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Sample records for system affect health-related

  1. Mediation, moderation, and context: Understanding complex relations among cognition, affect, and health behaviour.

    Science.gov (United States)

    Kiviniemi, Marc T; Ellis, Erin M; Hall, Marissa G; Moss, Jennifer L; Lillie, Sarah E; Brewer, Noel T; Klein, William M P

    2018-01-01

    Researchers have historically treated cognition and affect as separate constructs in motivating health behaviour. We present a framework and empirical evidence for complex relations between cognition and affect in predicting health behaviour. Main Outcome, Design and Results: First, affect and cognition can mediate each other's relation to health behaviour. Second, affect and cognition can moderate the other's impact. Third, context can change the interplay of affect and cognition. Fourth, affect and cognition may be indelibly fused in some psychological constructs (e.g. worry, anticipated regret and reactance). These four propositions in our framework are not mutually exclusive. Examination of the types of complex relations described here can benefit theory development, empirical testing of theories and intervention design. Doing so will advance the understanding of mechanisms involved in regulation of health behaviours and the effectiveness of interventions to change health behaviours.

  2. How health behaviors relate to academic performance via affect: an intensive longitudinal study.

    Directory of Open Access Journals (Sweden)

    Lavinia Flueckiger

    Full Text Available OBJECTIVE: This intensive longitudinal study examined how sleep and physical activity relate to university students' affect and academic performance during a stressful examination period. METHODS: On 32 consecutive days, 72 first-year students answered online questionnaires on their sleep quality, physical activity, positive and negative affect, learning goal achievement, and examination grades. First-year university students are particularly well-suited to test our hypotheses: They represent a relatively homogeneous population in a natural, but controlled setting, and simultaneously deal with similar stressors, such as examinations. Data were analyzed using multilevel structural equation models. RESULTS: Over the examination period, better average sleep quality but not physical activity predicted better learning goal achievement. Better learning goal achievement was associated with increased probability of passing all examinations. Relations of average sleep quality and average physical activity with learning goal achievement were mediated by experienced positive affect. In terms of day-to-day dynamics, on days with better sleep quality, participants reported better learning goal achievement. Day-to-day physical activity was not related to daily learning goal achievement. Daily positive and negative affect both mediated the effect of day-to-day sleep quality and physical activity on daily learning goal achievement. CONCLUSION: Health behaviors such as sleep quality and physical activity seem important for both academic performance and affect experience, an indicator of mental health, during a stressful examination period. These results are a first step toward a better understanding of between- and within-person variations in health behaviors, affect, and academic performance, and could inform prevention and intervention programs for university students.

  3. How health behaviors relate to academic performance via affect: an intensive longitudinal study.

    Science.gov (United States)

    Flueckiger, Lavinia; Lieb, Roselind; Meyer, Andrea H; Mata, Jutta

    2014-01-01

    This intensive longitudinal study examined how sleep and physical activity relate to university students' affect and academic performance during a stressful examination period. On 32 consecutive days, 72 first-year students answered online questionnaires on their sleep quality, physical activity, positive and negative affect, learning goal achievement, and examination grades. First-year university students are particularly well-suited to test our hypotheses: They represent a relatively homogeneous population in a natural, but controlled setting, and simultaneously deal with similar stressors, such as examinations. Data were analyzed using multilevel structural equation models. Over the examination period, better average sleep quality but not physical activity predicted better learning goal achievement. Better learning goal achievement was associated with increased probability of passing all examinations. Relations of average sleep quality and average physical activity with learning goal achievement were mediated by experienced positive affect. In terms of day-to-day dynamics, on days with better sleep quality, participants reported better learning goal achievement. Day-to-day physical activity was not related to daily learning goal achievement. Daily positive and negative affect both mediated the effect of day-to-day sleep quality and physical activity on daily learning goal achievement. Health behaviors such as sleep quality and physical activity seem important for both academic performance and affect experience, an indicator of mental health, during a stressful examination period. These results are a first step toward a better understanding of between- and within-person variations in health behaviors, affect, and academic performance, and could inform prevention and intervention programs for university students.

  4. Personality and Stressor-Related Affect

    Science.gov (United States)

    Leger, Kate A.; Charles, Susan T.; Turiano, Nicholas A.; Almeida, David M.

    2015-01-01

    Greater increases in negative affect and greater decreases in positive affect on days stressors occur portend poorer mental and physical health years later. Although personality traits influence stressor-related affect, only neuroticism and extraversion among the Big Five personality traits have been examined in any detail. Moreover, personality traits may shape how people appraise daily stressors, yet few studies have examined how stressor-related appraisals may account for associations between personality and stressor-related affect. Two studies used participants (N=2022, age 30–84) from the National Study of Daily Experiences II (NSDE II) to examine the associations between Big Five personality traits and stressor-related affect, in addition to how appraisals may account for these relationships. Results from Study 1 indicate that higher levels of extraversion, conscientiousness, and openness to experience, and lower levels of neuroticism, are related to less stressor-related negative affect. Only agreeableness was associated with stressor-related positive affect, such that higher levels were related to greater decreases in positive affect on days stressors occur. The second study found that stressor-related appraisals partially accounted for the significant associations between stressor-related negative affect and personality. Implications for these findings in relation to how personality may influence physical and emotional health are discussed. PMID:26796984

  5. Does personality affect health-related quality of life? A systematic review

    Science.gov (United States)

    Huang, I-Chan; Lee, Joy L.; Ketheeswaran, Pavinarmatha; Jones, Conor M.; Revicki, Dennis A.; Wu, Albert W.

    2017-01-01

    Background Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear. Methods This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study. Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%. Conclusions Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation. PMID:28355244

  6. Exploring the influence of the Global Fund and the GAVI Alliance on health systems in conflict-affected countries.

    Science.gov (United States)

    Patel, Preeti; Cummings, Rachael; Roberts, Bayard

    2015-01-01

    Global Health Initiatives (GHIs) respond to high-impact communicable diseases in resource-poor countries, including health systems support, and are major actors in global health. GHIs could play an important role in countries affected by armed conflict given these countries commonly have weak health systems and a high burden of communicable disease. The aim of this study is to explore the influence of two leading GHIs, the Global Fund and the GAVI Alliance, on the health systems of conflict-affected countries. This study used an analytical review approach to identify evidence on the role of the Global Fund and the GAVI Alliance with regards to health systems support to 19 conflict-affected countries. Primary and secondary published and grey literature were used, including country evaluations from the Global Fund and the GAVI Alliance. The WHO heath systems building blocks framework was used for the analysis. There is a limited evidence-base on the influence of GHIs on health systems of conflict-affected countries. The findings suggest that GHIs are increasingly investing in conflict-affected countries which has helped to rapidly scale up health services, strengthen human resources, improve procurement, and develop guidelines and protocols. Negative influences include distorting priorities within the health system, inequitable financing of disease-specific services over other health services, diverting staff away from more essential health care services, inadequate attention to capacity building, burdensome reporting requirements, and limited flexibility and responsiveness to the contextual challenges of conflict-affected countries. There is some evidence of increasing engagement of the Global Fund and the GAVI Alliance with health systems in conflict-affected countries, but this engagement should be supported by more context-specific policies and approaches.

