WorldWideScience

Sample records for sustaining soldier health

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

    Science.gov (United States)

    1994-10-01

    extended post - partum depression . Because of family problems, soldiers may be irritable, nervous, inattentive and have difficulty sleeping. Soldiers returning...it most, regardless of rank, shyness or distance from post . c. Keep families and friends Informed. Establish effective lines of communication with the

  2. Soldiers

    DEFF Research Database (Denmark)

    Lech, Marcel Lysgaard

    2018-01-01

    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...... comedy, the independent mercenary becomes a central character of New Comedy. Thus the comic view on soldiers reflects the martial attitudes and ideologies of contemporary society....

  3. Soldier Health Habits and the Metabolically Optimized Brain.

    Science.gov (United States)

    Friedl, Karl E; Breivik, Torbjorn J; Carter, Robert; Leyk, Dieter; Opstad, Per Kristian; Taverniers, John; Trousselard, Marion

    2016-11-01

    Human performance enhancement was the subject of a NATO workshop that considered the direct benefits of individual soldier health and fitness habits to brain health and performance. Some of the important health and fitness include physical activity and purposeful exercise, nutritional intake, sleep and rest behaviors, psychological outlook and mindfulness, and other physiologically based systemic challenges such as thermal exposure. These influences were considered in an integrated framework with insights contributed by each of five participating NATO member countries using representative research to highlight relevant interrelationships. Key conclusions are that (1) understanding the neurobiological bases and consequences of personal health behaviors is a priority for soldier performance research, and this also involves long-term brain health consequences to veterans and (2) health and fitness habits have been underappreciated as reliably effective performance enhancers and these should be preferred targets in the development of scientifically based recommendations for soldier brain health and performance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. Mental health care use by soldiers conducting counterinsurgency operations.

    Science.gov (United States)

    Applewhite, Larry; Keller, Nathan; Borah, Adam

    2012-05-01

    Counterinsurgency (COIN) has become the cornerstone of the military's strategy to combat terrorist threats. COIN operations are complex and often expose soldiers to unfamiliar stressors as they fight the enemy while developing and maintaining rapport with the local populace. Utilizing a retrospective record review protocol, we examined 282 mental health files of soldiers assigned to a brigade combat team that operated from a large forward operating base in Iraq during the counterinsurgency campaign. Most reported sleep disturbance, depression, anxiety, irritability, and conflict with supervisors related to either operational stress, exposure to direct combat, or home front concerns. Most received brief individual supportive therapy or attended solution-focused group counseling emphasizing life skills training, post-traumatic stress treatment, women's support, or relationship skills. Psychopharmacologic treatment was an essential adjunct to the counseling program. Results indicate that supporting a COIN deployment requires a comprehensive mental health program that can respond to a wide range of mental health problems.

  5. Facilitating Soldier Receipt of Needed Mental Health Treatment

    Science.gov (United States)

    2014-11-01

    Young males, 18 or 19-year-old males; it’s like a soldier (that inhibits treatment- bullpen. They beat each other up, and don’t give seeking...forced me to go to mental health. After seeing a therapist, [they said I] someone wasn’t suicidal , wasn’t homicidal, but [they] told me I...I was given a choice to either stay at the house or go to this Uuvenile delinquency ] group home...Our therapist was good at what she did. That

  6. 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…

  7. Health promotion research in active duty army soldiers: The road to a fit and ready force.

    Science.gov (United States)

    McCarthy, Mary S; Elshaw, Evelyn B; Szekely, Barbara M; Pflugeisen, Bethann

    In the last decade the Military Health System has changed its paradigm to focus on health promotion and disease prevention. This paper reviews a decade of research exploring the effects of military life on nutritional status and bone health of Army soldiers. Descriptive and experimental approaches have assessed occupational demands on soldiers in variable environments that require optimal nutrition status and physical health. The prevalence of overweight and obesity in the military has risen dramatically and the implications for health, readiness, productivity, and cost demands attention. The related nutritional deficits such as suboptimal vitamin D status likely contribute to musculoskeletal injuries which have a greater impact on the performance and readiness of soldiers than any other medical condition in peacetime or conflict. The greatest challenge in our system for health is optimizing the performance of all soldiers while minimizing health risks and long-term disability resulting from occupational hazards, particularly those inherent to war. Published by Elsevier Inc.

  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. Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011.

    Science.gov (United States)

    Quartana, Phillip J; Wilk, Joshua E; Thomas, Jeffrey L; Bray, Robert M; Rae Olmsted, Kristine L; Brown, Janice M; Williams, Jason; Kim, Paul Y; Clarke-Walper, Kristina; Hoge, Charles W

    2014-09-01

    We characterized trends in mental health services utilization and stigma over the course of the Afghanistan and Iraq wars among active-component US soldiers. We evaluated trends in mental health services utilization and stigma using US Army data from the Health-Related Behavior (HRB) surveys from 2002, 2005, and 2008 (n = 12,835) and the Land Combat Study (LCS) surveys administered to soldiers annually from 2003 to 2009 and again in 2011 (n = 22,627). HRB and LCS data suggested increased mental health services utilization and decreased stigma in US soldiers between 2002 and 2011. These trends were evident in soldiers with and without posttraumatic stress disorder (PTSD), major depressive disorder (MDD), or PTSD and MDD. Despite the improving trends, more than half of soldiers with mental health problems did not report seeking care. Mental health services utilization increased and stigma decreased over the course of the wars in Iraq and Afghanistan. Although promising, these findings indicate that a significant proportion of US soldiers meeting criteria for PTSD or MDD do not utilize mental health services, and stigma remains a pervasive problem requiring further attention.

  11. Sustainable Transportation and Health

    Directory of Open Access Journals (Sweden)

    Norbert Mundorf

    2018-03-01

    Full Text Available We are experiencing a shift in thinking about Transportation and Mobility, which makes this Special Issue on Sustainable Transportation and Health in the International Journal of Environmental Research and Public Health especially timely.[...

  12. Stigma, barriers to care, and use of mental health services among active duty and National Guard soldiers after combat.

    Science.gov (United States)

    Kim, Paul Y; Thomas, Jeffrey L; Wilk, Joshua E; Castro, Carl A; Hoge, Charles W

    2010-06-01

    This study examined rates of utilization of mental health care among active duty and National Guard soldiers with mental health problems three and 12 months after they returned from combat in Iraq. Stigma and barriers to care were also reported for each component (active duty and National Guard). Cross-sectional, anonymous surveys were administered to 10,386 soldiers across both time points and components. Mean scores from 11 items measuring stigma and barriers to care were computed. Service utilization was assessed by asking soldiers whether they had received services for a mental health problem from a mental health professional, a medical doctor, or the Department of Veterans Affairs in the past month. Risk of mental problems was measured using the Patient Health Questionnaire, the PTSD Checklist, and items asking about aggressive behaviors and "stress, emotional, alcohol, or family" problems within the past month. A higher proportion of active duty soldiers than National Guard soldiers reported at least one type of mental health problem at both three months (45% versus 33%) and 12 months (44% versus 35%) postdeployment. Among soldiers with mental health problems, National Guard soldiers reported significantly higher rates of mental health care utilization 12 months after deployment, compared with active duty soldiers (27% versus 13%). Mean stigma scores were higher among active duty soldiers than among National Guard soldiers. Active duty soldiers with a mental health problem had significantly lower rates of service utilization than National Guard soldiers and significantly higher endorsements of stigma. Current and future efforts to improve care for veterans should work toward reducing the stigma of receiving mental health care.

  13. 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...

  14. 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.

  15. Social Health and Sustainability

    DEFF Research Database (Denmark)

    Andersen, Heidi Lene

    2015-01-01

    ?’ (Kickbusch, 2011: p. 7). The empirical case study presented here describes the local planning process of a health project in a deprived community in Copenhagen, Denmark. This setting opened an opportunity for intersectional cooperation and interaction between the municipality’s Environmental and Healthcare...... language in the search for a shared agenda is based in the social aspect of heath and sustainability. The other conclusion is that the search for a shared agenda is in itself a strategy for achieving integration between health and the environmental, economic and social impacts, both within the field...

  16. 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

  17. Association between baseline psychological attributes and mental health outcomes after soldiers returned from deployment.

    Science.gov (United States)

    Shen, Yu-Chu; Arkes, Jeremy; Lester, Paul B

    2017-10-05

    Psychological health is vital for effective employees, especially in stressful occupations like military and public safety sectors. Yet, until recently little empirical work has made the link between requisite psychological resources and important mental health outcomes across time in those sectors. In this study we explore the association between 14 baseline psychological health attributes (such as adaptability, coping ability, optimism) and mental health outcomes following exposure to combat deployment. Retrospective analysis of all U.S. Army soldiers who enlisted between 2009 and 2012 and took the Global Assessment Tools (GAT) before their first deployment (n = 63,186). We analyze whether a soldier screened positive for depression and posttraumatic stress disorder (PTSD) after returning from deployment using logistic regressions. Our key independent variables are 14 psychological attributes based on GAT, and we control for relevant demographic and service characteristics. In addition, we generate a composite risk score for each soldier based on the predicted probabilities from the above multivariate model using just baseline psychological attributes and demographic information. Comparing those who scored in the bottom 5 percentile of each attribute to those in the top 95 percentile, the odds ratio of post-deployment depression symptoms ranges from 1.21 (95% CI 1.06, 1.40) for organizational trust to 1.73 (CI 1.52, 1.97) for baseline depression. The odds ratio of positive screening of PTSD symptoms ranges from 1.22 for family support (CI 1.08, 1.38) to 1.51 for baseline depression (CI 1.32, 1.73). The risk profile analysis shows that 31% of those who screened positive for depression and 27% of those who screened positive for PTSD were concentrated among the top 5% high risk population. A set of validated, self-reported questions administered early in a soldier's career can predict future mental health problems, and can be used to improve workforce fit and

  18. Results of the reproductive health education program for soldiers and noncommissioned officers.

    Science.gov (United States)

    Sevig, Umit; Yilmaz, Senay; Başer, Mürüvvet; Taşci, Sultan

    2006-12-01

    The Turkish Armed Forces Commando Brigade has started a continuous and systematic education program, called the Patriotic Awareness Acquirement Project (PCAP), to inform soldiers who will be demobilized. Within the PCAP, topics such as Turkish history, the Armenian question, and manners/etiquette, as well as healthy living, reproductive health, family planning, general hygiene, and sexually transmitted diseases were included. The aim of Reproductive Health Education (RHE) conducted within the PCAP is to inform male individuals about reproductive health and to increase their knowledge, awareness, and sensitivity. In the RHE, the privates were provided with information regarding male and female reproductive organs, the menstruation mechanism, pregnancy, determination of gender, fertility-infertility, and sexually transmitted diseases. After the evaluation, it was reported that the privates indicated they were satisfied with RHE, were informed, took notice of the incorrect information, and, for postmilitary life, would visit health clinics for counseling.

  19. 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.

  20. Comparing post-deployment mental health services utilization in soldiers deployed to Balkan, Iraq and Afghanistan

    DEFF Research Database (Denmark)

    Madsen, T; Sadowa Vedtofte, M; Nordentoft, M

    2017-01-01

    OBJECTIVE: Insight on how different missions have impacted rates of mental health service (MHS) utilization is unexplored. We compared postdeployment MHS utilization in a national cohort of first-time deployed to missions in Balkan, Iraq, and Afghanistan respectively. METHODS: A prospective...... national cohort study of 13 246 first-time deployed in the period 1996 through 2012 to missions in Balkan area, Iraq, or Afghanistan respectively. Soldiers 'MHS utilization was also compared with a 5:1 sex-, age-, and calendar year-matched never-deployed background population. Postdeployment utilization...... of psychotropics. RESULTS: Utilizing of psychiatric outpatient services and psychotropics was significantly higher in first-time deployed to Iraq and Afghanistan compared with deployed to Balkan. However, the rate of postdeployment admission to psychiatric hospital did not differ between missions. Postdeployment...

  1. Investigation of army soldiers readiness about health actions in critical circumstances. Case study: Malek Ashtar Military Garrison’s

    Directory of Open Access Journals (Sweden)

    abdollah vosoughi niri

    2013-08-01

    Full Text Available Introduction: Health related measures in emergencies are of the issues that, if taken properly, can reduce damages of a disaster effectively. To have this situation happened knowledge of health personnel, crisis staff, and military and other related groups has to improve. This study aimed to determine military staffs’ attitude and knowledge about health measures in emergencies. Methods: This descriptive and cross-sectional study was conducted through a self-administrated questionnaire. Validity and reliability of the questionnaire was previously proven. The questionnaire included items on personal information and knowledge and attitude about health measures in emergencies. Using a multi-stage sampling, 190 soldiers of Malek Ashtar Military Garrison in Arak were selected. ANOVA, Kruskal- Wallis, Chi Square, Spearman rho’s coefficient correlation and T-test were used to analyze that data. Results: Findings showed that 43 percent of soldiers had good knowledge of health measures in emergencies. About 11 percent of staff had poor knowledge. Half of staff had an average attitude toward emergency health measures. Concerning the degree of knowledge, no significant difference was observed between soldiers with different levels of education. Regarding knowledge and attitude, there was no statistically significant difference between different age groups. Conclusion: Having a basic knowledge of health measures in emergencies is of salient importance. Considering lack of such basic knowledge among some military staff, provision of training on health related measures for those staff is recommended. Keywords: knowledge, attitude, health measures, military staff, crisis

  2. 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......, or in the margins of official political economies. Rather, shadow soldiering is a phenomenon that is becoming increasingly central in the context of security outsourcing and militarisation in a global economy....

  3. Prior Health Care Utilization Patterns and Suicide among U.S. Army Soldiers

    Science.gov (United States)

    Bell, Nicole S.; Harford, Thomas C.; Amoroso, Paul J.; Hollander, Ilyssa E.; Kay, Ashley B.

    2010-01-01

    Suicides among U.S. Army soldiers are increasing and, in January 2009, outpaced deaths due to combat. For this study, 1,873 army suicides identified through death, inpatient, and emergency room records were matched with 5,619 controls. In multivariate models, older, male, White, single, and enlisted soldiers with a prior injury (OR = 2.04, 95% CI…

  4. 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 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 validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

  5. Effects of Command and Control Vehicle (C2V) Operational Environment on Soldier Health and Performance

    Science.gov (United States)

    Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles; Tauson, Richard

    1999-01-01

    The purpose of this project was to use NASA technology to assist the US Army in the assessment of motion sickness and performance of soldiers in the Command and Control Vehicle (C2V). Three different vehicle configurations were tested: oblique, (3 seats at a 20-degree angle from the direction of travel); perpendicular, (3 seats at a 90 degree angle); and 4-forward, (all seats faced forward). In all vehicles, the front seat faced forward. Sixteen men and eight women participated for 15 days: 2 days of classroom instruction; 12 days of field tests in the C2V, and 15 minutes of post-field test performance measures. Conditions for field tests were: an initial Park; four Moves (i.e., travel over a mixed terrain); and four Short-halts following movement. NASA task batteries, mood and symptom scales, and physiological data were collected during field tests. Motion sickness symptoms ranging from slight to severe were reported for all subjects. Conclusions were: (1) there was no difference between vehicle configurations; (2) there was a negative impact on crew performance and health when subjects attended to visual screens during vehicle movement; and (3) symptoms and performance degradation were not mitigated by intermittent short-halts.

  6. 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.

  7. 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

    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. 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). 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. Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.

  8. 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.

  9. Lake Naivasha Sustainability : Ecosystem Improvement for Health ...

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

    Lake Naivasha Sustainability : Ecosystem Improvement for Health and ... The overall goal is to make recommendations for the sustainable management of natural ... to improve livestock vaccine development and production to benefit farmers ...

  10. Health is a sustainable state.

    Science.gov (United States)

    King, M

    1990-09-15

    -term population-increasing consequences?" He suggests that other factors such as ecological deterioration, integrity of the ecosystem, and the welfare of future communities need to be taken into consideration. King presents a new global strategy based on the concept of "sustainability". He says that "sustainability should be the maintenance of the capacity of the ecosystem to support life in quantity and variety". Specifically, he advocates for consumption control in the industrial North with intensive energy conservation and recycling. In the South, he calls for renewed vigor in family planning efforts. Public health measures need to be understood in terms of their demographic and ecological implications. If measures are found to be desustaining, King says that complementary ecologically sustaining measures should be introduced with them. He also believes that desustaining measures, such as oral rehydration, should not be introduced on a public health scale if no adequately sustaining complementary measures are possible. He asserts that desustaining measures, without complementary interventions, can ultimately increase the man-years of human misery.

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

    Science.gov (United States)

    2015-03-13

    statistically significant differences in calories, micronutrients, macronutrients , calcium, vitamin D, phosphorus, vitamin C, vitamin K, or...Acceptable Macronutrient Distribution Range (20-35%) 3 Dietary Reference Intake (DRI) 4 Vitamin D: 15 ug/day = 600 IU As evident in Table 4, neither...encouraging TG soldiers to engage in weight-bearing, muscle-strengthening exercises. The most frequently reported sports included soccer

  12. PTSD Trajectory, Comorbidity, and Utilization of Mental Health Services Among National Guard Soldiers

    Science.gov (United States)

    2013-10-01

    Reserve), 45 years or older, divorced/separated or never married ( vs . married ), enlisted ( vs . officer), or living in a household with a total income...officers, and those who were married had a lower prevalence of anger than unmarried soldiers. Probable civilian-related PTSD was documented among 4.3% of...between the ages of 18 and 35 (59.9%), and married (53.1%). In our sample, the Army National Guard had the highest representation (43.4%) and the

  13. Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations.

    Science.gov (United States)

    Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil

    2010-01-01

    little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

  14. 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.

  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. 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...... of food as food waste is reduced. The lack of attention given to reducing the oversupply of food calls for governance initiatives directed towards reducing the overproduction of primary food produce in order to reap the environmental benefits and the health promotion benefits of reducing food waste...

  17. 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.

  18. Barriers and Facilitators of Mental Health Treatment-Seeking in U.S. Active Duty Soldiers With Sexual Assault Histories.

    Science.gov (United States)

    Zinzow, Heidi M; Britt, Thomas W; Pury, Cynthia L S; Jennings, Kristen; Cheung, Janelle H; Raymond, Mary Anne

    2015-08-01

    Despite significant mental health needs among sexual assault (SA) victims in the military, little is known about treatment-seeking patterns or factors associated with service use. This study examined service use behavior, barriers, and facilitators of mental health treatment-seeking in an active duty sample of 927 U.S. Army soldiers with mental health problems. SA victims (n = 113) did not differ from non-victims on barriers or facilitators after adjusting for demographic and mental health variables, with stigma rated as the largest barrier. Most SA victims (87.6%) had sought informal support and 59.3% had sought formal treatment. One third of treatment-seekers had dropped out of treatment. Multivariate logistic regression analyses identified several correlates of treatment-seeking among SA victims: Black race (OR = 7.57), SA during the military (OR = 4.34), positive treatment beliefs (OR = 2.22), social support for treatment (OR = 2.14), self-reliance (OR = 0.47), and stigma towards treatment seekers (OR = 0.43). Mental health symptoms were not associated with treatment seeking. Findings suggested that treatment-facilitating interventions should focus on improving recognition of mental health symptoms, altering perceptions related to self-reliance, and reducing stigma. Interventions should also enlist support for treatment-seeking from unit members, leaders, and significant others. © 2015 International Society for Traumatic Stress Studies.

  19. 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.

  20. 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 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 longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring. PMID:23061830

  1. Health, sustainability and student travel.

    Science.gov (United States)

    Green, Gill; Morris, Jenny; Wade, Margaret

    2012-01-01

    A survey of 246 pre-registration nursing students in a University in the South West of England was carried out to explore the impact of course related travel on the student experience. Results from the survey indicated that students' main mode of transport to practice placements was by car which reflects the rural nature of the South West and the relative paucity of public transport. Long distances that many students travel to their study centre and to placements, and the concurrent financial strain that this creates, impacted negatively on the student experience. Students recognised the need to travel to a place of study and clinical placements and suggestions of minimising the negative impact of travel were offered. These included the increased use of electronic delivery of lectures, attendance at local university premises, the provision of shared transport to placements and placements closer to the student's home. Few students, however, considered the environmental impact of travel. Higher Education Institutions need to address issues of sustainability through promoting student wellbeing and taking steps to reduce greenhouse gas emissions. It is therefore important that student awareness of sustainability related issues is increased as well as focusing on reducing the environmental impact through organisational change. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. 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.

  3. Technology-Enabled Capability Demonstration 4A Sustainability and Logistics-Basing: Initial Quality of Life and Soldier Readiness User Assessment

    Science.gov (United States)

    2014-10-30

    Eat (MRE), Meal Cold Weather/Long Range Patrol (MCW/LRP), Unitized Group Ration (UGR) Heat & Serve, UGR‐E...1000 PAX camp has the Soldiers receiving a hot meal (UGR‐A) for dinner in addition to breakfast. The 1000 PAX camp also has larger numbers of MWR...over AC in the TOC any day.” Figure 14: MWR Attribute Scores 3.1.3.5 Field Feeding The Soldiers prioritized breakfast rations slightly over dinner

  4. 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.

  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. [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.

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

    Science.gov (United States)

    1993-06-01

    Some diseases spread by insects are serious and can be fatal. The risk of infection from insects is seasonal . Peak months of tick activity are March...genital warts, herpes, hepatitis B infection, and infection with the AIDS virus (HIV), all occur in the FRY. Abstinence is the best way to prevent...thorns which can puncture the skin and cause infections. Other plants (Clematis) can cause rashes just by touching the skin. Contact with the smoke

  8. 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

  9. 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

  10. Family as a Total Package: Restoring and Enhancing Psychological Health for Citizen Soldiers and Families

    Science.gov (United States)

    2012-03-01

    Outcome) High Score=Better Health 3.80 (1.07) 3.48 (1.02) 3.66 (1.05) Predictors Marital Status -1= Unmarried ; 0= Married ; 1=Separated -.348 .168 -.159...members vs . 37% among supporters). • Levels of depression and PTSD symptoms were slightly worse among supporters, compared to service members (PHQ...means among service members was 3.6 vs . 5.7 among supporters; PCL means among service members 27.0 vs . 28.3 among supporters. Taken together

  11. 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.

  12. 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.

  13. Commentary on "The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)": Army STARRS: a Framingham-like study of psychological health risk factors in soldiers.

