelihoods.

  4. Child Soldiers: Rights Denied, Hope Restored

    Science.gov (United States)

    Carano, Kenneth T.; Bailey, Robert W.

    2012-01-01

    The forceful induction of children as child soldiers is an abhorrent violation of human rights. It is very disturbing that while many children are forcibly recruited into armed conflicts, others actually volunteer, due to their nightmarish alternatives. Although the practice has recently gained worldwide attention, awareness alone will not end the…

  5. Posttraumatic Resilience in Former Ugandan Child Soldiers

    Science.gov (United States)

    Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Post, Manuela; Hoyer, Catrin; Adam, Hubertus

    2010-01-01

    The present research examines posttraumatic resilience in extremely exposed children and adolescents based on interviews with 330 former Ugandan child soldiers (age = 11-17, female = 48.5%). Despite severe trauma exposure, 27.6% showed posttraumatic resilience as indicated by the absence of posttraumatic stress disorder, depression, and clinically…

  6. Women Soldiers in Korea: Troop Viewpoints

    Science.gov (United States)

    1977-12-01

    large- scala hostilities ’commenced) weresam pled before the alert. Data regarding those soldiers utider less immediaterisk of early eney contact was...icason that the results may be used to help foranIyate EUSA recorvueevdations about the nuir-ers and kinds o- wuc_,en Lo b2 assigned to the coixand

  7. Diogenes, Dogfaced Soldiers, and Deployment Music Videos

    Science.gov (United States)

    Carter, Geoffrey; Williamson, Bill

    2010-01-01

    This webtext explores the cynical/kynical humor of soldier videos, suggesting that amateur videos paradoxically both undercut authority and honor effective leaders, both make light of and also publicly reveal deployment hardships, both distance the performers from military groupthink and celebrate unit camaraderie.

  8. Liberia's Child Soldiers: Prospects and Problems I

    African Journals Online (AJOL)

    This is an abridged version of a research report on the role of social support networks in the rehabilitation of child ..... eating from the same plate, playing a game together, or working in the same office with a child soldier, ..... certain needs and facilities such as electricity, television and video tended to negatively impact on ...

  9. Modelling worker physical health and societal sustainability at farm level: an application to conventional and organic dairy farming

    NARCIS (Netherlands)

    Calker, van K.J.; Berentsen, P.B.M.; Boer, de I.J.M.; Giesen, G.W.J.; Huirne, R.B.M.

    2007-01-01

    Farm-level modelling can be used to determine how farming systems and individual farm-management measures influence different sustainability indicators. Until now however, worker physical health and societal sustainability have been lacking in farm models. For this paper, we first selected

  10. Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad

    Directory of Open Access Journals (Sweden)

    Jonathan Lilje

    2016-11-01

    Full Text Available Behavior that has changed following promotion campaigns is usually not maintained at its initial level. Psychosocial factors for initiating behavior are often not the same as for the continuation of health behaviors such as water treatment and are much less understood. Better knowledge of factors for behavioral continuation would help to improve programs, both in the design of strategies for sustainable behavior change and by defining stronger criteria for the evaluation of sustainability. This study compared the mindsets of caregivers who continuously performed household drinking water treatment over time with individuals that stopped doing so in a population sample from Chad. Several factors from health psychology based on the Risks, Attitudes, Norms, Abilities, and Self-Regulation (RANAS model were used to compare the two groups and examine their differing development. Normative factors such as others’ behavior, personal obligation, social support and discourse, perceived self-efficacy convictions, action control, and intention best discriminated between the two groups and developed significantly more positively over time for continuers of water treatment. These factors should be considered when designing future interventions intended to lead to sustainable behavior change.

  11. Healthy living champions network: An opportunity for community pharmacy's sustained participation in tackling local health inequalities.

    Science.gov (United States)

    Nazar, Zachariah; Portlock, Jane; Rutter, Paul; Brown, David

    Evaluations recognize healthy living champions (HLCs) as key contributors to the Health Living Pharmacy (HLP) project's success; the project has served to reduce pressure on family doctor services and clients who would have otherwise not sought professional advice have accessed HLP services. To investigate the impact of innovative networking opportunities in supporting HLCs to function within their role and to explore the network's potential in promoting sustained HLP participation. Twenty of Portsmouth's (England) HLCs (n = 33) agreed to participate in focus groups. Transcripts were subjected to interpretative phenomenological analysis guided by grounded theory. The transcripts were read repeatedly; recurrent themes were identified and coded manually and consensus was reached by discussion within the research team. Network meetings provide HLCs with professional development, networking opportunities and continued encouragement. Recommendations to develop and sustain the network included the formation of a group committee and establishing of a communication facility accessible between meetings. The successful Portsmouth HLP project informed the design of UK HLP projects. The current focus is to build a successful strategy to sustain the positive outcomes, building on the recognized enablers. This study contributes further lessons learned to guide health commissioners and service implementers to best support staff development, involvement and motivation through innovative practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Attitudes of the Lifestyle of Health and Sustainability Segment in Hungary

    Directory of Open Access Journals (Sweden)

    Zoltán Szakály

    2017-09-01

    Full Text Available The aim of the research was to define the size of the Hungarian LOHAS (Lifestyle of Health and Sustainability consumer group by analyzing its lifestyle based on sustainable values. To achieve this goal, a representative questionnaire-based survey was carried out involving 1000 individuals in Hungary. During the value-orientated research, 25 lifestyle statements were drawn up. According to the results, five value-based segments could be distinguished. The largest cluster, the young trend followers group, reflects the characteristics of the LOHAS consumers’ lifestyle to the greatest extent. However, this segment cannot entirely be regarded as a consumer group devoted to LOHAS values, which is why a further segmentation of this group was necessary. As a result of this further segmentation, the third sub-cluster, which emphasizes the ethical (competence statements the most, can be identified with the LOHAS consumer group, which makes up 8.7% of the Hungarian population. Further research is necessary to find out whether the situation regarding value orientation in Hungary is similar to that in other Eastern European countries whose social and cultural backgrounds are very similar. Revealing the values of the Lifestyle of Health and Sustainability segment contributes to the extension of the literature.

  13. Financial sustainability of academic health centers: identifying challenges and strategic responses.

    Science.gov (United States)

    Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

    2014-06-01

    Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

  14. The sustainability of systems of care for children's mental health: lessons learned.

    Science.gov (United States)

    Stroul, Beth A; Manteuffel, Brigitte A

    2007-07-01

    The federal Comprehensive Community Mental Health Services for Children and Their Families Program was initiated in 1992 to provide grants to states, communities, territories, and Indian tribes to develop systems of care to serve children and adolescents with or at risk for emotional disorders and their families. As part of the national evaluation of this program, a study was undertaken to assess the ability of funded sites to sustain their systems of care beyond the federal grant period. The study involved a web survey and telephone interviews with local and state respondents to examine the extent to which key components of systems of care were maintained during the period in which federal funds were phasing out and during the post grant period. Study results demonstrate positive and negative changes that occurred in the communities which are included in the sample, with respect to maintaining the availability of each service included in the broad service array, the implementation of system of care principles, the system of care infrastructure, and the achievement of system of care goals. In addition, results identify factors that contribute to or impede the ability to sustain systems of care, and the effectiveness of various strategies for sustainability. Study findings offer guidance not only to federally funded system of care communities but also to non-funded communities engaged in system of care development to enhance their ability to sustain systems of care for this population over time. Findings will also assist federal, state, and local policymakers, technical assistance providers, family members, advocates, and other key stakeholders to more effectively support the development of viable, sustainable systems of care.

  15. 2006 Harben Lecture. World poverty and population health: the need for sustainable change.

    Science.gov (United States)

    Aitsi-Selmi, Amina

    2008-06-01

    Despite important recent initiatives to improve the health of the most disadvantaged in the world (the Millennium Development Goals, debt cancellation campaigns), poverty and preventable diseases still plague many parts of the globe. Sub-Saharan Africa remains one of the most severely affected. It is the only region in the world where life expectancy has not seen much improvement. Some countries have employed strategies of investment in public services, such as education, with positive results (e.g. the 'tiger economies'). Others have tried to follow prescribed strategies from global institutions such as the International Monetary Fund and World Bank with varying degrees of success. Sustainable development will require continuous commitment from donors and recipients to long-term strategies. Oxfam believes investment in public services and education is key to sustainability, in combination with more effective debt cancellation. These concepts are explored in the 2006 Harben Lecture given by Barbara Stocking, Director of Oxfam.

  16. Food quality, effects on health and sustainability today: a model case report.

    Science.gov (United States)

    Borroni, Vittorio Natale; Fargion, Silvia; Mazzocchi, Alessandra; Giachetti, Marco; Lanzarini, Achille; Dall'Asta, Margherita; Scazzina, Francesca; Agostoni, Carlo

    2017-02-01

    The Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico is a five-century institution that, besides the unique clinical role in the center of Milan, may rely on benefactor donations such as fields and farming houses not far from the city, for a total of 8500 ha, all managed by the "Sviluppo Ca' Granda' Foundation". Presently, the main products of these fields are represented by rice and cow's milk. During the latest years, farmers and managers have developed a model of sustainable food production, with great attention to the product quality based on compositional analysis and functional nutritional characteristics. This experience represents a new holistic model of food production and consumption, taking great care of both sustainability and health.

  17. A comparison between two methods of measuring total fat in the Iranian soldiers

    Directory of Open Access Journals (Sweden)

    J. Rahmani

    2017-04-01

    Full Text Available Background: Constant checkup and control of body fat mass is an important parameter for the health and efficiency of individuals in any society. This parameter is especially crucial in army soldiers since physical fitness is a key role in reaching high physical performance, health, and survival in war. Objective: This study was designed to compare two methods of measuring fat, the method of circumference-based military equations (CBEs to estimate body fat mass compared to the method of skinfold thickness-based equation (SBE in Iranian soldiers. Methods: This cross-sectional study was conducted on 246 Iranian soldiers were recruited in Tehran (2016. Height, waist, and neck circumference were measured and the total body fat mass was calculated using CBEs. Then, the results of using Pierson’s correlation and Bland-Altman methods were compared with Jackson and Pollock’s skinfold thickness measurement. Findings: The total body fat mass of the soldiers using CBEs was 18.94±6.30% and using Jakson and Pollock’s skinfold thickness formula was 17.43±4.45%. The correlation between the two methods was r=0.984 and SEE was 1.1% (P<0.001. Conclusion: The more body fat makes the error waist circumference greater. The error is so much that don’t use this method to measure fat.

  18. Exploring How Knowledge Translation Can Improve Sustainability of Community-Based Health Initiatives for People with Intellectual/Developmental Disabilities

    Science.gov (United States)

    Spassiani, Natasha A.; Parker Harris, Sarah; Hammel, Joy

    2016-01-01

    Community-based health initiatives (CBHI) play an important role in maintaining the health, function and participation of people with intellectual/developmental disabilities (I/DD) living in the community. However, implementation and long-term sustainability of CBHI is challenging. The Promoting Action on Research Implementation in Health Services…

  19. Development of a Model of Soldier Effectiveness: Retranslation Materials and Results

    Science.gov (United States)

    1987-05-01

    Although this soldier knew that alcohol was prohibited in the field, he brought along a bottle of vodka to the field site. 107. This soldier...soldier made up a fake excuse for his tardiness to a counseling session. 72. This soldier did not properly clean his weapon. 73. This soldier did not

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

    Science.gov (United States)

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

    2018-01-01

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

  1. Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

    Science.gov (United States)

    Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

    2010-07-01

    The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

  2. Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign.

    Science.gov (United States)

    McGrath, Katherine M; Bennett, Denise M; Ben-Tovim, David I; Boyages, Steven C; Lyons, Nigel J; O'Connell, Tony J

    2008-03-17

    *Clinical process redesign has enabled significant improvements in the delivery of health care services in emergency departments and elective surgery programs in New South Wales and at Flinders Medical Centre in South Australia, with tangible benefits for patients and staff. *The principles used in clinical process redesign are not new; they have been applied in other industries with significant gains for many years, but have only recently been introduced into health care systems. *Through experience with clinical process redesign, we have learnt much about the factors critical to the success of implementing and sustaining this process in the health care setting. *The key elements for success are leadership by senior executives, clinical leadership, team-based problem solving, a focus on the patient journey, access to data, ambitious targets, strong performance management, and a process for maintaining improvement.

  3. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work?

    DEFF Research Database (Denmark)

    Holtermann, A; Blangsted, A K; Christensen, H

    2009-01-01

    OBJECTIVES: The aim of this case-control study was to investigate characteristics of cleaners with good musculoskeletal health after years with physically heavy work. METHODS: One hundred and 41 female seniority cleaners participated. Twenty-five reported no musculoskeletal symptoms, whereas 83...... work factors, and leisure time physical activity were assessed by a postal questionnaire. RESULTS: Cleaners with good musculoskeletal health were not reporting different exposure to physical risk factors at work or leisure time physical activity, but had higher muscular strength and reported higher...... influence at work than cleaners with severe symptoms. CONCLUSIONS: These findings suggest that muscular strength and influence at work are of relevance for sustaining good musculoskeletal health in workers with physically heavy work....

  4. Sustainable ubiquitous home health care--architectural considerations and first practical experiences.

    Science.gov (United States)

    Marschollek, Michael; Wolf, Klaus-H; Bott, Oliver-J; Geisler, Mirko; Plischke, Maik; Ludwig, Wolfram; Hornberger, Andreas; Haux, Reinhold

    2007-01-01

    Despite the abundance of past home care projects and the maturity of the technologies used, there is no widespread dissemination as yet. The absence of accepted standards and thus interoperability and the inadequate integration into transinstitutional health information systems (tHIS) are perceived as key factors. Based on the respective literature and previous experiences in home care projects we propose an architectural model for home care as part of a transinstitutional health information system using the HL7 clinical document architecture (CDA) as well as the HL7 Arden Syntax for Medical Logic Systems. In two short case studies we describe the practical realization of the architecture as well as first experiences. Our work can be regarded as a first step towards an interoperable - and in our view sustainable - home care architecture based on a prominent document standard from the health information system domain.

  5. Financing the Millennium Development Goals for health and beyond: sustaining the 'Big Push'

    Directory of Open Access Journals (Sweden)

    Basu Sanjay

    2010-10-01

    Full Text Available Abstract Many of the Millennium Development Goals are not being achieved in the world's poorest countries, yet only five years remain until the target date. The financing of these Goals is not merely insufficient; current evidence indicates that the temporary nature of the financing, as well as challenges to coordinating its delivery and directing it to the most needy recipients, hinder achievement of the Goals in countries that may benefit most. Traditional approaches to providing development assistance for health have not been able to address both prevalent and emergent public health challenges captured in the Goals; these challenges demand sustained forms of financial redistribution through a coordinated mechanism. A global social health protection fund is proposed to address recurring failures in the modern aid distribution mechanism. Such a Fund could use established and effective strategies for aid delivery to mitigate many financial problems currently undermining the Millennium Development Goals initiative.