  7. Does cultural and linguistic diversity affect health-related outcomes for people with stroke at discharge from hospital?

    Science.gov (United States)

    Davies, Sarah E; Dodd, Karen J; Hill, Keith D

    2017-04-01

    Primary purpose to determine if cultural and linguistic diversity affects health-related outcomes in people with stroke at discharge from hospital and secondary purpose to explore whether interpreter use alters these outcomes. Systematic search of: Cochrane, PEDro, CINAHL, Medline, Pubmed, Embase, PsycINFO and Ageline databases. Publications were classified into whether they examined the impact of diversity in culture, or language or culture and language combined. Quality of evidence available was summarized using Best Evidence Synthesis. Eleven studies met inclusion criteria and were reviewed. Best Evidence Synthesis indicated conflicting evidence about the impact of culture alone and language barriers alone on health-related outcomes. There was strong evidence that hospital length of stay does not differ between groups when the combined impact of culture and language was investigated. Conflicting evidence was found for other outcomes including admission, discharge and change in FIM scores, and post-hospital discharge living arrangements. It is unknown if interpreter use alters health-related outcomes, because this was infrequently reported. The current limited research suggests that cultural and linguistic diversity does not appear to impact on health-related outcomes at discharge from hospital for people who have had a stroke, however further research is needed to address identified gaps. Implications for Rehabilitation The different language, culture and beliefs about health demonstrated by patients with stroke from minority groups in North America do not appear to significantly impact on their health-related outcomes during their admission to hospital. It is not known whether interpreter use influences outcomes in stroke rehabilitation because there is insufficient high quality research in this area. Clinicians in countries with different health systems and different cultural and linguistic groups within their communities need to view the results with caution

  8. How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

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    Boccabella, Allegra; Malouf, John

    2017-05-15

    To measure differences in functional status between men and women presenting with sleep-related health problems. A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores ( P sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. © 2017 American Academy of Sleep Medicine

  9. Identification of Action Units Related to Affective States in a Tutoring System for Mathematics

    Science.gov (United States)

    Padrón-Rivera, Gustavo; Rebolledo-Mendez, Genaro; Parra, Pilar Pozos; Huerta-Pacheco, N. Sofia

    2016-01-01

    Affect is an important element of the learning process both in the classroom and with educational technology. This paper presents analyses in relation to the identification of Action Units (AUs) related to affective states and their impact on learning with a tutoring system. To assess affect, a tool was devised to identify AUs on pictures of human…

  10. How did market competition affect outpatient utilization under the diagnosis-related group-based payment system?

    Science.gov (United States)

    Kim, Seung Ju; Park, Eun-Cheol; Kim, Sun Jung; Han, Kyu-Tae; Jang, Sung-In

    2017-06-01

    Although competition is known to affect quality of care, less is known about the effects of competition on outpatient health service utilization under the diagnosis-related group payment system. This study aimed to evaluate these effects and assess differences before and after hospitalization in South Korea. Population-based retrospective observational study. We used two data set including outpatient data and hospitalization data from National Health Claim data from 2011 to 2014. Participants who were admitted to the hospital for hemorrhoidectomy were included. A total of 804 884 hospitalizations were included in our analysis. The outcome variables included the costs associated with outpatient examinations and the number of outpatient visits within 30 days before and after hospitalization. High-competition areas were associated with lower pre-surgery examination costs (rate ratio [RR]: 0.88, 95% confidence interval [CI]: 0.88-0.89) and fewer outpatient visits before hospitalization (RR: 0.98, 95% CI: 0.98-0.99) as well as after hospitalization compared with moderate-competition areas. Our study reveals that outpatient health service utilization is affected by the degree of market competition. Future evaluations of hospital performance should consider external factors such as market structure and hospital location. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. Factors affecting oral health-related quality of life among pregnant women.

    Science.gov (United States)

    Acharya, S; Bhat, P V; Acharya, S

    2009-05-01

    To assess oral health status and to describe the possible factors that could affect the oral health-related quality of life (OHRQoL) among a group of pregnant rural women in South India. A total of 259 pregnant women (mean age 26 +/- 5.5 years) who participated in the cross-sectional study were administered the Oral Health Impact Profile (OHIP-14) questionnaire and were clinically examined for caries and periodontal status. The highest oral impact on quality of life was reported for 'painful mouth' (mean: 1.7) and 'difficulty in eating' (mean: 1.1). On comparing the mean OHIP-14 scores against the various self-reported oral problems, it was seen that the mean OHIP-14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.

  12. Is the political system really related to health?

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    Klomp, Jeroen; de Haan, Jakob

    2009-07-01

    We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new health measures, i.e., the health of individuals and the quality of the health care sector. Using a cross-country structural equation model with various economic and demographic control variables, we examine the relationship between the type of regime and political stability on the one hand and health on the other. The political variables and the control variables are measured as averages over the period 1980-1999. Our results suggest that democracy has a positive relationship with the health of individuals, while regime instability has a negative relationship with the health of individuals. Government instability is negatively related to individual health via its link with the quality of the health care sector, while democracy is positively related with individual health through its link with income. Our main findings are confirmed by the results of a panel model and various sensitivity tests.

  13. Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: Validation of the Danish Global Mood Scale

    DEFF Research Database (Denmark)

    Spindler, Helle; Denollet, Johan; Kruse, Charlotte

    2009-01-01

    The Global Mood Scale (GMS), assessing negative affect (NA) and positive affect (PA), is sensitive to tapping treatment-related changes in patients with cardiac conditions. We examined the psychometric properties of the Danish GMS and the influence of NA and PA on distress and health-related qual...

  14. Is the political system really related to health?

    NARCIS (Netherlands)

    Klomp, J.G.; de Haan, J.

    We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new

  15. Work-related psychological health among clergy serving in the Presbyterian Church (USA) : testing the idea of balanced affect

    OpenAIRE

    Francis, Leslie J.; Village, Andrew; Robbins, Mandy; Wulff, Keith

    2011-01-01

    Drawing on the classic model of balanced affect, the Francis Burnout Inventory (FBI) conceptualises good work-related psychological health among clergy in terms of negative affect being balanced by positive affect. In a random sample of 744 clergy (539 clergymen and 205 clergywomen) serving in The Presbyterian Church (USA), negative affect was assessed by the Scale of Emotional Exhaustion in Ministry (SEEM) and positive affect was assessed by the Satisfaction in Ministry Scale (SIMS). At the ...