    Science.gov (United States)

    Ressler, Kerry J; Schoomaker, Eric B

    2014-01-01

    Although historically the Army suicide rate has been significantly lower than the civilian rate, in 2004, the suicide and accidental death rates began trending upward. By 2008, the Army suicide rate had risen above the national average (20.2 per 100,000). In 2009, 160 active duty Soldiers took their lives, making suicide the third leading cause of death among the Army population. If accidental death, frequently the result of high-risk behavior, is included, then more Soldiers died by their own actions than in combat in 2009. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was thus created in 2009 to begin to address these problems. The Army STARRS project is a large consortium of seven different studies to develop data-driven methods for mitigating or preventing suicide behaviors and improving the overall mental health and behavioral functioning of Army Soldiers during and after their Army service. The first research articles from the Army STARRS project were published in late 2013 and early 2014. This work has already begun to outline important facets of risk in the military, and it is helping to drive an empirically derived approach to improvements in understanding mental disorders and risk behavior and to improve prevention and support of mental health and resilience. The Framingham Heart Study, started in the 1940s, marked a watershed event in utilizing large cross-sectional and prospective longitudinal collaborative research to identify and understand risk factors for cardiovascular disease. The Army STARRS project, through its collaborative, prospective, and robust innovative design and implementation, may provide the beginning of a similar scientific cohort in mental disorders. The work of this project will help understand biological and psychological aspects of military service, including those leading to suicide. When coupled with timely feedback to Army leadership, it permits near real-time steps to diagnose, mitigate, and

  14. Sustainable Improvement of Animal Production and Health

    International Nuclear Information System (INIS)

    Odongo, N.E.; Garcia, M.; Viljoen, G.J.

    2010-01-01

    The world's poorest people, some one billion living mostly in Africa and Asia, depend on livestock for their day-to-day livelihood. To reduce poverty, fight hunger and ensure global food security, there is an urgent need to increase livestock production in sustainable ways. However, livestock production in developing countries is constrained by low genetic potential of the animals, poor nutrition and husbandry practices and infectious diseases. Nuclear techniques, when applied in conjunction with conventional methods, can identify constraints to livestock productivity as well as interventions that lead to their reduction or elimination in ways that are economically and socially acceptable. The challenge is how best to exploit these techniques for solving problems faced by livestock keepers within the many agricultural production systems that exist in developing countries and demonstrating their advantages to owners, local communities and government authorities. This publication is a compilation of the contributions emanating from an international Symposium on Sustainable Improvement of Animal Production and Health organised by the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture in cooperation with the Animal Production and Health Division of FAO. It provides invaluable information not only on how nuclear and related techniques can be used to support sustainable livestock production systems, but also about the constraints and opportunities for using these techniques in developing countries; it also attempts to identify specific research needs and gaps and new options for using these techniques for solving established and emerging problems. As such, it is hoped that the information presented and suggestions made will provide valuable guidance to scientists in both the public and private sectors as well as to government and institutional policy and decision makers. The Symposium comprised a plenary session and four thematic sessions, covering (i

  15. Sustainable Improvement of Animal Production and Health

    Energy Technology Data Exchange (ETDEWEB)

    Odongo, N E; Garcia, M; Viljoen, G J [Animal Production and Health Subprogramme, Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Department of Nuclear Sciences and Applications, International Atomic Agency, Vienna (Austria)

    2010-07-01

    The world's poorest people, some one billion living mostly in Africa and Asia, depend on livestock for their day-to-day livelihood. To reduce poverty, fight hunger and ensure global food security, there is an urgent need to increase livestock production in sustainable ways. However, livestock production in developing countries is constrained by low genetic potential of the animals, poor nutrition and husbandry practices and infectious diseases. Nuclear techniques, when applied in conjunction with conventional methods, can identify constraints to livestock productivity as well as interventions that lead to their reduction or elimination in ways that are economically and socially acceptable. The challenge is how best to exploit these techniques for solving problems faced by livestock keepers within the many agricultural production systems that exist in developing countries and demonstrating their advantages to owners, local communities and government authorities. This publication is a compilation of the contributions emanating from an international Symposium on Sustainable Improvement of Animal Production and Health organised by the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture in cooperation with the Animal Production and Health Division of FAO. It provides invaluable information not only on how nuclear and related techniques can be used to support sustainable livestock production systems, but also about the constraints and opportunities for using these techniques in developing countries; it also attempts to identify specific research needs and gaps and new options for using these techniques for solving established and emerging problems. As such, it is hoped that the information presented and suggestions made will provide valuable guidance to scientists in both the public and private sectors as well as to government and institutional policy and decision makers. The Symposium comprised a plenary session and four thematic sessions, covering (i

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

    OpenAIRE

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

    2010-01-01

    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, ...

  17. Nottingham Health Science Biobank: a sustainable bioresource.

    Science.gov (United States)

    Matharoo-Ball, Balwir; Thomson, Brian J

    2014-10-01

    Nottingham Health Science Biobank (NHSB) was established in 2011 by a 3-year "pump priming" grant from the United Kingdom National Institute of Health Research. Before biobanking operations began, NHSB commissioned a financial report on the full costs of biobanking and worked with key stakeholders and external consultants to develop a business plan with the aim of achieving financial and operational sustainability. The plan included: scanning published information, telephone interviews with commercial companies, Freedom of Information Requests, dialogue with prospective customers, and a market analysis of global trends in the use of human tissue samples in research. Our financial report provided a comprehensive and structured costing template for biobanking and confirmed the absolute requirement to ensure cost-efficient processes, careful staff utilization, and maximization of sample turnover. Together with our external consultants, we developed a business model responsive to global interest in healthcare founded on i) identification of key therapeutic areas that mapped to the strengths of the NHSB; ii) a systematic approach to identifying companies operating in these therapy areas; iii) engagement with noncommercial stakeholders to agree strategically aligned sample collection with the aim of ensuring the value of our tissue resource. By adopting this systematic approach to business modelling, the NHSB has achieved sustainability after less than 3 years of operation.

  18. Bayelsa, in search of a sustainable health financing scheme ...

    African Journals Online (AJOL)

    Journal Home > Vol 23, No 1 (2017) > ... Background: A sustainable health care financing scheme has been difficult to ... These meagre allocations were because the same source that funds patient care services also funds health research, capital ... a sustainable health financing scheme will depend on a health system that ...

  19. Danish soldiers in Iraq

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...

  20. 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.

  1. Soldiers Magazine | Telling the Soldier's story

    Science.gov (United States)

    Soldier, fight in the Korean War and serve as a intelligence agent during the Cold War. 14 April 2016 professionals vying for Best Medic bragging rights. 14 October 2016 The U.S. Army's Hispanic-American Medal of possible On Women's Equality Day, learn about 19 ways U.S. Army women helped make the 19th Amendment

  2. 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.

  3. Patents for Soldiers

    Science.gov (United States)

    2016-06-10

    PATENTS FOR SOLDIERS A thesis presented to the Faculty of the U.S. Army Command and General Staff College in partial fulfillment...COVERED (From - To) AUG 2015 – JUNE 2016 4. TITLE AND SUBTITLE Patents for Soldiers 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...protection of an innovative idea; that is, a patent . A Soldier’s pursuit of patents provides the Army with tangible and intangible benefits. There are on

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

    OpenAIRE

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

    2013-01-01

    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 i...

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

    African Journals Online (AJOL)

    Journal Home > Vol 8, No 3 (2016) > ... a natural environment and away from the pollution of urban life , traditional medical care, hydrotherapy, sports and ... Keywords: Health; city health; smart; sustainability in architecture; architectural design ...

  7. 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

  8. 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.

  9. Review: Animal health and sustainable global livestock systems.

    Science.gov (United States)

    Perry, B D; Robinson, T P; Grace, D C

    2018-04-10

    This paper discusses the sustainability of livestock systems, emphasising bidirectional relations with animal health. We review conventional and contrarian thinking on sustainability and argue that in the most common approaches to understanding sustainability, health aspects have been under-examined. Literature review reveals deep concerns over the sustainability of livestock systems; we recognise that interventions are required to shift to more sustainable trajectories, and explore approaches to prioritising in different systems, focusing on interventions that lead to better health. A previously proposed three-tiered categorisation of 'hot spots', 'cold spots' and 'worried well' animal health trajectories provides a mental model that, by taking into consideration the different animal health status, animal health risks, service response needs and key drivers in each system, can help identify and implement interventions. Combining sustainability concepts with animal health trajectories allows for a richer analysis, and we apply this to three case studies drawn from North Africa and the Middle East; Bangladesh; and the Eastern Cape of South Africa. We conclude that the quest for sustainability of livestock production systems from the perspective of human and animal health is elusive and difficult to reconcile with the massive anticipated growth in demand for livestock products, mainly in low- and middle-income countries, as well as the aspirations of poor livestock keepers for better lives. Nevertheless, improving the health of livestock can contribute to health sustainability both through reducing negative health impacts of livestock and increasing efficiency of production. However, the choice of the most appropriate options must be under-pinned by an understanding of agro-ecology, economy and values. We argue that a new pillar of One Health should be added to the three traditional sustainability pillars of economics, society and environment when addressing

  10. 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. [...

  11. Sustainability: Environmental Studies and Public Health

    OpenAIRE

    Scholz, Miklas

    2009-01-01

    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. Challenges in managing and sustaining urban slum health ...

    African Journals Online (AJOL)

    Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.

  14. 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.

  15. 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.

  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. 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.

  18. The Strategic Implications of Sustaining and Improving Military Health Care

    Science.gov (United States)

    2010-03-01

    Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide . Disengaged clerks, unqualified...platoon sergeants, and overworked case managers struggle to provide patient’s with simple needs: feeding soldiers’ families who are close to poverty...require. Suicide attempts and unintentional overdoses from prescription drugs and alcohol have occurred as a direct result of these shortages. No

  19. Public Health Engineering for the Built Environment: Completing Sustainability

    NARCIS (Netherlands)

    Bronswijk, van J.E.M.H.; Koren, L.G.H.; Pernot, C.E.E.; Vliet, van A.A.M.; Rameckers, E.M.A.L.; Erkelens, P.A.; Jonge, de S.; Vliet, van A.A.M.

    2000-01-01

    Good health is a prerequisite for sustainable development. From ancient times on environments are built with the good of man in mind, especially to extend his vital life span. At first most building could be considered as public health engineering. Built environments, however, always posed new risks

  20. 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…

  1. 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.

  2. [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.

  3. Promoting Health, Livelihoods, and Sustainable Livestock Systems ...

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

    These areas are experiencing zoonotic (animal to human and vice-versa) ... and shed light on interactions between disease risk, livestock and human health, and ... and social development to support safe food production, healthy livestock, ...

  4. Linking health education and sustainability education in schools

    DEFF Research Database (Denmark)

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

    2015-01-01

    , the focus is on transformation processes occurring on the trajectory from international policy frameworks to the national context. The chapter considers the consequences of these transformation processes for educational practices within schools in light of the current major reform of basic general education......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...... 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...

  5. 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.

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

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

    IDRC frequently supports collaborative Canada-South research on subjects of vital ... to structure and manage Canada-South research partnerships more effectively. ... Africa, Latin America and Canada leading to region-specific working papers on ... for the Joint Canada-Israel Health Research Program 2018 competition.

  7. A future task for health-promotion research: Integration of health promotion and sustainable development.

    Science.gov (United States)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper; Kjærgård, Bente; Andersen, Heidi Myglegård; From, Ditte-Marie; Land, Birgit; Pedersen, Kirsten Bransholm

    2018-02-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health-promotion research regarding integration of sustainable development principles. 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 and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified. These are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development, as well as the politics and implementation of policy goals in both areas. Three focal points are proposed as important challenges to address in future research: (a) the duality of health promotion and sustainability and how it can be handled in order to enhance mutually supportive processes between them; (b) the social dimension of sustainability and how it can be strengthened in the development of strategies for health promotion and sustainable development; and (c) exploring and identifying policy approaches and strategies for integrating health promotion and sustainable development.

  8. Sustainability Strategies for Regional Health Information Organization Startups

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding...

  9. Sustainable quality systems for every Health Service

    International Nuclear Information System (INIS)

    Touzet, Rodolfo; Pittaluga, Roberto R.

    2008-01-01

    The implementation of a Quality system is an indispensable requirement to assure the protection and the radiological safety, especially in those facilities where the potential risks are important. One of the 'general conclusions' of the Conference of Malaga (to achieve the RPP) is also the implementation of quality systems. Lamentably the great majority of the Services of Health in the world, more than 95 %, has not nowadays any formal quality system but only any elements what can be named a 'natural quality system' that includes protocols of work, records of several processes, certified of training of the personnel and diverse practices that are realized in systematic form but that not always are documented. Most health services do not have the necessary means available to adhere quickly to international standards. At the same time the health services do not have either qualified or trained personnel to lead a certification or accreditation project and most of them do not have the resources available to hire external consultants, especially the public hospitals. The scenario described represents a challenge for the Regulatory Authorities who must determine 'how to ensure that installations comply with an acceptable standard of quality without it placing an impossible strain on their budget?' Due to these circumstances a 'Basic Guide' has developed for the implementation of a quality system in every Health Service that takes the elements as a foundation of the standard ISO - 9000:2000 and the standard for systems management GSR-3 of the IAEA. The criteria and the methodologies are showed in the presentation. (author)

  10. Sustainability.

    Science.gov (United States)

    Chang, Chein-Chi; DiGiovanni, Kimberly; Mei, Ying; Wei, Li

    2016-10-01

    This review on Sustainability covers selected 2015 publications on the focus of Sustainability. It is divided into the following sections : • Sustainable water and wastewater utilities • Sustainable water resources management • Stormwater and green infrastructure • Sustainability in wastewater treatment • Life cycle assessment (LCA) applications • Sustainability and energy in wastewater industry, • Sustainability and asset management.

  11. Sustainable development and public health: rating European countries

    Directory of Open Access Journals (Sweden)

    Seke Kristina

    2013-01-01

    Full Text Available Abstract Background Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe’s current situation of sustainable development in the area of public health. Methods A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. Results According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union’s newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80% in rating countries are found to be “healthy life years at birth, females” (r2 = 0.880, “healthy life years at birth, males” (r2 = 0.864, “death rate due to chronic diseases, males” (r2 = 0.850, and “healthy life years, 65, females” (r2 = 0.844. Conclusions Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved. After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS, this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem.

  12. Sustainable development and public health: rating European countries.

    Science.gov (United States)

    Seke, Kristina; Petrovic, Natasa; Jeremic, Veljko; Vukmirovic, Jovanka; Kilibarda, Biljana; Martic, Milan

    2013-01-28

    Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe's current situation of sustainable development in the area of public health. A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT) has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union's newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80%) in rating countries are found to be "healthy life years at birth, females" (r2 = 0.880), "healthy life years at birth, males" (r2 = 0.864), "death rate due to chronic diseases, males" (r2 = 0.850), and "healthy life years, 65, females" (r2 = 0.844). Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved.After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS), this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem.

  13. 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.

  14. [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.

  15. 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.

  16. Building a sustainable Academic Health Department: the South Carolina model.

    Science.gov (United States)

    Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

    2014-01-01

    Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

  17. 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...

  18. 59 Poverty Eradication and Sustainability of Healthful Living in Nigeria

    African Journals Online (AJOL)

    User

    2010-10-17

    Oct 17, 2010 ... sustainable livelihoods; hunger, and malnutrition; ill health, limited or lack of ... poverty level has changed very little over the past two decades, poverty ... recent estimate of the food and Agriculture Organization of the United ... b) the food and energy price hikes in 2007-2008 increased the global poverty.

  19. Key performance indicators for measuring sustainability in health ...

    African Journals Online (AJOL)

    Key performance indicators for measuring sustainability in health care industry in Malaysia. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Journal Home > Vol 10, No 1S (2018) > ... Next, an in-depth meeting was conducted to gain insights and feedbacks with the management of a private hospital.

  20. 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 ...

  1. 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...

  2. Improving animal health for poverty alleviation and sustainable livelihoods.

    Science.gov (United States)

    Stringer, Andy

    2014-11-29

    Animals are vital to ensuring food security for individuals, families and communities in countries around the world. In this, the latest article in Veterinary Record's series promoting One Health, Andy Stringer, director of veterinary programmes at the Society for the Protection of Animals Abroad, discusses how improving animal health, particularly of poultry and working equids, has the potential to reduce poverty and promote food security and sustainable livelihoods in low-income countries. British Veterinary Association.

  3. 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.

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

    DEFF Research Database (Denmark)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

    2018-01-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health promotion research regarding integration of sustainable development principles....... 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...... and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified: these are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development...

  5. [Environmental health and inequalities: building indicators for sustainable development].

    Science.gov (United States)

    Carneiro, Fernando Ferreira; Franco Netto, Guilherme; Corvalan, Carlos; de Freitas, Carlos Machado; Sales, Luiz Belino Ferreira

    2012-06-01

    Despite its progress in terms of socio-economic indicators, Brazil is still unequal, which is due to an unequal and exclusionary historical process. In this paper we selected the Human Development Index - HDI and other social, economic, environmental and health indicators to exemplify this situation. We selected the municipalities that had the lowest HDI in the country in 2000 comparing their evolution over time between 2000 and 2010 by means of indicators linked to the economic, environmental and social pillars of sustainable development. These municipalities have an HDI classified as low (sustainable development with quality of life, the improvement of sanitation and education indicators should be a priority for Brazil.

  6. 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.

  7. 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.

  8. Green Open Space: Awareness for Health or Sustainability?

    Science.gov (United States)

    Dewi, O. C.; Chairunnisa, I.; Hidayat, T.; Anggraini, M.; Napitupulu, A.

    2018-03-01

    Universitas Indonesia in cooperation with American Red Cross and Indonesian Red Cross have been assisting green open space revitalisation program in 7 locations in Bogor Regency (2016-2017). The program was held under The Urban Disaster Risk Reduction Greater Jakarta Project; an initiative program from American Red Cross Indonesia. This project was not only improving the existing green open space quality, but also creating one adapted from public land. The revitalization project figures what happened on daily basis on the existing land, proposing new programming facilities, community-based construction, monitoring and handing over. This paper discovers the meaning of a green space for the community, whether the community aware of its benefit on human health or environmental sustainability. The research question is does the community aware of green open space benefit for human health or environmental sustainability? Or both? The original data from the community was gathered and grouped based on its relevance with environmental quality and public health.

  9. 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...... pain. RESULTS: Fifty-three participants were included. The Post-traumatic Stress Disorder Checklist-Civilian score was in median (interquartile range) 26 (22-31), the Hospital Anxiety and Depression Scale score was 4 (2-6.5) and 2 (1-5) for anxiety and depression respectively. Evidence of neuropathic...

  10. 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

    Corporation. Meyer, G. J., Finn, S. E., Eyde , L. D., Kay, G. G., Moreland, K. L., Dies, R. R.,…Reed, G. M. (2001). Psychological testing and...reduce Naval basic training attrition rates by improving psychological functioning. BOOT STRAP was tested among recruits undergoing a stressful... psychological health problems has been taken in previous research (Wilk et al., 2010 ). Analytic Strategy: Mediation Analyses The indirect effect

  11. Sustainable development goals for health promotion: a critical frame analysis.

    Science.gov (United States)

    Spencer, Grace; Corbin, J Hope; Miedema, Esther

    2018-05-25

    The Sustainable Development Goals (SDGs) lay the foundations for supporting global health and international development work for the next 15 years. Thirty years ago, the Ottawa Charter defined health promotion and outlined key principles for global action on health, including the importance of advocating, enabling and mediating for health equity. Advocacy underscores a human right to health and suggests political action to support its attainment. Enabling speaks to health promotion's focus on the empowerment of people and communities to take control over their health and aspirations. Mediation draws attention to the critical intersectoral partnerships required to address health and social inequities. Underpinned by this approach, the aim of this paper is to consider how key health promotion principles, namely, rights, empowerment and partnership feature (and are framed) within the SDGs and to consider how these framings may shape future directions for health promotion. To that end, a critical frame analysis of the Transforming Our World document was conducted. The analysis interrogated varying uses and meanings of partnerships, empowerment and rights (and their connections) within the SDGs. The analysis here presents three framings from the SDGs: (1) a moral code for global action on (in)equity; (2) a future orientation to address global issues yet devoid of history; and (3) a reductionist framing of health as the absence of disease. These framings raise important questions about the underpinning values of the SDGs and pathways to health equity - offering both challenges and opportunities for defining the nature and scope of health promotion.

  12. 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.

  13. Barriers and Facilitators to Sustaining School Health Teams in Coordinated School Health Programs.

    Science.gov (United States)

    Cheung, Karen; Lesesne, Catherine A; Rasberry, Catherine N; Kroupa, Elizabeth; Fisher, Deborah; Robin, Leah; Pitt Barnes, Seraphine

    2017-05-01

    Coordinated school health (CSH) programs address multiple factors related to students' overall health, thereby increasing their physical and mental readiness to learn. A formative evaluation of three school districts in 2010-2011 examined strategies for sustaining the school health teams (SHTs) that lead CSH efforts. Qualitative data from 39 interviews and 13 focus groups revealed facilitators and barriers for sustaining SHTs. Quantitative data from 68 questionnaires completed by SHT members and school principals examined factors associated with having more active SHTs and district and school characteristics SHT members believed to be important to their schools' efforts to implement CSH. Facilitators of sustaining SHTs included administrative support, staff engagement in the SHT, and shared goals and responsibility. Barriers to sustaining SHTs included limited time and competing priorities, budget and funding constraints, and staff turnover. Findings provide valuable insight into challenges and potential solutions for improving the sustainability of SHTs to enable them to better support CSH efforts.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. Soldier Survey Data Book

    Science.gov (United States)

    1991-07-01

    programs and policies and to increase the knowledge base needed for informed decisionmaking. Data for the soldier survey were collected in on-site...Subsequent analyses will be prepared in the form of reports and other materials designed to meet the needs of Army program and policy staff and other...743 * -C Mm C mm l W G gi’ 4.18L. 1 mmI 2In m -P 6- C-4 , 4. C14 u Cc 3 4.1 41 4.1 - C I-D 6. 1 +5 4.1 4-- C-4 RO C4 r ’ C-4, CD 0 f33 Es *i C5 W CNCD

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

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

    Science.gov (United States)

    2017-03-13

    Providing familiar foods and beverages reminds Soldiers of the world outside the AO and can provide an important bump that sustains morale. “I’m Hispanic...including fellow Soldiers, local nationals, civilians, etc. Emotional Anything having to do with managing your emotions, handling stress, and...almost removed from the group for your own mental well-being.” Back 38UNCLASSIFIED Billets Act as an Oasis Food Is More Than Fuel Top-Line: Field

  3. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

    2015-08-31

    In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of

  4. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

    Directory of Open Access Journals (Sweden)

    Maziar Moradi-Lakeh

    2015-10-01

    Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The

  5. 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…

  6. 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

  7. A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    2015-01-01

    Background: 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.Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health.De...