  6. Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Michelle M. Haby

    Full Text Available ABSTRACT Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as “sustainable,” interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development, all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

  7. Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-08-01

    Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development), all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

  8. Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists

    Directory of Open Access Journals (Sweden)

    Alexandra Nugent

    2017-01-01

    Full Text Available Background/Aim. Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists’ experiences of developing and sustaining recovery-orientation in mental health practice. Methods. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Results. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists’ workplace environment influenced this process. Conclusions. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

  9. Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists.

    Science.gov (United States)

    Nugent, Alexandra; Hancock, Nicola; Honey, Anne

    2017-01-01

    Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists' experiences of developing and sustaining recovery-orientation in mental health practice. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists' workplace environment influenced this process. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

  10. Financial sustainability of home care in the health system of the Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Konstantinović Dejan

    2013-01-01

    Full Text Available Introduction. Over the last several years, during the economic crisis, the Ministry of Health and the Republican Health Insurance Fund (RHIF have been faced with new challenges in the sphere of healthcare services financing both in the primary as well as other types of health insurance in the Republic of Serbia (RS. Objective. Analysis of cost­effectiveness of two models of organization of home treatment and healthcare in the primary insurance, with evaluation of the cost sustainability of a single visit by the in­home therapy team. Methods. Economic evaluation of the cost of home treatment and healthcare provision in 2011 was performed. In statistical analysis, the methods of descriptive statistics were employed. The structure of fixed costs of home healthcare was developed according to the RS official norms, as well as fixed costs of providing services of home therapy by the Healthcare Centre "New Belgrade". The statement of account for provided home therapy services was made utilizing the RHIF price list. Results. The results showed that the cost of home healthcare and therapy of the heterogeneous population of patients in the Healthcare Centre "New Belgrade" was more cost­effective in relation to the cost of providing home therapy services according to the RS official norms. Conclusion. Approved costs utilized when making a contract for services of home therapy and healthcare with the RHIF are not financially sustainable. It was shown that the price of 10 EUR for each home visit by the in­home therapy team enables sustainability of this form of providing healthcare services in RS.

  11. [Financial sustainability of home care in the health system of the Republic of Serbia].

    Science.gov (United States)

    Konstantinović, Dejan; Lazarević, Vesna; Milovanović, Valentina; Lapcević, Mirjana; Konstantinović, Vladan; Vuković, Mira

    2013-01-01

    Over the last several years, during the economic crisis, the Ministry of Health and the Republican Health Insurance Fund (RHIF) have been faced with new challenges in the sphere of healthcare services financing both in the primary as well as other types of health insurance in the Republic of Serbia (RS). Analysis of cost-effectiveness of two models of organization of home treatment and healthcare in the primary insurance, with evaluation of the cost sustainability of a single visit by the in-home therapy team. Economic evaluation of the cost of home treatment and healthcare provision in 2011 was performed. In statistical analysis, the methods of descriptive statistics were employed. The structure of fixed costs of home healthcare was developed according to the RS official norms, as well as fixed costs of providing services of home therapy by the Healthcare Centre "New Belgrade". The statement of account for provided home therapy services was made utilizing the RHIF price list. The results showed that the cost of home healthcare and therapy of the heterogeneous population of patients in the Healthcare Centre "New Belgrade" was more cost-effective in relation to the cost of providing home therapy services according to the RS official norms. Approved costs utilized when making a contract for services of home therapy and healthcare with the RHIF are not financially sustainable. It was shown that the price of 10 EUR for each home visit by the in-home therapy team enables sustainability of this form of providing healthcare services in RS.

  12. Posttraumatic Stress Disorder and Health Functioning in a Non-Treatment-Seeking Sample of Iraq War Veterans: A Prospective Analysis

    National Research Council Canada - National Science Library

    Vasterling, Jennifer J; Schumm, Jeremiah; Proctor, Susan P; Gentry, Elisabeth; King, Daniel W; King, Lynda A

    2007-01-01

    .... Army soldiers before and after 1-year military deployments to Iraq. As part of the Neurocognition Deployment Health Study procedures, each soldier completed at both time points self-report indexes of PTSD symptom severity, health behaviors...

  13. Enterprising health: creating the conditions for entrepreneurial behaviour as a strategy for effective and sustainable change in health services.

    Science.gov (United States)

    Exton, Rosemary

    2010-01-01

    This paper seeks to investigate conditions under which entrepreneurs emerge as agents of effective and sustainable change in UK National Health Service Trusts. The research synthesises literature on changing regulatory structures ("post-bureaucracy") and entrepreneurial behaviour to understand how individual identity construction is informed both by context and by individual attributes. Thematic analysis of interview data involving managers from 11 NHS Trusts, including detailed analysis of six transcripts, focuses on regulatory processes, the emergence of entrepreneurial behaviour and outcome variations in workplace innovation and improvement. This study identifies co-existing modes of regulation, which interact with individual behaviour, generating strategies differentiated as entrepreneurial or conformist. Four ideal types are identified: organisational entrepreneurship, resisted or dissonant entrepreneurship, conformity, and symbolic entrepreneurship. Analysis reinforces those literature findings, which suggest that the interaction of regulatory structures and the identity work of individuals influence the emergence of entrepreneurial behaviour and the effectiveness of change. The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of the organisation's ability to generate the structures, processes, individual competence and motivation which enable employees at all levels to act entrepreneurially with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures. The study identifies specific conditions, which stimulate the emergence of entrepreneurs as agents of effective and sustainable change in the NHS, identifying factors that policymakers should consider when implementing change.

  14. Assessing the universal health coverage target in the Sustainable Development Goals from a human rights perspective.

    Science.gov (United States)

    Chapman, Audrey R

    2016-12-15

    The UN's Sustainable Development Goals (SDGs), adopted in September 2015, include a comprehensive health goal, "to ensure healthy lives and promote well-being at all ages." The health goal (SDG 3) has nine substantive targets and four additional targets which are identified as a means of implementation. One of these commitments, to achieve universal health coverage (UHC), has been acknowledged as central to the achievement of all of the other health targets. As defined in the SDGs, UHC includes financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. This article evaluates the extent to which the UHC target in the SDGs conforms with the requirements of the right to health enumerated in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, and other international human rights instruments and interpreted by international human rights bodies. It does so as a means to identify strengths and weaknesses in the framing of the UHC target that are likely to affect its implementation. While UHC as defined in the SDGs overlaps with human rights standards, there are important human rights omissions that will likely weaken the implementation and reduce the potential benefits of the UHC target. The most important of these is the failure to confer priority to providing access to health services to poor and disadvantaged communities in the process of expanding health coverage and in determining which health services to provide. Unless the furthest behind are given priority and strategies adopted to secure their participation in the development of national health plans, the SDGs, like the MDGs, are likely to leave the most disadvantaged and vulnerable communities behind.

  15. Achieving Sustainable, Community-Based Health in Detroit Through Adaptation of the UNSDGs.

    Science.gov (United States)

    Plum, Alexander; Kaljee, Linda

    In 2012, the Rio+20 meeting initiated the concept of the Sustainable Development Goals (SDGs) as a continuation of the Millennium Development Goals. The resulting document "The Future We Want" is best conceived as a roadmap toward poverty eradication and sustainable development. Although the SDGs were developed for low- and middle-income countries, many of these same issues face low-resource cities and communities in higher-income countries. The aim of this study was to use the SDGs as a platform to develop health-related goals for the city of Detroit. A 1-day workshop was convened in October 2015 including 55 representatives from government, academia, and community- and faith-based organizations. Four health-related SDGs were discussed: food security (SDG2); ensuring healthy lives at all ages (SDG3); access to potable water (SDG6); and making cities inclusive, safe, resilient, and sustainable living environments (SDG11). Workshop attendees broke into 4 groups to determine how the SDG targets for these 4 goals could be adapted for Detroit. At the end of the day, each group presented its decisions to the larger group. Workshop participants expressed that the SDGs empower local communities to respond to their unique health challenges and to see themselves as part of a larger more global conversation about development and sustainability. Participants suggested that inclusive and participatory means of decision making were a significant component of the SDGs and that such a process is the direction needed to make community-focused changes in Detroit. Additionally, shortly after the workshop, a roundtable of participants representing 5 community partners began to meet monthly and has become an advocacy group for public health and addressing the city-order water shutoffs in neighborhoods throughout Detroit. For participants and organizers, the workshop reinforced the hypothesis that the SDGs are relevant to Detroit and other low-resource cities in the United States

  16. Global health and development: conceptualizing health between economic growth and environmental sustainability.

    Science.gov (United States)

    Borowy, Iris

    2013-07-01

    After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too. Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development.

  17. Impacts of flood on children and adults’ health and ways to sustainable development

    Science.gov (United States)

    Mohamed, S.; Ebenehi, I. Y.; Adaji, A.; Seow, T. W.; Chan, N. W.; Goh, K. C.; Rahim, M. H. I. Abd

    2017-11-01

    One of the events that will remain fresh in the minds of Kelantanese is the 2014 massive flood that occurred at the end of that year. Heavy rains fell initiating vast flooding in most areas of Kelantan leading to great destruction of livelihood of local communities. Natural hazard such as floods are not only caused by natural processes but also by human activities. The flood recorded severe fatalities, injuries and exposed many vulnerable to diseases. This paper through critical review of literature considered the long-term impact of floods on human’s health as the effects could meaningfully contribute to the worldwide burden of disease. Also, its outcomes are relentless hence need to be adequately comprehended and addressed through sustainability. This study revealed vulnerability to flood inclined ailments as psychological distress in the survivors is liable for a quota of all physical ailments. Hence, sustainable approach to flood preparedness and prevention is instantly needed. Accolades should be given to the Malaysian government for taken bold steps in that direction in recent time but success will be achieved if implementation is in compliance with sustainability agenda spelt in the New Sendai Framework for Disaster Risk Reduction 2015-2030.

  18. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework.

    Science.gov (United States)

    Iwelunmor, Juliet; Blackstone, Sarah; Veira, Dorice; Nwaozuru, Ucheoma; Airhihenbuwa, Collins; Munodawafa, Davison; Kalipeni, Ezekiel; Jutal, Antar; Shelley, Donna; Ogedegebe, Gbenga

    2016-03-23

    Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment

  19. Challenges, alternatives, and paths to sustainability for health information exchange efforts.

    Science.gov (United States)

    Vest, Joshua R; Campion, Thomas R; Kaushal, Rainu

    2013-12-01

    Health information exchange (HIE) is a promising approach to improving the cost and quality of healthcare. We sought to identify the strengths and weaknesses of organizational models to achieve exchange, and what can be done to ensure the sustainability and effectiveness of exchange efforts. We interviewed state and national health informatics policy experts (n = 17). Data were collected as part of an evaluation of the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) program and included respondents from both the private and public sectors. Data were analyzed using a general inductive and comparative approach with open coding of themes. Interviewees generally viewed HIE as a public or societal good to be valued. However, they identified challenges with the regional health information organization (RHIO) model of facilitating exchange including: economics, organizational issues, and geography. RHIOs were contrasted against alternative methods of exchange such as Direct, enterprise HIE, and vendor-mediated exchange. HIE is a difficult undertaking due to political and economic reasons. Alternatives to the RHIO model have features that may be more attractive to participants, but may be of less public benefit. Using states as intermediaries and mandating exchange under public health law may avoid the challenges facing exchange efforts. Moving forward, policies will have to address the shortcomings of each HIE model to ensure information is effectively shared between providers to maximize health benefits.

  20. Challenges and Opportunities for Urban Environmental Health and Sustainability: the HEALTHY-POLIS initiative.

    Science.gov (United States)

    Vardoulakis, Sotiris; Dear, Keith; Wilkinson, Paul

    2016-03-08

    Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.

  1. Assessing Heat Health Risk for Sustainability in Beijing’s Urban Heat Island

    Directory of Open Access Journals (Sweden)

    Weihua Dong

    2014-10-01

    Full Text Available This research is motivated by the increasing threat of urban heat waves that are likely worsened by pervasive global warming and urbanization. Different regions of the city including urban, borderland and rural area will experience different levels of heat health risk. In this paper, we propose an improved approach to quantitatively assess Beijing’s heat health risk based on three factors from hazard, vulnerability and especially environment which is considered as an independent factor because different land use/cover types have different influence on ambient air temperatures under the Urban Heat Island effect. The results show that the heat health risk of Beijing demonstrates a spatial-temporal pattern with higher risk in the urban area, lower risk in the borderland between urban and rural area, and lowest risk in the rural area, and the total risk fluctuated dramatically during 2008–2011. To be more specific, the heat health risk was clearly higher in 2009 and 2010 than in 2008 and 2011. Further analysis with the urban area at sub-district level signifies that the impervious surface (urban area such as buildings, roads, et al. ratio is of high correlation with the heat health risk. The validation results show that the proposed method improved the accuracy of heat health risk assessment. We recommend that policy makers should develop efficient urban planning to accomplish Beijing’s sustainable development.

  2. Reasons for medical evacuations of soldiers serving in International Security Assistance Force (ISAF) operation in Afghanistan.

    Science.gov (United States)

    Korzeniewski, Krzysztof; Gregulski, Robert

    2014-01-01

    The article presents the results of a research study into the reasons for medical evacuations of Polish military personnel taking part in the International Security Assistance Force (ISAF) operation in Afghanistan from 2007 to 2013. The authors have analysed medical records of 485 soldiers who were medically evacuated out of a combat zone in Afghanistan for battle injuries, non-battle injuries and diseases. Each medically evacuated Polish soldier was subjected to statistical analysis. The study population comprised 25,974 soldiers assigned to the Polish Military Contingent Afghanistan in the given period. From 2007 to 2013, 1.9% of the Polish military personnel (n = 485) participating in the ISAF operation in Afghanistan were evacuated for medical reasons before the scheduled termination of their contract. 40.6% of all medical evacuations were due to battle injuries, 32.4% due to non-battle injuries, and 27.0% due to diseases. ISAF is an example of a combat operation, in which battle injuries remain the leading health problem in mission participants. 3 of 4 Polish soldiers who were medically evacuated from Afghanistan were no longer fit for military service in the area of operations due to the traumas they had suffered.

  3. Developing and sustaining human resources in the health supply chain in Ethiopia: barriers and enablers.

    Science.gov (United States)

    Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N

    2016-01-01

    The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.

  4. Sustainability and public health nutrition at school: assessing the integration of healthy and environmentally sustainable food initiatives in Vancouver schools.

    Science.gov (United States)

    Black, Jennifer L; Velazquez, Cayley E; Ahmadi, Naseam; Chapman, Gwen E; Carten, Sarah; Edward, Joshua; Shulhan, Stephanie; Stephens, Teya; Rojas, Alejandro

    2015-09-01

    To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. Vancouver, Canada. A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

  5. Towards equity and sustainability of rural and remote health services access: supporting social capital and integrated organisational and professional development.