  16. Gender-related differences in lifestyle may affect health status.

    Science.gov (United States)

    Varì, Rosaria; Scazzocchio, Beatrice; D'Amore, Antonio; Giovannini, Claudio; Gessani, Sandra; Masella, Roberta

    2016-01-01

    Consistent epidemiological and clinical evidence strongly indicates that chronic non-communicable diseases are largely associated with four lifestyle risk factors: inadequate diet, physical inactivity, tobacco use, and excessive alcohol use. Notably, obesity, a worldwide-growing pathological condition determined by the combination between inadequate diet and insufficient physical activity, is now considered a main risk factor for most chronic diseases. Dietary habits and physical activity are strongly influenced by gender attitudes and behaviors that promote different patterns of healthy or unhealthy lifestyles among women and men. Furthermore, different roles and unequal relations between genders strongly interact with differences in social and economic aspects as well as cultural and societal environment. Because of the complex network of factors involved in determining the risk for chronic diseases, it has been promoting a systemic approach that, by integrating sex and gender analysis, explores how sex-specific biological factors and gender-related social factors can interact to influence the health status.

  17. Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship.

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    Green, Michelle; Decourville, Nancy; Sadava, Stanley

    2012-01-01

    Structural equation modeling was used to test a model in which positive affect, negative affect, perceived stress, and social support were hypothesized to mediate the relationship between forgiveness and mental and physical health. Six hundred and twenty-three undergraduates completed a battery of self-report measures. Results of the analyses indicated that the forgiveness-health relation was mediated by positive affect, negative affect, stress, and the interrelationship between negative affect and stress. There was limited support for social support and the interrelationship between positive affect and social support as mediators. The results suggested that the relationship between forgiveness and health is mediated rather than direct. Implications and directions for future research are discussed.

  18. Health, Health Care, and Systems Science: Emerging Paradigm.

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    Janecka, Ivo

    2017-02-15

    our incongruous decisions that are detrimental to health. A biologic system/a human body originates from structural, deterministic genes as well as shared epigenetic memory of our ancestors affecting our bodily function and structure. The political governing systems' vertical hierarchy has control over money and laws, neither of which materially affect individual lifestyle/behavioral choices toward health. Improved health comes from focusing on enhancing the biologic age and not the chronologic one, which simply represents a linear time from a birth certificate to a death certificate and is applicable only in its extremes. "Age-related diseases" are simply reflections of a given culture. Biologic age, reflecting the actual state of health, could be used in all health-related assessments including health-life insurance premiums, licensing of job categories, etc., all with a broader and healthy societal impact.

  19. What Health-Related Functions Are Regulated by the Nervous System?

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    ... What health-related functions are regulated by the nervous system? The nervous system plays a role in nearly every aspect of ... feeling emotions. Functions that are regulated by the nervous system include (but are not limited to): Brain growth ...

  20. Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation

    Directory of Open Access Journals (Sweden)

    Tina Pretnar

    2014-08-01

    Full Text Available Background: Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL, but the presence of systemic diseases can also affect the well-being of an individual.The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP.Methods: 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8 were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images.Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %, followed by a headache (N = 15, 11.5 %, allergies and asthma (n = 13, 10 %, and a rheumatic disease (N = 11, 8.5 %. Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024. The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP, and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104.Conclusions: The total number of remaining teeth in the oral cavity (p = 0.031, the presence of osteoporosis (p = 0.024, and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104. Other systemic diseases (cardiovascular disease, headache, allergies and

  1. Contribution of the Japan International Cooperation Agency health-related projects to health system strengthening.

    Science.gov (United States)

    Yuasa, Motoyuki; Yamaguchi, Yoshie; Imada, Mihoko

    2013-09-22

    The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening. This study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide. We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects' contributions to health system strengthening. The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development. The vast majority (87.6%) of JICA projects addressed public health issues, for example programs to improve maternal and child health, and the prevention and treatment of infectious diseases such as AIDS, tuberculosis and malaria. Nearly 90% of JICA technical healthcare assistance directly focused on improving governance as the most critical means of accomplishing its goals. Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. Nevertheless, our findings suggest that JICA assistance could be used to support financial aspects of healthcare systems, which is an area of increasing concern. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes. This may help policy makers and practitioners focus future projects on priority areas.

  2. Affective health bias in older adults: Considering positive and negative affect in a general health context.

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    Whitehead, Brenda R; Bergeman, C S

    2016-09-01

    Because subjective health reports are a primary source of health information in a number of medical and research-based contexts, much research has been devoted to establishing the extent to which these self-reports of health correspond to health information from more objective sources. One of the key factors considered in this area is trait affect, with most studies emphasizing the impact of negative affect (negative emotions) over positive affect (positive emotions), and focusing on high-arousal affect (e.g., anger, excitement) over moderate- or low-arousal affect (e.g., relaxed, depressed). The present study examines the impact of both Positive and Negative Affect (PA/NA)-measured by items of both high and low arousal-on the correspondence between objective health information and subjective health reports. Another limitation of existing literature in the area is the focus on samples suffering from a particular diagnosis or on specific symptom reports; here, these effects are investigated in a sample of community-dwelling older adults representing a broader spectrum of health. 153 older adults (Mage = 71.2) took surveys assessing Perceived Health and Affect and underwent an objective physical health assessment. Structural equation modeling was used to investigate the extent to which the relationship between Objective Health and Perceived Health was moderated by PA or NA, which would indicate the presence of affective health bias. Results reveal a significant moderation effect for NA, but not for PA; PA appeared to serve a more mediational function, indicating that NA and PA operate on health perceptions in distinct ways. These findings provide evidence that in our high-functioning, community-dwelling sample of older adults, a) affective health bias is present within a general health context, and not only within specific symptom or diagnostic categories; and b) that both PA and NA play important roles in the process. Copyright © 2016 Elsevier Ltd. All rights

  3. Tracking official development assistance for reproductive health in conflict-affected countries.

    Science.gov (United States)

    Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

    2009-06-09

    Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

  4. Tracking official development assistance for reproductive health in conflict-affected countries.

    Directory of Open Access Journals (Sweden)

    Preeti Patel

    2009-06-01

    Full Text Available BACKGROUND: Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA for reproductive health activities in conflict-affected countries from 2003 to 2006. METHODS AND FINDINGS: The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4% was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. CONCLUSIONS: This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

  5. [Public relations in institutions and establishments of the health administration system].

    Science.gov (United States)

    Martynenko, A V

    2002-01-01

    The article is dedicated to development of directions and specific functions of the health system bodies/institutions public relations (PR) activities. Priorities are set forth depending on the form of property thereof. A complex use of approaches toward carrying out of PR activities permits optimizing work both within the system itself and relations with the society as a whole.

  6. Policies and practices related to information system adoption in hospitals owned by Ministries of Health in the Arab Gulf.