  9. 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).

  10. Assessment of Environmental Sustainability in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    María Carmen Carnero

    2015-06-01

    Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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).

  16. Conference on soldiers, civilians and environment protection against contaminations

    International Nuclear Information System (INIS)

    1994-01-01

    The military and civil aspects of radiation protection have been discussed. The special emphasize has been done on contamination monitoring of environment, soldier radiological protection during hypothetical warfare, radiological health hazard assessment, post Chernobyl contamination control of environment and food products in Poland, dose equivalent estimation and radiometric control equipment used in military and civil service

  17. 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

  18. Improving the long-term sustainability of health aid: are Global Health Partnerships leading the way?

    Science.gov (United States)

    Dodd, Rebecca; Lane, Christopher

    2010-09-01

    Over the last decade development assistance for health has more than doubled. This increase provides an unprecedented opportunity to scale up health services, and in doing so, achieve the health Millennium Development Goals. However, sustaining scaling up will in turn require sustainable donor support until domestic health financing can substitute for it. The provision of long-term predictable finance is of particular concern in health because the bulk of costs are recurrent and many interventions require sustained, multi-year support to be successful. This is also true for health systems strengthening efforts. As the bulk of new aid resources flow through Global Health Partnerships (GHPs), their ability to make long-term commitments is critical to health systems development. In order to better understand the constraints that prevent development partners from making long-term commitments of health aid, the World Health Organization reviewed the practices of seven major health partners in committing development assistance funds over the long term. The review found increasing evidence of long-term commitments of aid for health in each of the seven agencies. The GHPs and their funders have been at the forefront of this trend, pioneering many of the new approaches. The study concludes that all partners have scope to improve the duration of aid within existing rules and regulations, and that the main constraints to doing so are political. Predictability is even more of a concern in current global economic circumstances, as access to resources begins to be squeezed. In this context it is important that we learn from GHPs, which have successfully tested innovative approaches to both raising and disbursing health funds. The prospects for change associated with the new administration in the United States-the largest health donor and the most unpredictable, but also a major supporter of GHPs-make this task even more urgent.

  19. 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...

  20. 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.

  1. Healthcare quality in Ghana : Improving healthcare quality and health worker motivation to promote sustainable health insurance

    NARCIS (Netherlands)

    Alhassan, R.K.

    2017-01-01

    This thesis is about promoting a sustainable National Health Insurance Scheme (NHIS) in Ghana through improved client-centred quality care and effective community engagement in quality care assessment. The thesis comprises of two main parts. Part one reports on findings from baseline surveys

  2. 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

  3. 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

  4. 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

    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 deployed to

  5. 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

  6. Measuring sustainability as a programming tool for health sector investments: report from a pilot sustainability assessment in five Nepalese health districts.

    Science.gov (United States)

    Sarriot, Eric; Ricca, Jim; Ryan, Leo; Basnet, Jagat; Arscott-Mills, Sharon

    2009-01-01

    Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system-the unit of analysis of the study-was defined as the health district.We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal, child, health, and family planning results for the five districts included in this pilot study, ranked from "no sustainability" to "beginning of sustainability."We conclude that systematic application of the Sustainability Framework could improve the health sector investment decisions of development agencies. It could also give districts an information base on which to build autonomy and accountability. The ability to form and test hypotheses about the sustainability of outcomes under various funding strategies-made possible by this approach-will be a prerequisite for more efficiently meeting the global health agenda.

  7. Family Functioning and Soldier PTSD: Correlates of Treatment Engagement and Military Job Satisfaction

    Science.gov (United States)

    2015-10-01

    a mother with depression may be less sensitive to her child’s cues, and may feel less efficacious as a parent, decreasing her application of...functioning, spouse depression , spouse anxiety, child mental health symptoms and service use, and Soldier job satisfaction. Spouse depression was the...in Soldiers with PTSD and their spouses, and also to describe rates of spouse depression and anxiety, as well as child mental health problems. The

  8. 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...

  9. 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 ...

  10. 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.

  11. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

    Science.gov (United States)

    de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

    2016-09-01

    With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

  12. 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.

  13. 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

  14. Defining sustainable practice in community-based health promotion: a Delphi study of practitioner perspectives.

    Science.gov (United States)

    Harris, Neil; Sandor, Maria

    2013-04-01

    Sustainability of practice must be a central imperative in the practice of community-based health promotion to achieve population health and attract a greater share of public health spending. Although there has been some consideration of sustainability at the project or program levels, often understood as intervention longevity, very limited attention has been given to understanding sustainable practice. The present study develops a definition and features of sustainable practice in community-based health promotion through a Delphi method with health promotion practitioners in Queensland, Australia. The study presents a consensus definition and features of sustainable practice. The definition highlights the importance of collaboration, health determinants and aspirations, processes and outcomes. The four features of sustainable practice identified in the study are: (1) effective relationships and partnerships; (2) evidence-based decision making and practice; (3) emphasis on building community capacity; and (4) supportive context for practice. The definition and features are, to a large extent, consistent with the limited literature around sustainability at the project and program levels of health promotion. Together, they provide insight into a form of community-based health promotion that will be both viable and productive. So what? This consensus understanding of sustainable practice articulates the foundations of working effectively with local communities in achieving improved population health within global limits.

  15. Walking, sustainability and health: findings from a study of a Walking for Health group.

    Science.gov (United States)

    Grant, Gordon; Machaczek, Kasia; Pollard, Nick; Allmark, Peter

    2017-05-01

    Not only is it tacitly understood that walking is good for health and well-being but there is also now robust evidence to support this link. There is also growing evidence that regular short walks can be a protective factor for a range of long-term health conditions. Walking in the countryside can bring additional benefits, but access to the countryside brings complexities, especially for people with poorer material resources and from different ethnic communities. Reasons for people taking up walking as a physical activity are reasonably well understood, but factors linked to sustained walking, and therefore sustained benefit, are not. Based on an ethnographic study of a Walking for Health group in Lincolnshire, UK, this paper considers the motivations and rewards of group walks for older people. Nineteen members of the walking group, almost all with long-term conditions, took part in tape-recorded interviews about the personal benefits of walking. The paper provides insights into the links between walking as a sustainable activity and health, and why a combination of personal adaptive capacities, design elements of the walks and relational achievements of the walking group are important to this understanding. The paper concludes with some observations about the need to reframe conventional thinking about adherence to physical activity programmes. © 2017 John Wiley & Sons Ltd.

  16. Injury patterns of soldiers in the second Lebanon war.

    Science.gov (United States)

    Schwartz, Dagan; Glassberg, Elon; Nadler, Roy; Hirschhorn, Gil; Marom, Ophir Cohen; Aharonson-Daniel, Limor

    2014-01-01

    In the second Lebanon war in 2006, the Israeli Defense Forces fought against well-prepared and well-equipped paramilitary forces. The conflict took place near the Israeli border and major Israeli medical centers. Good data records were maintained throughout the campaign, allowing accurate analysis of injury characteristics. This study is an in-depth analysis of injury mechanisms, severity, and anatomic locations. Data regarding all injured soldiers were collected from all care points up to the definitive care hospitals and were cross-referenced. In addition, trauma branch physicians and nurses interviewed medical teams to validate data accuracy. Injuries were analyzed using Injury Severity Score (ISS) (when precise anatomic data were available) and multiple injury patterns scoring for all. A total of 833 soldiers sustained combat-related injury during the study period, including 119 fatalities (14.3%). Although most soldiers (361) sustained injury only to one Abbreviated Injury Scale (AIS) region, the average number of regions per soldier was 2.0 but was 1.5 for survivors versus 4.2 for fatalities. Current war injury classifications have limitations that hinder valid comparisons between campaigns and settings. In addition, limitation on full autopsy in war fatalities further hinders data use. To partly compensate for those limitations, we have looked at the correlation between fatality rates and number of involved anatomic regions and found it to be strong. We have also found high fatality rates in some "combined" injuries such as head and chest injuries (71%) or in the abdomen and an extremity (75%). The use of multiinjury patterns analysis may help understand fatality rates and improve the utility of war injury analysis. Epidemiologic study, level III.

  17. 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.

  18. The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

    Science.gov (United States)

    2016-06-10

    14 Revolution, is an excellent account of social, economic, and political factors in colonial America that influenced the concept of the citizen ...THE MYTH OF THE CITIZEN -SOLDIER: RHODE ISLAND PROVINCIAL SOLDIERS IN THE FRENCH AND INDIAN WAR A thesis presented to the...From - To) AUG 2015 – JUN 2016 4. TITLE AND SUBTITLE The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

  19. 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…

  20. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    Science.gov (United States)

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

    Science.gov (United States)

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

    2012-01-01

    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. PMID:22585909

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

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

    Science.gov (United States)

    Erickson, Larry E; Jennings, Merrisa

    2017-01-01

    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.

  12. 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

  13. [Sustainability analysis of an evaluation policy: the case of primary health care in Brazil].

    Science.gov (United States)

    Felisberto, Eronildo; Freese, Eduardo; Bezerra, Luciana Caroline Albuquerque; Alves, Cinthia Kalyne de Almeida; Samico, Isabella

    2010-06-01

    This study analyzes the sustainability of Brazil's National Policy for the Evaluation of Primary Health Care, based on the identification and categorization of representative critical events in the institutionalization process. This was an evaluative study of two analytical units: Federal Management of Primary Health Care and State Health Secretariats, using multiple case studies with data collected through interviews and institutional documents, using the critical incidents technique. Events that were temporally classified as specific to implementation, sustainability, and mixed were categorized analytically as pertaining to memory, adaptation, values, and rules. Federal management and one of the State Health Secretariats showed medium-level sustainability, while the other State Secretariat showed strong sustainability. The results indicate that the events were concurrent and suggest a weighting process, since the adaptation of activities, adequacy, and stabilization of resources displayed a strong influence on the others. Innovations and the development of technical capability are considered the most important results for sustainability.

  14. [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.

  15. 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.

  16. Picture Book Soldiers: Men and Messages.

    Science.gov (United States)

    Desai, Christina M.

    2001-01-01

    Examines children's picture books about soldiers and war, including fiction, folktales, and historical fiction, analyzing their implicit and explicit messages about war and the military, and evaluating them for gender stereotyping. Finds that the soldiers conform almost uniformly to an exaggerated male stereotype. Shows different value judgments…

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

    Science.gov (United States)

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

    2013-01-01

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

  18. Prevalence and impact of short sleep duration in redeployed OIF soldiers.

    Science.gov (United States)

    Luxton, David D; Greenburg, David; Ryan, Jenny; Niven, Alexander; Wheeler, Gary; Mysliwiec, Vincent

    2011-09-01

    Short sleep duration (SSD) is common among deployed soldiers. The prevalence of SSD during redeployment, however, is unknown. Cross-sectional study of a brigade combat team (n = 3152 US Army soldiers) surveyed 90-180 days after completing a 6-15 month deployment to Iraq as part of Operation Iraqi Freedom (OIF). Survey items targeted sleep habits and comorbid medical conditions. Multivariate logistic regression analyses were performed to calculate adjusted odds ratios of medical comorbidities associated with SSD. US Army Infantry Post. All soldiers from a redeploying brigade combat team participated in a health assessment between 90 and 180 days upon return to Ft. Lewis from Iraq. None. A total of 2738 (86.9%) soldiers answered questions regarding self-perceived sleep and were included in the analysis. Mean sleep duration was 5.8 ± 1.2 hours. Nineteen hundred fifty-nine (72%) slept ≤ 6 h, but only 16% reported a daytime nap or felt their job performance was affected due to lack of sleep. Short sleep was more common among soldiers who reported combat exposure. After controlling for combat exposure, short sleep duration (SSD) was associated with symptoms of depression, posttraumatic stress disorder, panic syndrome, and with high-risk health behaviors such as abuse of tobacco and alcohol products, and suicide attempts. SSD is common among redeployed soldiers. Soldiers who experienced combat are at increased risk for persistent SSD and comorbidities associated with SSD. Efforts to reestablish good sleep habits and aggressive evaluation of soldiers with persistent SSD following deployment may aid in the prevention and management of associated medical conditions.

  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

    Background 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. Objective In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design 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. Results 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. Conclusions 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. PMID:26328948

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Naowarut Charoenca

    2015-08-01

    Full Text Available Background: 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. Objective: In this article, we analyze how Thailand, a middle-income country, created a mechanism for sustainable funding for health. Design: 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. Results: 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. Conclusions: 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.

  2. 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...... surveys with similar questions, we find that soldiers are more normatively motivated to contribute to society than other citizens (higher commitment to the public interest), while their affectively based motivation is lower (lower compassion). This points towards a potential problem in regard...

  3. 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. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  4. The Soldier Fitness Tracker: global delivery of Comprehensive Soldier Fitness.

    Science.gov (United States)

    Fravell, Mike; Nasser, Katherine; Cornum, Rhonda

    2011-01-01

    Carefully implemented technology strategies are vital to the success of large-scale initiatives such as the U.S. Army's Comprehensive Soldier Fitness (CSF) program. Achieving the U.S. Army's vision for CSF required a robust information technology platform that was scaled to millions of users and that leveraged the Internet to enable global reach. The platform needed to be agile, provide powerful real-time reporting, and have the capacity to quickly transform to meet emerging requirements. Existing organizational applications, such as "Single Sign-On," and authoritative data sources were exploited to the maximum extent possible. Development of the "Soldier Fitness Tracker" is the most recent, and possibly the best, demonstration of the potential benefits possible when existing organizational capabilities are married to new, innovative applications. Combining the capabilities of the extant applications with the newly developed applications expedited development, eliminated redundant data collection, resulted in the exceeding of program objectives, and produced a comfortable experience for the end user, all in less than six months. This is a model for future technology integration. (c) 2010 APA, all rights reserved.

  5. [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.

  6. British Columbia's fish health regulatory framework's contribution to sustainability goals related to salmon aquaculture.

    Science.gov (United States)

    Stephen, Craig; Dicicco, Emiliano; Munk, Brandon

    2008-12-01

    Salmon farming is a significant contribution to the global seafood market to which the goal of sustainability is often applied. Diseases related to farms are perhaps the most contentious issues associated with sustainable salmon farming. We reviewed literature and policies in British Columbia, Canada, as well as interviewed key informants to examine how fish health regulations do or could support sustainability goals. We found four main obstacles to the development and application of a sustainability-based health management system. First, salmon farming faced the same challenges as other industries when trying to establish an operational definition of sustainability that captures all stakeholders' interests. Second, there was no program responsible for integrating the various regulations, responsible departments, and monitoring efforts to develop a comprehensive view of sustainability. Third, there was inadequate research base and social consensus on the criteria that should be used to track health outcomes for sustainability purposes. Fourth, the regulatory and management paradigm for salmon farming has been focused on diseases and pathogens as opposed to embracing a more inclusive health promotion model that includes biotic, abiotic, and social determinants of health. A transparent and inclusive participatory process that effectively links expert views with community and industry concerns should serve as the foundation for the next generation of health management regulations for salmon farming.

  7. 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

    Objective To examine how attributes affecting sustainability differ across VHA organizational components and by staff characteristics. Subjects Surveys of 870 change team members and 50 staff interviews within the VA’s Mental Health System Redesign initiative. Methods A one-way ANOVA with a Tukey post-hoc test examined differences in sustainability by VISN, 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. Results Sustainability differed across VISN and staff tenure. Job classification differences existed for: 1) Benefits and Credibility of the change and 2) staff involvement and attitudes toward change. Sustainability barriers were: staff and institutional resistance, and non-supportive leadership. Facilitators were: commitment to veterans, strong leadership, and use of QI Tools. Sustainability predictors were outcomes tracking, regular reporting, and use of PDSA cycles. Conclusions Creating homogeneous implementation and sustainability processes across a national health system is difficult. Despite the VA’s 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 QI collaborative affects sustainability. PMID:21971024

  8. 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.

  9. 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.

  10. An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study

    Science.gov (United States)

    2018-01-01

    Background The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. Objective The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. Methods A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. Results This study identifies 3 core current perceived value factors and 5 potential perceived value factors—how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Conclusions Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. PMID:29712623

  11. An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study.

    Science.gov (United States)

    Feldman, Sue S

    2018-04-30

    The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. This study identifies 3 core current perceived value factors and 5 potential perceived value factors-how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. ©Sue S Feldman. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 30.04.2018.

  12. A methodological approach and framework for sustainability assessment in NGO-implemented primary health care programs.

    Science.gov (United States)

    Sarriot, Eric G; Winch, Peter J; Ryan, Leo J; Bowie, Janice; Kouletio, Michelle; Swedberg, Eric; LeBan, Karen; Edison, Jay; Welch, Rikki; Pacqué, Michel C

    2004-01-01

    An estimated 10.8 million children under 5 continue to die each year in developing countries from causes easily treatable or preventable. Non governmental organizations (NGOs) are frontline implementers of low-cost and effective child health interventions, but their progress toward sustainable child health gains is a challenge to evaluate. This paper presents the Child Survival Sustainability Assessment (CSSA) methodology--a framework and process--to map progress towards sustainable child health from the community level and upward. The CSSA was developed with NGOs through a participatory process of research and dialogue. Commitment to sustainability requires a systematic and systemic consideration of human, social and organizational processes beyond a purely biomedical perspective. The CSSA is organized around three interrelated dimensions of evaluation: (1) health and health services; (2) capacity and viability of local organizations; (3) capacity of the community in its social ecological context. The CSSA uses a participatory, action-planning process, engaging a 'local system' of stakeholders in the contextual definition of objectives and indicators. Improved conditions measured in the three dimensions correspond to progress toward a sustainable health situation for the population. This framework opens new opportunities for evaluation and research design and places sustainability at the center of primary health care programming.

  13. NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

    Science.gov (United States)

    Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

    2018-01-01

    The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

  14. 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.

  15. Perspective: Improving nutritional guidelines for sustainable health policies: Current status and perspectives

    DEFF Research Database (Denmark)

    Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio

    2017-01-01

    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...

  16. 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.

  17. Interpersonal conflict and referrals to counseling among married soldiers following return from deployment.

    Science.gov (United States)

    Gibbs, Deborah A; Clinton-Sherrod, A Monique; Johnson, Ruby E

    2012-10-01

    Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.

  18. Developing and sustaining leadership in public health nursing: findings from one British Columbia health authority.

    Science.gov (United States)

    Mills, Leslie; Wong, Sabrina T; Bhagat, Radhika; Quail, Donna; Triolet, Kathy; Weber, Tannis

    2012-12-01

    To develop clinical leadership among front-line public health nurses (PHNs). This paper describes a quality improvement process to develop clinical leadership among front-line PHNs. Three activities were undertaken by a working group consisting mainly of front-line staff: engaging PHNs in an online change-readiness questionnaire, administering a survey to clients who had ever used public health services delivered by one Vancouver Community Infant, Child and Youth (ICY) program team and conducting three group interviews with public health providers. The group interviews asked about PHN practice. They were analyzed using thematic content analysis. This quality improvement project suggests that PHNs (n=70) strongly believed in opportunities for system improvement. Client surveys (n=429) and community partner surveys (n=79) revealed the importance of the PHN role. Group interview data yielded three themes: PHNs were the "hub" of community care; PHNs lacked a common language to describe their work; PHNs envisioned their future practice encompassing their full scope of competencies. PHNs developed the "ICY Public Health Nursing Model," which articulates 14 public health interventions and identifies the scope of their work. Developing and sustaining clinical leadership in front-line PHNs was accomplished through these various quality assurance activities. Copyright © 2013 Longwoods Publishing.

  19. The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

    Science.gov (United States)

    Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

    2010-11-01

    There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

  20. 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.

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

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

    ... including the burden of parasitic diseases in livestock and human exposure to ... for: -improving livestock production, animal, and human health; -supporting local ... Nutrition, health policy, and ethics in the age of public-private partnerships.

  2. 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.

  3. 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

  4. Whatever happened to the soldiers?

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... the systematic analysis of the qualitative case studies. This review found that a large amount of projects offering NAT to veterans suffering from PTSD exist in many parts of the world and they present no adverse negative results. Recommendations for future practice and research are posed....... 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...

  5. Is health workforce sustainability in Australia and New Zealand a realistic policy goal?

    Science.gov (United States)

    Buchan, James M; Naccarella, Lucio; Brooks, Peter M

    2011-05-01

    This paper assesses what health workforce 'sustainability' might mean for Australia and New Zealand, given the policy direction set out in the World Health Organization draft code on international recruitment of health workers. The governments in both countries have in the past made policy statements about the desirability of health workforce 'self-sufficiency', but OECD data show that both have a high level of dependence on internationally recruited health professionals relative to most other OECD countries. The paper argues that if a target of 'self-sufficiency' or sustainability were to be based on meeting health workforce requirements from home based training, both Australia and New Zealand fall far short of this measure, and continue to be active recruiters. The paper stresses that there is no common agreed definition of what health workforce 'self-sufficiency', or 'sustainability' is in practice, and that without an agreed definition it will be difficult for policy-makers to move the debate on to reaching agreement and possibly setting measurable targets or timelines for achievement. The paper concludes that any policy decisions related to health workforce sustainability will also have to taken in the context of a wider community debate on what is required of a health system and how is it to be funded.