    Science.gov (United States)

    Schoo, Adrian; Lawn, Sharon; Carson, Dean

    2016-04-02

    Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case study is used to demonstrate how such an approach could work. Disjointed health services are common in rural areas due to the 'tyranny of distance.' Recruitment and retention of health professionals in rural areas and access to and sustainability of rural health services is therefore compromised. Strategies to address these issues tend to have a narrow focus. An integrated approach is needed to enhance rural workforce and health services; one that develops, acknowledges and accounts for social capital and social relations within the rural community.

  6. The relationship between symptoms of attention deficit and hyperactivity disorder and oppositional defiant disorder with soldier performance during training.

    Science.gov (United States)

    Rice, Valerie J; Butler, Jenny; Marra, Diane

    2013-01-01

    During interviews with Health Care Specialist military cadre, instructors voiced concern that symptoms associated with attention deficit and hyperactivity disorder (SoADHD) and oppositional defiant disorder (SoODD) were interfering with soldiers' ability to complete training. The purpose of this research was to examine the relationship between SoADHD and SoODD with soldiers' grade point average (GPA), Army Physical Fitness Test (APFT) scores, and musculoskeletal injuries during Health Care Specialist (HCS) Advanced Individual Training (AIT). Participants included 122 soldiers attending HCS training. Participants completed a demographic survey and Barkley and Murphy's ADHD and ODD self-report symptom surveys. Their ADHD and ODD self-report scores were correlated with course performance metrics at the conclusion of their 16 weeks of training. Pearson Correlation Coefficients revealed a significant negative relationship between ratings on the Oppositional Defiant Disorder scale with soldiers' GPA (p APFT scores or musculoskeletal injuries. Symptoms associated with ADHD and ODD had little impact on the academic and physical performance of soldiers attending HCS training. Implications and future research are explored, in this article.

  7. Social Network Analysis and Soldier Resilience

    Science.gov (United States)

    2011-04-01

    Soldiers before they even enter their office. One current treatment available is cognitive -behavioral treatment (CBT). This is a leading psychological...of a unit. It is common for different people to have different perceptions of the same situation; cognitively speaking it is very unlikely for an...Asch’s experiment three decades later [Electronic version]. Gedrag: Tijdschrift voor Psychologie , 13(1), 49-55. Thirty years later Vlaander and

  8. Gascoyne Growers Market: a sustainable health promotion activity developed in partnership with the community.

    Science.gov (United States)

    Payet, Jennifer; Gilles, Marisa; Howat, Peter

    2005-10-01

    To explore the social, health and economic impact of a farmers' market on a small rural community in the north of Western Australia. Qualitative and quantitative research using a random structured intercept survey, and focus group interviews around four domains of social capital: economic impact, governance and capacity building, healthy public places and social and civic participation. The Gascoyne Growers Markets in Carnarvon. One hundred consumers and 28 market stallholders. Consumers demonstrated community pride and an increase in fruit and vegetable consumption since they commenced shopping at the markets. The stallholders appear to have gained economically, professionally and socially from the market experience. The Gascoyne Growers Markets demonstrate a sustainable health promotion activity developed in partnership with the community. It has contributed to the local economy, providing local quality fruit and vegetables directly to the community while also increasing social capital and creating a healthy public space.

  9. Market reforms in health care and sustainability of the welfare state

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1995-01-01

    'pressed out' and reduced waiting lists. Increased efficiency however, threatens equity in some specific aspects. Fee-for-service payment means increased production and so far even increased costs. If they are to be met with increased private financing, rather than with present tax financing, it will bring......Reforming health care systems which are predominantly publicly provided and financed has usually been motivated as a way of increasing efficiency even if it seldom is explicit whether it is in the official sense related to individual utility or in the unofficial sense related to health outcomes....... In the case of Sweden the welfare state has been made politically sustainable through a construction where cash benefits and service provision are tailored to satisfy not only the basic needs but even the more discriminating needs of the middle classes. Their loyalty with the taxes is politically crucial...

  10. Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board.

    Science.gov (United States)

    Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew

    2012-05-11

    In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.

  11. Effective nutrition education and communication for sustainable maternal and child health.

    Science.gov (United States)

    Murimi, Mary W; Moyeda-Carabaza, Ana Florencia

    2017-06-30

    Maternal and child health (MCH) consists of an interdependent reproductive system that collectively determines the survival of the mother during childbirth, and determines the health and survival of the child. This interdependency underscores the importance of appropriate and timely interventions during pregnancy through the first 1000 d at the minimum. The Millennium Development Goals (MDG) recommended the use of the continuum of care for the development of interventions by addressing all the stages of MCH. The purpose of the present paper is to review the factors that contributed to the attainment of the MDG 4 and MDG 5 by analysing the interventions conducted by the countries that achieved at least 5·0 and 5·5 %, respectively, and determine the level of their intervention based on the MCH conceptual framework. Out of the eighteen selected countries discussed, fifteen countries achieved their target for either MDG 4 or MDG 5 or both, while three countries did not achieve their target. The countries that were more likely to achieve their targets addressed the societal, underlying and direct causes, and implemented country wide policies. In contrast, the countries that did not succeed were more likely to address the direct causes with poor policy implementation. Understanding the motivation and limitations of the target population, including nutrition education and targeting behaviour change has the potential to result in sustainable MCH. This information has the potential to enlighten the policymakers as we progress to the sustainable development goals, specifically goals 2 and 3.

  12. Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

    Science.gov (United States)

    Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

    2017-01-01

    The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Searching for the Right to Health in the Sustainable Development Agenda Comment on "Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?".

    Science.gov (United States)

    Hawkes, Sarah; Buse, Kent

    2016-02-24

    The United Nations (UN) Sustainable Development Agenda offers an opportunity to realise the right to health for all. The Agenda's "interlinked and integrated" Sustainable Development Goals (SDGs) provide the prospect of focusing attention and mobilising resources not just for the provision of health services through universal health coverage (UHC), but also for addressing the underlying social, structural, and political determinants of illness and health inequity. However, achieving the goals' promises will require new mechanisms for inter-sectoral coordination and action, enhanced instruments for rational priority-setting that involve affected population groups, and new approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas. In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a health-promoting and health protecting environment for each and every one of us. We argue that realizing the right to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments, not least those outlined in other goals, and pursue complementary openings in the Agenda - from inclusive policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind. © 2016 by Kerman University of Medical Sciences.

  14. Perspective: Improving Nutritional Guidelines for Sustainable Health Policies: Current Status and Perspectives.

    Science.gov (United States)

    Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio; Agostoni, Carlo; Astrup, Arne; Brighenti, Furio; Cook, Robert; Folco, Emanuela; Fontana, Luigi; Gibson, Robert A; Guerra, Ranieri; Guyatt, Gordon H; Ioannidis, John Pa; Jackson, Ann S; Klurfeld, David M; Makrides, Maria; Mathioudakis, Basil; Monaco, Alessandro; Patel, Chirag J; Racagni, Giorgio; Schünemann, Holger J; Shamir, Raanan; Zmora, Niv; Peracino, Andrea

    2017-07-01

    A large body of evidence supports the notion that incorrect or insufficient nutrition contributes to disease development. A pivotal goal is thus to understand what exactly is appropriate and what is inappropriate in food ingestion and the consequent nutritional status and health. The effective application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline recommendations, properly grading the quality of the available evidence, promoting adherence to the well-established evidence hierarchy in nutrition, and enhancing strategies for appropriate vetting and transparent reporting that will solidify the recommendations for health promotion. The final goal is to build a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic biomarkers, food quality and intake frequency, lifestyle variables such as physical activity, and environmental variables including one's microbiome profile. There is a strong and urgent need to develop a successful commitment among all the stakeholders to define novel and sustainable approaches toward the management of the health value of nutrition at individual and population levels. Moving forward requires adherence to well-established principles of evidence evaluation as well as identification of effective tools to obtain better quality evidence. Much remains to be done in the near future. © 2017 American Society for Nutrition.

  15. Controlling cost escalation of healthcare: making universal health coverage sustainable in China.

    Science.gov (United States)

    Tang, Shenglan; Tao, Jingjing; Bekedam, Henk

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China.There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable.

  16. Development models, sustainability and occupational and environmental health in the Americas: neoliberalism versus sustainable theories of development

    Directory of Open Access Journals (Sweden)

    Moure-Eraso Rafael

    2003-01-01

    Full Text Available This article describes the inherent contradiction between competitive capitalism and the pursuing of the "three bottom lines": 1 economic prosperity, 2 environmental quality (including the workplace and 3 social justice. An alternative, genuine, sustainable approach to development; the Integrated Human Ecosystem Approach will be described and contrasted with neoliberal development. The IHE approach was developed by The International Development Research Center of Canada in 2001. In this approach, the triple bottom line is not a simple tool for neoliberal development, but the focus of allocation and management of resources for sustainable development. The acquisition of only state power by governments opposed to neoliberalism is necessary but not sufficient condition to successfully find a human alternative to the market ideology. A road map needs to be developed in which a clear definition of technologies that permit the acquisition and implementation of an alternative ideology to achieve "social power." The IHE model provides developing countries with the basis for that ideology.

  17. Development models, sustainability and occupational and environmental health in the Americas: neoliberalism versus sustainable theories of development

    Directory of Open Access Journals (Sweden)

    Rafael Moure-Eraso

    Full Text Available This article describes the inherent contradiction between competitive capitalism and the pursuing of the "three bottom lines": 1 economic prosperity, 2 environmental quality (including the workplace and 3 social justice. An alternative, genuine, sustainable approach to development; the Integrated Human Ecosystem Approach will be described and contrasted with neoliberal development. The IHE approach was developed by The International Development Research Center of Canada in 2001. In this approach, the triple bottom line is not a simple tool for neoliberal development, but the focus of allocation and management of resources for sustainable development. The acquisition of only state power by governments opposed to neoliberalism is necessary but not sufficient condition to successfully find a human alternative to the market ideology. A road map needs to be developed in which a clear definition of technologies that permit the acquisition and implementation of an alternative ideology to achieve "social power." The IHE model provides developing countries with the basis for that ideology.

  18. Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana.

    Science.gov (United States)

    Chatio, Samuel; Akweongo, Patricia

    2017-01-01

    The shortage of formal health workers has led to the utilization of Community-Based Health Volunteers (CBHV) to provide health care services to people especially in rural and neglected communities. Community-based health volunteers have been effective partners in health care delivery at the community level for many years. The challenge is how to retain these volunteers and also sustain their activities. This study explored factors affecting retention and sustainability of community-based health volunteers' activities in a rural setting in Northern Ghana. This was a qualitative study comprising thirty-two in-depth interviews (IDIs) with health volunteers and health workers in-charge of health volunteers' activities. Purposive sampling technique was used to select study participants for the interviews. The interviews were transcribed and coded into themes using Nvivo 10 software. The thematic analysis framework was used to analyze the data. Study participants reported that the desire to help community members, prestige and recognition as doctors in community mainly motivated them to work as health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected the work. They suggested that lack of these things discouraged them from working as health volunteers. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots, bicycles, awards to hard working volunteers are mechanisms that can help retain community-based health volunteers and also sustain their activities. Providing means of transport and non-monetary incentives would help to retain community-based health volunteers and also sustain their activities at the community level.

  19. Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana.

    Directory of Open Access Journals (Sweden)

    Samuel Chatio

    Full Text Available The shortage of formal health workers has led to the utilization of Community-Based Health Volunteers (CBHV to provide health care services to people especially in rural and neglected communities. Community-based health volunteers have been effective partners in health care delivery at the community level for many years. The challenge is how to retain these volunteers and also sustain their activities. This study explored factors affecting retention and sustainability of community-based health volunteers' activities in a rural setting in Northern Ghana.This was a qualitative study comprising thirty-two in-depth interviews (IDIs with health volunteers and health workers in-charge of health volunteers' activities. Purposive sampling technique was used to select study participants for the interviews. The interviews were transcribed and coded into themes using Nvivo 10 software. The thematic analysis framework was used to analyze the data.Study participants reported that the desire to help community members, prestige and recognition as doctors in community mainly motivated them to work as health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected the work. They suggested that lack of these things discouraged them from working as health volunteers. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots, bicycles, awards to hard working volunteers are mechanisms that can help retain community-based health volunteers and also sustain their activities.Providing means of transport and non-monetary incentives would help to retain community-based health volunteers and also sustain their activities at the

  20. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being.

    Science.gov (United States)

    Nunes, Ana Raquel; Lee, Kelley; O'Riordan, Tim

    2016-01-01

    The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving 'integrated and indivisible' goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development.

  1. The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being

    Science.gov (United States)

    Lee, Kelley; O'Riordan, Tim

    2016-01-01

    The 2030 Agenda for Sustainable Development came into force in January 2016 as the central United Nations (UN) platform for achieving ‘integrated and indivisible’ goals and targets across the three characteristic dimensions of sustainable development: the social, environmental and economic. We argue that, despite the UN adoption of the Sustainable Development Goals (SDGs), a framework for operationalising them in an integrated fashion is lacking. This article puts forth a framework for integrating health and well-being across the SDGs as both preconditions and outcomes of sustainable development. We present a rationale for this approach, and identify the challenges and opportunities for implementing and monitoring such a framework through a series of examples. We encourage other sectors to develop similar integrating frameworks for supporting a more coordinated approach for operationalising the 2030 Agenda for Sustainable Development. PMID:28588955

  2. An evaluation of eHealth systems implementation frameworks for sustainability in resource constrained environment: A literature review

    CSIR Research Space (South Africa)

    Fanta, GB

    2015-06-01

    Full Text Available countries exhibited much more failures than the developed ones. Several eHealth implementation frameworks have been reported on literatures. However, this paper assesses the ability of these frameworks to ensure sustainability of eHealth systems in resource...

  3. Towards a better integration of global health and biodiversity in the new sustainable development goals beyond Rio+20.

    Science.gov (United States)

    Langlois, Etienne V; Campbell, Kathryn; Prieur-Richard, Anne-Hélène; Karesh, William B; Daszak, Peter

    2012-12-01

    In June 2012, Brazil hosted Rio+20, the United Nations Conference on Sustainable Development (UNCSD) marking the 20th anniversary of the 1992 Earth Summit. The Rio+20 outcome document entitled The future we want provides general guidance to shape sustainable development policies, but fell short of providing legally binding agreements or pragmatic goals. Negotiators agreed to develop a process for the establishment of new Sustainable Development Goals (SDGs), building upon the Millennium Development Goals, and setting the foundation for the post-2015 UN development agenda. Our objective is to argue that discussions beyond Rio+20 and toward the adoption of SDGs offer a critical opportunity to re-assess the major challenges for global health and sustainable development. There is an urgent need to translate the general aspirations put forth by Rio+20 into concrete health outcomes and greater health equity. The way toward the post-2015 SDGs will likely be more effective if it highlights the full gamut of linkages between ecosystem processes, anthropogenic environmental changes (climate change, biodiversity loss, and land use), socio-economic changes, and global health. Negotiations beyond Rio+20 should strongly acknowledge the global health benefits of biodiversity protection and climate change mitigation and adaptation strategies, which reduce diseases of poverty and protect the health of the most vulnerable. We argue that health and ecosystems are inextricably linked to all development sectors and that health should remain a critical priority for the upcoming SDGs in the context of global environmental change.