    Science.gov (United States)

    Nabali, H M

    1992-07-01

    This is a discussion paper based on the findings from a study of the factors affecting the adoption of computer-based hospital information systems (CBHIS) in the Arabian Gulf. The study involved on-site visits to hospitals in Bahrain, Kingdom of Saudi Arabia, Kuwait, Qatar and the United Arab Emirates as well as visits to ministries of health in these countries. The focus of this paper is on the adoption of CBHIS by ministry of health (MOH) hospitals, in specific, because of the main role that ministries of health play as providers of health care in the Region. Prior to describing CBHIS adoption practices, an overview of the Region in terms of its economic development and its health care delivery systems is presented. Next, the research setting along with the major findings are briefly described followed by a discussion of the advantages and disadvantages of centralized CBHIS adoptions. Finally, management guidelines related to the adoption of CBHIS by multi-hospital institutions are proposed.

  7. Work-related psychological health among clergywomen in Australia

    OpenAIRE

    Robbins, Mandy; Francis, Leslie J.; Powell, Ruth, Ph.D.

    2012-01-01

    Drawing on the classic model of balanced affect, the Francis Burnout Inventory conceptualises good work-related psychological health among clergy in terms of negative affect being balanced by positive affect. This paper sets out to explore the relationship between work-related psychological health and psychological type (as assessed by the Francis Psychological-Type Scales) among a sample of 212 Australian clergywomen who completed the National Church Life Survey Form L in 2006. The data supp...

  8. Exploring Health System Responsiveness in Ambulatory Care and Disease Management and its Relation to Other Dimensions of Health System Performance (RAC) - Study Design and Methodology.

    Science.gov (United States)

    Röttger, Julia; Blümel, Miriam; Engel, Susanne; Grenz-Farenholtz, Brigitte; Fuchs, Sabine; Linder, Roland; Verheyen, Frank; Busse, Reinhard

    2015-05-20

    The responsiveness of a health system is considered to be an intrinsic goal of health systems and an essential aspect in performance assessment. Numerous studies have analysed health system responsiveness and related concepts, especially across different countries and health systems. However, fewer studies have applied the concept for the evaluation of specific healthcare delivery structures and thoroughly analysed its determinants within one country. The aims of this study are to assess the level of perceived health system responsiveness to patients with chronic diseases in ambulatory care in Germany and to analyse the determinants of health system responsiveness as well as its distribution across different population groups. The target population consists of chronically ill people in Germany, with a focus on patients suffering from type 2 diabetes and/or from coronary heart disease (CHD). Data comes from two different sources: (i) cross-sectional survey data from a postal survey and (ii) claims data from a German sickness fund. Data from both sources will be linked at an individual-level. The postal survey has the purpose of measuring perceived health system responsiveness, health related quality of life, experiences with disease management programmes (DMPs) and (subjective) socioeconomic background. The claims data consists of information on (co)morbidities, service utilization, enrolment within a DMP and sociodemographic characteristics, including the type of residential area. RAC is one of the first projects linking survey data on health system responsiveness at individual level with claims data. With this unique database, it will be possible to comprehensively analyse determinants of health system responsiveness and its relation to other aspects of health system performance assessment. The results of the project will allow German health system decision-makers to assess the performance of nonclinical aspects of healthcare delivery and their determinants in two

  9. Co-occurrence of substance use related and mental health problems in the Finnish social and health care system.

    Science.gov (United States)

    Kuussaari, Kristiina; Hirschovits-Gerz, Tanja

    2016-03-01

    Many studies have noted that substance abuse and mental health problems often occur simultaneously. The aim of the work reported here was to study the co-occurrence of mental health problems and problems related to substance use in a sample of clients visiting the Finnish social and health care services for issues related to substance use. We collected background information on the clients and considered the parts of the treatment system in which these clients were treated. Survey data on intoxicant-related cases in the Finnish health care and social services were gathered on a single day in 2011. During the 24 hours of data collection, all intoxicant-related cases were reported and data were obtained for 11,738 intoxicant-related cases. In this analysis we took into account the clients' background variables, mental health variables, information on the treatment type and the main reasons for the client being in treatment. The χ(2) test, Fisher's exact test and binary logistic regression analysis were used. Half of the visiting clients had both substance use related and mental health problems. The strongest factors associated with the co-occurrence of substance use related and mental health problems were female sex, younger age and single marital status. Clients with co-occurring problems were more often treated in the health care services, whereas clients with only substance use related problems were primarily treated in specialized services for the treatment of substance abuse. It is important to identify clients with co-occurring substance use related and mental health problems. In this study, half of the clients presenting to the Finnish social and health care treatment system had both these problems. © 2015 the Nordic Societies of Public Health.

  10. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    Science.gov (United States)

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  11. Affective touch awareness in mental health and disease relates to autistic traits - An explorative neurophysiological investigation.

    Science.gov (United States)

    Croy, Ilona; Geide, Helen; Paulus, Martin; Weidner, Kerstin; Olausson, Håkan

    2016-11-30

    Affective touch is important for social interaction within families and groups and there is evidence that unmyelinated C tactile fibers are involved in this process. Individuals with autism spectrum disorders show alterations in the perception and processing of affective touch. sThus, we hypothesized that affective touch awareness based on C tactile fiber activation is impaired in individuals with high levels of autistic trait. The pleasantness perception of optimal and suboptimal C tactile stimuli was tested in an explorative study in 70 patients recruited from an outpatient psychotherapy clinic and 69 healthy comparison subjects. All participants completed questionnaires about autistic traits, depressive symptomatology, childhood maltreatment, and about the daily amount of touch. Relative to comparison subjects, patients reported engaging in touch less frequently in daily life and rated touch less pleasant. Reduced valence ratings of touch were explained by childhood maltreatment but not by any particular disorder or depression severity. Among all tested variables, the affective touch awareness correlated with autistic traits only - in patients as well as in comparison subjects. Taken together, individuals with mental health issues have a lower baseline of expression and reception of affective touch. Autistic traits and childhood maltreatment modulate the experience of affective touch. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Health-related ad information and health motivation effects on product evaluations

    DEFF Research Database (Denmark)

    Chrysochou, Polymeros; Grunert, Klaus G

    2014-01-01

    This study tests the effect of health-related ad information on perceived product healthfulness and purchase intention. Also, the study investigates whether consumers' health motivation moderates the effects, because of the way health motivation affects processing of health-related information...... in ads. Three types of healthrelated ad elements are distinguished: functional claims, process claims and health imagery. These elements were combined in mock ads and an online experiment was run to test the study hypotheses. Results show that health imagery has the largest impact on consumers' product...

  13. 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.

  14. Comparison of relative and non-relative adoptive parent health status.

    Science.gov (United States)

    Foli, Karen J; Lim, Eunjung; Sands, Laura P

    2015-03-01

    Across the United States, kinship parents, extended family members and close friends, render care to the 2.7 million children who have been removed from their birth parents' care. However, differences between relative and non-relative parents reported health statuses have not been explored. The National Survey of Adoptive Parents data were used to investigate the health status of relative (n = 469) and non-relative (n = 1,599) adoptive parents. Perceived happiness in the parent-child relationship and the parents' ability to cope appear to affect parental health status. Only non-related mothers of children younger than 6 years reported better emotional health than those mothers who were related to their children. With this exception, and despite caring for children who have a greater likelihood of abuse, neglect, and exposure to drugs and alcohol prior to birth, the reported health statuses of relative parents did not differ from non-relative parents. © The Author(s) 2013.