  6. Asthma and psychiatric disorders in male army recruits and soldiers.

    Science.gov (United States)

    Lev-Tzion, Raffi; Friedman, Tal; Shochat, Tzippy; Gazala, Eliyahu; Wohl, Yonit

    2007-05-01

    Numerous studies have shown an association between asthma and mental disorders. While elevated rates of asthma have been noted among psychiatric patients with anxiety disorders and post-traumatic stress disorder, several studies have found elevated rates of mental disorders among asthma patients. Such studies, however, have generally relied upon questionnaires and assessment by non-specialist physicians to diagnose mental disorders and asthma. To examine a possible association between asthma and psychiatric diagnoses in Israeli military recruits and soldiers. In this cross-sectional study we compared the prevalence of mental diagnoses in asthmatic recruits and soldiers with that in non-asthmatic recruits and soldiers. A total of 195,903 recruits and soldiers were examined by Israel Defense Forces recruiting offices and fitness boards. Diagnoses of asthma were based on a pulmonologist's diagnosis, including spirometry at rest and exercise testing as indicated; diagnoses of mental disorders were based on examination by a psychiatrist. The prevalence of asthma was found to be 7.8% (current) and 9.8% (lifetime). The prevalence of mental disorders was 13.4%. Current asthma was associated with an increased likelihood of any mental disorder (OR = 1.20, 95% Cl = 1.15-1.26), and specifically with mood and anxiety disorders (1.31, 1.19-1.46), introvert personality disorders (1.20, 1.12-1.28) and adjustment disorder (1.43, 1.26-1.62). Lifetime asthma was associated with an increased likelihood of the same disorders, but the association was not as powerful. The results validate the previously documented association between asthma and mental disorders, using a sample of unprecedented size and improved methodology. A multidisciplinary approach to asthma that incorporates mental health professionals in the treatment of poorly controlled asthma and perhaps of asthma in general is recommended.

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

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2012-03-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  8. Public-academic partnerships: working together to meet the needs of Army National Guard soldiers: an academic-military partnership.

    Science.gov (United States)

    Dalack, Gregory W; Blow, Adrian J; Valenstein, Marcia; Gorman, Lisa; Spinner, Jane; Marcus, Sheila; Kees, Michelle; McDonough, Susan; Greden, John F; Ames, Barbara; Francisco, Burton; Anderson, James R; Bartolacci, James; Lagrou, Robert

    2010-11-01

    The conflicts in Afghanistan and Iraq have greatly increased the number of veterans returning home with combat exposure, reintegration issues, and psychiatric symptoms. National Guard soldiers face additional challenges. Unlike active duty soldiers, they do not return to military installations with access to military health services or peers. The authors describe the formation and activities of a partnership among two large state universities in Michigan and the Michigan Army National Guard, established to assess and develop programming to meet the needs of returning soldiers. The process of forming the partnership and the challenges, opportunities, and benefits arising from it are described.

  9. 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.

  10. 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.

  11. Epidemiology and health-environment relationship: reflections on environmental change, sustainable development and population health

    Directory of Open Access Journals (Sweden)

    Diana M. Montoya

    2009-08-01

    Full Text Available This essay presents a discussion on current environmental problems and their relationship to the health of populations. The limitations of the model of economic and social development are analyzed focusing on the augmentation of the capital and the industrial production and its negative impact on natural resources, the balance of ecosystems and human vulnerability. The methodological basics and the developments in environmental epidemiological approach are exposed analyzing their main potential application. Finally, options for solutions are formulated linking them to the premises of sustainable development and environmental justice. The responsibility of the academic environment is pointed out in the training of human and scientific resources in the field of environmental epidemiology, as well as the role of the community in terms of environmental awareness and active participation from a point of view that becomes critical, responsible and capable of defining proposals to make part of the solution.

  12. Soldier Flexible Personal Digital Assistant Program

    National Research Council Canada - National Science Library

    Price, Mark; Woytowich, Jason; Carlson, Marc

    2008-01-01

    The main goal of the Soldier Flexible Personal Digital Assistant Program was to develop prototypes of a novel flexible display technology device for demonstration in a laboratory setting and use in Future Force Warrior (FFW) demonstrations...

  13. Immersive Simulation Training for the Dismounted Soldier

    National Research Council Canada - National Science Library

    Knerr, Bruce W

    2007-01-01

    ... R&D organizations during the period 1997 - 2005. The major findings are organized around the topics of training effectiveness, Soldier task performance, and advantages and disadvantages of immersive...

  14. Support of USARIEM Postpartum Soldier Research Study

    National Research Council Canada - National Science Library

    Dettori, Joseph

    1996-01-01

    It is estimated approximately 9% of Army women are pregnant at any one time. Shortly after delivery, postpartum soldiers are expected to return to full duty, meet body fat standards and pass the APFT...

  15. 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

  16. 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

  17. Cultural Adaptation of Second Language Soldiers.

    Science.gov (United States)

    1981-07-05

    Micronesian), Operations Sergeant; SSG Willie Maxwell, Field First Sergeant; SGT Tipo Toomalatai (Western Samoan), Platoon Sergeant, and SSG Alfredo Taitague...Rican), ESL Instructor and Ms. Norma Garrett (Puerto Rican), ESL Instructor, BSEP Program, Ft Jackson, SC, 16 Jun 81. NARRATIVE Ms. Padilla and Ms...psychiatric disor- de .’s in the Puerto Rican population at large and among Puerto Rican soldiers. Compare these with the US population and Anglo soldiers. 9. Mr

  18. Could rebel child soldiers prolong civil wars?

    OpenAIRE

    Haer, Roos; Böhmelt, Tobias

    2017-01-01

    While we know why rebels may recruit children for their cause, our understanding of the consequences of child soldiering by non-state armed groups remains limited. The following research contributes to addressing this by examining how rebels’ child recruitment practice affects the duration of internal armed conflicts. We advance the argument that child soldiering increases the strength of rebel organizations vis-a-vis the government. This, in turn, lowers the capability asymmetry between thes...

  19. Soldier Readiness: Insights from Qualitative Interviews

    Science.gov (United States)

    2018-01-10

    domains interact and influence performance. From January to May 2016, the research team conducted three qualitative studies with Soldiers including... Research Questions UNCLASSIFIED 9 • From January to May 2016, the research team conducted a series of qualitative studies with Soldiers from the 82nd...that the Army’s current approach for providing these types of training is not always ideal. Specifically, the train-the-trainer method or use of

  20. Administrative management of the soldier with seizures.

    Science.gov (United States)

    Gunderson, C H

    1991-07-01

    Based on improvement in our understanding of the prognosis of young adults with new onset seizures, and cumulative experience with the rules in effect for the last 30 years, a substantial change in the regulations affecting the fitness and profiling of these soldiers has been made. In general, these liberalize retention and profiling, set limits on the duration of trials of duty, provide for fitness determinations in soldiers with pseudo-seizures, and specify when neurologic consultation is required.

  1. Environment of sustainable job in construction: the interface risk and right to health

    Directory of Open Access Journals (Sweden)

    Nilton Cesar Flores

    2016-04-01

    Full Text Available This study analyzes the right to health in the middle of construction work environment, through risk perspective, prevention, sustainability and public policy, with an emphasis on activity that exposes the worker to solar radiation and, therefore, implies a means not sustainable environment. The analysis will focus on the environmental risk arising from exposure to radiation and its legal effects. In this context of risk, prevention is essential to the realization of the right to health in the workplace, and the extension of the right to health is the result of a constitutional reading for a sustainable environment, particularly from the art. 196 and art. 7, item XXII, which refers to prevention in the working environment. In this context, public policies show up as a guarantor instrument of disease prevention and the implementation of the right to health in the workplace. For this study, we use the theory of social systems as a theoretical framework

  2. 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.

  3. 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…

  4. Sustainability of public health in diadema, 2000 - 2011: a picture of SUS building limits

    Directory of Open Access Journals (Sweden)

    Mariana Alves Melo

    2015-12-01

    Full Text Available Introduction: between 2000 to 2011, Diadema paulista municipality has faced many obstacles in health management, struggling to ensure the sustainability of its health system. Objective: to contribute to the discussion of the Unified Health System (SUS and its foreseable turbulent future, based on the analysis of the municipal point of view, identifying the limits of its building in Diadema. Methods: Diadema is characterized as one of the first municipalities that adhered to the principles of the SUS, since its implementation, allowing an analysis as a case study in view of the system's sustainability at the local level. The term sustainability used was addressed in two dimensions: the structure of this system and its process. Results: in SUS implementation period, Diadema stood out by increasing investment in health, reaching an average allocation of about 30% of its tax revenues, including constitutional transfers. Results diagnosed by observing the structure of dimensions and the process indicate that the sustainability of the municipal health system is threatened, as the significant expansion of the range of services and health actions was not followed by sufficient resources to its health maintenance. Conclusions: the existence of obstacles justified and formed the basis for the diagnosis of the main limits on SUS conformation, in health policy and management of resources, funding and budgetary impacts.

  5. Promotion of sustainable employability : Occupational health in the meat processing industry

    NARCIS (Netherlands)

    van Holland, Breunis Johannes

    2016-01-01

    Due to rising retirement age, sustainable employability is gaining interest among employers. Such is the case in the meat processing industry. A strategy to address these challenges is health promotion at work. Therefore, the largest Dutch meat processing company has implemented a Workers’ Health

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

    Science.gov (United States)

    Hill, Peter S; Buse, Kent; Brolan, Claire E; Ooms, Gorik

    2014-04-03

    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.

  7. Nursing and the barriers to sustainable health care: a literature review.

    Science.gov (United States)

    Griggs, Chloe; Fernandez, Ana; Callanan, Margie

    2017-12-14

    global warming poses a serious threat to human health, yet healthcare organisations and staff have been relatively slow to engage with sustainable healthcare practices. This review of the literature seeks to frame what is already known about nurses and their views on global warming and sustainable health care. 11 primary research articles were sourced from a search of five mainstream databases. These articles were subject to a basic thematic analysis. six themes were identified: sustainability, endemic blindness to global issues, environmental numbness, social norms, priority assigned to sustainability, and psychology of responsibility and blame. from the literature reviewed, there are a number of social, cultural and psychological barriers that have led to widespread inaction. This article recommends further research to understand the psychological barriers in more depth as this is a poorly understood area.

  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. 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.

  10. Global diets link environmental sustainability and human health

    Science.gov (United States)

    Tilman, David; Clark, Michael

    2014-11-01

    Diets link environmental and human health. Rising incomes and urbanization are driving a global dietary transition in which traditional diets are replaced by diets higher in refined sugars, refined fats, oils and meats. By 2050 these dietary trends, if unchecked, would be a major contributor to an estimated 80 per cent increase in global agricultural greenhouse gas emissions from food production and to global land clearing. Moreover, these dietary shifts are greatly increasing the incidence of type II diabetes, coronary heart disease and other chronic non-communicable diseases that lower global life expectancies. Alternative diets that offer substantial health benefits could, if widely adopted, reduce global agricultural greenhouse gas emissions, reduce land clearing and resultant species extinctions, and help prevent such diet-related chronic non-communicable diseases. The implementation of dietary solutions to the tightly linked diet-environment-health trilemma is a global challenge, and opportunity, of great environmental and public health importance.

  11. [Structural Change, Contextuality, and Transfer in Health Promotion--Sustainable Implementation of the BIG Project].

    Science.gov (United States)

    Rütten, A; Frahsa, A; Rosenhäger, N; Wolff, A

    2015-09-01

    The BIG approach aims at promoting physical activity and health among socially disadvantaged women. BIG has been developed and sustainably implemented in Erlangen/Bavaria. Subsequently, it has been transferred to other communities and states in Germany. Crucial factors for sustainability and transfer in BIG are (1) lifestyle and policy analysis, (2) assets approach, (3) empowerment of target group, (4) enabling of policy-makers and professionals. © Georg Thieme Verlag KG Stuttgart · New York.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. [Mental disorders in German soldiers after deployment - impact of personal values and resilience].

    Science.gov (United States)

    Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens; Backus, Johannes; Alliger-Horn, Christina; Willmund, Gerd; Hellenthal, Andrea; Bauer, Amanda; Petermann, Franz; Maercker, Andreas

    2015-11-01

    Soldiers are at increased risk of developing mental health disorders after military deployment. The impact of personal values on psychological symptomatology based on an empirical working model has not yet been studied in a military environment. 117 German Armed Forces soldiers completed the Portrait-Values-Questionnaire (PVQ), the Patient-Health-Questionnaire (PHQ) and the Resilience-Scale (RS-11) after their deployment to Afghanistan. In the regression analyses the values hedonism, benevolence, tradition, self-direction and universalism had a differential significant impact on depression, anxiety and somatoform symptoms of the PHQ. The RS-11 sum scale values were negatively correlated with symptomatology. Personal values and resilience seem to be associated with psychological symptomatology in soldiers after military deployment. The results can contribute to the further development of both preventive and therapeutic approaches. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Radiation environment assessment, measurement and its impact on health and sustainable development

    International Nuclear Information System (INIS)

    Kumar, Pradeep; Panwar, Brijandra Singh

    2012-01-01

    Present paper deals with Radiation Environment Assessment, Measurement and its Impact on Health, its meaning and in particular with sustainable development perspective. Health and Environment appears to be different subjects and concepts, but in reality they are interrelated and interdependent. One cannot exist without the other. For good health hygienic environment is a sine qua non. Article 3 of Universal Declaration of Human Right 1948 incorporates the right to life. It has been interpreted by the international court that the word life does not means simply to live but it means to live with dignity and in well and pollution and radiation free environment which is a gift of nature on this universe. There is no doubt about the nuclear revolution that has taken place and has made life of human beings worth living on this earth with comfort. It is growing development of the nation. But in the process the development that has been done at the cost of human life, public health and environment which will prove fatal in the long run. So there is a need for Sustainable Development of the human and environment of the world. Precisely and concisely, the sustainable development is a process that meets the needs of the present without compromising ability of future generations to meet their own needs. A hygienic and redaction free environment will ensure the better Health of the people. Environment and nuclear power plant can coexist. The harmonization of the two needs has led to the concept of Radiation Environment Assessment and sustainable development, so much so that it has become the most significant and focal point of environmental legislation relating to the same. Sustainable development, simply put, is a process in which development can be sustained over generations effects of radiation on humans and on the environment. Finally, this paper deals with the impact of radiation on environment and the need of sustainable development for achieving a better human. (author)

  19. Creating and sustaining a military women's Health Research Interest Group.

    Science.gov (United States)

    Wilson, Candy; Trego, Lori; Rychnovsky, Jacqueline; Steele, Nancy; Foradori, Megan

    2015-01-01

    In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication.

  20. INFLUENCE OF WORKING ENVIRONMENT ON SUSTAINABLE DEVELOPMENT THROUGH THE HEALTH PROTECTION OF THE ENTERPRISE STAFF

    Directory of Open Access Journals (Sweden)

    Yuliya V. Karpovich

    2017-06-01

    Full Text Available The article investigates the processes of health protection at modern industrial enterprises. Occupational health of workers is considered in the article as an important component of the sustainable development of the enterprise. The process of health protection is described in the study not only as a social component, but also as a process relating to all areas of sustainable development. The article attempts to show the place of ‘health-protection subsystem’ as part of an integrated system of industrial enterprises’ sustainable development. Four independent spheres of health protection programs implementation were pointed out at the level of enterprise – professional environment, the quality of workplace, involvement of employees in the process of health protection, involvement of the enterprise in the processes of health protection. The article emphasizes the interrelationship of biological and economic characteristics of human life and society in the formation of health protection processes. Programs for sustainable development taking into account the management of health protection should include two sets of activities: corrective and special ones. Tools used in health management programs aimed at expanding the choices of healthier behavior and altering the character of individual preferences in behavior within the framework of the formation of health tastes and preferences are defined. The authors present the results of the analysis of occupational diseases on the example of the three companies of the Perm region (Saranovskaya shakhta ‘Rudnaya’ OJSC, Motovilikhinskie zavody PJSC and Proton-PM PJSC. The results allowed to offer a list of universal and special arrangements for the implementation of health protection control programs within the mentioned industrial enterprises.

  1. Warrior Transition Command Information Briefing to 2011 AMEDD Pre-Command Course: Soldier Success Through Focused Commitment

    Science.gov (United States)

    2011-02-22

    JTF CAPMED Veterans Affairs – Veterans Health Administration – Veterans Benefits Administration – Federal Recovery Coordinators – Polytrauma...investment of families is critical • Initial interview should reveal services that the Soldier and Family needs • Increased Social Workers exposure for...Soldier has his/her own unique set of challenges • Early involvement and investment of Families is critical • We cannot do enough for the Families of

  2. THE DEVELOPMENT AND USE OF A MODEL TO PREDICT SUSTAINABILITY OF CHANGE IN HEALTH CARE SETTINGS.

    Science.gov (United States)

    Molfenter, Todd; Ford, James H; Bhattacharya, Abhik

    2011-01-01

    Innovations adopted through organizational change initiatives are often not sustained leading to diminished quality, productivity, and consumer satisfaction. Research explaining variance in the use of adopted innovations in health care settings is sparse, suggesting the need for a theoretical model to guide research and practice. In this article, we describe the development of a hybrid conjoint decision theoretic model designed to predict the sustainability of organizational change in health care settings. An initial test of the model's predictive validity using expert scored hypothetic profiles resulted in an r-squared value of .77. The test of this model offers a theoretical base for future research on the sustainability of change in health care settings.

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Building Sustainable Health and Education Partnerships: Stories from Local Communities

    Science.gov (United States)

    Blank, Martin J.

    2015-01-01

    Background: 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…

  8. Feasibility and Sustainability of Community Based Health Insurance in Rural Areas Case Study of Musana, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Lazarus MUCHABAIWA

    2017-12-01

    Full Text Available The Zimbabwe Demographic Health Survey (ZDHS 2010-11 showed that only 6 percent of the population is covered by health insurance in Zimbabwe. This study investigated the feasibility, acceptability and sustainability of Community Based Health Insurance (CBHI as an alternative to pooling risk and financing social protection in Zimbabwe. Willingness to Pay (WTP for health insurance and socioeconomic data were collected through interviews with 121 household heads selected using a 2-stage sampling procedure on 14 villages in Musana and Domboshava rural areas, a population which is largely unemployed and reliant on subsistence agriculture. A CBHI scheme was established and followed up for 3 years documenting data on visits made, financial contributions from recruited households and their actual health expenditures. Findings indicate that CBHI is generally accepted as a means of health insurance in rural communities. The median willingness to pay for health insurance was $5.43 against monthly expenditures ranging of up to $180. The low WTP is attributable to low incomes as only 3.4 percent of the respondents relied on formal employment. Trust issues, adverse selection, moral hazard, and administration costs were challenges threatening sustainability of CBHI. A financial gap averaging 42% was generally on a downward trend and was closed by the end of the follow-up study as contributions were equivalent to medical expenses. We conclude that CBHI is feasible, has potential for sustainability and should be considered as a springboard for the planned Zimbabwean National Health Insurance.

  9. How to connect bioethics and environmental ethics: health, sustainability, and justice.

    Science.gov (United States)

    Dwyer, James

    2009-11-01

    In this paper, I explore one way to bring bioethics and environmental ethics closer together. I focus on a question at the interface of health, sustainability, and justice: How well does a society promote health with the use of no more than a just share of environmental capacity? To address this question, I propose and discuss a mode of assessment that combines a measurement of population health, an estimate of environmental sustainability, and an assumption about what constitutes a fair or just share. This mode of assessment provides an estimate of the just and sustainable life expectancy of a population. It could be used to monitor how well a particular society promotes health within just environmental limits. It could also serve as a source of information that stakeholders use when they deliberate about programs, policies, and technologies. The purpose of this work is to focus attention on an ethical task: the need to fashion institutions and forms of life that promote health in ways that recognize the claims of sustainability and justice.

  10. Documented family violence and risk of suicide attempt among U.S. Army soldiers.

    Science.gov (United States)

    Ursano, Robert J; Stein, Murray B; Herberman Mash, Holly B; Naifeh, James A; Fullerton, Carol S; 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; Kessler, Ronald C

    2018-04-01

    Suicide attempt (SA) rates in the U.S. Army increased substantially during the wars in Afghanistan and Iraq. This study examined associations of family violence (FV) history with SA risk among soldiers. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records of active duty, Regular Army, enlisted soldiers with medically documented SAs from 2004 to 2009 (n = 9650) and a sample of control person-months (n = 153,528). Logistic regression analyses examined associations of FV with SA, adjusting for socio-demographics, service-related characteristics, and prior mental health diagnosis. Odds of SA were higher in soldiers with a FV history and increased as the number of FV events increased. Soldiers experiencing past-month FV were almost five times as likely to attempt suicide as those with no FV history. Odds of SA were elevated for both perpetrators and those who were exclusively victims. Male perpetrators had higher odds of SA than male victims, whereas female perpetrators and female victims did not differ in SA risk. A discrete-time hazard function indicated that SA risk was highest in the initial months following the first FV event. FV is an important consideration in understanding risk of SA among soldiers. Published by Elsevier B.V.

  11. 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.

  12. User Evaluation of a Soldier Flexible Display Personal Digital Assistant

    National Research Council Canada - National Science Library

    Sampson, James B; Boynton, Angela C; Mitchell, K. B; Magnifico, Dennis S; DuPont, Frederick J

    2008-01-01

    The U.S. Army Natick Soldier Research, Development and Engineering Center and U.S. Army Research Laboratory, Human Research and Engineering Directorate conducted an evaluation of a Soldier Flexible Display Personal Digital Assistant...

  13. 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.

  14. Indicators of sustainable capacity building for health research: analysis of four African case studies.

    Science.gov (United States)

    Bates, Imelda; Taegtmeyer, Miriam; Squire, S Bertel; Ansong, Daniel; Nhlema-Simwaka, Bertha; Baba, Amuda; Theobald, Sally

    2011-03-28

    Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable. Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. By mapping the capacity building activities in each case study onto a framework previously used for evaluating health research capacity in Ghana, we were able to identify activities that were common to all projects. We used these activities to derive indicators which could be used in other projects to monitor progress towards building sustainable research capacity. Indicators of sustainable capacity building increased in complexity as projects matured and included- early engagement of stakeholders; explicit plans for scale up; strategies for influencing policies; quality assessments (awareness and experiential stages)- improved resources; institutionalisation of activities; innovation (expansion stage)- funding for core activities secured; management and decision-making led by southern partners (consolidation stage).Projects became sustainable after a median of 66 months. The main challenges to achieving sustainability were high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development. Our indicators of sustainable capacity building need to be tested prospectively in a variety of projects to assess their usefulness. For each project the evidence required to show that indicators have been achieved should evolve with the project and they should be determined prospectively in collaboration with stakeholders.

  15. 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.

  16. Anthropometry and Range of Motion of the Encumbered Soldier

    Science.gov (United States)

    2017-03-01

    claims of the encumbered dismounted Soldier. Soldiers are required to wear multiple layers of clothing and protective equipment in addition to mission...depth (i.e., bulk) measurements related to Soldier CIE that had a significant decrement on the Soldiers’ range of motion for many body movements...bulk) measurements related to Soldier CIE that had a significant decrement on the Soldiers’ range of motion for many body movements. The

  17. [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.