  4. Searching for the Right to Health in the Sustainable Development Agenda; Comment on “Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?”

    Directory of Open Access Journals (Sweden)

    Sarah Hawkes

    2016-05-01

    Full Text Available The United Nations (UN Sustainable Development Agenda offers an opportunity to realise the right to health for all. The Agenda’s “interlinked and integrated” Sustainable Development Goals (SDGs provide the prospect of focusing attention and mobilising resources not just for the provision of health services through universal health coverage (UHC, but also for addressing the underlying social, structural, and political determinants of illness and health inequity. However, achieving the goals’ promises will require new mechanisms for inter-sectoral coordination and action, enhanced instruments for rational priority-setting that involve affected population groups, and new approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas. In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a healthpromoting and health protecting environment for each and every one of us. We argue that realizing the right to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments, not least those outlined in other goals, and pursue complementary openings in the Agenda – from inclusive policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind.

  5. City leadership for health and sustainable development: the World Health Organization European Healthy Cities Network.

    Science.gov (United States)

    Tsouros, Agis

    2009-11-01

    This paper provides an overview of European Healthy Cities Network (EHCN) organized by the WHO Regional Office Europe. The focus is on the third of five phases covering the period 1998-2002. Fifty-six cities were members of the WHO-EHCN and over 1000 European cities were members of national networks. Association with WHO has given municipalities legitimacy to move into a domain often associated with health service. Equity and community participation are core values. City mayors provide political leadership. Intersectoral cooperation underpins a Healthy Cities approach. The WHO Regional Office for Europe supports WHO-EHCN, providing guidance and technical leadership. Cities' processes and structures are prerequisits for improvements in health and are central to the evaluation of Phase III of the WHO-EHCN.

  6. Ideological commitment and posttraumatic stress in former Tamil child soldiers.

    Science.gov (United States)

    Kanagaratnam, Pushpa; Raundalen, Magne; Asbjørnsen, Arve E

    2005-12-01

    This study focuses on the impact of present ideological commitment on posttraumatic stress symptoms in former child soldiers living in exile. Eighteen men and two women (aged 25-37), who had joined different Tamil armed groups in Sri Lanka between the ages of 13 and 17 years, participated. The Impact of Event Scale was used to measure posttraumatic symptoms. Qualitative methods were used to investigate the participants' ideological commitment. Participants reported being exposed to many potentially traumatizing events, and had high scores on the Impact of Event Scale. Twenty-five percent of the sample showed strong ideological commitment to the "cause". Ideological commitment at the present seemed to predict better mental health when exposure was less intense and overwhelming. Time had a negative impact on ideological commitment.

  7. Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network.

    Science.gov (United States)

    Sun, Christina J; Mann, Lilli; Eng, Eugenia; Downs, Mario; Rhodes, Scott D

    2015-10-01

    Little is known about the sustainability of male- and men's health-focused lay health advisors. HoMBReS Por un Cambio was a community-level social network intervention designed to improve sexual health among Latino men who were members of soccer teams. During the year after the intervention implementation, lay health advisors (Navegantes) continued to promote sexual health; over 84% (16 of the 19) Navegantes conducted 9 of 10 primary health promotion activities. Describing where to get condoms was the activity that the most Navegantes reported having conducted. Navegantes had broad reach with their social networks, although the number of Navegantes that conducted each activity differed across the categories of social network members (soccer teammates, nonteammates, and women). Results suggest that HIV-related health disparities may be addressed through lay health advisor interventions because they are sustained after the intervention ends and reach large numbers of community members.

  8. Towards a sustainable livestock production in developing countries and the importance of animal health strategy therein.

    Science.gov (United States)

    Kaasschieter, G A; de Jong, R; Schiere, J B; Zwart, D

    1992-04-01

    Livestock and animal health development projects have not always led to substantial increases in animal productivity or in farmers' welfare. Some have even resulted in unsustainable systems, when they were not based on an understanding of (livestock) production systems. The multipurpose functions of livestock and complex relationships between the biological, technical and social components require a systems approach, whereby nutrition, animal health, breeding, biotechnology knowhow, inputs and technologies are used to optimise resource use. The challenge for developed and developing countries is to reverse the current degradation of the environment, and arrive at sustainable increases in crop and livestock production to secure present and future food supplies. For rural development, governments should show long term commitment and political will to support the rural population in development programmes, because smallholders (including women and landless livestock keepers) represent a large labour force in developing countries. Different systems need different approaches. Pastoral systems must focus on effective management of grazing pressure of the rangelands. Communal rangelands management involves not only the development and application of technologies (e.g. feedlots, vaccination campaigns), but also land tenure policies, institutional development, economic return and a reduction in the number of people depending upon livestock. Smallholder mixed farms must aim at intensification of the total production system, in which external inputs are indispensable, but with the emphasis on optimum input-output relationships by reducing resource losses due to poor management. Resource-poor farming systems must aim at the improved management of the various livestock species in backyards and very small farms, and proper packages for cattle, buffaloes, sheep, goats, rabbits and poultry should be developed. Specialised commercial livestock farming systems (poultry, pigs, dairy

  9. Human health alters the sustainability of fishing practices in East Africa.

    Science.gov (United States)

    Fiorella, Kathryn J; Milner, Erin M; Salmen, Charles R; Hickey, Matthew D; Omollo, Dan O; Odhiambo, Abdi; Mattah, Brian; Bukusi, Elizabeth A; Fernald, Lia C H; Brashares, Justin S

    2017-04-18

    Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources. We followed 303 households living on Lake Victoria, Kenya over four time points to examine how illness influenced fishing. Using fixed effect conditional logit models to control for individual-level and time-invariant factors, we analyzed the effect of illness on fishing effort and methods. Illness among individuals who listed fishing as their primary occupation affected their participation in fishing. However, among active fishers, we found limited evidence that illness reduced fishing effort. Instead, ill fishers shifted their fishing methods. When ill, fishers were more likely to use methods that were illegal, destructive, and concentrated in inshore areas but required less travel and energy. Ill fishers were also less likely to fish using legal methods that are physically demanding, require travel to deep waters, and are considered more sustainable. By altering the physical capacity and outlook of fishers, human illness shifted their effort, their engagement with natural resources, and the sustainability of their actions. These findings show a previously unexplored pathway through which poor human health may negatively impact the environment.

  10. Achieving sustainability in health information systems: a field tested measure of country ownership.

    Science.gov (United States)

    Watson-Grant, Stephanie; Xiong, Khou; Thomas, James C

    2017-06-24

    A country will trust, value, and use, its health information system (HIS) to the extent it has had a role in its creation and maintenance. A sense of ownership contributes in turn to the long-term sustainability of the HIS, and thus the country's ability to monitor and evaluate population health and health services. To facilitate progress toward greater ownership, we developed and tested a tool to measure the country's ownership of its monitoring and evaluation (M&E) system. Through a systematic review of the literature, we identified four dimensions of country ownership of an M&E system: partnership, commitment and responsibility, capacity, and accountability. We identified relevant indicators of the dimensions already in use in other tools used to assess M&E systems. We tested the data collection tool with 95 stakeholders of the Tanzanian HIS for HIV/AIDS control. We identified 56 items that addressed elements of the four dimensions. The respondents found our tool for assessing country ownership of an HIS to be clear and relevant, leading to the identification of important issues to be discussed. For example, all stakeholder groups affirmed that the Tanzanian Commission for AIDS is "playing a leadership role in addressing HIV through collaborative partnerships and work across borders to achieve greater impact." While many respondents disagreed with the statement, "There is an adequate number of government monitoring and evaluation posts at the sub-national level." Stakeholders found the M&E country ownership tool to address relevant questions clearly. It enabled them to identify successes and challenges within four dimensions of country ownership. It thus holds the potential to lead to an agenda for strengthening country ownership. If implemented every few years, the tool can provide a means of monitoring progress through a set of standardized indicators. As country ownership of M&E increases, so will the long-term sustainability of the HIS.

  11. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hassen Kebede

    2014-02-01

    Full Text Available Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin, oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00% clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%, poor management and lack of awareness (60.00% and inadequate budget (40.00%. For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00% and lack of knowledge of animal diseases and physical distance from the service centre (50.00%. Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers’ indiscriminate use of drugs from the black market (23.00% was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased

  12. Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study.

    Science.gov (United States)

    Scheirer, Mary Ann; Santos, Sherie Lou Z; Tagai, Erin K; Bowie, Janice; Slade, Jimmie; Carter, Roxanne; Holt, Cheryl L

    2017-03-28

    Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101:2059-2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL. We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities, c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project's management database; and open-ended comments from CHAs, staff, and community partners. Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops

  13. Steps to a sustainable public health surveillance enterprise
a commentary from the international society for disease surveillance.

    Science.gov (United States)

    Mirza, Nabila; Reynolds, Tera; Coletta, Michael; Suda, Katie; Soyiri, Ireneous; Markle, Ariana; Leopold, Henry; Lenert, Leslie; Samoff, Erika; Siniscalchi, Alan; Streichert, Laura

    2013-01-01

    More than a decade into the 21(st) century, the ability to effectively monitor community health status, as well as forecast, detect, and respond to disease outbreaks and other events of public health significance, remains a major challenge. As an issue that affects population health, economic stability, and global security, the public health surveillance enterprise warrants the attention of decision makers at all levels. Public health practitioners responsible for surveillance functions are best positioned to identify the key elements needed for creating and maintaining effective and sustainable surveillance systems. This paper presents the recommendations of the Sustainable Surveillance Workgroup convened by the International Society for Disease Surveillance (ISDS) to identify strategies for building, strengthening, and maintaining surveillance systems that are equipped to provide data continuity and to handle both established and new data sources and public health surveillance practices.

  14. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    Science.gov (United States)

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation. © 2014 The New York Academy of Sciences.

  15. The missed Constitutional Reform and its possible impact on the sustainability of the Italian National Health Service.

    Science.gov (United States)

    Signorelli, Carlo; Odone, Anna; Gozzini, Armando; Petrelli, Fabio; Tirani, Marcello; Zangrandi, Antonello; Zoni, Roberta; Florindo, Nicola

    2017-04-28

    The rejection of the Constitutional Law Bill No.1429-D in the December 2016 referendum, has stimulated a cause for reflection on current health legislation and the future prospects of the Italian National Health Service; also in the context of the recent approval of the new Essential Levels of care (LEA) and other relevant laws approved by the Parliament. This article analyzes possible future legislative and organizational scenarios with particular regard to issues related to National health system's sustainability.

  16. Launch of the ‘One Health Global Think-Tank for Sustainable Health & Well-being’ – 2030 (GHW-2030

    Directory of Open Access Journals (Sweden)

    Ulrich Laaser

    2016-04-01

    Full Text Available The central mission of the GHW-2030 multi-sectoral think tank is to contribute to the implementation of the UN Sustainable Development Goals (SDGs by working toward achieving the education and health goals in cooperation with the Commonwealth Secretariat using an international interdisciplinary/multidisciplinary/transdisciplinary global One Health approach. A major focus of the think tank will be on the health and well-being – physical, emotional, aspirational – of children and young people particularly as these relate to their personal security, physical and emotional well-being, education and employment and the sustainability of life on the planet.

  17. Future of keeping pet reptiles and amphibians: towards integrating animal welfare, human health and environmental sustainability.

    Science.gov (United States)

    Pasmans, Frank; Bogaerts, Serge; Braeckman, Johan; Cunningham, Andrew A; Hellebuyck, Tom; Griffiths, Richard A; Sparreboom, Max; Schmidt, Benedikt R; Martel, An

    2017-10-28

    The keeping of exotic pets is currently under debate and governments of several countries are increasingly exploring the regulation, or even the banning, of exotic pet keeping. Major concerns are issues of public health and safety, animal welfare and biodiversity conservation. The keeping of reptiles and amphibians in captivity encompasses all the potential issues identified with keeping exotic pets, and many of those relating to traditional domestic pets. Within the context of risks posed by pets in general, the authors argue for the responsible and sustainable keeping of reptile and amphibian pets by private persons, based on scientific evidence and on the authors' own expertise (veterinary medicine, captive husbandry, conservation biology). © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Academic psychiatry and health care reform: strategic initiatives for sustaining the clinical mission.

    Science.gov (United States)

    McCabe, O Lee; Gwon, Howard S; McHugh, Paul R; Breakey, William R; Schwartz, Joseph M; Clark, Michael R; Kaminsky, Michael J

    2003-02-01

    Health care reform has posed special challenges for departments of psychiatry in academic medical centers. This report describes one department's strategic responses to a marketplace with high penetration by managed care and provides examples of the kinds of faculty concerns that can arise when major departmental reorganizations are attempted. The department's successful adaptation to a radically altered professional environment is attributed to the following five initiatives: vertical integration and diversification of clinical programs, service line management, outcomes measurement, regional network development, and institutional managed care partnerships Although the authors did not design their adaptive efforts as a research study, they offer objective data to support their conclusion that the viability of their overall clinical enterprise has been sustained despite an external environment inhospitable to academic psychiatry.

  19. Managing a sustainable, low carbon supply chain in the English National Health Service: The views of senior managers.

    Science.gov (United States)

    Grose, Jane; Richardson, Janet

    2013-04-18

    Objectives:In an effort to reduce costs and respond to climate change, health care providers (Trusts) in England have started to change how they purchase goods and services. Many factors, both internal and external, affect the supply chain. Our aim was to identify those factors, so as to maintain future supply and business continuity in health and social care.Methods:Qualitative interviews with 20 senior managers from private and public sector health service providers and social care providers in south west England. Interviews were recorded, transcribed and thematically analysed.Results:There were four areas of concern: contradictions with government legislation which caused confusion about how best to deliver sustainable solutions; procurement was unclear and created multiple approaches to purchasing bulk items at low cost; internal organizational systems needed to be reconsidered to embed sustainability; and embedding sustainability requires a review of organizational systems. There are examples of sustainability solutions throughout the National Health Service (NHS) but the response continues to be patchy. More research is needed into why some Trusts and some staff do not recognize the benefits of a core approach or find the systems unable to respond.Conclusions:The NHS is one of the major purchasers of goods and services in England and is therefore in an excellent position to encourage sustainable resource management, manufacturing, use and disposal.

  20. The Soldier Medic Mettle Study

    Science.gov (United States)

    2011-10-01

    AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER TAMPA VA R EARCH AND EDUCATION FOUNDATI JOHN HERN 13000 BRUCE B DOWNS BLVD...and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351, 13–22. Kim, P.Y., Thomas, J.L., Wilk , J.E...Brandi Booth Brandi.Booth@AMEDD.ARMY.MIL Dr. Booth is a clinical psychologist with a range of experience working in the VA and DoD. Specifically, she

  1. Characteristics of the suicidal soldier in the Israeli Defense Force-a review of literature

    OpenAIRE

    Shelef, Leah; Laur, Lucian; Fruchter, Eyal

    2015-01-01

    Suicide is the third leading cause of death among adolescents in most Western world countries. Similar findings have been reported among adolescents in Israel (including the Israeli army) in times of peace; nonetheless, suicide rate has decreased significantly in recent years. In Israel, IDF service is mandatory and adolescents are obligated to serve by law. Therefore, the IDF is responsible under state and moral law to care for the physical and mental health of its soldiers. Additionally, th...