  15. [Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia].

    Science.gov (United States)

    Kim, Jinhee; Na, Hyunjoo

    2017-10-01

    Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia. The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis. Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant. The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia. © 2017 Korean Society of Nursing Science

  16. The Comprehensive Assessment List for Affective Disorders (COALA): a polydiagnostic, comprehensive, and serial semistructured interview system for affective and related disorders.

    Science.gov (United States)

    Furukawa, T; Takahashi, K; Kitamura, T; Okawa, M; Miyaoka, H; Hirai, T; Ueda, H; Sakamoto, K; Miki, K; Fujita, K

    1995-01-01

    This supplement describes the development and structure of the Comprehensive Assessment List of Affective Disorders (COALA) system, which was recently developed for a collaborative follow-up study of a broad spectrum of affective disorders in Japan and which consists of a series of semistructured interviews for affective and related disorders. The COALA distinguishes itself from the extant semistructured interviews by being able to provide polydiagnostic, comprehensive and serial assessments. It is polydiagnostic because it derives diagnoses according to 29 historical and modern diagnostic systems through computer algorithms. It is comprehensive because it not only depicts the symptoms profile and rates their severity according to various endogenicity indices and severity rating scales but also measures, in the psychosocial domain, the life events and their characteristics. In addition, it has sections for past illnesses and family history. It is serial because the system includes follow-up semistructured interviews that can be administered monthly and that monitor changes in the psychopathological and psychosocial features. The theoretical underpinnings of the COALA system, especially its polydiagnostic approach to a broad spectrum of affective disorders and its treatment of psychosocial factors, are discussed in view of recent proposals for the future nosological research. The findings of the interrater reliability study (n = 107) are also presented, with satisfactory to excellent results for almost all of the psychopathological and psychosocial variables, all of the composite severity ratings and most of the polydiagnostic evaluations.

  17. Tracing health system challenges in post-conflict Côte d'Ivoire from 1893 to 2013.

    Science.gov (United States)

    Gaber, Sabrina; Patel, Preeti

    2013-07-01

    While scholarship on health in conflict-affected countries is growing, there has been relatively little analysis of how armed conflict affects health systems in specific African countries, especially former French colonies. There is even less literature on the role of history in shaping health systems and how historical factors such as inequity may influence health impacts of armed conflict. Based on Côte d'Ivoire, this article argues that historical multidisciplinary analysis can provide valuable insight into the macro-level political, economic and social determinants of the health system over time. It explores how armed conflict has affected health services and exacerbates historically inherited challenges to the health system including unequal distribution of health services, bias towards curative care in urban areas, inadequate human resources and weak health governance. In the post-conflict period, this understanding may assist governments and other stakeholders to develop more appropriate health policies that address both urgent and long-term health needs.

  18. Health information systems and pesticide poisoning at Pernambuco.

    Science.gov (United States)

    de Albuquerque, Pedro Costa Cavalcanti; Gurgel, Idê Gomes Dantas; Gurgel, Aline do Monte; Augusto, Lia Giraldo da Silva; de Siqueira, Marília Teixeira

    2015-01-01

    Understanding the epidemiologic profile of a particular disease is key to undertake health actions. To that end, information systems that present quality data help in the decision-making process and demonstrate the impact of the problems. To analyze the contribution of health information systems for the characterization of pesticide poisoning through SINAN, CEATOX and SIM in the State of Pernambuco. In this study, the completeness and consistency of the data were assessed, as well as the epidemiological profile of pesticide poisoning in Pernambuco in the period from 2008 to 2012, based on the following Health Information Systems: Center for Toxicological Assistance of Pernambuco (CEATOX), Notifiable Diseases Information System (SINAN) and Mortality Information System (SIM). The data revealed incompleteness and inconsistencies in information. Regarding the profile, females are more affected in the morbidity profile, and men have a higher mortality rate. Poisoning was more frequent in young adults with low educational level. With regard to the circumstances, most of the cases were suicide attempts, unique acute cases and not related to work. Despite suggesting underreporting, the data showed that persons engaged in agriculture are most commonly affected. The strengthening of these systems is necessary for the generation of consistent information that support health policies for the population groups involved.

  19. A cross-case comparative analysis of international security forces' impacts on health systems in conflict-affected and fragile states.

    Science.gov (United States)

    Bourdeaux, Margaret; Kerry, Vanessa; Haggenmiller, Christian; Nickel, Karlheinz

    2015-01-01

    Destruction of health systems in fragile and conflict-affected states increases civilian mortality. Despite the size, scope, scale and political influence of international security forces intervening in fragile states, little attention has been paid to array of ways they may impact health systems beyond their effects on short-term humanitarian health aid delivery. Using case studies we published on international security forces' impacts on health systems in Haiti, Kosovo, Afghanistan and Libya, we conducted a comparative analysis that examined three questions: What aspects, or building blocks, of health systems did security forces impact across the cases and what was the nature of these impacts? What forums or mechanisms did international security forces use to interact with health system actors? What policies facilitated or hindered security forces from supporting health systems? We found international security forces impacted health system governance, information systems and indigenous health delivery organizations. Positive impacts included bolstering the authority, transparency and capability of health system leadership. Negative impacts included undermining the impartial nature of indigenous health institutions by using health projects to achieve security objectives. Interactions between security and health actors were primarily ad hoc, often to the detriment of health system support efforts. When international security forces were engaged in health system support activities, the most helpful communication and consultative mechanisms to manage their involvement were ones that could address a wide array of problems, were nimble enough to accommodate rapidly changing circumstances, leveraged the power of personal relationships, and were able to address the tensions that arose between security and health system supporting strategies. Policy barriers to international security organizations participating in health system support included lack of mandate, conflicts

  20. Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

    OpenAIRE

    Özhayat, Esben Boeskov

    2013-01-01

    Background The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. Methods OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthe...

  1. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Science.gov (United States)

    2010-07-01

    ... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different agencies...

  2. On the Convergence of Affective and Persuasive Technologies in Computer- Mediated Health-Care Systems

    Directory of Open Access Journals (Sweden)

    Rebeca I. García-Betances

    2015-01-01

    Full Text Available This paper offers a portrayal of how affective computing and persuasive technologies can converge into an effective tool for interfacing biomedical engineering with behavioral sciences and medicine. We describe the characteristics, features, applications, present state of the art, perspectives, and trends of both streams of research. In particular, these streams are analyzed in light of the potential contribution of their convergence for improving computer-mediated health-care systems, by facilitating the modification of patients’ attitudes and behaviors, such as engagement and compliance. We propose a framework for future research in this emerging area, highlighting how key constructs and intervening variables should be considered. Some specific implications and challenges posed by the convergence of these two technologies in health care, such as paradigm change, multimodality, patients’ attitude improvement, and cost reduction, are also briefly addressed and discussed.