  18. 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.

  19. 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.

  20. 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.

  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. 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

  3. 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.

  4. Code of Sustainable Practice in Occupational and Environmental Health and Safety for Corporations.

    Science.gov (United States)

    Castleman, Barry; Allen, Barbara; Barca, Stefania; Bohme, Susanna Rankin; Henry, Emmanuel; Kaur, Amarjit; Massard-Guilbaud, Genvieve; Melling, Joseph; Menendez-Navarro, Alfredo; Renfrew, Daniel; Santiago, Myrna; Sellers, Christopher; Tweedale, Geoffrey; Zalik, Anna; Zavestoski, Stephen

    2008-01-01

    At a conference held at Stony Brook University in December 2007, "Dangerous Trade: Histories of Industrial Hazard across a Globalizing World," participants endorsed a Code of Sustainable Practice in Occupational and Environmental Health and Safety for Corporations. The Code outlines practices that would ensure corporations enact the highest health and environmentally protective measures in all the locations in which they operate. Corporations should observe international guidelines on occupational exposure to air contaminants, plant safety, air and water pollutant releases, hazardous waste disposal practices, remediation of polluted sites, public disclosure of toxic releases, product hazard labeling, sale of products for specific uses, storage and transport of toxic intermediates and products, corporate safety and health auditing, and corporate environmental auditing. Protective measures in all locations should be consonant with the most protective measures applied anywhere in the world, and should apply to the corporations' subsidiaries, contractors, suppliers, distributors, and licensees of technology. Key words: corporations, sustainability, environmental protection, occupational health, code of practice.

  5. Role Reversal Protest in Nigeria: Soldiers Still the Boss? A ...

    African Journals Online (AJOL)

    Today's world is used to all sorts of inter-group violent conflicts, but definitely not the type in the post military Nigeria where soldiers and policemen fatally combat each other; soldiers claiming superiority over policemen who, in turn, want to seize every opportunity to act that in a democracy, they, no longer the soldiers, are ...

  6. Depleted uranium internal contamination of US soldiers deployed in Samawah, Iraq during operation Iraqi freedom

    International Nuclear Information System (INIS)

    Asaf Durakovic; Isaac Zimmerman; Axel Gerdes

    2004-01-01

    l.7 x 10 -7 ±1.9 x 10 -7 with a detectable presence of 236 U in all seven samples. Conclusions: Our previous studies reported that over fifty percent of British, Canadian, and United States Gulf War I veterans had depleted uranium in their urine nine years previous to exposure. DU was also found in the lung and bone of a deceased Canadian veteran. The consistency of our current findings compared with our previous data confirms contamination of the biosphere with isotopes of uranium as a consequence of DU ordnance in the modern battlefield. While it has been established that DU internal contamination presents a potential neurological, endocrine, reproductive, kidney, and mutagenic alterations, current controversy over the possible relationship of uranium dust in the environment and its potential health hazards warrants a need for sustained inter disciplinary research of the assessment of the post-conflict environment. Our current studies of plutonium isotopes analysis are in progress for the additional evaluation of the potential presence of other actinides in radioactive warfare. (authors)

  7. 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.

  8. 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...

  9. Toward a sustainable cement industry in 2020 : improvement of the environmental, health & safety performance

    NARCIS (Netherlands)

    2001-01-01

    This background document concentrates on technical and managerial aspects of Environmental, Health & Safety Performance (EHS) control in the cement industry. It gives an overview of options for improvement toward a sustainable cement production in 2020. Energy consumption and use of alternative

  10. Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention.

    Science.gov (United States)

    Mundorf, Norbert; Redding, Colleen A; Paiva, Andrea L

    2018-01-18

    Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.

  11. Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention

    Directory of Open Access Journals (Sweden)

    Norbert Mundorf

    2018-01-01

    Full Text Available Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST using the Transtheoretical Model of Change (TTM, which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604 that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.

  12. Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention

    Science.gov (United States)

    Mundorf, Norbert; Redding, Colleen A.; Paiva, Andrea L.

    2018-01-01

    Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices. PMID:29346314

  13. 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,

  14. "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…

  15. 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.

  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. 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

  18. 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.

  19. 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

  20. 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

  1. Institutionalizing and sustaining social change in health systems: the case of Uganda.

    Science.gov (United States)

    Hage, Jerald; Valadez, Joseph J

    2017-11-01

    The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used

  2. 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.

  3. 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.

  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. Understanding Sustainable Diets: A Descriptive Analysis of the Determinants and Processes That Influence Diets and Their Impact on Health, Food Security, and Environmental Sustainability 1 2 3

    OpenAIRE

    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 exa...

  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. 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.

  8. 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......, Injuries, and Risk Factors Study 2015 (GBD 2015). METHODS: We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990...... and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed...

  9. A model of sustainable development of scientific research health institutions, providing high-tech medical care

    Directory of Open Access Journals (Sweden)

    I. Yu. Bedoreva

    2017-01-01

    Full Text Available The issue of sustainability is relevant for all types of businesses and organizations. Long-term development has always been and remains one of the most difficult tasks faced by organizations. The implementation the provisions of international standards ISO series 9000 has proven to be effective. The ISO standards are concentrated on the global experience for sustainable success of organizations. The standards incorporated all the rational that has been accumulated in this field of knowledge and practice. These standards not only eliminate technical barriers in collaboration and have established standardized approaches, but also serve as a valuable source of international experience and ready management solutions. They became a practical guide for the creation of management systems for sustainable development in organizations of different spheres of activity.Problem and purpose. The article presents the author’s approach to the problem of sustainable development health of the organization. The purpose of this article is to examine the approaches to management for sustainable success of organizations and to describe a model of sustainable development applied in research healthcare institutions providing high-tech medical care.Methodology. The study used general scientific methods of empirical and theoretical knowledge, general logical methods and techniques and methods of system analysis, comparison, analogy, generalization, the materials research for the development of medical organizations.The main results of our work are to first develop the technique of complex estimation of activity of the scientific-research institutions of health and deploy key elements of the management system that allows the level of maturity of the management system of the institution to be set in order to identify its strengths and weaknesses, and to identify areas for improvements and innovation, and to set priorities for determining the sequence of action when

  10. The Factors of Soldier’s Load

    Science.gov (United States)

    1994-06-03

    turtles . My ruck weighed 120 pounds. American Airborne Soldier Grenada, 1983 One of the tenets of Army doctrine in Field Manual 100-5 QIp.r.aition•. is...from a lack of the appropriate physical conditioning in some units; and the more nebulous problem of insufficient logistical challenges built into

  11. Energy interventions that facilitate sustainable development and impact health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-04-01

    Objective To inform policy by providing an overview of systematic reviews on interventions that facilitate sustainable energy use 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 13 databases and nine websites based on a pre-defined protocol, including clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese during the 17 years from January 1997 - January 2014 was 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 Five systematic reviews and one economic evaluation met the inclusion criteria. The most promising interventions that impacted health were electricity for lighting and other uses (developing countries); improved stoves for cooking and health and/or cleaner fuels for cooking (developing countries); and household energy efficiency measures (developed countries). These interventions also had potential environmental and economic impacts. Their cost-effectiveness is not known, nor is their impact on health inequalities. Conclusions What is needed now is careful implementation of interventions where the impacts are likely to be positive but their implementation needs to be rigorously evaluated, including possible adverse impacts. Care needs to be taken not to exacerbate health inequalities and to consider context, human behavior and cultural factors so that the potential health benefits are realized in real-life implementation. Possible impact on health inequalities needs to be considered and measured in future primary studies and systematic reviews.

  12. 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.

  13. How Satisfied are Soldiers with their Ballistic Helmets? A Comparison of Soldiers' Opinions about the Advanced Combat Helmet and the Personal Armor System for Ground Troops

    National Research Council Canada - National Science Library

    Ivins, Brian J; Schwab, Karen; Crowley, John S; McEntire, B. J; Trumble, Christopher C; Brown, Fred H; Warden, Deborah L

    2008-01-01

    .... These factors affect Soldiers' decisions about helmet use; therefore, rigorous research about Soldiers' real-life experiences with helmets is critical to assessing a helmet's overall protective efficacy...

  14. Prevalence of Pain Diagnoses and Burden of Pain Among Active Duty Soldiers, FY2012.

    Science.gov (United States)

    Reif, Sharon; Adams, Rachel Sayko; Ritter, Grant A; Williams, Thomas V; Larson, Mary Jo

    2018-03-14

    Soldiers are at risk for acute and chronic pain due to the mental and physical challenges of military duties and ongoing training for force readiness. With the burden of pain on any individual attributable across pain sources, a broad perspective that goes beyond prior characterizations of pain is important. We aim to further the understanding of pain's effects among non-deployed active duty soldiers and the Military Health System (MHS), by describing prevalence of 10 painful conditions, reported pain levels, duration of pain and impact of pain on military duty limitations. Data are from the MHS Data Repository including outpatient MHS direct care encounters, claims for outpatient purchased care from civilian providers, and vital records, for all soldiers continuously enrolled in TRICARE and not deployed in FY 2012. Ten pain-related diagnostic categories were conceptually derived for this analysis and identified using ICD-9-CM diagnostic codes. We report the FY 2012 prevalence at the soldier-level (N = 297,120) for each pain category as a primary diagnosis, as well as in any diagnostic position, and at the soldier-level for reported pain level, duration, and military duty limitations. Institutional Review Board approval was obtained prior to analyses. Overall, 63% of soldiers had at least one pain diagnosis and 59% had a primary pain diagnosis during FY 2012. Back and neck pain (22%), non-traumatic joint disorders (28%), and other musculoskeletal pain (30%) were the most frequent categories for primary diagnosis. Nearly two-thirds of soldiers had a primary pain diagnosis in more than one category, and 23% in four or more categories. Moderate or severe pain levels were reported at least once during the year by 55% of soldiers who had a primary pain diagnosis. In the subsample of soldiers with primary pain in the first quarter, duration and chronicity of pain diagnoses varied by pain category: the back and neck pain category was the most common for both persistent

  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. Backache amongst soldiers: a prospective analytical study

    International Nuclear Information System (INIS)

    Ilyas, S.; Rehman, A.U.; Janjua, S.H.; Tarrar, A.M.

    2012-01-01

    Objective: To investigate the occupational predispositions of low back pain in soldiers Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital, Bahawalpur, from June 2009 to Jan 2010. Patients and Methods: A questionnaire was developed to investigate the occupation-related issues in soldiers reporting with low backache in surgical OPD at CMH Bahawalpur. It included personal and occupational factors. The body mass index was also calculated. Of the 107 male soldiers assessed, 90 were enrolled into the study. The statistical analysis was performed by descriptive analysis of the data using SPSS 17.0. Results: Of all the soldiers evaluated (n=90), 32 (35.6%) were clerks/computer operators, 21 (23.1%) were drivers and 14(15.6%) were signal men. All were males (100%) and the average BMI was 24.8 kg/m2. The 69 (76.7%) patients who had backache had prolonged working hours (average 10.8 hours per day), 68 (75.6%) patients used to sleep over tape/nawar bed and only 12 (13.3%) had been sleeping on mattresses. The onset of pain was sudden in 58 (64.4%) patients. 27 (23.3%) had developed acute backache after prolonged sitting, 21 (30%) after lifting heavy objects. The pain was exaggerated by doing morning physical training 82 (91.1%), prolonged sitting 61 (67.8%) and standing with rifle 24 (26.7%). Conclusion: The prevalence of low back pain in sedentary occupation or soldiers on sitting jobs was higher 69 (76%). The number of working hours on these occupations was associated with occurrence as well as aggravation of low back pain. (author)

  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?

    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.

  19. 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.

  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. Gender differences in suicide and suicide attempts among US Army soldiers.

    Science.gov (United States)

    Maguen, Shira; Skopp, Nancy A; Zhang, Ying; Smolenski, Derek J

    2015-02-28

    In order to best tailor suicide prevention initiatives and programs, it is critical to gain an understanding of how service members׳ suicide risk factors may differ by gender. We aimed to better understand gender differences in suicide and suicide attempts among soldiers, including demographic, military, mental health, and other risk factors. We also examined risk factors uniquely associated with suicide and suicide attempts. We conducted a retrospective study of 1857 US Army soldiers who died by suicide or attempted suicide between 2008 and 2010 and had a Department of Defense Suicide Event Report. Female and male soldiers had more similarities than differences when examining risk factors associated with suicide. The only gender difference approaching significance was workplace difficulties, which was more strongly associated with suicide for female soldiers, compared to their male counterparts. Among suicide decedents, the most common risk factor was having a failed intimate relationship in the 90 days prior to suicide. Among those who attempted suicide, the most common risk factor was a major psychiatric diagnosis. Better understanding both gender differences and risk factors uniquely associated with suicide has critical prevention and public health implications as we work to better understand preventable mortality in our youngest generation of service members. Published by Elsevier Ireland Ltd.

  2. 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.

  3. [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.

  4. 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/.

  5. Soldier Quality of Life Assessment

    Science.gov (United States)

    2016-09-01

    SUSTAINMENT LOGISTICS EMOTIONS QUALITY OF LIFE MENTAL READINESS FUEL DEMAND REDUCTION FEEDBACK ARMY PERSONNEL ARMY...QoL as a measure of how well a given camp supports the physical and mental (to include the cognitive, social, and emotional dimensions) readiness of...housing fewer than 1,000 personnel. Larger FOBs have significantly more capabilities (e.g., food courts with contractor-prepared, name brand fast foods

  6. [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.

  7. Can you model growth of trust? A study of the sustainability of a rural community health centre in North India

    OpenAIRE

    Smith, H. K.; Harper, Paul Robert

    2015-01-01

    Trust in the service provided by any health facility is of vital importance to its sustainability, whether it is a community clinic in a rural area of a developing country or an international telemedicine service. Community health centres can be used as a means of delivering highly accessible, low-cost health service in the developing world. A major strategic issue for planners of such centres is the expected level of uptake of services throughout a region and its effect on sustainability of ...

  8. 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

  9. 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.

  10. 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.

  11. 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.

    2015-01-01

    Context 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. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results 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 compared to 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

  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. 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.

    Science.gov (United States)

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

    2013-04-30

    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. A prospective cohort of 790 soldiers was assessed both pre- and immediately after deployment to determine predictors of physical and mental function after war. On average, OEF/OIF Veterans showed significant declines in both physical (t=6.65, pfunction (t=7.11, pdeployment function, poorer physical function after deployment was associated with older age, more physical symptoms, blunted systolic blood pressure reactivity and being injured. After controlling for pre-deployment function, poorer mental function after deployment was associated with younger age, lower social desirability, lower social support, greater physical symptoms and greater PTSD symptoms. Combat deployment was associated with an immediate decline in both mental and physical function. The relationship of combat deployment to function is complex and influenced by demographic, psychosocial, physiological and experiential factors. Social support and physical symptoms emerged as potentially modifiable factors.

  15. [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.

  16. 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.

  17. 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.

  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

    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

  20. The medium-term sustainability of organisational innovations in the national health service

    Science.gov (United States)

    2011-01-01

    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 Through comparison and

  1. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; Van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.P.; Rinke de Wit, T.F.

    2015-01-01

    Background: Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  2. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  3. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.; Rinke de Wit, T.F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  4. 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.

  5. Ant tending influences soldier production in a social aphid.

    Science.gov (United States)

    Shingleton, A W; Foster, W A

    2000-09-22

    The aphid Pseudoregma sundanica (Van der Goot) (Homoptera: Aphididae) has two defence strategies. It is obligatorily tended by various species of ant and also produces sterile soldiers. We investigated how they allocate their investment in these two strategies. We measured the size, number of soldiers, number and species of tending ant, and number and species of predators in P. sundanica populations. We found that the level of ant tending correlated negatively with soldier investment in P. sundanica. The species of tending ant also influenced soldier investment. We excluded ants from aphid populations and recorded changes in population size and structure over four weeks. Ant exclusion led to population decline and extinction. At the same time, surviving populations showed a significant increase in soldier investment. The data demonstrate that social aphids can adjust their investment in soldiers in direct response to environmental change.

  6. 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.

  7. 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.

  8. Global commitments and China's endeavors to promote health and achieve sustainable development goals.

    Science.gov (United States)

    Tan, Xiaodong; Wu, Qian; Shao, Haiyan

    2018-04-12

    With its immense population and as the largest developing country in the world, China has made remarkable achievements in health promotion at a relatively low cost. However, China is still faced with challenges such as changes of disease spectrum, the coming era of an aging society, and the risk of environmental pollution. On October 25, 2016, China formally passed the blueprint of "Healthy China 2030," working towards the national goal of reaching a health standard on par with developed countries by 2030, which was also a response to realize the 2030 United Nations Sustainable Development Goals. "Healthy China 2030" is comprised of 29 chapters that cover five health areas. China is sparing no effort to transfer from being merely the most populous country, to becoming a leading nation in health education. In "Healthy China 2030," collaborated construction and resource sharing were clearly stated as the core strategy. A shift in concentration towards coordinated development of health-based economy from a previous pursuit of rapid economic growth was also underlined. There are also several major issues, such as severely aging population, the burden of chronic diseases, the insufficiency of health expenditure, and the great demand on health protection, waiting to be dealt with during the implementation process of "Healthy China 2030". "Healthy China 2030" is a momentous move to enhance public health, which is also a response to the global commitments. We also need to rethink our approach to reach the living standards and maintain a better environment.

  9. Toxicants exposures as novel zoonoses: reflections on sustainable development, food safety and veterinary public health.

    Science.gov (United States)

    Frazzoli, C; Mantovani, A

    2010-12-01

    The modern concept of zoonosis considers any detriment to the health and/or quality of human life resulting from relationships with (other) vertebrate or edible or toxic invertebrate animals. Whereas exposure to toxicants through foods of animal origin (a.o.) is a well-established issue, hereby we discuss it as novel zoonoses, from the standpoints of health implications as well as similarities and differences with classical zoonoses caused by biological agents. Novel toxicant-related zoonoses are linked with new issues in food safety, such as the environment-feed-food chain. In fact, the potential effect of the combined and repeated exposure to dietary toxicants is generally long-term and not readily discernible. Endocrine disrupting chemicals in staple foods of a.o. are discussed as a telling example of a food safety issue summing up critical points covered by the definition of sustainable development, also implicating health risks for generations to come. We suggest some critical points to implement the veterinary public health action in sustainable food safety, such as enhancement of Hazard Analysis and Critical Control Points systems for toxicological risk management. © 2010 Blackwell Verlag GmbH.

  10. 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.

  11. US Army Soldiers With Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Choi, Y Sammy; Cucura, Jon

    2018-04-01

    US Army soldiers diagnosed with type 1 diabetes were previously considered unfit for duty. For highly motivated soldiers, current advanced technologies allow the possibility of not only retention on active duty, but military deployment. We present our experience at Fort Bragg, North Carolina, taking care of soldiers newly diagnosed with type 1 diabetes mellitus. Through intensive diabetes education, extensive military and physical training, optimization of diabetes technology, and remote real-time monitoring, soldiers are able to continue to serve their country in the most specialized roles.

  12. 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.

  13. 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.

  14. The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

    Science.gov (United States)

    Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

    2013-01-01

    Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

  15. Urban systems complexity in sustainability and health: an interdisciplinary modelling study

    Directory of Open Access Journals (Sweden)

    Nici Zimmermann, PhD

    2018-05-01

    Full Text Available Background: Improving urban health and sustainability raises complex questions that are best addressed through interdisciplinary and even transdisciplinary approaches, in which scientific research and analysis and stakeholder engagement have important roles. In this study we report pilot work in Nairobi (Kenya and London (UK that uses innovative methods to integrate qualitative and quantitative modelling to provide evidence to support policy development for health and sustainability in these cities. Methods: We used two primary modelling methods, system dynamics and microsimulation, and sought to understand the value of these tools in combination to support policy decisions. System dynamics was used to establish an aggregated and non-linear causal map of the interconnections between diverse variables, and thus to gain insight into the policies and specific processes that need to be examined in further depth. System dynamics was a key tool for city-level stakeholder engagement. In part informed by the outcome of the system dynamics process, microsimulation was then used to quantify local effects on health of selected policy options. The results were mapped using geographic information systems methods. Findings: The combination of system dynamics and microsimulation models provided a framework that enhanced collective knowledge about the interrelationships of policy decisions, funding, public awareness, and environmental and health effects. Our initial participatory system dynamics work on air pollution in Nairobi found that a combination of policies that focus on households and outdoor air could reduce household air pollution by about 50%, leaving it still above WHO-recommended levels. Yet, the investments in monitoring and health impact assessment have the potential to trigger reinforcing mechanisms that create synergies among existing policies and increase the return on investment. Preliminary 106-year microsimulation runs of the effects of PM2

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Building Sustainable Local Capacity for Global Health Research in West Africa.

    Science.gov (United States)

    Sam-Agudu, Nadia A; Paintsil, Elijah; Aliyu, Muktar H; Kwara, Awewura; Ogunsola, Folasade; Afrane, Yaw A; Onoka, Chima; Awandare, Gordon A; Amponsah, Gladys; Cornelius, Llewellyn J; Mendy, Gabou; Sturke, Rachel; Ghansah, Anita; Siberry, George K; Ezeanolue, Echezona E

    Global health research in resource-limited countries has been largely sponsored and led by foreign institutions. Thus, these countries' training capacity and productivity in global health research is limited. Local participation at all levels of global health knowledge generation promotes equitable access to evidence-based solutions. Additionally, leadership inclusive of competent local professionals promotes best outcomes for local contextualization and implementation of successful global health solutions. Among the sub-Saharan African regions, West Africa in particular lags in research infrastructure, productivity, and impact in global health research. In this paper, experts discuss strategies for scaling up West Africa's participation in global health evidence generation using examples from Ghana and Nigeria. We conducted an online and professional network search to identify grants awarded for global health research and research education in Ghana and Nigeria. Principal investigators, global health educators, and representatives of funding institutions were invited to add their knowledge and expertise with regard to strengthening research capacity in West Africa. While there has been some progress in obtaining foreign funding, foreign institutions still dominate local research. Local research funding opportunities in the 2 countries were found to be insufficient, disjointed, poorly sustained, and inadequately publicized, indicating weak infrastructure. As a result, research training programs produce graduates who ultimately fail to launch independent investigator careers because of lack of mentoring and poor infrastructural support. Research funding and training opportunities in Ghana and Nigeria remain inadequate. We recommend systems-level changes in mentoring, collaboration, and funding to drive the global health research agenda in these countries. Additionally, research training programs should be evaluated not only by numbers of individuals graduated but

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. A survey of bacterial diversity from successive life stages of black soldier fly (Diptera: Stratiomyidae) by using 16S rDNA pyrosequencing

    Science.gov (United States)

    Black soldier fly (BSF), Hermetia illucens (L.), larvae represent a sustainable method for reducing animal and plant wastes. Larvae reduce dry matter, bacteria, offensive odor, and house fly populations. The prepupae can be self-harvested and used as feedstuff for livestock and poultry. While som...