  2. The Objective Force Soldier/Soldier Team. Volume I: Executive Summary

    Science.gov (United States)

    2001-11-01

    Roy Cooper Dr. Bert Smith Dr. Phil Brandler Don Wajda Don Woodbury Ed Doucette Bonnie Jezior COL Gary Engel Earl Rubright Kathleen Kinsella Dan...Donald Wajda U.S. Army Natick Soldier Center Staff Assistant Mr. Tom Conway Army Materiel Command Cadet Assistant CDT Erik Wright Rose

  3. Sustainable development goals for global health: facilitating good governance in a complex environment.

    Science.gov (United States)

    Haffeld, Just

    2013-11-01

    Increasing complexity is following in the wake of rampant globalization. Thus, the discussion about Sustainable Development Goals (SDGs) requires new thinking that departs from a critique of current policy tools in exploration of a complexity-friendly approach. This article argues that potential SDGs should: treat stakeholders, like states, business and civil society actors, as agents on different aggregate levels of networks; incorporate good governance processes that facilitate early involvement of relevant resources, as well as equitable participation, consultative processes, and regular policy and programme implementation reviews; anchor adoption and enforcement of such rules to democratic processes in accountable organizations; and include comprehensive systems evaluations, including procedural indicators. A global framework convention for health could be a suitable instrument for handling some of the challenges related to the governance of a complex environment. It could structure and legitimize government involvement, engage stakeholders, arrange deliberation and decision-making processes with due participation and regular policy review, and define minimum standards for health services. A monitoring scheme could ensure that agents in networks comply according to whole-systems targets, locally defined outcome indicators, and process indicators, thus resolving the paradox of government control vs. local policy space. A convention could thus exploit the energy created in the encounter between civil society, international organizations and national authorities. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  4. [Towards a sustainable, cost-effective mental health care; a policy perspective].

    Science.gov (United States)

    Jeurissen, P P T; Ravesteijn, B A; Janssen, R T J M; Tanke, M A C

    After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery. AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses. METHOD: Review of academic articles and policy studies. RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health. Employers and stakeholders can perhaps play a role in financing some of these services. Severe mental disorders can be handled more often on an integrated ambulatory basis setting than only in a hospital setting, while scaling down inpatient capacity. These steps would represent a major transition and would require spending cuts and a change in the provider 'landscape'. CONCLUSION: Sustainable mental healthcare is inseparably linked to an agenda that provides value for money and it implies a major transition. However, in principle, it should be possible to fit these changes into the current system of governance. More attention needs to be given to coordination between the various domains, and to a reduction in administrative costs. Reimbursement methods should align e-health, collaborative care, case-management and best-practice pathways.

  5. [Evaluation of Germany's sixth national health target entitled "Depressive illnesses - prevention, early diagnosis, sustainable treatment"].

    Science.gov (United States)

    Bermejo, I; Klärs, G; Böhm, K; Hundertmark-Mayser, J; Lampert, T; Maschewsky-Schneider, U; Riedel-Heller, S; Härter, M

    2009-10-01

    In 2006, Germany's sixth national health target entitled "Depressive illnesses - prevention, early diagnosis, sustainable treatment" was developed by an interdisciplinary group of experts. A total of six areas of activity and proposals for action with potential for improvement were defined. Subsequently, a group of experts was entrusted with designing evaluation strategies, defining indicators of progress, and examining the accessibility of data sources for evaluation. For the primary start-up activities set out in the health targets, specific progress indicators were deduced, and routine data available for evaluation were identified. As a next step, the limitations of these data sources were analyzed and necessary improvements described. Relevant indicators of progress for specific areas of activity have been described, the availability and usability of different existing data sources examined, and further supplements or additional specifications with respect to the indicators described. Due to inadequate data sources, additional systematic surveys are required to evaluate the health target and its implementation. Existing German surveys should be extended by questions concerning relevant measures and progress indicators; various progress indicators should be analyzed on a general basis.

  6. Community mental health provider modifications to cognitive therapy: implications for sustainability.

    Science.gov (United States)

    Wiltsey Stirman, Shannon; Calloway, Amber; Toder, Katherine; Miller, Christopher J; Devito, Andrea K; Meisel, Samuel N; Xhezo, Regina; Evans, Arthur C; Beck, Aaron T; Crits-Christoph, Paul

    2013-10-01

    This study identified modifications to an evidence-based psychosocial treatment (cognitive therapy) within a community mental health system after clinicians had received intensive training and consultation. A coding system, consisting of four types of contextual modifications, 12 types of content-related modifications, seven levels at which modifications can occur, and a code for changes to training or evaluation processes, was applied to data from interviews with 27 clinicians who treat adult consumers within a mental health system. Nine of 12 content modifications were endorsed, and four (tailoring, integration into other therapeutic approaches, loosening structure, and drift) accounted for 65% of all modifications identified. Contextual modifications were rarely endorsed by clinicians in this sample. Modifications typically occurred at the client or clinician level. Clinicians in community mental health settings made several modifications to an evidence-based practice (EBP), often in an effort to improve the fit of the intervention to the client's needs or to the clinician's therapeutic style. These findings have implications for implementation and sustainability of EBPs in community settings, client-level outcomes, and training and consultation.

  7. The Developmental Origins of Health and Disease and Sustainable Development Goals: mapping the way forward.

    Science.gov (United States)

    Kajee, N; Sobngwi, E; Macnab, A; Daar, A S

    2018-02-01

    In this paper, meant to stimulate debate, we argue that there is considerable benefit in approaching together the implementation of two seemingly separate recent developments. First, on the global development agenda, we have the United Nations General Assembly's 2015 finalized list of 17 Sustainable Development Goals (SDGs). Several of the SDGs are related to health. Second, the field of Developmental Origins of Health and Disease (DOHaD) has garnered enough compelling evidence demonstrating that early exposures in life affect not only future health, but that the effects of that exposure can be transmitted across generations - necessitating that we begin to focus on prevention. We argue that implementing the SDGs and DOHaD together will be beneficial in several ways; and will require attending to multiple, complex and multidisciplinary approaches as we reach the point of translating science to policy to impact. Here, we begin by providing the context for our work and making the case for a mutually reinforcing, synergistic approach to implementing SDGs and DOHaD, particularly in Africa. To do this, we initiate discussion via an early mapping of some of the overlapping considerations between SDGs and DOHaD.

  8. Curriculum learning designs: teaching health assessment skills for advanced nursing practitioners through sustainable flexible learning.

    Science.gov (United States)

    Fitzgerald, Les; Wong, Pauline; Hannon, John; Solberg Tokerud, Marte; Lyons, Judith

    2013-10-01

    Innovative curriculum designs are vital for effective learning in contemporary nursing education where traditional modes of delivery are not adequate to meet the learning needs of postgraduate students. This instance of postgraduate teaching in a distributed learning environment offered the opportunity to design a flexible learning model for teaching advanced clinical skills. To present a sustainable model for flexible learning that enables specialist nurses to gain postgraduate qualifications without on-campus class attendance by teaching and assessing clinical health care skills in an authentic workplace setting. An action research methodology was used to gather evidence and report on the process of curriculum development of a core unit, Comprehensive Health Assessment (CHA), within 13 different postgraduate speciality courses. Qualitative data was collected from 27 teaching academics, 21 clinical specialist staff, and 7 hospital managers via interviews, focus groups and journal reflections. Evaluations from the initial iteration of CHA from 36 students were obtained. Data was analyzed to develop and evaluate the curriculum design of CHA. The key factors indicated by participants in the curriculum design process were coordination and structuring of teaching and assessment; integration of content development; working with technologies, balancing specialities and core knowledge; and managing induction and expectations. A set of recommendations emerged as a result of the action research process. These included: a constructive alignment approach to curriculum design; the production of a facilitator's guide that specifies expectations and unit information for academic and clinical education staff; an agreed template for content authors; and the inclusion of synchronous communication for real-time online tutoring. The highlight of the project was that it built curriculum design capabilities of clinicians and students which can sustain this alternative model of online

  9. Sustainability of current agriculture practices, community perception, and implications for ecosystem health: an Indian study.

    Science.gov (United States)

    Sarkar, Atanu; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary

    2011-12-01

    In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.

  10. Did the right to health get across the line? Examining the United Nations resolution on the Sustainable Development Goals.

    Science.gov (United States)

    Brolan, Claire E; Te, Vannarath; Floden, Nadia; Hill, Peter S; Forman, Lisa

    2017-01-01

    Since the new global health and development goal, Sustainable Development Goal (SDG) 3, and its nine targets and four means of implementation were introduced to the world through a United Nations (UN) General Assembly resolution in September 2015, right to health practitioners have queried whether this goal mirrors the content of the human right to health in international law. This study examines the text of the UN SDG resolution, Transforming our world: the 2030 Agenda for Sustainable Development , from a right to health minimalist and right to health maximalist analytic perspective. When reviewing the UN SDG resolution's text, a right to health minimalist questions whether the content of the right to health is at least implicitly included in this document, specifically focusing on SDG 3 and its metrics framework. A right to health maximalist, on the other hand, queries whether the content of the right to health is explicitly included. This study finds that whether the right to health is contained in the UN SDG resolution, and the SDG metrics therein, ultimately depends on the individual analyst's subjective persuasion in relation to right to health minimalism or maximalism. We conclude that the UN General Assembly's lack of cogency on the right to health's position in the UN SDG resolution will continue to blur if not divest human rights' (and specifically the right to health's) integral relationship to high-level development planning, implementation and SDG monitoring and evaluation efforts.

  11. Advancing the application of systems thinking in health: sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh.

    Science.gov (United States)

    Sarriot, Eric G; Kouletio, Michelle; Jahan, Dr Shamim; Rasul, Izaz; Musha, Akm

    2014-08-26

    Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required a method, an explicit set of processes, to guide their decisions and choices during and after the project. Concern chose the Sustainability Framework method to generate creative thinking from stakeholders, create a common vision, and monitor progress. The Framework is based on participatory and iterative steps: defining (mapping) the local system and articulating a long-term vision, describing scenarios for achieving the vision, defining the elements of the model, and selecting corresponding indicators, setting and executing an assessment plan,, and repeated stakeholder engagement in analysis and decisions . Formal assessments took place up to 5 years post-project (2009). Strategic choices for the project were guided by articulating a collective vision for sustainable health, mapping the system of actors required to effect and sustain change, and defining different components of analysis. Municipal authorities oriented health teams toward equity-oriented service delivery efforts, strengthening of the functionality of Ward Health Committees, resource leveraging between municipalities and the Ministry of Health, and mitigation of contextual risks. Regular reference to a vision (and set of metrics (population health, organizational and community capacity) mitigated political factors. Key structures and processes were maintained following elections and political changes. Post-project achievements included the maintenance or improvement 5 years post-project (2009) in 9 of the 11 health indicator gains realized during the project (1999-2004). Some elements of performance and capacity weakened, but reductions in the equity gap

  12. Tyraminergic and Octopaminergic Modulation of Defensive Behavior in Termite Soldier.

    Directory of Open Access Journals (Sweden)

    Yuki Ishikawa

    Full Text Available In termites, i.e. a major group of eusocial insects, the soldier caste exhibits specific morphological characteristics and extremely high aggression against predators. Although the genomic background is identical to the other non-aggressive castes, they acquire the soldier-specific behavioral character during the course of caste differentiation. The high aggressiveness and defensive behavior is essential for colony survival, but the neurophysiological bases are completely unknown. In the present study, using the damp-wood termite Hodotermopsis sjostedti, we focused on two biogenic amines, octopamine (OA and tyramine (TA, as candidate neuromodulators for the defensive behavior in soldiers. High-performance liquid chromatographic analysis revealed that TA levels in the brain and suboesophageal ganglion (SOG and the OA level in brain were increased in soldiers than in pseudergates (worker caste. Immunohistochemical analysis revealed that TA/OA neurons that innervate specific areas, including the mandibular muscles, antennal nerve, central complex, suboesophageal ganglion, and thoracic and/or abdominal ganglia, were enlarged in a soldier-specific manner. Together with the results that pharmacological application of TA promoted the defensive behavior in pseudergates, these findings suggest that the increased TA/OA levels induce the higher aggressiveness and defensive behavior in termite soldiers. The projection targets of these soldier-specific enlarged TA/OA neurons may have important roles in the higher aggressiveness and defensive behavior of the termite soldiers, inducing the neuronal transition that accompanies external morphological changes.

  13. Training Capability Data for Dismounted Soldier Training System

    Science.gov (United States)

    2015-06-01

    Soldier Training System, Simulation Training Capabilities, Immersive Training, Squad Tactical Tasks 16. SECURITY CLASSIFICATION OF: 17...Simulation, VSTS – Virtual Squad Training System 4 and microphone. The VSMM utilizes radio frequency identification ( RFID ) tags and hand sensors to...are available when programmed into the RFID tags. Soldiers can be issued a lensatic compass or GPS based on leadership discretion. These items

  14. Computational sustainability

    CERN Document Server

    Kersting, Kristian; Morik, Katharina

    2016-01-01

    The book at hand gives an overview of the state of the art research in Computational Sustainability as well as case studies of different application scenarios. This covers topics such as renewable energy supply, energy storage and e-mobility, efficiency in data centers and networks, sustainable food and water supply, sustainable health, industrial production and quality, etc. The book describes computational methods and possible application scenarios.

  15. Sustenance and sustainability: maximizing the impact of school gardens on health outcomes.

    Science.gov (United States)

    Davis, Jaimie N; Spaniol, Mackenzie R; Somerset, Shawn

    2015-09-01

    School garden programmes have become popular action-oriented learning environments in many countries, often driven by converging priorities of environmental sustainability and healthful diets. Many of these programmes have assessed the impact on dietary intake, specifically fruit and vegetable intake, and related dietary behaviours, such as knowledge, preference, motivation, intention and self-efficacy to eat and prepare fruit and vegetables. The objective of the present study was twofold: (i) to review published garden-based programmes conducted in schools targeting dietary intake and/or determinants of dietary behaviour in children; and (ii) to identify similar strategies and components employed by these garden-based programmes. The review included thirteen studies that have examined the impact of garden-based programmes conducted in school, either during school hours or in after-school settings, on dietary behaviours in children (kindergarten through 8th grade students). Three of the reviewed studies did not have a comparison or control group and simply evaluated within-group changes after a garden intervention. None of the reviewed studies were randomized, but were assigned based on school's interest and timing of new school gardens being built. Out of the eleven programmes that examined dietary intake, six found that the programme resulted in increased vegetable intake, whereas four showed no effect. Seven of the eight studies that measured preference found that the programmes resulted in increased preference for vegetables. Gardening programmes also resulted in improved attitudes towards, willingness to taste, identification of and self-efficacy to prepare/cook fruit and vegetables. Similar strategies/components employed by the majority of the programmes included: 'hands on' curriculum, incorporation of a cooking component, providing the instructors, parental and stakeholder support, food provision and using the garden as the focal point for media promotion

  16. Nutrition as a component of the performance triad: how healthy eating behaviors contribute to soldier performance and military readiness.