  3. The Quality of Online Health-Related Information – an Emergent Consumer Health Issue

    Directory of Open Access Journals (Sweden)

    Nădăşan Valentin

    2016-12-01

    Full Text Available The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.

  4. Perceived health in lung cancer patients: the role of positive and negative affect.

    Science.gov (United States)

    Hirsch, Jameson K; Floyd, Andrea R; Duberstein, Paul R

    2012-03-01

    To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health. A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys. Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated with adaptive social functioning, fewer emotion-based role limitations, and less severe bodily pain. In a full model, positive affect was significantly associated with greater levels of social functioning and general health, over and above the effects of negative affect. Reduction of negative affect is an important therapeutic goal, but the ability to maintain positive affect may result in greater perceived health. Indeed, engagement in behaviors that result in greater state positive affect may, over time, result in dispositional changes and enhancement of quality of life.

  5. Urban-rural disparities in child nutrition-related health outcomes in China: The role of hukou policy.

    Science.gov (United States)

    Liu, Hong; Rizzo, John A; Fang, Hai

    2015-11-23

    Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type. Children with urban hukou have 0.25 (P system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.

  6. Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems.

    Science.gov (United States)

    Bertone, Maria Paola; Falisse, Jean-Benoît; Russo, Giuliano; Witter, Sophie

    2018-01-01

    Performance-based financing (PBF) schemes have been expanding rapidly across low and middle income countries in the past decade, with considerable external financing from multilateral, bilateral and global health initiatives. Many of these countries have been fragile and conflict-affected (FCAS), but while the influence of context is acknowledged to be important to the operation of PBF, there has been little examination of how it affects adoption and implementation of PBF. This article lays out initial hypotheses about how FCAS contexts may influence the adoption, adaption, implementation and health system effects of PBF. These are then interrogated through a review of available grey and published literature (140 documents in total, covering 23 PBF schemes). We find that PBF has been more common in FCAS contexts, which were also more commonly early adopters. Very little explanation of the rationale for its adoption, in particular in relation with the contextual features, is given in programme documents. However, there are a number of factors which could explain this, including the greater role of external actors and donors, a greater openness to institutional reform, and lower levels of trust within the public system and between government and donors, all of which favour more contractual approaches. These suggest that rather than emerging despite fragility, conditions of fragility may favour the rapid emergence of PBF. We also document few emerging adaptations of PBF to humanitarian settings and limited evidence of health system effects which may be contextually driven, but these require more in-depth analysis. Another area meriting more study is the political economy of PBF and its diffusion across contexts.

  7. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

    DEFF Research Database (Denmark)

    Larsen, Ellen Frøsig Moseholm; Rydahl Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio...... diagnosis had the greatest effect on HRQoL around the time of diagnosis. Conclusions Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQo...... in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis...

  8. [Biological exposure-related injuries in workers in a health system of the health service of Galicia, Spain].

    Science.gov (United States)

    Cores Calvo, Juan; Muñiz Saborido, José Ramón; González Iglesias, Marta Clara

    2013-01-01

    The objective of this study was to describe the factors involved in biological exposure-related injuries occurring in worker from a health system in Galicia, Spain. The study was conducted in a health system of the Health Service of Galicia, that included four hospitals and 72 primary care centers, with nearly 6000 workers. The study used occupational injury data available o in the injury registry of the Health Service of Galicia for the year 2011. We identified 194 biohazard-related injuries. Exposures, locations, devices, tasks and causes of these incidents were analysed. The majority of biological exposures occurred through needlestick injuries (82%). The areas where more injuries occurred were in inpatient wards (37%) and operating rooms (25%). The devices most frequently involved were suture needles (15%) and insulin needles (15%). The most frequently recorded causes were lack of training and information, together with lack of biosafety devices. Worker training and information should be promoted along with the implementation of biosafety devices, as the latter measure alone does not seem sufficient to reduce the number of injuries. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  9. How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia.

    Science.gov (United States)

    Witter, Sophie; Wurie, Haja; Chandiwana, Pamela; Namakula, Justine; So, Sovannarith; Alonso-Garbayo, Alvaro; Ssengooba, Freddie; Raven, Joanna

    2017-11-01

    This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied-Uganda, Sierra Leone, Zimbabwe and Cambodia-which were at different distances from conflict and crisis, as well as having unique conflict stories. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research on health worker incentives, we captured insights from 128 life histories and in-depth interviews with a variety of staff that had remained in service. This article aims to draw together lessons from these contexts which can provide lessons for enhancing staff and therefore health system resilience in future, especially in similarly fragile and conflict-affected contexts. We examine the reported effects, both personal and professional, of the three different types of shock (conflicts, epidemics and prolonged political-economic crises), and how staff coped. We find that the impact of shocks and coping strategies are similar between conflict/post-conflict and epidemic contexts-particularly in relation to physical threats and psychosocial threats-while all three contexts create challenges and staff responses for working conditions and remuneration. Health staff showed considerable inventiveness and resilience, and also benefited from external assistance of various kinds, but there are important gaps which point to ways in which they should be better protected and supported in the future. Health systems are increasingly fragile and conflict-prone, and shocks are often prolonged or repeated. Resilience should not be taken for granted or used as an excuse for abandoning frontline health staff. Strategies should be in place at local, national and international levels to prepare for predictable crises of various sorts, rather than waiting for them to occur and responding belatedly, or relying on personal sacrifices by staff to keep

  10. Does Leaders' Health (and Work-Related Experiences) Affect their Evaluation of Followers' Stress?

    Science.gov (United States)

    Giorgi, Gabriele; Mancuso, Serena; Fiz Perez, Francisco Javier; Montani, Francesco; Courcy, Francois; Arcangeli, Giulio

    2015-09-01

    Stressed workers suffer from severe health problems which appear to have increased. Poor leadership is especially considered a source of stress. Indeed, supervisors might perceive their subordinates to be similar to them as far as stress is concerned and this might more widespread in organizations than previously thought. The present research investigates the relationships between leaders' health, in terms of work-related stress, mental health, and workplace bullying and their evaluation of subordinates' stress. Five regression models were formulated to test our hypothesis. This is a cross-sectional study among 261 Italian leaders, using supervisor self-assessment and leaders' assessments of their subordinates. Leaders' health was related to their evaluation of staff stress. Job demand, lack of job control, and lack of support by colleagues and supervisors evaluated in their subordinates were particularly associated with the leaders' own health. Implications for developing healthy leaders are finally discussed.

  11. Neglected Issues Relating to African Health Systems: An Incentive ...

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

    Several issues that affect access to and quality of health care for the poor and ... Conferences will be held at local, district and national levels to share the results of the ... Minister Bibeau announces appointments of IDRC's President and new ...