  10. Mechanism of injury and microbiological flora of the geographical location are essential for the prognosis in soldiers with serious warfare injuries

    DEFF Research Database (Denmark)

    Wetterslev, Mik; Rose-Larsen, Katrine; Hansen-Schwartz, Jacob

    2013-01-01

    Denmark has been engaged in the Afghanistan war and as a result, Rigshospitalet has received a number of multi-traumatized Danish soldiers. Lesions sustained in armed conflict differ from their civilian counterparts and knowledge of the pathophysiology related to these types of lesions is essential...

  11. 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.

  12. Building sustainable community partnerships into the structure of new academic public health schools and programs.

    Science.gov (United States)

    Gaughan, Monica; Gillman, Laura B; Boumbulian, Paul; Davis, Marsha; Galen, Robert S

    2011-01-01

    We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.

  13. 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.

  14. 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.

  15. Revising a conceptual model of partnership and sustainability in global health.

    Science.gov (United States)

    Upvall, Michele J; Leffers, Jeanne M

    2018-05-01

    Models to guide global health partnerships are rare in the nursing literature. The Conceptual Model for Partnership and Sustainability in Global Health while significant was based on Western perspectives. The purpose of this study was to revise the model to include the voice of nurses from low- and middle-resource countries. Grounded theory was used to maintain fidelity with the design in the original model. A purposive sample of 15 participants from a variety of countries in Africa, the Caribbean, and Southeast Asia and having extensive experience in global health partnerships were interviewed. Skype recordings and in-person interviews were audiotaped using the same questions as the original study. Theoretical coding and a comparison of results with the original study was completed independently by the researchers. The process of global health partnerships was expanded from the original model to include engagement processes and processes for ongoing partnership development. New concepts of Transparency, Expanded World View, and Accompaniment were included as well as three broad themes: Geopolitical Influence, Power differential/Inequities, and Collegial Friendships. The revised conceptual model embodies a more comprehensive model of global health partnerships with representation of nurses from low- and middle-resource countries. © 2018 Wiley Periodicals, Inc.

  16. 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).

  17. 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.

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

    African Journals Online (AJOL)

    EB

    Objective: To determine the perception and practice of contraception among male soldiers of Sobi ... Methodology: A cross-sectional survey of 334 male soldiers using multistage sampling ..... gender equality and involvement of religious leaders ... unusual in Nigeria for women to use contraceptives .... United Arab Emirates.

  19. Global Deployment of Reserve Soldiers: A Leadership Challenge

    National Research Council Canada - National Science Library

    McKenzie, Wendy; Healy-Morrow, Isabel

    2006-01-01

    ...? Is there an overlap in organizational cultures, or does military leadership need to provide special attention for these unique soldiers? The purpose of this paper is to demonstrate how a deeper understanding of the overlap between civilian and military organizational culture can improve the psychological preparedness of Reserve Force soldiers who are mobilized for full-time military operations.

  20. Hold Your Fire!: Preventing Fratricide in the Dismounted Soldier Domain

    NARCIS (Netherlands)

    Burghouts, G.J.; Jong, J.L. de; Hiemstra, H.; Schutte, K.; Marvelde, A. te; Norden, W. van; Spaans, M.

    2008-01-01

    Since WWI, an estimated 15% of all soldiers killed in combat are attributed to fratricide, and recent military operations show no decline. A substantial amount concerns fratricide incidents between dismounted soldiers. However, most techniques introduced to prevent fratricide focus on inter-vehicle

  1. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    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. PMID:22992484

  2. A life-course approach to health: synergy with sustainable development goals.

    Science.gov (United States)

    Kuruvilla, Shyama; Sadana, Ritu; Montesinos, Eugenio Villar; Beard, John; Vasdeki, Jennifer Franz; Araujo de Carvalho, Islene; Thomas, Rebekah Bosco; Drisse, Marie-Noel Brunne; Daelmans, Bernadette; Goodman, Tracey; Koller, Theadora; Officer, Alana; Vogel, Joanna; Valentine, Nicole; Wootton, Emily; Banerjee, Anshu; Magar, Veronica; Neira, Maria; Bele, Jean Marie Okwo; Worning, Anne Marie; Bustreo, Flavia

    2018-01-01

    A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the life-course approach to health can be extended to all age groups, health topics and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. A conceptual framework for the approach is presented along with implications for implementation in the areas of: (i) policy and investment; (ii) health services and systems; (iii) local, multisectoral and multistakeholder action; and (iv) measurement, monitoring and research. The SDGs provide a unique context for applying a holistic, multisectoral approach to achieving transformative outcomes for people, prosperity and the environment. A life-course approach can reinforce these efforts, particularly given its emphasis on rights and equity.

  3. Meeting Report: Threats to Human Health and Environmental Sustainability in the Pacific Basin

    Science.gov (United States)

    Arnold, Robert G.; Carpenter, David O.; Kirk, Donald; Koh, David; Armour, Margaret-Ann; Cebrian, Mariano; Cifuentes, Luis; Khwaja, Mahmood; Ling, Bo; Makalinao, Irma; Paz-y-Miño, César; Peralta, Genandrialine; Prasad, Rajendra; Singh, Kirpal; Sly, Peter; Tohyama, Chiharu; Woodward, Alistair; Zheng, Baoshan; Maiden, Todd

    2007-01-01

    The coastal zone of the Pacific Rim is home for about one-third of the world’s population. Disproportionate growth of Far Eastern economies has produced a disproportionate share of related environmental difficulties. As the region searches for acceptable compromises between growth and environmental quality, its influence on global environmental health is certain to increase. Consequences of global environmental change such as habitat alteration, storms, and sealevel rise will be particularly acute among Pacific Rim nations. Adverse health effects from arsenic exposure in Pacific Rim nations have been used to justify drinking water standards in the United States and elsewhere. As global manufacturing in the Pacific Rim increases, the centroid of global air quality and waste management issues will shift further toward Far Eastern nations. The Eleventh International Conference of the Pacific Basin Consortium (PBC) was held in September 2005 in Honolulu, Hawaii. The purpose of the conference was to bring together individuals to discuss regional challenges to sustainable growth. The historic emphasis of the conference on hazardous wastes in relation to human health makes the PBC an ideal forum for discussing technical aspects of sustainable economic growth in the Pacific region. That role is reflected in the 2005 PBC conference themes, which included management of arsenic in potable waters, air quality, climate change, pesticides, mercury, and electronics industry waste—each with emphasis on relationships to human health. Arsenic management exemplifies the manner in which the PBC can focus interdisciplinary discussion in a single technical area. The conference program provided talks on arsenic toxicology, treatment technologies, management of arsenic-bearing residuals from water treatment, and the probable societal costs and benefits of arsenic management. PMID:18087598

  4. Meeting report: threats to human health and environmental sustainability in the pacific basin.

    Science.gov (United States)

    Arnold, Robert G; Carpenter, David O; Kirk, Donald; Koh, David; Armour, Margaret-Ann; Cebrian, Mariano; Cifuentes, Luis; Khwaja, Mahmood; Ling, Bo; Makalinao, Irma; Paz-Y-Miño, César; Peralta, Genandrialine; Prasad, Rajendra; Singh, Kirpal; Sly, Peter; Tohyama, Chiharu; Woodward, Alistair; Zheng, Baoshan; Maiden, Todd

    2007-12-01

    The coastal zone of the Pacific Rim is home for about one-third of the world's population. Disproportionate growth of Far Eastern economies has produced a disproportionate share of related environmental difficulties. As the region searches for acceptable compromises between growth and environmental quality, its influence on global environmental health is certain to increase. Consequences of global environmental change such as habitat alteration, storms, and sea level rise will be particularly acute among Pacific Rim nations. Adverse health effects from arsenic exposure in Pacific Rim nations have been used to justify drinking water standards in the United States and elsewhere. As global manufacturing in the Pacific Rim increases, the centroid of global air quality and waste management issues will shift further toward Far Eastern nations. The Eleventh International Conference of the Pacific Basin Consortium (PBC) was held in September 2005 in Honolulu, Hawaii. The purpose of the conference was to bring together individuals to discuss regional challenges to sustainable growth. The historic emphasis of the conference on hazardous wastes in relation to human health makes the PBC an ideal forum for discussing technical aspects of sustainable economic growth in the Pacific region. That role is reflected in the 2005 PBC conference themes, which included management of arsenic in potable waters, air quality, climate change, pesticides, mercury, and electronics industry waste-each with emphasis on relationships to human health. Arsenic management exemplifies the manner in which the PBC can focus interdisciplinary discussion in a single technical area. The conference program provided talks on arsenic toxicology, treatment technologies, management of arsenic-bearing residuals from water treatment, and the probable societal costs and benefits of arsenic management.

  5. Psycho-physiological response of soldiers in urban combat

    Directory of Open Access Journals (Sweden)

    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.

  6. Stress fractures of the femora in soldiers

    International Nuclear Information System (INIS)

    Meurman, K.O.A.; Somer, K.; Lamminen, A.

    1981-01-01

    Amongst 936 stress fractures found in soldiers, there were 58 in the femora (6%); of these 31 were in the neck and 27 in the shaft. Two were bilateral, and two patients had other stress fractures. Three displacements were found in the necks. In the shaft, 20 fractures were proximal, four were in the middle third and three in the distal third. In the latter group, it is necessary to differentiate from a sarcoma. CT is a new aid in this respect. Sport in highly motivated individuals appears to contribute particularly to fractures of the shaft. The symptoms from these fractures are relatively mild. (orig.) [de

  7. Stress fractures of the femora in soldiers

    Energy Technology Data Exchange (ETDEWEB)

    Meurman, K O.A.; Somer, K; Lamminen, A

    1981-05-01

    Amongst 936 stress fractures found in soldiers, there were 58 in the femora (6%); of these 31 were in the neck and 27 in the shaft. Two were bilateral, and two patients had other stress fractures. Three displacements were found in the necks. In the shaft, 20 fractures were proximal, four were in the middle third and three in the distal third. In the latter group, it is necessary to differentiate from a sarcoma. CT is a new aid in this respect. Sport in highly motivated individuals appears to contribute particularly to fractures of the shaft. The symptoms from these fractures are relatively mild.

  8. 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

  9. 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.

  10. 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.

  11. Indigenous health: effective and sustainable health services through continuous quality improvement.

    Science.gov (United States)

    Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

    2007-05-21

    The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

  12. After The Demonstration: What States Sustained After the End of Federal Grants to Improve Children’s Health Care Quality

    Science.gov (United States)

    Brach, Cindy; Anglin, Grace; Devers, Kelly J.; Burton, Rachel

    2018-01-01

    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. PMID:29119478

  13. Brush Day & Night Phase III to Phase IV: ensuring that good oral health habits are sustainable.

    Science.gov (United States)

    Melo, Paulo; Fine, Charlotte; Malone, Sinead; Horn, Virginie

    2018-05-01

    Over the past 10 years, the FDI-Unilever Brush Day & Night partnership has significantly influenced the life of children worldwide through the implementation of school programmes for oral health education and prevention. This article reports the key facts and outcomes of Phase III of the partnership, and announces the launch of Phase IV. During Phase III, the expert advisors of the Brush Day & Night partnership conducted a longitudinal study to evaluate the impact of the '21 Day' programme in almost 8,000 children in 10 countries. Analysis revealed the effectiveness of the 21 Day programme in sustainably educating children to brush their teeth twice a day, with the greatest impact observed in children aged 7-9 years. With the launch of Phase IV, the Brush Day & Night partnership will continue to deliver its oral health school programme for 7-9 year-old children with a strengthened methodology, including randomized sampling and control groups. The scope of the evaluation will be broadened to include oral health-related quality of life indicators, and monitoring of the oral health knowledge of children's parents/carers. © 2018 FDI World Dental Federation.

  14. Role of soil health in maintaining environmental sustainability of surface coal mining.

    Science.gov (United States)

    Acton, Peter M; Fox, James F; Campbell, J Elliott; Jones, Alice L; Rowe, Harold; Martin, Darren; Bryson, Sebastian

    2011-12-01

    Mountaintop coal mining (MCM) in the Southern Appalachian forest region greatly impacts both soil and aquatic ecosystems. Policy and practice currently in place emphasize water quality and soil stability but do not consider upland soil health. Here we report soil organic carbon (SOC) measurements and other soil quality indicators for reclaimed soils in the Southern Appalachian forest region to quantify the health of the soil ecosystem. The SOC sequestration rate of the MCM soils was 1.3 MgC ha(-1) yr(-1) and stocks ranged from 1.3 ± 0.9 to 20.9 ± 5.9 Mg ha(-1) and contained only 11% of the SOC of surrounding forest soils. Comparable reclaimed mining soils reported in the literature that are supportive of soil ecosystem health had SOC stocks 2.5-5 times greater than the MCM soils and sequestration rates were also 1.6-3 times greater. The high compaction associated with reclamation in this region greatly reduces both the vegetative rooting depth and infiltration of the soil and increases surface runoff, thus bypassing the ability of soil to naturally filter groundwater. In the context of environmental sustainability of MCM, it is proposed that the entire watershed ecosystem be assessed and that a revision of current policy be conducted to reflect the health of both water and soil.

  15. 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

  16. Sustaining enrollment in health insurance for vulnerable populations: lessons from Massachusetts.

    Science.gov (United States)

    Capoccia, Victor; Croze, Colette; Cohen, Martin; O'Brien, John P

    2013-04-01

    Since 2008 Massachusetts has had universal health insurance with an individual mandate. As a result, only about 3% of the population is uninsured. However, patients who use behavioral health services are uninsured at much higher rates. This 2011 study sought to understand reasons for the discrepancy and identify approaches to reduce disenrollment and sustain coverage. The qualitative study was based on structured interviews and focus groups. Structured interviews were conducted with 15 policy makers, consumer advocates, and chief executive officers of provider organizations, and three focus groups were held with 33 patient volunteers. The interviews and focus groups identified several disenrollment opportunities, all of which contribute to "churn" (the process by which disenrolled persons who remain eligible are reenrolled in the same or a different plan): missing and incomplete documentation, acute and chronic conditions and long-term disabilities that interfere with a patient's ability to respond to program communications, and lack of awareness among beneficiaries of the consequences of changes that trigger termination and the need to transfer to another program. Although safeguards are built into the system to avoid some disenrollments, the policies and procedures that drive the system are built on a default assumption of ineligibility or disenrollment until the individual establishes eligibility and completes requirements. Practices that can sustain enrollment include real-time Web-based prepopulated enrollment and redetermination processes, redetermination flexibility for designated chronic illnesses, and standardized performance metrics for churn and associated costs. Changes in the information system infrastructure and in outreach, enrollment, disenrollment, and reenrollment procedures can improve continuity and retention of health insurance coverage.

  17. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hassen Kebede

    2014-11-01

    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

  18. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia.

    Science.gov (United States)

    Kebede, Hassen; Melaku, Achenef; Kebede, Elias

    2014-11-12

    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 awareness for all

  19. Chronic daily headache in U.S. soldiers after concussion.

    Science.gov (United States)

    Theeler, Brett J; Flynn, Frederick G; Erickson, Jay C

    2012-05-01

    To determine the prevalence and characteristics of, and factors associated with, chronic daily headache (CDH) in U.S. soldiers after a deployment-related concussion. A cross-sectional, questionnaire-based study was conducted with a cohort of 978 U.S. soldiers who screened positive for a deployment-related concussion upon returning from Iraq or Afghanistan. All soldiers underwent a clinical evaluation at the Madigan Traumatic Brain Injury Program that included a history, physical examination, 13-item self-administered headache questionnaire, and a battery of cognitive and psychological assessments. Soldiers with CDH, defined as headaches occurring on 15 or more days per month for the previous 3 months, were compared to soldiers with episodic headaches occurring less than 15 days per month. One hundred ninety-six of 978 soldiers (20%) with a history of deployment-related concussion met criteria for CDH and 761 (78%) had episodic headache. Soldiers with CDH had a median of 27 headache days per month, and 46/196 (23%) reported headaches occurring every day. One hundred seven out of 196 (55%) soldiers with CDH had onset of headaches within 1 week of head trauma and thereby met the time criterion for posttraumatic headache (PTHA) compared to 253/761 (33%) soldiers with episodic headache. Ninety-seven out of 196 (49%) soldiers with CDH used abortive medications to treat headache on 15 or more days per month for the previous 3 months. One hundred thirty out of 196 (66%) soldiers with CDH had headaches meeting criteria for migraine compared to 49% of soldiers with episodic headache. The number of concussions, blast exposures, and concussions with loss of consciousness was not significantly different between soldiers with and without CDH. Cognitive performance was also similar for soldiers with and without CDH. Soldiers with CDH had significantly higher average scores on the posttraumatic stress disorder (PTSD) checklist compared to soldiers with episodic headaches. Forty

  20. 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

  1. Classification of the financial sustainability of health insurance beneficiaries through data mining techniques

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    Sílvia Maria Dias Pedro Rebouças

    2016-09-01

    Full Text Available Advances in information technologies have led to the storage of large amounts of data by organizations. An analysis of this data through data mining techniques is important support for decision-making. This article aims to apply techniques for the classification of the beneficiaries of an operator of health insurance in Brazil, according to their financial sustainability, via their sociodemographic characteristics and their healthcare cost history. Beneficiaries with a loss ratio greater than 0.75 are considered unsustainable. The sample consists of 38875 beneficiaries, active between the years 2011 and 2013. The techniques used were logistic regression and classification trees. The performance of the models was compared to accuracy rates and receiver operating Characteristic curves (ROC curves, by determining the area under the curves (AUC. The results showed that most of the sample is composed of sustainable beneficiaries. The logistic regression model had a 68.43% accuracy rate with AUC of 0.7501, and the classification tree obtained 67.76% accuracy and an AUC of 0.6855. Age and the type of plan were the most important variables related to the profile of the beneficiaries in the classification. The highlights with regard to healthcare costs were annual spending on consultation and on dental insurance.

  2. 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.

  3. Launch of the ‘One Health Global Think-Tank for Sustainable Health & Well-being’ – 2030 (GHW-2030

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    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.

  4. Prospects for the sustainability of delivering the Basic Package of Health Services in Afghanistan: a stakeholder analysis.

    Science.gov (United States)

    Haidari, A M; Zaidi, S; Gul, R

    2014-06-09

    This study explored the readiness of stakeholders in Afghanistan for sustaining delivery of the Basic Package of Health Services (BPHS) without external technical and financial assistance. A stakeholder analysis was applied using qualitative methods. Fifteen stakeholders were purposively drawn from the Afghanistan ministries of public health and finance, political representatives, development partners, nonprofit organizations and public health experts. Data were collected through in-depth interviews with the stakeholders and desk review of pertinent documents. We found that sustainability of the BPHS in Afghanistan is questionable as stakeholders are suboptimally organized to come up with effective alternatives. Uneven ownership and divisive positioning are bottlenecks to the evolution of a realistic continuation plan. Those with the most significant influence are lukewarm, while those who are most supportive have the least influence. Sustainability needs to be tackled at the start in designing the BPHS rather than in the wake of eventual donor withdrawal.

  5. 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.

  6. 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.

  7. Nutritional Sustainability: Aligning Priorities in Nutrition and Public Health with Agricultural Production.

    Science.gov (United States)

    Finley, John W; Dimick, Dennis; Marshall, Elizabeth; Nelson, Gerald Charles; Mein, Jonathan R; Gustafson, David I

    2017-09-01

    Nutrition science-based dietary advice urges changes that may have a great impact on agricultural systems. For example, the 2016 Dietary Guidelines for Americans (DGA) recommends greatly increased fruit and vegetable consumption, but the present domestic production is insufficient to accommodate large-scale adoption of these guidelines. Increasing production to the extent needed to meet the DGA will necessitate changes in an already stressed agriculture and food system and will require nutrition and agriculture professionals to come together in open and collegial discourse. All involved need to understand the stress placed on the food system by increasing populations, changing diets, and changing environments, and recognize the major diet-based public health challenges. Furthermore, there is a need to understand the intricate interplay of the myriad parts of the food system and the vast amount of work necessary to make even small changes. New systems approaches are needed, especially at the research level, where nutrition, public health, agriculture, and the food industry work together to solve interconnected problems. Future well-being depends on a sustainable food system that continues to deliver optimal health with minimal impact on the environment. © 2017 American Society for Nutrition.

  8. Building sustainability indicators in the health dimension for solid waste management

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    Tatiane Bonametti Veiga

    Full Text Available ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7% and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79 to 4,72 (±0,64, in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important". Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context.

  9. Building sustainability indicators in the health dimension for solid waste management 1

    Science.gov (United States)

    Veiga, Tatiane Bonametti; Coutinho, Silvano da Silva; Andre, Silvia Carla Silva; Mendes, Adriana Aparecida; Takayanagui, Angela Maria Magosso

    2016-01-01

    ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7%) and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79) to 4,72 (±0,64), in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important"). Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context. PMID:27508905

  10. Small steps to health: building sustainable partnerships in pediatric obesity care.

    Science.gov (United States)

    Pomietto, Mo; Docter, Alicia Dixon; Van Borkulo, Nicole; Alfonsi, Lorrie; Krieger, James; Liu, Lenna L

    2009-06-01

    Given the prevalence of childhood obesity and the limited support for preventing and managing obesity in primary care settings, the Seattle Children's Hospital's Children's Obesity Action Team has partnered with Steps to Health King County to develop a pediatric obesity quality-improvement project. Primary care clinics joined year-long quality-improvement collaboratives to integrate obesity prevention and management into the clinic setting by using the chronic-disease model. Sustainability was enhanced through integration at multiple levels by emphasizing small, consistent behavior changes and self-regulation of eating/feeding practices with children, teenagers, and families; building local community partnerships; and encouraging broader advocacy and policy change. Cultural competency and attention to disparities were integrated into quality-improvement efforts. . Participating clinics were able to increase BMI measurement and weight classification; integrate management of overweight/obese children and family and self-management support; and grow community collaborations. Over the course of 4 years, this project grew from a local effort involving 3 clinics to a statewide program recently adopted by the Washington State Department of Health. This model can be used by other states/regions to develop pediatric obesity quality-improvement programs to support the assessment, prevention, and management of childhood obesity. Furthermore, these health care efforts can be integrated into broader community-wide childhood-obesity action plans.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. Achieving and sustaining automated health data linkages for learning systems: barriers and solutions.