    Science.gov (United States)

    Purvis, Dianna L; Lentino, Cynthia V; Jackson, Theresa K; Murphy, Kaitlin J; Deuster, Patricia A

    2013-01-01

    Nutrition is a critical element of Soldier health and performance. Food choices, meal timing, and dietary intake behaviors contribute to nutritional fitness. The objectives of this study were to describe Soldier dietary behaviors and quantify the association between healthy eating behaviors and demographic, lifestyle, and psychosocial factors. The Comprehensive Soldier and Family Fitness Global Assessment Tool (GAT) assesses emotional, social, family, and spiritual fitness. In 2012, 57 pilot questions were added to the GAT to create a physical dimension that included nutrition assessments. Participants included 13,858 Active Duty, Reserve, and National Guard Soldiers: 83% male; 85% enlisted; a mean age of 28±9 years. A Healthy Eating Score (HES-5) was calculated from 5 questions assessing frequency of fruit, vegetable, whole grain, dairy, and fish intake (Cronbach α=0.81). Associations between HES-5 and other dietary habits, physical activity patterns, and GAT psychosocial dimension scores were examined. Soldiers who ate breakfast regularly (6 times/week or more), drank 7 servings or more of water/day, and met weekly exercise recommendations were more likely to be in the highest HES-5 quartile than those who did not. Those who passed their Army Physical Fitness Test (APFT) in the top quartile were also more likely to report high HES-5 scores than those who failed (P<.001). Soldiers with healthy anthropometric measures and the highest emotional, social, family, and spiritual fitness scores were also more likely to be in the top HES-5 quartile than those with unhealthy measures and with the lowest fitness scores (P<.001). The HES-5 may be a useful index for characterizing dietary intake behaviors. Healthy dietary intake behaviors are associated with all dimensions of health, physical fitness, and psychosocial status.

  17. Integrated soldier power and data system (ISPDS)

    Science.gov (United States)

    Ostroumov, Roman; Forrester, Thomas; Lee, Kang; Stephens, Robert; Lai, Anthony; Zahzah, Mohamad

    2014-06-01

    Physical Optics Corporation (POC) developed the body-worn Integrated Soldier Power and Data System (ISPDS), a configurable node for plug-in wired or wireless server/client or peer-to-peer computing with accommodations for power, sensor I/O interfaces, and energy harvesting. The enabling technology increases the efficacy of uniformed personnel and first responders and provides an option for reducing force structure associated with the need for hardware network infrastructure to enable a mobile digital communications architecture for dismounted troops. The ISPDS system addresses the DoD's need for an "intelligent" power control system in an effort to increase mission duration and maximize the first responders and warfighter's effectiveness without concern for the available energy resources (i.e., batteries). ISPDS maximizes durability and survivability, assesses influences that affect performance, and provides the network backbone and mobile node hardware. POC is producing two vest-integrated variants, one each for the U.S. Army PEO Ground Soldier and the Air Soldier, with each including state-of-the-art low-profile and robust wearable connectors, cabling, and harnesses, and an integrated low-profile power manager and conformal battery for data and power distribution. The innovative intelligent power controller (IPC), in the form of the ISPDS firmware and power sensing and control electronics, will enable ISPDS to optimize power levels both automatically and in accordance with manually set preferences. The IPC module is power dense and efficient, and adaptively provides lossless transfer of available harvested photovoltaic energy to the battery. The integrated systems were tested for suitable electrical, electromagnetic interference (EMI), and environmental performance as outlined in military standards such as MIL-STD- 810G and MIL STD-461F.

  18. Developmental and waste reduction plasticity of three black soldier fly strains (Diptera: Stratiomyidae) raised on different livestock manures.

    Science.gov (United States)

    Zhou, Fen; Tomberlin, Jeffery K; Zheng, Longyu; Yu, Ziniu; Zhang, Jibin

    2013-11-01

    Black soldier flies, Hermetia illucens L., are distributed throughout the temperate and tropic regions of the world and are known an established method for sustainably managing animal wastes. Colonies used to conduct research on the black soldier fly within the past 20 yr have predominately been established from eggs or larvae received from a colony originated from Bacon County, GA. Consequently, little is known about the phenotypic plasticity (i.e., development and waste conversion) across strains from different regions. This study compared the development of three strains of the black soldier fly (Texas; Guangzhou, China; and Wuhan, China) and their ability to reduce dry matter and associated nutrients in swine, dairy, and chicken manure. The Wuhan strain appeared to be more fit. Larvae from Wuhan needed 17.7-29.9% less time to reach the prepupal stage than those from Guangzhou or Texas, respectively. Larvae from Wuhan weighed 14.4-37.0% more than those from Guanghzhou or Texas, respectively. Larvae from the Wuhan strain reduced dry matter 46.0% (swine), 40.1% (dairy), and 48.4% (chicken) more than the Guangzhou strain and 6.9, 7.2, and 7.9% more than the Texas strain. This study demonstrates that phenotypic plasticity (e.g., development and waste conversion) varies across populations of black soldier flies and should be taken into account when selecting and establishing a population as a waste management agent in a given region of the world.

  19. Psycho-physiological response of soldiers in urban combat

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    Vicente J. Clemente-Suárez

    2013-05-01

    Full Text Available Current armed conflicts are asymmetrical and are developed m urban areas. These new requirements have not been studied for current literature. The aim of this study was to analyse changes in cortical arousal, blood lactate, muscle strength, autonomic modulation and rate of perceived exertion in a simulated urban combat. We analyzed 20 soldiers before and after an urban combat simulation. The results showed how urban combat produced high sympathetic nervous system activation, increasing the muscle strength, heart rate and blood lactate concentration of the soldiers. Despite this effort, rate of perceived exertion were not consistent with the physiological response that soldiers presented, the rate of perceived exertion was lower than the physiological response evaluated. Furthermore, the information processing and cortical arousal decreased after the urban combat simulation. These results have showed the psycho-physiological response of soldiers in combat, helping to better understanding and enabling an improvement of current training methods of soldiers.

  20. Acquisition and Retention of Soldiering Skills

    Science.gov (United States)

    1985-02-01

    Manual (SM); the task was rct going to be included in the 1iB Skill Qualification Test (SQT) hands-on ccmponent, SQT skill component, or Expert...Breech (8 steps): The step where most errors were made was to assemble the obturator so that the split rings were 180 degrees apart. Again, there is no...in this test is the obturator . If the soldier starts to disassemble any otber component, tell him, "You do not have to disassemble that component

  1. Sustainability Factor Related with the Implementation of Community Mental Health Nursing (CMHN in South and West Jakarta

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    Esti Winahayu

    2016-09-01

    Full Text Available The aim of this study was to determine the sustainability factor related with the implementation of CMHN in South and West Jakarta. The method of the study was cross sectional, data of the nurses was collected by questionnaire of CMHN and pearson correlation was used to analyzed the data. Interviews conducted on stakeholder to get stakeholder perceptions about the sustainability factor of CMHN. The ability of nurse in the implementation of CMHN is 45,86%. The nurse perception toward sustainability factor of CMHN is 67,49%. The result of study shows the significant relationship between the sustainability factor with the implementation of CMHN. The result of analysis interviews with stakeholder about 8 sustainability factors is obtained into several themes: the positive opinion of stakeholder toward the CMHN (the existence of nursing care to the patients, detecting of new case, and reducing stigma and the effort for the sustainability of CMHN (increasing the perception, budget planning, and socialization. The result of the study is recomended to improve the community mental health nursing service in other region. Keywords: CMHN nurses, stakeholder, sustainability, the implementation of CMHN

  2. Contributions of national and global health estimates to monitoring health-related Sustainable Development Goals in Thailand.

    Science.gov (United States)

    Bundhamcharoen, Kanitta; Limwattananon, Supon; Kusreesakul, Khanitta; Tangcharoensathien, Viroj

    2017-01-01

    The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons. This paper draws lessons learned from Thailand's burden of disease study (BOD) on capacity development for NHEs, and discusses the contributions and limitation of GHEs in informing policies at country level. Through training and technical support by external partners, capacities are gradually strengthened and institutionalized to enable regular updates of BOD at national and sub-national levels. Initially, the quality of cause of death reporting in the death certificates was inadequate, especially for deaths occurring in the community. Verbal autopsies were conducted, using domestic resources, to determine probable causes of deaths occurring in the community. This helped improve the estimation of years of life lost. Since the achievement of universal health coverage in 2002, the quality of clinical data on morbidities has also considerably improved. There are significant discrepancies between the 2010 Global Burden of Diseases (GBD) estimates for Thailand and the 1999 nationally generated BOD, especially for years of life lost due to HIV/AIDS, and the ranking of priority diseases. National ownership of NHEs and effective interfaces between researchers and decision makers contribute to enhanced country policy responses, while sub-national data are intended to be used by various sub-national-level partners. Though GHEs contribute to benchmarking country achievement compared with global health

  3. A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

    2016-01-01

    The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

  4. Sustaining Health Care Interventions to Achieve Quality Care: What We Can Learn From Rapid Response Teams.

    Science.gov (United States)

    Stolldorf, Deonni P

    Rapid response team (RRT) adoption and implementation are associated with improved quality of care of patients who experience an unanticipated medical emergency. The sustainability of RRTs is vital to achieve long-term benefits of these teams for patients, staff, and hospitals. Factors required to achieve RRT sustainability remain unclear. This study examined the relationship between sustainability elements and RRT sustainability in hospitals that have previously implemented RRTs.

  5. Investigating service features to sustain engagement in early intervention mental health services.

    Science.gov (United States)

    Becker, Mackenzie; Cunningham, Charles E; Christensen, Bruce K; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Madsen, Victoria; Bieling, Peter; Chen, Yvonne; Mielko, Stephanie; Zipursky, Robert B

    2017-08-23

    To understand what service features would sustain patient engagement in early intervention mental health treatment. Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services. Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service. Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services. © 2017 John Wiley & Sons Australia, Ltd.

  6. Market reforms in health care and sustainability of the welfare state: lessons from Sweden.

    Science.gov (United States)

    Diderichsen, F

    1995-01-01

    Reforming health care systems which are predominantly publicly provided and financed has usually been motivated as a way of increasing efficiency even if it seldom is explicit whether it is in the official sense related to individual utility or in the unofficial sense related to health outcomes. In the case of Sweden the welfare state has been made politically sustainable through a construction where cash benefits and service provision are tailored to satisfy not only the basic needs but even the more discriminating needs of the middle classes. Their loyalty with the taxes is politically crucial and therefore their evaluation of the services in the welfarist sense equally important. That loyalty was however threatened in a situation where cost-containment policies were applied while equity principles were still a strong priority. Health care utilization was increasing among the very old and chronically ill while it was decreasing for other groups. The reforms introduced in some counties during the 1990s have been focussing on a purchaser-provider split and fee-for-service payment of providers. They have increased productivity sharply, increased utilization even among the groups that previously were 'pressed out' and reduced waiting lists. Increased efficiency however, threatens equity in some specific aspects. Fee-for-service payment means increased production and so far even increased costs. If they are to be met with increased private financing, rather than with present tax financing, it will bring the risk of inequities. Payment of hospitals through DRG systems means payment to providers for medical interventions with no incentives to deal with social consequences of illness. Inequities in health care can be related to the way health care deals with inequalities in health due to inequalities in living conditions or inequalities in living conditions due to ill health. In the short perspective the reforms may threaten equity in the second aspect, in the longer

  7. Factors Contributing To The Sustainability Of 5S Programmes In Government Hospitals In Regional Director Of Health Services Area Kurunegala

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    Dr. K.W.C.U.K Kendangamuwa

    2015-03-01

    Full Text Available Abstract Introduction 5S is the stepping stone for many quality improvement concepts and its roots date back to 16th century. When successfully implemented 5S gives many benefits to the organization as well as its stakeholders. Though 5S itself has a tool to sustain most of the organizations find it difficult to sustain the 5S practice over the time. Therefore the objective of this study was to find out the factors contributing to sustainability of 5S programmes in Government Hospitals in RDHS area Kurunegala. Methodology This study was a descriptive cross sectional study with two components. First component was to identify the 5S sustaining hospitals from not sustaining hospitals by validated evaluation sheet. Second component was to determine the factors contributing to sustainability of 5S programmes in selected study setting. Self-administrated questionnaire was used for this purpose. Total study population was 543 employees of all the categories of hospital staff. Calculated sample size was 422 and 375 were responded to the questionnaire giving response rate of 88.9. Results The study revealed that the implemented 5S programmes were sustaining in eight hospitals out of ten i.e. sustaining rate was 80. When it considered the degree of sustainability 50 of the selected hospitals reported more than 70 sustainability. This was considered as favourable trend in government health sector in healthcare quality point of view. Ten factors were studied as contributing factors for the 5S sustainability. Socio- demographic factors were also considered. Those ten factors were top management commitment leadership of the organization commitment of middle amp frontline managers commitment amp satisfaction of employees training amp changing attitude of employees motivation of employees organizational culture group cohesiveness community participation and customer satisfaction. Study revealed that organizational leadership customer satisfaction community

  8. Sustainable clinical research, health economic aspects and medical marketing: drivers of product innovation.

    Science.gov (United States)

    Haschke, Ferdinand; Klassen-Wigger, Petra

    2010-01-01

    Marketing-driven innovation in the field of pediatric nutrition, in particular in the infant formula segment is not sustainable. New benefits of products must be scientifically proven and safety and efficacy of new formulae established in clinical trials. The scientific innovation process of three infant formulae is described. Improvement in protein quality allowed to reduce the protein concentration in whey-based infant formula. Weight gain and BMI of infants fed those formulae corresponds to breastfed infants and is lower than in infants fed traditional formulae with higher protein concentration. A meta-analysis indicates associations between rapid weight gain in infancy and obesity later in life. If infants cannot be exclusively breastfed until 4-6 months of age, feeding low-protein formulae may contribute to positive long-term health outcome with potentially important health economic effects. A partially hydrolyzed whey based formula for prevention of allergic symptoms in children with hereditary risk for allergic diseases was developed more than 25 years ago. The most recent meta-analysis which included 15 randomized clinical trials indicates that the risk of all allergic diseases and atopic dermatitis/eczema is significantly reduced in infants at risk when the partially hydrolyzed formula is fed. The partially hydrolyzed formula had the same protective effect as casein-based high-degree extensively hydrolyzed formula. Because of substantial price differences between the two formulae, feeding the partially hydrolyzed whey formula is cost saving. Hypoallergenic claims can be made in many countries, and international nutrition committees have positively commented the preventive effect of those formulae. Acidified formulae have been widely used during the last decade in replacement feeding programs for infants whose mothers are HIV positive. The formula was innovated by improving whey protein quality and lowering protein concentration. The bacteriostatic

  9. Contexts for Sustainable Implementation of a Colorectal Cancer Screening Program at a Community Health Center.

    Science.gov (United States)

    Yip, Mei-Po; Chun, Alan; Edelson, Jane; Feng, Xuaohua; Tu, Shin-Ping

    2016-01-01

    "Context" is a mediating construct that significantly influences the initiation and maintenance of program implementation, but it has seldom been studied in process evaluation. This case study describes the contextual factors that encourage or impede the implementation processes of a research-tested program at a Federally Qualified Community Health Center. We conducted 14 key informant interviews with providers, nurses, medical assistants, and clinic staff in leadership and management positions during the 24 months of active implementation. Interview data were analyzed using Atlas.ti software. A written log documenting exposure, adherence, and coverage of the implementation was used to describe implementation fidelity. Findings indicated that program implementation needs to align with the organization's mission and values. Sensemaking caused individuals to understand the importance of the new process and increased their motivation to follow assigned procedures. Revisions of the implementation process allowed the program to fit better with the clinic's existing workflow. However, permitting flexibility in the delivery of an intervention may result in inconsistent implementation fidelity. In this study, threats to implementation included unanticipated changes in the clinic environment, such as budget cuts to resources and staff turnover as a consequence of the current economic downturn. Momentum leading to sustainable implementation requires a continuous team effort and a stable environment; consequently, a successful implementation requires a structure that supports problem solving, communication, and evaluation. © 2015 Society for Public Health Education.