  12. Governance of Health Systems Comment on “A Network Based Theory of Health Systems and Cycles of Well-Being”

    OpenAIRE

    Blanchet, Karl

    2013-01-01

    Health systems research aims to understand the governance of health systems (i.e. how health systems function and perform and how their actors interact with each other). This can be achieved by applying innovative methodologies and concepts that are going to capture the complexity and dynamics of health systems when they are affected by shocks. The capacity of health systems to adapt to shocks (i.e. the resilience of health systems) is a new area of investigation. Social network analysis is a...

  13. Tracking official development assistance for reproductive health in conflict-affected countries: 2002-2011.

    Science.gov (United States)

    Patel, P; Dahab, M; Tanabe, M; Murphy, A; Ettema, L; Guy, S; Roberts, B

    2016-09-01

    To provide information on trends on official development assistance (ODA) disbursement patterns for reproductive health activities in 18 conflict-affected countries. Secondary data analysis. 18 conflict-affected countries and 36 non-conflict-affected countries. The Creditor Reporting System (CRS) database was analyzed for ODA disbursement for direct and indirect reproductive health activities to 18 conflict-affected countries (2002-2011). A comparative analysis was also made with 36 non-conflict-affected counties in the same 'least-developed' income category. Multivariate regression analyses examined associations between conflict status and reproductive health ODA and between reproductive needs and ODA disbursements. Patterns of ODA disbursements (constant U.S. dollars) for reproductive health activities. The average annual ODA disbursed for reproductive health to 18 conflict-affected countries from 2002 to 2011 was US$ 1.93 per person per year. There was an increase of 298% in ODA for reproductive health activities to the conflict-affected countries between 2002 and 2011; 56% of this increase was due to increases in HIV/AIDS funding. The average annual per capita reproductive health ODA disbursed to least-developed non-conflict-affected countries was 57% higher than to least-developed conflict-affected countries. Regression analyses confirmed disparities in ODA to and between conflict-affected countries. Despite increases in ODA for reproductive health for conflict-affected countries (albeit largely for HIV/AIDS activities), considerable disparities remains. Study tracking 10 years of aid for reproductive aid shows major disparities for conflict-affected countries. © 2016 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  14. Alexithymia Components Are Differentially Related to Explicit Negative Affect But Not Associated with Explicit Positive Affect or Implicit Affectivity.

    Science.gov (United States)

    Suslow, Thomas; Donges, Uta-Susan

    2017-01-01

    Alexithymia represents a multifaceted personality construct defined by difficulties in recognizing and verbalizing emotions and externally oriented thinking. According to clinical observations, experience of negative affects is exacerbated and experience of positive affects is decreased in alexithymia. Findings from research based on self-report indicate that all alexithymia facets are negatively associated with the experience of positive affects, whereas difficulties identifying and describing feelings are related to heightened negative affect. Implicit affectivity, which can be measured using indirect assessment methods, relates to processes of the impulsive system. The aim of the present study was to examine, for the first time, the relations between alexithymia components and implicit and explicit positive and negative affectivity in healthy adults. The 20-item Toronto Alexithymia Scale, the Implicit Positive and Negative Affect Test and the Positive and Negative Affect Schedule (PANAS) were administered to two hundred and forty-one healthy individuals along with measures of depression and trait anxiety. Difficulties identifying feelings were correlated with explicit negative trait affect, depressive mood and trait anxiety. Difficulties describing feelings showed smaller but also significant correlations with depressive mood and trait anxiety but were not correlated with explicit state or trait affect as assessed by the PANAS. Externally oriented thinking was not significantly correlated with any of the implicit and explicit affect measures. According to our findings, an externally oriented, concrete way of thinking appears to be generally unrelated to dispositions to develop positive or negative affects. Difficulties identifying feelings seem to be associated with increased conscious negative affects but not with a heightened disposition to develop negative affects at an automatic response level.

  15. Alexithymia Components Are Differentially Related to Explicit Negative Affect But Not Associated with Explicit Positive Affect or Implicit Affectivity

    Directory of Open Access Journals (Sweden)

    Thomas Suslow

    2017-10-01

    Full Text Available Alexithymia represents a multifaceted personality construct defined by difficulties in recognizing and verbalizing emotions and externally oriented thinking. According to clinical observations, experience of negative affects is exacerbated and experience of positive affects is decreased in alexithymia. Findings from research based on self-report indicate that all alexithymia facets are negatively associated with the experience of positive affects, whereas difficulties identifying and describing feelings are related to heightened negative affect. Implicit affectivity, which can be measured using indirect assessment methods, relates to processes of the impulsive system. The aim of the present study was to examine, for the first time, the relations between alexithymia components and implicit and explicit positive and negative affectivity in healthy adults. The 20-item Toronto Alexithymia Scale, the Implicit Positive and Negative Affect Test and the Positive and Negative Affect Schedule (PANAS were administered to two hundred and forty-one healthy individuals along with measures of depression and trait anxiety. Difficulties identifying feelings were correlated with explicit negative trait affect, depressive mood and trait anxiety. Difficulties describing feelings showed smaller but also significant correlations with depressive mood and trait anxiety but were not correlated with explicit state or trait affect as assessed by the PANAS. Externally oriented thinking was not significantly correlated with any of the implicit and explicit affect measures. According to our findings, an externally oriented, concrete way of thinking appears to be generally unrelated to dispositions to develop positive or negative affects. Difficulties identifying feelings seem to be associated with increased conscious negative affects but not with a heightened disposition to develop negative affects at an automatic response level.

  16. Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System.

    Science.gov (United States)

    Tseng, Phillip; Kaplan, Robert S; Richman, Barak D; Shah, Mahek A; Schulman, Kevin A

    2018-02-20

    Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. This study used time-driven activity-based costing. Interviews were conducted with 27 health system administrators and 34 physicians in 2016 and 2017 to construct a process map charting the path of an insurance claim through the revenue cycle management process. These data were used to calculate the cost for each major billing and insurance-related activity and were aggregated to estimate the health system's total cost of processing an insurance claim. Estimated time required to perform billing and insurance-related activities, based on interviews with management personnel and physicians. Estimated billing and insurance-related costs for 5 types of patient encounters: primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures, and inpatient surgical procedures. Estimated processing time and total costs for billing and insurance-related activities were 13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for a discharged emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgical procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. Of these totals, time and costs for activities carried out by physicians were estimated at a median of 3 minutes or $6.36 for a primary care visit, 3 minutes or $10.97 for an emergency department visit, 5 minutes or $13.29 for a general inpatient stay, 15 minutes or $51.20 for an ambulatory surgical procedure, and 15 minutes or $51.20 for an inpatient surgical procedure. Of

  17. Water Related Health Problems in Central Asia—A Review

    Directory of Open Access Journals (Sweden)