    Science.gov (United States)

    Van Eaton, Erik G; Devlin, Allison B; Devine, Emily Beth; Flum, David R; Tarczy-Hornoch, Peter

    2014-01-01

    Delivering more appropriate, safer, and highly effective health care is the goal of a learning health care system. The Agency for Healthcare Research and Quality (AHRQ) funded enhanced registry projects: (1) to create and analyze valid data for comparative effectiveness research (CER); and (2) to enhance the ability to monitor and advance clinical quality improvement (QI). This case report describes barriers and solutions from one state-wide enhanced registry project. The Comparative Effectiveness Research and Translation Network (CERTAIN) deployed the commercially available Amalga Unified Intelligence System™ (Amalga) as a central data repository to enhance an existing QI registry (the Automation Project). An eight-step implementation process included hospital recruitment, technical electronic health record (EHR) review, hospital-specific interface planning, data ingestion, and validation. Data ownership and security protocols were established, along with formal methods to separate data management for QI purposes and research purposes. Sustainability would come from lowered chart review costs and the hospital's desire to invest in the infrastructure after trying it. CERTAIN approached 19 hospitals in Washington State operating within 12 unaffiliated health care systems for the Automation Project. Five of the 19 completed all implementation steps. Four hospitals did not participate due to lack of perceived institutional value. Ten hospitals did not participate because their information technology (IT) departments were oversubscribed (e.g., too busy with Meaningful Use upgrades). One organization representing 22 additional hospitals expressed interest, but was unable to overcome data governance barriers in time. Questions about data use for QI versus research were resolved in a widely adopted project framework. Hospitals restricted data delivery to a subset of patients, introducing substantial technical challenges. Overcoming challenges of idiosyncratic EHR

  20. 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

  1. Technological Areas to Improve Soldier Decisiveness: Insights From the Soldier-System Design Perspective

    Science.gov (United States)

    2012-03-01

    input several sets of words or concepts and return novel concepts or ideas. While being driven largely by the advertising industry , these base...Soldiers fitted with ballistic and laser-protective eyewear that contains or is itself a screen on which images and information can be projected. Images...visible through the eyewear would be augmented by imagery created by the UAV surveillance platforms described previously. In addition to augmenting

  2. Sustainability Factor Related with the Implementation of Community Mental Health Nursing (CMHN in South and West Jakarta

    Directory of Open Access Journals (Sweden)

    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

  3. 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

  4. 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

    Background 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. Methods 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. Results 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. Conclusions 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

  5. 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.

  6. A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available 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 (reenrolment 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.

  7. 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.

  8. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F

    2015-01-01

    Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, pquality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the need to intensify client education and balanced

  9. Factors Contributing To The Sustainability Of 5S Programmes In Government Hospitals In Regional Director Of Health Services Area Kurunegala

    Directory of Open Access Journals (Sweden)

    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

  10. Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

    Science.gov (United States)

    Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

    2016-01-01

    The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. How is the use of e-cigarettes sustained in the customers with serious health symptoms?

    Directory of Open Access Journals (Sweden)

    Ummuhan Pece Sonmez

    2018-03-01

    166 headings and 9588 messages. The symptoms were reported 3 weeks to 3 months after the use of e-cigarettes. The most frequent symptoms were related to respiratory system, oral cavity and gums. 2830 of the messages were responded by an anonymous admin(s. Of these responses 48 % recommended the change of ingredients, % 24 claimed that health complaints were not related with e-cigarette use, % 13 attributed the symptoms to quitting classical cigarettes, 6 % reassured that the problem will soon disappear and recommended the continuation of e-cigarettes, 7 % proposed herbal medicine, 5 % actual pharmaceutical drugs, only 5 % to consult to a medical expert. Conclusions Members of this internet forum who used a product which is not legally available, they tended not to apply to regular health clinics in case of harmful effects. The forum administrators tried their best to sustain the addiction in spite of very serious complaints. Control over the websites and social forums must be part of the tobacco control enforcement strategies.

  16. Biosynthesis and metabolic engineering of palmitoleate production, an important contributor to human health and sustainable industry.

    Science.gov (United States)

    Wu, Yongmei; Li, Runzhi; Hildebrand, David F

    2012-10-01

    Palmitoleate (cis-Δ9-16:1) shows numerous health benefits such as increased cell membrane fluidity, reduced inflammation, protection of the cardiovascular system, and inhibition of oncogenesis. Plant oils containing this unusual fatty acid can also be sustainable feedstocks for producing industrially important and high-demand 1-octene. Vegetable oils rich in palmitoleate are the ideal candidates for biodiesel production. Several wild plants are known that can synthesize high levels of palmitoleate in seeds. However, low yields and poor agronomic characteristics of these plants limit their commercialization. Metabolic engineering has been developed to create oilseed crops that accumulate high levels of palmitoleate or other unusual fatty acids, and significant advances have been made recently in this field, particularly using the model plant Arabidopsis as the host. The engineered targets for enhancing palmitoleate synthesis include overexpression of Δ9 desaturase from mammals, yeast, fungi, and plants, down-regulating KASII, coexpression of an ACP-Δ9 desaturase in plastids and CoA-Δ9 desaturase in endoplasmic reticulum (ER), and optimizing the metabolic flux into triacylglycerols (TAGs). This review will mainly describe the recent progress towards producing palmitoleate in transgenic plants by metabolic engineering along with our current understanding of palmitoleate biosynthesis and its regulation, as well as highlighting the bottlenecks that require additional investigation by combining lipidomics, transgenics and other "-omics" tools. A brief review of reported health benefits and non-food uses of palmitoleate will also be covered. Copyright © 2012. Published by Elsevier Ltd.

  17. Perception and practice of contraception among male soldiers in Sobi barracks, Ilorin, Nigeria.

    Science.gov (United States)

    Hussain, N A; Akande, T M; Osagbemi, G K; Olasupo, S T; Salawu, K Y; Adebayo, E T

    2013-06-01

    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 female-targetted contraception strategies, with less focus on their husbands; who are the dominant fertility determinants. To determine the perception and practice of contraception among male soldiers of Sobi Cantonment, Ilorin, Nigeria, with a view to instituting male-targeted contraceptive/family planning strategies. A cross-sectional survey of 334 male soldiers using multistage sampling technique and pre-tested interviewer administered questionnaires. The respondents' approval of contraception (73.6%) and willingness to discuss it with their spouses/partners (71.6%) were high. Fear of wives/partner's sexual promiscuity (55.7%), cultural and religious beliefs (43.2%), fear of the side effects of contraceptives (29.5%) and the desire for more children (21.6%) were reported reasons for the non-approval of contraception. The prevalence of contraceptive use among the respondents was low (12.3%). There was a significant relationship between the respondents' educational level and contraceptive use (pcontraception with their spouses/partners but low contraceptive use.

  18. Predicting domestic and community violence by soldiers living in a conflict region.

    Science.gov (United States)

    Nandi, Corina; Elbert, Thomas; Bambonye, Manassé; Weierstall, Roland; Reichert, Manfred; Zeller, Anja; Crombach, Anselm

    2017-11-01

    Past research revealed war trauma and posttraumatic stress disorder (PTSD) symptoms as potential predictors for domestic and community violence in crisis regions and among soldiers in different armed conflicts. The impact of family violence and other adversities experienced in childhood as well as of a combat-enhanced appeal for aggressive behavior (appetitive aggression) remains to be specified. In the present study, the authors separately predicted violence against children, intimate partner violence and community violence in 381 Burundian soldiers returning from foreign deployment and living in a post- conflict region. Using path analysis, they aimed to disentangle the independent contributions and pathways of the following variables: Exposure to war trauma and childhood familial violence, PTSD and depression symptom severity, and appetitive aggression. Childhood familial violence had an independent effect on all contexts of violence and was the only significant predictor for violence against the soldiers' own children. Intimate partner violence was additionally predicted by depression symptom severity, while community violence was additionally predicted by PTSD symptom severity and appetitive aggression. Besides war-related mental ill-health and appetitive aggression, violent experiences during childhood development must not be overlooked as a factor fueling the cycle of violence in conflict regions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. [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.

  20. 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

  1. A transition program to primary health care for new graduate nurses: a strategy towards building a sustainable primary health care nurse workforce?

    Science.gov (United States)

    Gordon, Christopher J; Aggar, Christina; Williams, Anna M; Walker, Lynne; Willcock, Simon M; Bloomfield, Jacqueline

    2014-01-01

    This debate discusses the potential merits of a New Graduate Nurse Transition to Primary Health Care Program as an untested but potential nursing workforce development and sustainability strategy. Increasingly in Australia, health policy is focusing on the role of general practice and multidisciplinary teams in meeting the service needs of ageing populations in the community. Primary health care nurses who work in general practice are integral members of the multidisciplinary team - but this workforce is ageing and predicted to face increasing shortages in the future. At the same time, Australia is currently experiencing a surplus of and a corresponding lack of employment opportunities for new graduate nurses. This situation is likely to compound workforce shortages in the future. A national nursing workforce plan that addresses supply and demand issues of primary health care nurses is required. Innovative solutions are required to support and retain the current primary health care nursing workforce, whilst building a skilled and sustainable workforce for the future. This debate article discusses the primary health care nursing workforce dilemma currently facing policy makers in Australia and presents an argument for the potential value of a New Graduate Transition to Primary Health Care Program as a workforce development and sustainability strategy. An exploration of factors that may contribute or hinder transition program for new graduates in primary health care implementation is considered. A graduate transition program to primary health care may play an important role in addressing primary health care workforce shortages in the future. There are, however, a number of factors that need to be simultaneously addressed if a skilled and sustainable workforce for the future is to be realised. The development of a transition program to primary health care should be based on a number of core principles and be subjected to both a summative and cost

  2. [Sustainable Implementation of Evidence-Based Programmes in Health Promotion: A Theoretical Framework and Concept of Interactive Knowledge to Action].

    Science.gov (United States)

    Rütten, A; Wolff, A; Streber, A

    2016-03-01

    This article discusses 2 current issues in the field of public health research: (i) transfer of scientific knowledge into practice and (ii) sustainable implementation of good practice projects. It also supports integration of scientific and practice-based evidence production. Furthermore, it supports utilisation of interactive models that transcend deductive approaches to the process of knowledge transfer. Existing theoretical approaches, pilot studies and thoughtful conceptual considerations are incorporated into a framework showing the interplay of science, politics and prevention practice, which fosters a more sustainable implementation of health promotion programmes. The framework depicts 4 key processes of interaction between science and prevention practice: interactive knowledge to action, capacity building, programme adaptation and adaptation of the implementation context. Ensuring sustainability of health promotion programmes requires a concentrated process of integrating scientific and practice-based evidence production in the context of implementation. Central to the integration process is the approach of interactive knowledge to action, which especially benefits from capacity building processes that facilitate participation and systematic interaction between relevant stakeholders. Intense cooperation also induces a dynamic interaction between multiple actors and components such as health promotion programmes, target groups, relevant organisations and social, cultural and political contexts. The reciprocal adaptation of programmes and key components of the implementation context can foster effectiveness and sustainability of programmes. Sustainable implementation of evidence-based health promotion programmes requires alternatives to recent deductive models of knowledge transfer. Interactive approaches prove to be promising alternatives. Simultaneously, they change the responsibilities of science, policy and public health practice. Existing boundaries

  3. Soldier's Expectancies, Implications for Recruitment and Job Satisfaction

    National Research Council Canada - National Science Library

    Gelooven, Renier

    1999-01-01

    .... Also expectancies about a job influence attrition and job satisfaction. This paper uses results of several studies to describe the image of the soldiers job and its effects on recruitment, early attrition and job satisfaction.

  4. Theory to Strategy: War Insight for the Strategic Soldier

    National Research Council Canada - National Science Library

    Fregoso, Luis A

    2008-01-01

    .... These Strategic Soldiers and their respective leaders must not only be aware of their potential influence in a war environment, they must learn how to harness this ability in support of their nation's war strategy...

  5. Post traumatic stress disorder among former child soldiers attending ...

    African Journals Online (AJOL)

    Post traumatic stress disorder among former child soldiers attending a rehabilitative service ... school in northern Uganda with a case of mass psychotic behavior. ... Methods: Data on post-traumatic stress disorder, depressed mood, physical ...

  6. Computer Backgrounds of Soldiers in Army Units: FY00

    National Research Council Canada - National Science Library

    Fober, Gene

    2001-01-01

    .... Soldiers from four Army installations were given a survey that examined their experiences with computers, self-perceptions of their skill, and an objective test of their ability to identify Windows-based icons...

  7. The Computer Backgrounds of Soldiers in Army Units: FY01

    National Research Council Canada - National Science Library

    Singh, Harnam

    2002-01-01

    A multi-year research effort was instituted in FY99 to examine soldiers' experiences with computers, self- perceptions of their computer skill, and their ability to identify frequently used, Windows-based icons...

  8. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    Holland, van Berry J.; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    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

  9. 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

  10. Differences in health, participation and life satisfaction outcomes in adults following paediatric- versus adult-sustained spinal cord injury

    NARCIS (Netherlands)

    Ma, J. K.; Post, M. W. M.; Gorter, J. W.; Ginis, K. A. Martin

    2016-01-01

    Study design: Cross-sectional. Objectives: To compare differences in self-reported health status, participation and life satisfaction outcomes between adults with a spinal cord injury (SCI) sustained during paediatric (P) versus adulthood (A) years. Setting: Ontario, Canada. Methods: Secondary

  11. "Meatless days" or "less but better"? Exploring strategies to adapt Western meat consumption to health and sustainability challenges

    NARCIS (Netherlands)

    de Boer, J.; Schösler, H.; Aiking, H.

    2014-01-01

    Adapting Western meat consumption to health and sustainability challenges requires an overall reduction of industrially produced animal proteins plus a partial replacement by plant proteins. Combining insights on food, environment, and consumers, this paper aims to explore change strategies that may

  12. 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...

  13. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    Science.gov (United States)

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  14. Limitations imposed by wearing armour on Medieval soldiers' locomotor performance

    OpenAIRE

    Askew, Graham N.; Formenti, Federico; Minetti, Alberto E.

    2011-01-01

    In Medieval Europe, soldiers wore steel plate armour for protection during warfare. Armour design reflected a trade-off between protection and mobility it offered the wearer. By the fifteenth century, a typical suit of field armour weighed between 30 and 50 kg and was distributed over the entire body. How much wearing armour affected Medieval soldiers' locomotor energetics and biomechanics is unknown. We investigated the mechanics and the energetic cost of locomotion in armour, and determined...

  15. Improving Employment Prospects for Soldiers Leaving the Regular Army

    Science.gov (United States)

    2017-01-01

    difficulties in the civilian job market . Furthermore, since 2012, the Army has been reducing its active component end strength; this has increased the number... online versions of the surveys to collect data on civilian occupations. Making the surveys available to soldiers online and integrating them into the...civilian occupation matches by MOS and pay grade. An online format could even help gen- erate job recommendations for individual soldiers based on

  16. Training Capability Data for Dismounted Soldier Training System

    Science.gov (United States)

    2015-06-01

    Virtual Squad Training System ( VSTS ). Like some of its predecessors, VSTS included a combination of man-wearable, tethered, and desktop interfaces...Simulator Bayonet w/Omni Directional Treadmill TRAC-WSMR Soldier Station Soldier Visualization Station V-IMTS SVS2-DI, DAGGERS, ASWETS VSTS Dismounted...Simulation, VSTS – Virtual Squad Training System 4 and microphone. The VSMM utilizes radio frequency identification (RFID) tags and hand sensors to

  17. Establishment of sustainable health science for future generations: from a hundred years ago to a hundred years in the future.

    Science.gov (United States)

    Mori, Chisato; Todaka, Emiko

    2009-01-01

    Recently, we have investigated the relationship between environment and health from a scientific perspective and developed a new academic field, "Sustainable Health Science" that will contribute to creating a healthy environment for future generations. There are three key points in Sustainable Heath Science. The first key point is "focusing on future generations"-society should improve the environment and prevent possible adverse health effects on future generations (Environmental Preventive Medicine). The second key point is the "precautious principle". The third key point is "transdisciplinary science", which means that not only medical science but also other scientific fields, such as architectural and engineering science, should be involved. Here, we introduce our recent challenging project "Chemiless Town Project", in which a model town is under construction with fewer chemicals. In the project, a trial of an education program and a health-examination system of chemical exposure is going to be conducted. In the future, we are aiming to establish health examination of exposure to chemicals of women of reproductive age so that the risk of adverse health effects to future generations will decrease and they can enjoy a better quality of life. We hope that society will accept the importance of forming a sustainable society for future generations not only with regard to chemicals but also to the whole surrounding environment. As the proverb of American native people tells us, we should live considering the effects on seven generations in the future.

  18. A Methodology for Measuring the Physiological Strain of Enhanced Soldiers: The 1998 Soldier Combat System Enhancement Study

    National Research Council Canada - National Science Library

    Amos, Denys

    1998-01-01

    ... or enhanced capabilities conducting routine operations in the tropics. Core temperature, mean skin temperature and heart rate are appropriate measures for evaluating the physiological burden of soldier combat system enhancements...

  19. 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)

    Nuti, Sabina

    2017-01-01

    Summary 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. PMID:28791771

  20. Developing Sustainable Workplaces with Leadership: Feedback about Organizational Working Conditions to Support Leaders in Health-Promoting Behavior

    Directory of Open Access Journals (Sweden)

    Paul Jiménez

    2017-10-01

    Full Text Available Organizations should support leaders in promoting their employees’ health in every possible way to achieve a sustainable workplace. A good way to support leaders could include getting feedback about their health-promoting behavior from their employees. The present study introduces an instrument (Health-Promoting Leadership Conditions; HPLC that enables the provision of feedback about the leaders’ efforts to create health-promoting working conditions in seven key aspects: health awareness, workload, control, reward, community, fairness and value-fit. The instrument was used in employee surveys and in an online study, obtaining a sample of 430 participants. The results showed that all seven key aspects of health-promoting leadership can be assigned to a main factor of health-promoting leadership. In addition, the HPLC shows high construct validity with dimensions of stress, resources and burnout (Recovery-Stress- Questionnaire for Work [RESTQ-Work] and Maslach Burnout Inventory General Survey [MBI-GS]. The results indicate that the HPLC can be used as a basis on which to assess health-promoting leadership behavior with a focus on changing working conditions. By getting feedback about their leadership behavior from their employees, leaders can identify their potential and fields for improvement for supporting their employees’ health and developing a sustainable workplace.

  1. A Healthy Eating Identity is Associated with Healthier Food Choice Behaviors Among U.S. Army Soldiers.

    Science.gov (United States)

    Jayne, Julianna M; Frongillo, Edward A; Torres-McGehee, Toni M; Emerson, Dawn M; Glover, Saundra H; Blake, Christine E

    2018-04-04

    Promoting healthy eating among Soldiers is a priority to the Army due to the link between nutrition and performance. The Army typically uses nutrition education to encourage Soldiers to make healthier food choices with low emphasis on other psychosocial determinants of food choice behaviors. Drill Sergeant Candidates (n = 575) completed surveys assessing nutrition knowledge, eating identity type, and food choice behaviors including fruit and vegetable intake, skipping meals, and eating out frequency. In multiple linear regression models using full-information maximum likelihood estimation while controlling for race/ethnicity, education, and marital status, we examined relationships between nutrition knowledge, a healthy eating identity, and Soldiers' food choice behaviors. The study was approved by the Department of Defense and University of South Carolina's Institutional Review Boards. A healthy eating identity was positively associated with greater fruit and vegetable consumption (p eating out frequency (p healthy eating identity may be more effective for promoting healthy food choice behaviors than nutrition education alone. Determining if various points in a Soldier's career could be leveraged to influence a healthy eating identity and behaviors could be an important strategy to improve compliance with health promotion programs.