  10. Sustainable development, demography and sexual and reproductive health: inseparable linkages and their policy implications.

    Science.gov (United States)

    Herrmann, Michael

    2014-05-01

    The greatest challenge today is to meet the needs of current and future generations, of a large and growing world population, without imposing catastrophic pressures on the natural environment. Meeting this challenge depends on decisive policy changes in three areas: more inclusive economic growth, greener economic growth, and population policies. This article focuses on efforts to address and harness demographic changes for sustainable development, which are largely outside the purview of the current debate. Efforts to this end must be based on the recognition that demographic changes are the cumulative result of individual choices and opportunities, and that demographic changes are best addressed through policies that enlarge these choices and opportunities, with a focus on ensuring unrestricted and universal access to sexual and reproductive health information and services, empowering women to fully participate in social, economic and political life, and investing in the education of the younger generation beyond the primary level. The article provides a strong argument for why the Programme of Action that was agreed at the International Conference on Population and Development (ICPD) 20 years ago continues to hold important implications and lessons for the formulation of the post-2015 development agenda, which is expected to supersede the Millennium Development Goals (MDGs). Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  11. Strategic factors for the sustainability of a health intervention at municipal level of Brazil.

    Science.gov (United States)

    Oliveira, Sydia Rosana de Araujo; Medina, Maria Guadalupe; Figueiró, Ana Cláudia; Potvin, Louise

    2017-07-27

    The present study aims to describe the evolution of an intervention, using a methodology that adopts the critical event as the unit of analysis, and to identify strategic factors that facilitate the continuation of the interventions. Six critical events were identified: dispute care models for health; area of advice: dispute field; change policy; break of interorganizational relations; lack of physical structure and turnover of staff; difficulty in organizing practices in the work process. these are developed into strategic factors: enabling network of allies; meetings and educational activities/building capacity; benefits perceived by community members; mobilization of key actors; intervention's compatibility with the government's vision; restoration of interrelationship; and stability of the workforce. These strategic factors form a group of interrelated conditions that provide the strengthened linkages between elements in the intervention, supporting the hypothesis that they collaborate for the sustainability of the interventions in health. Tracking down the transformations of an intervention set by the critical events, it was verified that these factors performed a protective role at times of changes in the intervention process.

  12. Environmental Assessment for Sustainability and Resiliency for Ecological and Human Health.

    Science.gov (United States)

    Burger, Joanna; Gochfeld, Michael; Clarke, James; Jeitner, Christian; Pittfield, Taryn

    2015-06-01

    Considerable attention has been devoted to environmental assessment and monitoring, primarily by physical and biological scientists, and more recently by social scientists. However, population growth and global change have resulted in an imperative to assess the resiliency of the environment to adapt to large scale changes and to continue to produce goods and services for future generations (sustainability). Changing land use needs or expectations may require the remediation and restoration of degraded or contaminated land. This paper provides an overview of monitoring types, and discusses how indicators for the different monitoring types can be developed to address questions of ecological health, human health, and whether restoration and remediation are effective. We suggest that along with more traditional types of monitoring, agencies should consider recovery indicators or metrics, as well as resiliency metrics. We suggest that one goal of assessment should be to determine if management, remediation, restoration, and mitigation reduce recovery time, thus reducing community vulnerability and enhancing resiliency to environmental stressors and disasters.

  13. Water Quality, Essential Condition Sustaining the Health, Production, Reproduction in Cattle. A Review

    Directory of Open Access Journals (Sweden)

    Cristina Iuliana El Mahdy

    2016-11-01

    Full Text Available The main component of the body: the water, alongside with many function which it has,represents a constituent in the diet of animal. There are many and various factors that influence the daily water requirements of animals: some dependent on animal: and others dependent on the environment. Water quality administered to livestock must meet the requirements for potability prerequisite to maintaining the health, externalization full productive potential and sustaining breeding. Knowing the importance of water quality consists in the negative action which can exert on the body to exceeding certain thresholds translated through: reducing water consumption simultaneously with the decrease milk production, decreased feed conversion rate and average daily gain, degradation of health status by reducing the local resistance, decrease overall body resistance, metabolic, digestive, skeletal disorders and impaired reproduction sphere translated through:decreasing fertility, abortions; elements interfering with the absorption of other essential water body, producing chronic or acute poisoning. The water composition plays essential role depending on which is supplemented or not as the case the quantity of the macro and trace minerals from feedingstuff  according to the synergism or antagonism action between  the minerals present.

  14. Health Rights and Realization Comment on "Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?".

    Science.gov (United States)

    Rushton, Simon

    2016-02-29

    In their hypothesis published in IJHPM, Lisa Forman and colleagues examined the prominence of the right to health and sexual and reproductive health rights (as well as related language) in four of the key reports that fed into the process of negotiating the Sustainable Development Goals (SDGs). Now that the SDGs have been formally adopted, this comment builds on some of the insights of Forman and colleagues to examine the extent to which those rights have been incorporated in SDGs 3 and 5. I argue that sexual and reproductive health rights are relatively well-covered within the SDGs. In terms of the right to health, however, the picture is much less clear. Some of the elements that make up that right are present and correct, but the SDGs have delivered no coherent vision of how a 'right to health' might actually be realized. An important task facing global health and human rights advocates is to continue pushing human rights framings so that progress is made both on meeting the SDGs and on realizing the right to health. © 2016 by Kerman University of Medical Sciences.

  15. Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico.

    Science.gov (United States)

    Mendes, Rosilda; Plaza, Veronica; Wallerstein, Nina

    2016-03-01

    Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's 'power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders.We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power

  16. Remains of War: Walt Whitman, Civil War Soldiers, and the Legacy of Medical Collections.

    Science.gov (United States)

    Barbian, Lenore; Sledzik, Paul S; Reznick, Jeffrey S

    2012-01-01

    The National Museum of Health and Medicine holds a collection of anatomical specimens from nearly 2,000 soldiers injured during the American Civil War. Originally collected as part of a study of trauma and disease during war, these specimens have been museum artifacts for over 140 years. During this time, they have been displayed and utilized in an array of interpretative strategies. They have functioned as medical specimens documenting the effects of gunshot wounds and infection to the human body, as mementos mori symbolizing the refuse of a nation divided by war, and as objects of osteological and forensic interest. The museum's curators recently discovered four of these specimens from soldiers who the poet and essayist Walt Whitman nursed in the wartime hospitals of Washington, DC. Uniting these remains with Whitman's words yields a new interpretation that bears witness to individual histories during a time of unprecedented conflict in American history.

  17. Diagnosis of sustainable collaboration in health promotion – a case study

    Directory of Open Access Journals (Sweden)

    van der Sar Rosalie

    2008-11-01

    Full Text Available Abstract Background Collaborations are important to health promotion in addressing multi-party problems. Interest in collaborative processes in health promotion is rising, but still lacks monitoring instruments. The authors developed the DIagnosis of Sustainable Collaboration (DISC model to enable comprehensive monitoring of public health collaboratives. The model focuses on opportunities and impediments for collaborative change, based on evidence from interorganizational collaboration, organizational behavior and planned organizational change. To illustrate and assess the DISC-model, the 2003/2004 application of the model to the Dutch whole-school health promotion collaboration is described. Methods The study combined quantitative research, using a cross-sectional survey, with qualitative research using the personal interview methodology and document analysis. A DISC-based survey was sent to 55 stakeholders in whole-school health promotion in one Dutch region. The survey consisted of 22 scales with 3 to 8 items. Only scales with a reliability score of 0.60 were accepted. The analysis provided for comparisons between stakeholders from education, public service and public health. The survey was followed by approaching 14 stakeholders for a semi-structured DISC-based interview. As the interviews were timed after the survey, the interviews were used to clarify unexpected and unclear outcomes of the survey as well. Additionally, a DISC-based document analysis was conducted including minutes of meetings, project descriptions and correspondence with schools and municipalities. Results Response of the survey was 77% and of the interviews 86%. Significant differences between respondents of different domains were found for the following scales: organizational characteristics scale, the change strategies, network development, project management, willingness to commit and innovative actions and adaptations. The interviews provided a more specific picture

  18. The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review.

    Science.gov (United States)

    Budhathoki, Shyam Sundar; Pokharel, Paras K; Good, Suvajee; Limbu, Sajani; Bhattachan, Meika; Osborne, Richard H

    2017-03-27

    Health literacy has been linked to health outcomes across population groups around the world. Nepal, a low income country, experiences the double burden of highly prevalent communicable as well as non-communicable diseases. The World Health Organization (WHO) has positioned health literacy as a key mechanism to meet the health-related Sustainable Development Goal (SDG3). However, there is little known about the status of health literacy in developing countries such as Nepal. This paper aims to review the potential of health literacy to address SDG3 in Nepal. A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on barriers to health care engagements in Nepal published in English language between January 2000 and December 2015. Barriers for healthcare engagement included knowledge and education as strong factors, followed by culture, gender roles, quality of service and cost of services. These barriers influence the Nepalese community to access and engage with services, and make and enact healthcare decisions, not only at the individual level but at the family level. These factors are directly linked to health literacy. Health literacy is a pivotal determinant of understanding, accessing and using health information and health services, it is important that the health literacy needs of the people be addressed. Locally identified and developed health literacy interventions may provide opportunities for systematic improvements in health to address impediments to healthcare in Nepal. Further research on health literacy and implementation of health literacy interventions may help reduce inequalities and increase the responsiveness of health systems which could potentially facilitate Nepal to meet the sustainable development goals. While there is currently little in place for health literacy to impact on the SDG3, this paper generates insights into health literacy's potential role.

  19. Sustained effects of integrated COPD management on health status and exercise capacity in primary care patients

    Directory of Open Access Journals (Sweden)

    Annemarije L Kruis

    2010-11-01

    > 2. In the Kroonluchter cohort, 56 subjects completed follow-up, were of mean age 69 years, with an FEV1/FVC ratio of 0.59, while their postbronchodilator FEV1 of 65% predicted was somewhat lower than in the total group. 6MWD improved significantly and in a clinically relevant manner up to 93 m at 12 months and was sustained at 83 m over 24 months; this effect occurred faster in patients with MRC dyspnea score > 2. In patients with baseline 6MWD < 400 m the improvement remained >100 m at 24 months.Conclusion: In this study, IDM improved and sustained health status and exercise capacity in primary care COPD patients during two years of follow-up. Improvements in health status are consistently higher in patients with CCQ > 1 at baseline, being strongest in patients with baseline MRC dyspnea score >2. Improvements in exercise capacity remain highest in patients with 6MWD < 400 m at baseline and seem to occur earlier in patients with MRC dyspnea score >2.Keywords: chronic obstructive pulmonary disease, disease management, integrated care, pulmonary rehabilitation, primary care

  20. The significance of ‘participation’ as an educational ideal in education for sustainable development and health education in schools

    DEFF Research Database (Denmark)

    Lysgaard, Jonas Greve; Simovska, Venka

    2016-01-01

    problems rather than on narrow curricula. Drawing on selected reviews of research literature on education for sustainable development and health education, Lacanian psychoanalysis provides inspiration for our analysis of the concept of participation, and how it is positioned and enacted in these fields...

  1. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2017-01-01

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

  2. Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study.

    Science.gov (United States)

    De Rosis, Sabina; Nuti, Sabina

    2017-08-08

    eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win-win strategies should be followed. Investments should take into account the need to long-term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

  3. Health Rights and Realization; Comment on “Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?”

    Directory of Open Access Journals (Sweden)

    Simon Rushton

    2016-05-01

    Full Text Available In their hypothesis published in IJHPM, Lisa Forman and colleagues examined the prominence of the right to health and sexual and reproductive health rights (as well as related language in four of the key reports that fed into the process of negotiating the Sustainable Development Goals (SDGs. Now that the SDGs have been formally adopted, this comment builds on some of the insights of Forman and colleagues to examine the extent to which those rights have been incorporated in SDGs 3 and 5. I argue that sexual and reproductive health rights are relatively well-covered within the SDGs. In terms of the right to health, however, the picture is much less clear. Some of the elements that make up that right are present and correct, but the SDGs have delivered no coherent vision of how a ‘right to health’ might actually be realized. An important task facing global health and human rights advocates is to continue pushing human rights framings so that progress is made both on meeting the SDGs and on realizing the right to health.

  4. System-Level Influences on the Sustainability of a Cognitive Therapy Program in a Community Behavioral Health Network.

    Science.gov (United States)

    Stirman, Shannon Wiltsey; Matza, Alexis; Gamarra, Jennifer; Toder, Katherine; Xhezo, Regina; Evans, Arthur C; Hurford, Matthew; Beck, Aaron T; Crits-Christoph, Paul; Creed, Torrey

    2015-07-01

    The purpose of this study was to examine influences on the sustainability of a program to implement an evidence-based psychotherapy in a mental health system. Interviews with program administrators, training consultants, agency administrators, and supervisors (N=24), along with summaries of program evaluation data and program documentation, were analyzed with a directed content-analytic approach. Findings suggested a number of interconnected and interacting influences on sustainability, including alignment with emerging sociopolitical influences and system and organizational priorities; program-level adaptation and evolution; intervention flexibility; strong communication, collaboration, planning, and support; and perceived benefit. These individual factors appeared to mutually influence one another and contribute to the degree of program sustainability achieved at the system level. Although most influences were positive, financial planning and support emerged as potentially both facilitator and barrier, and evaluation of benefits at the patient level remained a challenge. Several factors appeared to contribute to the sustainability of a psychosocial intervention in a large urban mental health system and warrant further investigation. Understanding interconnections between multiple individual facilitators and barriers appears critical to advancing understanding of sustainability in dynamic systems and adds to emerging recommendations for other implementation efforts. In particular, implications of the findings include the importance of implementation strategies, such as long-term planning, coalition building, clarifying roles and expectations, planned adaptation, evaluation, diversification of financing strategies, and incentivizing implementation.

  5. Assessing impact and sustainability of health, water, and sanitation interventions in Bolivia six years post-project.

    Science.gov (United States)

    Eder, Clara; Schooley, Janine; Fullerton, Judith; Murguia, Jose

    2012-07-01

    To assess the impact and sustainability of health, water, and sanitation interventions in Bolivia six years post-project. A mixed-method (qualitative-quantitative) study was conducted in 14 rural intervention and control communities in Bolivia in November 2008, six years after the completion of interventions designed to improve knowledge and practices related to maternal and child health and nutrition, community water systems, and household water and sanitation facilities. The degree to which participants had sustained the community and household practices promoted by the interventions was a particular focus. Community site visits were made to evaluate the status (functional condition) and sustainability (state of maintenance and repair) of community and household water and sanitation infrastructure. Key informant interviews and focus group discussions were conducted to assess knowledge and practices, and perceptions about the value of the interventions to the community. Six years post-project, participants remained committed to sustaining the practices promoted in the interventions. The average rating for the functional condition of community water systems was 42% higher than the average rating in control communities. In addition, more than two-thirds of households continued to practice selected maternal and child health behaviors promoted by the interventions (compared to less than half of the households in the control communities). Communities that received integrated investments (development and health) seemed to sustain the practices promoted in the interventions better than communities that received assistance in only one of the two sectors. Infrastructure for community water systems and household water and sanitation facilities was better built and maintained, and selected maternal and child health behaviors practiced more frequently, in intervention communities versus control communities.

  6. A survey of bacterial diversity from successive life stages of black soldier fly (Diptera: Stratiomyidae) by using 16S rDNA pyrosequencing.

    Science.gov (United States)

    Zheng, Longyu; Crippen, Tawni L; Singh, Baneshwar; Tarone, Aaron M; Dowd, Scot; Yu, Ziniu; Wood, Thomas K; Tomberlin, Jeffery K

    2013-05-01

    Sustainable methods for managing waste associated with people and animals have been proposed in the past. Black soldier fly, Hermetia illucens (L.), larvae represent one of the more promising methods. Larvae reduce dry matter, bacteria, offensive odor, and house fly populations. Prepupae can be used as feedstuff for livestock. However, it is not known if such a method results in the proliferation of potential pathogens. Although some bacterial species have been cultured and identified from black soldier fly, a true appreciation of fly associated bacterial diversity is not known. Such information is needed to understand pathogen colonization on decomposing animal and plant waste in the presence of black soldier fly larvae as well as develop research strategies for maximizing the use of this fly to reduce waste without risking environmental harm. Using 454 sequencing, we surveyed bacterial diversity associated with successive life stages of the black soldier fly reared on plant material. Bacteria diversity classified (99.8%) across all life stages spanned six bacterial phyla with > or = 80% bootstrap support. Bacteroidetes and Proteobacteria were the most dominant phyla associated with the black soldier fly accounting for two-thirds of the fauna identified. Many of these bacteria would go undetected because of their inability to be cultured.

  7. BOOK REVIEW - International Law and Child Soldiers by Gus Waschefort

    Directory of Open Access Journals (Sweden)

    Robbie Robinson

    2015-11-01

    Full Text Available Long gone are the days that the law pertaining to children essentially dealt with the position of children within the parent-child relationship. On the contrary it has become a highly specialised legal discipline in which international and regional conventions progressively establish norms and standards to be adhered to. This book by Waschefort, the 53rd volume in the series Studies in International Law, bears ample testimony to this. It reviews all of the international instruments containing proscriptive norms to prohibit the use and recruitment of child soldiers. It commences with an analysis of the current state of child soldiering internationally, after which relevant international instruments are comprehensively discussed with a clear focus on the question of whether or not the prohibitive norms are optimally enforced – are they capable of better enforcement? The author adopts an “issues-based approach” in terms of which no specific regime of law, for instance International Humanitarian Law, is considered dominant. He assesses universal and regional human rights law together with International Human Rights Law and International Criminal Law to establish a mutually reinforcing web of protection for children. He also critically assesses the international judicial, quasi-judicial and non-judicial entities most relevant to child soldier prevention. He argues that the effective implementation of child soldier prohibitive norms does not require fundamental changes to any entity or functionary engaged in such prevention. In fact, what is required according to the author is the constant reassessment and refinement of all such entities and functionaries. The conclusions which are reached are ultimately tested against the background of a comprehensive case study on the use and recruitment of child soldiers in the Democratic Republic of the Congo. International Law and Child Soldiers is to be welcomed as a timely contribution to the evaluation

  8. Do children make you happier? Sustained child-wish and mental health in women 11-17 years after fertility treatment

    NARCIS (Netherlands)

    Gameiro, S.; Belt-Dusebout, A.W. van den; Bleiker, E.; Braat, D.; Leeuwen, F.E. van; Verhaak, C.M.

    2014-01-01

    STUDY QUESTION: Are fertility treatment-related factors, parenthood status and sustained child-wish associated with women's long-term mental health? SUMMARY ANSWER: Sustaining a child-wish is more strongly associated with women's long-term mental health than fertility treatment-related factors and

  9. The Evolution of an Ecosystem Approach: the Diamond Schematic and an Adaptive Methodology for Ecosystem Sustainability and Health

    Directory of Open Access Journals (Sweden)

    David Waltner-Toews

    2005-06-01

    Full Text Available Over the past 15 yr, an international network of researchers has developed and tested a methodology for integrating complex systems theories into sustainable development projects. Drawing on our best theoretical understanding of complex systems and combining it with best practices of community engagement drawn from a wide variety of sources, we have developed a methodology that is theoretically sound and practically effective. AMESH, an Adaptive Methodology for Ecosystem Sustainability and Health, has emerged from, and been tested in, Nepal, Kenya, Canada, and Peru.

  10. Sustaining oral health services in remote and indigenous communities: a review of 10 years experience in Western Australia.

    Science.gov (United States)

    Kruger, Estie; Jacobs, Alissa; Tennant, Marc

    2010-04-01

    In line with findings throughout Australia, rural, remote and Indigenous Western Australians suffer from a higher burden of oral disease and have less access to dental practitioners and care than their urban and non-Indigenous counterparts. With workforce projections indicating an increase in the shortage of dental practitioners, especially in rural and remote areas, the Centre for Rural and Remote Oral Health (CRROH) in Western Australia set out to establish a sustainable programme to service such increasingly disadvantaged populations. Via the vertical integration of education, service and research CRROH pioneered a sustainable model to deliver much needed oral health services to some of Western Australia's most remote areas, while primarily focused on addressing the oral health needs of Indigenous Australians. One of the key lessons from the programme has been the development of a strong clinical governance framework and a support network to sustain services in remote locations. This study offers one way to provide and sustain dental care for those most in need, yet largely left out.

  11. Bridging gaps in discovery and development: chemical and biological sciences for affordable health, wellness and sustainability.

    Science.gov (United States)

    Chauhan, Prem Man Singh

    2011-05-01

    To commemorate 2011 as the International Year of Chemistry, the Indian Society of Chemists and Biologists organized its 15th International Conference on 'Bridging Gaps in Discovery and Development: Chemical and Biological Sciences for Affordable Health, Wellness and Sustainability' at Hotel Grand Bhagwati, in association with Saurashtra University, Rajkot, India. Anamik Shah, President of the Indian Society of Chemists and Biologists, was organizing secretary of the conference. Nicole Moreau, President of the International Union of Pure and Applied Chemistry and Secretary General of the Comité National de la Chimie, National Centre for Scientific Research France, was chief guest of the function. The four-day scientific program included 52 plenary lectures, 24 invited lectures by eminent scientists in the field and 12 oral presentations. A total of 317 posters were presented by young scientists and PhD students in three different poster sessions. Approximately 750 delegates from India, the USA, UK, France, Switzerland, Germany, Austria, Belgium, Sweden, Japan and other countries attended the conference. The majority of the speakers gave presentations related to their current projects and areas of interest and many of the talks covered synthesis, structure-activity relationships, current trends in medicinal chemistry and drug research.

  12. Sustainability of a successful health and nutrition program in a remote aboriginal community.

    Science.gov (United States)

    Lee, A J; Bonson, A P; Yarmirr, D; O'Dea, K; Mathews, J D

    1995-06-19

    To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.

  13. Towards a new welfare state: the social sustainability principle and health care strategies.

    Science.gov (United States)

    Garcés, Jorge; Ródenas, Francisco; Sanjosé, Vicente

    2003-09-01

    In this paper we propose a social and health care model that offers alternatives to three problems arising in converging European welfare states, particularly in the southern nations: the rise in demand for services and features linked to the ageing process, the increase in dependency and the crisis of informal support. Development of the principles of social sustainability implies re-formulation of the regulatory, care, economic, administrative, cultural, and axiological framework enabling a response to the needs of long term care without compromising the welfare of future generations. Together with this principle, quality of life elevated to a subjective right directs attention towards the sphere closest to citizens, eliminating all barriers, which hamper exercise of this right. All of the above produces economic and social costs which must be accepted from a viewpoint of social co-responsibility, which brings with it the supply of welfare individually, without detriment to the exercise of state responsibility in guaranteeing a social protection system of a universal nature.

  14. Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

    Directory of Open Access Journals (Sweden)

    Fabian Ling Ngai Tung

    2016-01-01

    Full Text Available Objectives: to explore nurses' knowledge of universal health coverage (UHC for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN or registered nurses (RN was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs. Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

  15. Sustainability of Endovenous Iron Deficiency Anaemia Treatment: Hospital-Based Health Technology Assessment in IBD Patients.

    Science.gov (United States)

    Poscia, A; Stojanovic, J; Kheiraoui, F; Proli, E M; Scaldaferri, F; Volpe, M; Di Pietro, M L; Gasbarrini, A; Fabrizio, L; Boccia, S; Favaretti, C

    2017-01-01

    Iron deficiency anaemia (IDA) is the main extraintestinal manifestation affecting patients with inflammatory bowel disease (IBD). The Health Technology Assessment approach was applied to evaluate the sustainability of intravenous (IV) iron formulations in the Italian hospital setting, with particular focus on ferric carboxymaltose. Data on the epidemiology of IBD and associated IDA, in addition to the efficacy and safety of IV iron formulations currently used in Italy, were retrieved from scientific literature. A hospital-based cost-analysis of the outpatient delivery of IV iron treatments was performed. Organizational and ethical implications were discussed. IDA prevalence in IBD patients varies markedly from 9 to 73%. IV iron preparations were proven to have good efficacy and safety profiles, and ferric carboxymaltose provided a fast correction of haemoglobin and serum ferritin levels in iron-deficient patients. Despite a higher price, ferric carboxymaltose would confer a beneficial effect to the hospital, in terms of reduced cost related to individual patient management and additionally to the patient by reducing the number of infusions and admissions to healthcare facilities. Ethically, the evaluation is appropriate due to its efficacy and compliance. This assessment supports the introduction of ferric carboxymaltose in the Italian outpatient setting.

  16. [Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level].

    Science.gov (United States)

    Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M

    2015-05-01

    Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard

  17. Utilizing Earth Observations for Reaching Sustainable Development Goals in Water, Sanitation and Public Health

    Science.gov (United States)

    Akanda, A. S.; Hasan, M. A.; Nusrat, F.; Jutla, A.; Huq, A.; Alam, M.; Colwell, R. R.

    2016-12-01

    The United Nations Sustainable Development Goals call for universal and equitable access to safe and affordable drinking water, improvement of water quality, and adequate and equitable sanitation for all, with special attention to the needs of women and girls and those in vulnerable situations (Goal 6). In addition, the world community also aims to end preventable deaths of newborns and children under 5 years of age, and end the epidemics of neglected tropical diseases and combat hepatitis, water-borne diseases and other infectious diseases (Goal 3). Water and sanitation-related diseases remain the leading causes of death in children under five, mostly in South Asia and sub-Saharan Africa, due to diarrheal diseases linked to poor sanitation and hygiene. Water scarcity affects more than 40 per cent of the global population and is projected to rise substantially. More than 80 per cent of wastewater resulting from human activities is also discharged into rivers or sea without any treatment and poor water quality controls. As a result, around 1.8 billion people globally are still forced to use a source of drinking water that is fecally contaminated. Earth observation techniques provide the most effective and encompassing tool to monitor both regional and local scale changes in water quality and quantity, impacts of droughts and flooding, and water resources vulnerabilities in delta regions around the globe. University of Rhode Island, along with partners in the US and Bangladesh, is using satellite remote sensing datasets and earth observation techniques to develop a series of tools for surveillance, analysis and decision support for various government, academic, and non-government stakeholder organizations in South-Asia to achieve sustainable development goals in 1) providing safe water and sanitation access in vulnerable regions through safe water resources mapping, 2) providing increasing access to medicine and vaccines through estimation of disease burden and

  18. [Child Soldiers as Refugees in Germany].

    Science.gov (United States)

    Zito, Dima

    2016-12-01

    Child Soldiers as Refugees in Germany How do former child soldiers cope with their potentially traumatic experiences, and how do the living conditions as refugees influence these coping processes? A dissertation at the faculty of human and social sciences at the University of Wuppertal, based on biographical-narrative interviews with 15 young refugees from six African countries, describes the characteristics of the traumatic sequences in the countries of origin and in exile, and elaborates typical coping processes. In order to survive a situation of absolute subjection within armed groups, children develop forms of adequate adaptation to the context like regulation and detachment of emotions e.g. with the use of drugs, assimilation to an idea of "hard masculinity" etc. They become victims, witnesses and often perpetrators of extreme violence (man-made-disaster), respectively traumatic processes can be seen in all sequences. After leaving the armed groups there is no way back into the families and communities destroyed by armed conflict, so they become refugees. In Germany, they are subjected to a bureaucratic and excluding asylum system, in which decisions on all relevant areas of life (age determination, place and right of residence, form of accommodation, access to education, etc.) are imposed on them. Especially the insecure right of residence and the living conditions in refugee camps are severe risk factors, impeding stabilization. Social support, e. g. by competent professionals, access to trauma- and culture-sensitive psychotherapy, societal inclusion, but also personal resilience are essential for coping with trauma and developing new future perspectives.

  19. University Students and Sustainability Skills in Occupational Health and Safety Master Degree

    Science.gov (United States)

    Míguez-Álvarez, Carla; Arce, Maria Elena; Souto-Gestal, Antonio

    2016-01-01

    Education is one of the key instruments to achieving global sustainability. In fact, sustainable development has to be integrated into higher education curricula. One of the difficulties of this challenge is to know if students are able to achieve the basic skills, something that is extremely important in emergency management. Thus, assessment of…