  2. Interventions that facilitate sustainable jobs and have a positive impact on workers’ health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Michelle M. Haby

    Full Text Available ABSTRACT Objective To identify interventions that facilitate sustainable jobs and have a positive impact on the health of workers in health sector workplaces. Methods This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including specific inclusion criteria. To be classified as “sustainable,” interventions needed to aim (explicitly or implicitly to 1 have a positive impact on at least two key dimensions of the integrated framework for sustainable development and 2 include measures of health impact. Only interventions conducted in, or applicable to, health sector workplaces were included. Results Fourteen systematic reviews and no economic evaluations met the inclusion criteria for the overview. The interventions that had a positive impact on health included 1 enforcement of occupational health and safety regulations; 2 use of the “degree of experience rating” feature of workers’ compensation; 3 provision of flexible working arrangements that increase worker control and choice; 4 implementation of certain organizational changes to shift work schedules; and 5 use of some employee participation schemes. Interventions with negative impacts on health included 1 downsizing/restructuring; 2 temporary and insecure work arrangements; 3 outsourcing/home-based work arrangements; and 4 some forms of task restructuring. Conclusions What is needed now is careful implementation, in health sector workplaces, of interventions likely to have positive impacts, but with careful evaluation of their effects including possible adverse impacts. Well-evaluated implementation of the interventions (including those at the pilot-study stage will contribute to the evidence base and inform future action. Interventions with negative health impacts should be withdrawn from practice (through regulation, where possible. If

  3. Interventions that facilitate sustainable jobs and have a positive impact on workers' health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-11-01

    To identify interventions that facilitate sustainable jobs and have a positive impact on the health of workers in health sector workplaces. This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including specific inclusion criteria. To be classified as "sustainable," interventions needed to aim (explicitly or implicitly) to 1) have a positive impact on at least two key dimensions of the integrated framework for sustainable development and 2) include measures of health impact. Only interventions conducted in, or applicable to, health sector workplaces were included. Fourteen systematic reviews and no economic evaluations met the inclusion criteria for the overview. The interventions that had a positive impact on health included 1) enforcement of occupational health and safety regulations; 2) use of the "degree of experience rating" feature of workers' compensation; 3) provision of flexible working arrangements that increase worker control and choice; 4) implementation of certain organizational changes to shift work schedules; and 5) use of some employee participation schemes. Interventions with negative impacts on health included 1) downsizing/restructuring; 2) temporary and insecure work arrangements; 3) outsourcing/home-based work arrangements; and 4) some forms of task restructuring. What is needed now is careful implementation, in health sector workplaces, of interventions likely to have positive impacts, but with careful evaluation of their effects including possible adverse impacts. Well-evaluated implementation of the interventions (including those at the pilot-study stage) will contribute to the evidence base and inform future action. Interventions with negative health impacts should be withdrawn from practice (through regulation, where possible). If use of these interventions is necessary, for other reasons

  4. Prevalence of overweight and obesity in professional soldiers of the Czech Army over an 11-year period.

    Science.gov (United States)

    Fajfrová, Jana; Pavlík, Vladimír; Psutka, Jan; Husarová, Michaela; Krutišová, Pavla; Fajfr, Miroslav

    2016-05-01

    Obesity is currently considered to be the most frequent metabolic disease worldwide, not only in developed but also in developing countries. The aim of this work was to describe the development of health status in soldiers of the Armed Forces of the Czech Republic (ACR) and to emphasizethe markers of non-communicable diseases. Our study describes the anthropometric and biochemical parameters of a large group of Czech Army professional soldiers. Data were obtained over a period of 11 years. During the monitored period, from 1999 to 2009, military physicians carried out on the average 6,360 examinations on professional soldiers per year and monitored their health and nutritional status with the aim of preventing the risk factors of non-communicable diseases. These examinations are compulsory for all professional soldiers at the age of 25, 30, 33, and 36 years. From the age of 39, these examinations are carried out every year till the end of their career. Besides taking personal histories and carrying out standard physical examinations, blood was taken for biochemical examination. The following anthropometric parameters were monitored: body constitution using body mass index (BMI) and waist circumference. Our study describes only part of the data concerning anthropometric and biochemical parameters of professional soldiers which were obtained over a period of 11 years. Average BMI values in men were in the overweight range (26.5-27 kg/m2). Average values of waist circumference, however, ranged from 91.9 cm to 93.4 cm. Between the first and the last year of monitoring a statistically significant decrease in these values ranging from 93.4 ± 9.8 cm to 92.7 ± 9.5 cm (p values of total cholesterol, triglycerides and LDL cholesterol was observed; from 5.5 ± 1.1 mmol/L to 5.1 ± 1.0 mmol/L (p values in the overweight range was observed. Although the number of overweight soldiers was overestimated as a result of the inclusion of individuals with increased body weight due

  5. "The Service I Rendered Was Just as True": African American Soldiers and Veterans as Activist Patients.

    Science.gov (United States)

    Adler, Jessica L

    2017-05-01

    In this article, I examine how African American soldiers and veterans experienced and shaped federally sponsored health care during and after World War I. Building on studies of the struggles of Black leaders and health care providers to win professional and public health advancement in the 1920s and 1930s, and of advocates to mobilize for health care rights in the mid-20th century, I focus primarily on the experiences and activism of patients in the interwar years. Private and government correspondence, congressional testimony, and reports from Black newspapers reveal that African American soldiers and veterans communicated directly with policymakers and bureaucrats regarding unequal treatment, assuming roles as "policy actors" who viewed health and medical care as "politics by other means." In the process, they drew attention to the paradoxes inherent in expanding government entitlements in the era of Jim Crow, and helped shape a veterans' health system that emerged in the 1920s and remained in place for the following century. They also laid the groundwork for the system's precedent-setting desegregation, referred to by advocates of the time as "a shining example to the rest of the country."

  6. 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

  7. Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative.

    Science.gov (United States)

    Stolee, Paul; McAiney, Carrie A; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

    2009-01-01

    This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management support, particularly designation of time for PRP activities, development of PRP teams, and supportive learning strategies were significant factors affecting sustained knowledge transfer. Continuing education that is provided and evaluated on an ongoing basis, secures management commitment, is integrated within a broader system strategy, and provides on-the-job support has the greatest potential to affect care.

  8. 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.

  9. 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.

  10. 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.

  11. Soldiers suicides risk factors in the Serbian Army Forces

    Directory of Open Access Journals (Sweden)

    Dedić Gordana

    2010-01-01

    Full Text Available Background/Aim. Analyses of suicide risk factors enable to undertake appropriate preventive measures within the Suicide Prevention Program in Military Environment, which was fully applied in 2003 in the Serbian Army Forces. The aim of our study was to identify the most important suicide risk factors in soldiers within the period from 1998 to 2007. Methods. Analysis of suicide risk factors was carried out on the basis of data obtained by psychological suicide autopsy. The control group was matched with adapted soldiers by socio-demographic factors. A descriptive statistical analysis was used. Comparison of groups of soldiers was done by the t-test and Pearson's χ2-test. Results. A total of 35 soldiers aged 22-49 years (21.76 ± 1.76 years on average committed suicide within the period 1999-2007, the 2/3 within, and 1/3 out of a military compound. More than one half soldiers committed suicide after transferring to a different post. Soldiers who committed suicide had come from uncompleted, dysfunctional families (p < 0.05. In comparison with the adapted soldiers, in premilitary period they had more interpersonal problems with their comrades (p < 0.001 and problems with law (p < 0.05. During military service, alcohol consumption was less presented; they used to have fewer separation problems (p < 0.05 and to be rarely awarded (p < 0.001 in comparison with the adapted soldiers. A soldier who committed suicide was emotionally and socially immature persons. The commonest motives for suicide were: decreased capacity of adaptation to military service, actual psychic disturbance, emotional interruption, fear of environment judgment, actual family problems, but in the one fifth, motive stayed unrecognized. Conclusion. Suicide risk factors in soldiers are primary in their immature personality organization, its relation with family and military environment factors which, in coexistence with actual life accidents, result in suicide as a consequence. A

  12. [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

  13. Physical training risk factors for musculoskeletal injury in female soldiers.

    Science.gov (United States)

    Roy, Tanja C; Songer, Thomas; Ye, Feifei; LaPorte, Ronald; Grier, Tyson; Anderson, Morgan; Chervak, Michelle

    2014-12-01

    Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  14. 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

  15. Leadership and post-traumatic stress disorder: are soldiers' perceptions of organizational justice during deployment protective?

    Science.gov (United States)

    Elrond, Andreas F; Høgh, Annie; Andersen, Søren B

    2018-01-01

    Background : Soldiers' perception of leadership during military deployment has gained research attention as a potentially modifiable factor to buffer against the development of postdeployment post-traumatic stress disorder (PTSD). Within nonmilitary research, the organizational justice (OJ) framework, i.e. distributive justice, procedural justice (PJ) and interactional justice (IJ), has been found to relate to mental health outcomes. Aspects of OJ may, therefore, be protective against PTSD. Objectives : We examined the prospective relationship between aspects of OJ, namely the perceptions of PJ and IJ by subordinate soldiers without leadership obligations in relationship to immediate superiors and PTSD. Method : Participants were soldiers ( n =  245) deployed to Helmand Province in Afghanistan in 2009. Logistic regression procedures were used. The primary analysis measured PTSD cases using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorder (SCID) 2½ years after homecoming. PJ/IJ was measured during deployment with a 6-item composite measure ranging from 0 to 12. Supplementary primary analyses were performed with PJ/IJ measured before and immediately after deployment. A secondary PJ/IJ analysis also tested against four postdeployment measures with the Post-Traumatic Stress Disorder Checklist Civilian (PCL-C) dichotomized at screening symptom levels. Results : Higher levels of perceived PJ/IJ for soldiers without leadership obligations during deployment had a prospective relation (OR = 0.86, 95% CI = 0.75-0.98) with PTSD on the SCID 2½ years after homecoming after adjustment for factors including predeployment PTSD symptoms, trauma and combat exposure, and state affectivity. Similar results were found by measuring PJ/IJ before (OR = 0.83, 95% CI = 0.71-0.95) but not immediately after homecoming (OR = 0.97, 95% CI = 0.85-1.11). A relationship with PTSD symptoms at the screening level at the four measurements of PCL-C was found, but only

  16. 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…

  17. Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care.

    Science.gov (United States)

    Klinga, Charlotte; Hasson, Henna; Andreen Sachs, Magna; Hansson, Johan

    2018-06-04

    Change initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy. A retrospective and qualitative case-study research design was used, and data from the model organisation's steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF). The development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care. This study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users' needs were essential in order

  18. Does Rapid and Sustained Economic Growth Lead to Convergence in Health Resources: The Case of China From 1980 to 2010.

    Science.gov (United States)

    Liang, Di; Zhang, Donglan; Huang, Jiayan; Schweitzer, Stuart

    2016-01-01

    China's rapid and sustained economic growth offers an opportunity to ask whether the advantages of growth diffuse throughout an economy, or remain localized in areas where the growth has been the greatest. A critical policy area in China has been the health system, and health inequality has become an issue that has led the government to broaden national health insurance programs. This study investigates whether health system resources and performance have converged over the past 30 years across China's 31 provinces. To examine geographic variation of health system resources and performance at the provincial level, we measure the degree of sigma convergence and beta convergence in indicators of health system resources (structure), health services utilization (process), and outcome. All data are from officially published sources: the China Health Statistics Year Book and the China Statistics Year Book. Sigma convergence is found for resource indicators, whereas it is not observed for either process or outcome indicators, indicating that disparities only narrowed in health system resources. Beta convergence is found in most indicators, except for 2 procedure indicators, reflecting that provinces with poorer resources were catching up. Convergence found in this study probably reflects the mixed outcome of government input, and market forces. Thus, left alone, the equitable distribution of health care resources may not occur naturally during a period of economic growth. Governmental and societal efforts are needed to reduce geographic health variation and promote health equity. © The Author(s) 2016.

  19. Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review.

    Science.gov (United States)

    Braithwaite, Jeffrey; Testa, Luke; Lamprell, Gina; Herkes, Jessica; Ludlow, Kristiana; McPherson, Elise; Campbell, Margie; Holt, Joanna

    2017-11-12

    The sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system. The protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies. As no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?

    Science.gov (United States)

    Chilundo, Baltazar Gm; Cliff, Julie L; Mariano, Alda Re; Rodríguez, Daniela C; George, Asha

    2015-12-01

    In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded 'old' CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Our analysis represents a nuanced assessment of the various domains that influence CHW programme

  1. Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

    Science.gov (United States)

    Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O

    2017-09-01

    Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

  2. Afterschool Sustainability

    Directory of Open Access Journals (Sweden)

    Hilary D. Joyce

    2014-12-01

    Full Text Available Youth participation in quality extended learning opportunities (ELOs results in positive academic, physical, mental health, and social/emotional outcomes. Funding is essential to implementing and sustaining quality ELOs; however multiple funding barriers and challenges exist. Understanding the types of funds available for ELOs and the factors that influence sustainability is critical. Through surveys and telephone interviews of ELO providers, this descriptive study identified and examined ELO funding streams, the ways ELO providers use these funding streams, and the barriers and challenges to sustainability. ELO programs often relied on one major funding stream coupled with nutrition supports as well as in-kind resources. Barriers to sustainability included year-to-year funding, transportation costs, reducing community partnerships, and difficulty in diversifying funds. Recommendations to enhance ELO sustainability are offered, particularly in relation to overcoming the challenges to diversification of funding resources and establishing mutually supportive partnerships and collaboration.

  3. The Large Marine Ecosystem Approach for 21st Century Ocean Health and International Sustainable Development

    Science.gov (United States)

    Honey, K. T.

    2014-12-01

    The global coastal ocean and watersheds are divided into 66 Large Marine Ecosystems (LMEs), which encompass regions from river basins, estuaries, and coasts to the seaward boundaries of continental shelves and margins of major currents. Approximately 80% of global fisheries catch comes from LME waters. Ecosystem goods and services from LMEs contribute an estimated US 18-25 trillion dollars annually to the global economy in market and non-market value. The critical importance of these large-scale systems, however, is threatened by human populations and pressures, including climate change. Fortunately, there is pragmatic reason for optimism. Interdisciplinary frameworks exist, such as the Large Marine Ecosystem (LME) approach for adaptive management that can integrate both nature-centric and human-centric views into ecosystem monitoring, assessment, and adaptive management practices for long-term sustainability. Originally proposed almost 30 years ago, the LME approach rests on five modules are: (i) productivity, (ii) fish and fisheries, (iii) pollution and ecosystem health, (iv) socioeconomics, and (v) governance for iterative adaptive management at a large, international scale of 200,000 km2 or greater. The Global Environment Facility (GEF), World Bank, and United Nations agencies recognize and support the LME approach—as evidenced by over 3.15 billion in financial assistance to date for LME projects. This year of 2014 is an exciting milestone in LME history, after 20 years of the United Nations and GEF organizations adopting LMEs as a unit for ecosystem-based approaches to management. The LME approach, however, is not perfect. Nor is it immutable. Similar to the adaptive management framework it propones, the LME approach itself must adapt to new and emerging 21st Century technologies, science, and realities. The LME approach must further consider socioeconomics and governance. Within the socioeconomics module alone, several trillion-dollar opportunities exist

  4. A Structural Equation Modeling of the Relationships between Depression, Drug Abuse and Social Support with Suicidal Ideation among Soldiers in Iran in 2015.

    Science.gov (United States)

    Nosratabadi, Mehdi; Halvaiepour, Zohreh

    2016-01-01

    Military service is a crucial period in the lives of young people and during this period soldier facing with multiple psychosocial problems. The present study aimed to explore structural analysis of the relationships between depression, drug abuse, social support and the risk of suicidal ideation among Military Medical University soldiers in Iran. In the present correlational research, a sample of 176 soldiers, from three units, was selected using randomly stratified sampling. Data were collected through the Social Support Questionnaire (SSQ), the Beck Depression Inventory-II (BDI-II), the Beck Scale for Suicide Ideation (BSS) and the Possibility of Drug Abuse Scale (LDAS). Structural equation modeling was used to test the fit of the model, identify direct and indirect effects of the psychosocial correlates. Data were analyzed using the SPSS and AMOS software (Verson22). out of the whole subjects, 28.4% had suicidal ideation and 65.3% had degrees of depression (mild to severe). A significant reverse relationship was observed between social support and suicidal ideation (pdrug abuse and suicidal ideation. The final structural model indicated that 74% of the variance in suicidal ideation was explained by the three examined variables of depression, social support and drug abuse. The overall results showed that the risk of suicidal ideation, depression and drug abuse are relatively significant in Military Medical University soldiers requiring taking serious actions by the authorities and other relevant organizations in order to improve the psychosocial health status of these soldiers.

  5. The Nation and the Soldier in German Civil-Military Relations, 1800-1945

    National Research Council Canada - National Science Library

    Brumley, Donald W

    2005-01-01

    .... The abdication of the monarchy in 1918 forced the professional soldier to look for a substitute sovereign who would insure the survival of the privileged role of the soldier in republican state and society...

  6. The Utility and Consequences of Using Impressed Child Soldiers in Africa's Contemporary Wars

    National Research Council Canada - National Science Library

    Woguwale, Jasom

    2000-01-01

    .... The purpose of this paper titled, "The Utility and Consequences of Using Impressed Child Soldiers in Africa's Contemporary Wars," is to examine the practice of using children as soldiers by various...

  7. The post-conflict treatment of child soldiers: A study of Liberian child ...

    African Journals Online (AJOL)

    The post-conflict treatment of child soldiers: A study of Liberian child soldiers. ... applied an unvarying standard of prevention in response to every occurrence ... encourage both domestic political transition and a changed understanding of

  8. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001. Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in

  9. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Directory of Open Access Journals (Sweden)

    Emily R Mangone

    Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

  10. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Science.gov (United States)

    Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

    2016-01-01

    There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

  11. The Hybrid Public Research University: A Comparative Case Study of Two Self-Sustaining Degree Programs in Public Health

    OpenAIRE

    Hagigi, Farhad A

    2014-01-01

    Abstract of the DissertationThe Hybrid Public Research University: A Comparative Case Study of Two Self‐Sustaining Degree Programs in Public HealthByFarhad Abas HagigiDoctor of Philosophy in EducationUniversity of California, Los Angeles, 2014Professor Walter R. Allen, Co-ChairProfessor Jos� Luis Santos, Co-ChairDecreased public funding, diminishing political and societal support, and increased competition from private institutions have led public research universities (PRUs) to under...

  12. Delay Discounting as an Index of Sustainable Behavior: Devaluation of Future Air Quality and Implications for Public Health.

    Science.gov (United States)

    Berry, Meredith S; Nickerson, Norma P; Odum, Amy L

    2017-09-01

    Poor air quality and resulting annual deaths represent significant public health concerns. Recently, rapid delay discounting (the devaluation of future outcomes) of air quality has been considered a potential barrier for engaging in long term, sustainable behaviors that might help to reduce emissions (e.g., reducing private car use, societal support for clean air initiatives). Delay discounting has been shown to be predictive of real world behavior outside of laboratory settings, and therefore may offer an important framework beyond traditional variables thought to measure sustainable behavior such as importance of an environmental issue, or environmental attitudes/values, although more research is needed in this area. We examined relations between discounting of air quality, respiratory health, and monetary gains and losses. We also examined, relations between discounting and self-reported importance of air quality and respiratory health, and nature relatedness. Results showed rapid delay discounting of all outcomes across the time frames assessed, and significant positive correlations between delay discounting of air quality, respiratory health, and monetary outcomes. Steeper discounting of monetary outcomes relative to air quality and respiratory health outcomes was observed in the context of gains; however, no differences in discounting were observed across losses of monetary, air quality, and respiratory health. Replicating the sign effect, monetary outcomes were discounted more steeply than monetary losses. Importance of air quality, respiratory health and nature relatedness were significantly and positively correlated with one another, but not with degree of delay discounting of any outcome, demonstrating the need for more comprehensive measures that predict pro-environmental behaviors that might benefit individuals and public health over time. These results add to our understanding of decision-making, and demonstrate alarming rates of delay discounting of

  13. Development and application of a community sustainability visualization tool through integration of US EPA’s Sustainable and Health Community Research Program tasks

    Science.gov (United States)

    Maintaining a harmonious balance between economic, social, and environmental well-being is paramount to community sustainability. Communities need a practical/usable suite of measures to assess their current position on a "surface" of sustainability created from the interaction ...

  14. VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

    Directory of Open Access Journals (Sweden)

    Claudia Marotta

    2017-10-01

    Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

  15. Former child soldiers' problems and needs: Congolese experiences.

    Science.gov (United States)

    Johannessen, Steinar; Holgersen, Helge

    2014-01-01

    With this article, we explore how staff working at transit centers and vocational training centers in the eastern Democratic Republic of the Congo experienced the problems and needs of former child soldiers. We argued that the staff's experience of the children's daily lives and their understanding of the sociocultural context of the conflict make their perspective a valuable source of information when trying to understand the phenomenon of child soldiering. Additionally, we reasoned that how the staff frame these children's problems influences how they attempt to aid the children. We conducted 11 semistructured interviews and analyzed these using a hermeneutical-phenomenological approach. We clustered our findings around six themes: unfavorable contextual factors, acting as if still in the army, addiction, symptoms of psychopathology, social rejection, and reintegration needs. The overarching message we observed was that the informants experienced that former child soldiers require help to be transformed into civilians who participate proactively in their society.

  16. Exoskeleton for Soldier Enhancement Systems Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, J.F.

    2000-09-28

    The development of a successful exoskeleton for human performance augmentation (EHPA) will require a multi-disciplinary systems approach based upon sound biomechanics, power generation and actuation systems, controls technology, and operator interfaces. The ability to integrate key components into a system that enhances performance without impeding operator mobility is essential. The purpose of this study and report are to address the issue of feasibility of building a fieldable EHPA. Previous efforts, while demonstrating progress and enhancing knowledge, have not approached the level required for a fully functional, fieldable system. It is doubtless that the technologies required for a successful exoskeleton have advanced, and some of them significantly. The question to be addressed in this report is have they advanced to the point of making a system feasible in the next three to five years? In this study, the key technologies required to successfully build an exoskeleton have been examined. The primary focus has been on the key technologies of power sources, actuators, and controls. Power sources, including internal combustion engines, fuel cells, batteries, super capacitors, and hybrid sources have been investigated and compared with respect to the exoskeleton application. Both conventional and non-conventional actuator technologies that could impact EHPA have been assessed. In addition to the current state of the art of actuators, the potential for near-term improvements using non-conventional actuators has also been addressed. Controls strategies, and their implication to the design approach, and the exoskeleton to soldier interface have also been investigated. In addition to these key subsystems and technologies, this report addresses technical concepts and issues relating to an integrated design. A recommended approach, based on the results of the study is also presented.

  17. Muzzle flash localization for the dismounted soldier

    Science.gov (United States)

    Kennedy Scott, Will

    2015-05-01

    The ability to accurately and rapidly know the precise location of enemy fire would be a substantial capability enhancement to the dismounted soldier. Acoustic gun-shot detections systems can provide an approximate bearing but it is desired to precisely know the location (direction and range) of enemy fire; for example to know from `which window' the fire is coming from. Funded by the UK MOD (via Roke Manor Research) QinetiQ is developing an imaging solution built around an InGaAs camera. This paper presents work that QinetiQ has undertaken on the Muzzle Flash Locator system. Key technical challenges that have been overcome are explained and discussed in this paper. They include; the design of the optical sensor and processing hardware to meet low size, weight and power requirements; the algorithm approach required to maintain sensitivity whilst rejecting false alarms from sources such as close passing insects and sun glint from scene objects; and operation on the move. This work shows that such a sensor can provide sufficient sensitivity to detect muzzle flash events to militarily significant ranges and that such a system can be combined with an acoustic gunshot detection system to minimize the false alarm rate. The muzzle flash sensor developed in this work operates in real-time and has a field of view of approximately 29° (horizontal) by 12° (vertical) with a pixel resolution of 0.13°. The work has demonstrated that extension to a sensor with realistic angular rotation rate is feasible.

  18. Group Trauma-Focused Cognitive-Behavioural Therapy with Former Child Soldiers and Other War-Affected Boys in the DR Congo: A Randomised Controlled Trial

    Science.gov (United States)

    McMullen, John; O'Callaghan, Paul; Shannon, Ciaran; Black, Alastair; Eakin, John

    2013-01-01

    Background: The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled…

  19. 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...... on existing capacities in the mission will be small, yet realistic, steps forward. This paper discusses mechanisms within the mission that have been established to raise gender awareness, based on fieldwork