    Zakir Bekturganov

    2016-05-01

    Full Text Available The present paper provides an extensive literature review on water related health issues in Central Asia. Even though the per capita amount of available freshwater is substantial in all Central Asian states the uneven distribution in time and space creates problems for water availability. Due to this, the Central Asian economies are developing under increasing water deficiency. The degradation of water supply systems and sewage treatment plants is often severe leading to potentially high water loss rates and inadequate accessibility to safe water supply. In this context, rural areas are the most affected. Low tariffs in combination with absent metering and low collection rates for water fees mean that operation and maintenance costs for basic services of water supply and sanitation are not covered. Unsafe water supply contains both microbiological and non-microbiological contaminants. Helminthiasis and intestinal protozoa infections are of considerable public health importance in Central Asia. Agricultural and industrial pollution is especially affecting downstream areas of Amu Darya and Syr Darya rivers. In large areas copper, zinc, and chromium concentrations in water exceed maximum permissible concentration. Thus, there is an urgent need to strengthen the environmental monitoring system. Small-scale water supply and sanitation systems need to be developed in line with more efficient public spending on these.

  18. Underutilization of Mental Health Services among College Students: An Examination of System-Related Barriers

    Science.gov (United States)

    Marsh, Carey N.; Wilcoxon, S. Allen

    2015-01-01

    Despite the documented benefits of counseling and mental health services on academic performance and degree attainment, only about 10% of psychologically distressed college students ever seek professional help. This investigation examined mental health care system-related barriers that might distinguish help seekers from nonhelp seekers among…

  19. Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling

    DEFF Research Database (Denmark)

    Vadstrup, Eva S; Frølich, Anne; Perrild, Hans

    2011-01-01

    Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness ...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

  20. When is affect variability bad for health? The association between affect variability and immune response to the influenza vaccination.

    Science.gov (United States)

    Jenkins, Brooke N; Hunter, John F; Cross, Marie P; Acevedo, Amanda M; Pressman, Sarah D

    2018-01-01

    This study addresses methodological and theoretical questions about the association between affect and physical health. Specifically, we examine the role of affect variability and its interaction with mean levels of affect to predict antibody (Ab) levels in response to an influenza vaccination. Participants (N=83) received the vaccination and completed daily diary measures of affect four times a day for 13days. At one and four months post-vaccination, blood was collected from the participants to assess Ab levels. Findings indicate that affect variability and its interaction with mean levels of affect predict an individual's immune response. Those high in mean positive affect (PA) who had more PA variability were more likely to have a lower Ab response in comparison to those who had high mean PA and less PA variability. Although it did not interact with mean negative affect (NA), NA variability on its own was associated with Ab response, whereby those with less NA variability mounted a more robust immune response. Affect variability is related to immune response to an influenza vaccination and, in some cases, interacts with mean levels of affect. These oscillations in affective experiences are critical to consider in order to unpack the intricacies of how affect influences health. These findings suggest that future researchers should consider the important role of affect variability on physical health-relevant outcomes as well as examine the moderating effect of mean affect levels. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. European health systems and the internal market: reshaping ideology?

    Science.gov (United States)

    da Costa Leite Borges, Danielle

    2011-12-01

    Departing from theories of distributive justice and their relation with the distribution of health care within society, especially egalitarianism and libertarianism, this paper aims at demonstrating that the approach taken by the European Court of Justice regarding the application of the Internal Market principles (or the market freedoms) to the field of health care services has introduced new values which are more concerned with a libertarian view of health care. Moreover, the paper also addresses the question of how these new values introduced by the Court may affect common principles of European health systems, such as equity and accessibility.

  2. Do It Yourself solution of Internet of Things Healthcare System: Measuring body parameters and environmental parameters affecting health.

    Directory of Open Access Journals (Sweden)

    Mirjana Maksimović

    2016-03-01

    Full Text Available The rapid advancements in information and communications technologies (ICT and the increasing number of smart things shift an old-fashioned healthcare system to a model better suited for a population of the 21st century. New healthcare approaches based on Internet of Things (IoT/Internet of Medical Things (IoMT powered systems make health monitoring, diagnostics and treatment more personalized, timely and convenient, enabling a global approach to the healthcare system infrastructure development. Commercial systems in this area exist in various forms but usually do not fit the general patient needs, and those that do are usually economically unacceptable due to the high operational and development costs. Do It Yourself (DIY healthcare, including mobile applications and consumer medical devices, nowadays is the top healthcare trend. Therefore, this paper, based on well-known low-cost technologies, presents a DIY IoMT solution for observing human vital parameter as well as environmental factors affecting health.

  3. Absolute and Relative Socioeconomic Health Inequalities across Age Groups

    NARCIS (Netherlands)

    van Zon, Sander K. R.; Bultmann, Ute; de Leon, Carlos F. Mendes; Reijneveld, Sijmen A.

    2015-01-01

    Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of

  4. Recent developments in affective recommender systems

    Science.gov (United States)

    Katarya, Rahul; Verma, Om Prakash

    2016-11-01

    Recommender systems (RSs) are playing a significant role since 1990s as they provide relevant, personalized information to the users over the internet. Lots of work have been done in information filtering, utilization, and application related to RS. However, an important area recently draws our attention which is affective recommender system. Affective recommender system (ARS) is latest trending area of research, as publication in this domain are few and recently published. ARS is associated with human behaviour, human factors, mood, senses, emotions, facial expressions, body gesture and physiological with human-computer interaction (HCI). Due to this assortment and various interests, more explanation is required, as it is in premature phase and growing as compared to other fields. So we have done literature review (LR) in the affective recommender systems by doing classification, incorporate reputed articles published from the year 2003 to February 2016. We include articles which highlight, analyse, and perform a study on affective recommender systems. This article categorizes, synthesizes, and discusses the research and development in ARS. We have classified and managed ARS papers according to different perspectives: research gaps, nature, algorithm or method adopted, datasets, the platform on executed, types of information and evaluation techniques applied. The researchers and professionals will positively support this survey article for understanding the current position, research in affective recommender systems and will guide future trends, opportunity and research focus in ARS.

  5. Does Leaders' Health (and Work-Related Experiences) Affect their Evaluation of Followers' Stress?

    OpenAIRE

    Giorgi, Gabriele; Mancuso, Serena; Fiz Perez, Francisco Javier; Montani, Francesco; Courcy, Francois; Arcangeli, Giulio

    2015-01-01

    Background: Stressed workers suffer from severe health problems which appear to have increased. Poor leadership is especially considered a source of stress. Indeed, supervisors might perceive their subordinates to be similar to them as far as stress is concerned and this might more widespread in organizations than previously thought. Methods: The present research investigates the relationships between leaders' health, in terms of work-related stress, mental health, and workplace bullying a...

  6. Controlled clinical trial of how mobile health applications affect blue-collar men’s physical health as well as thoughts and actions in relation to their own physical health

    DEFF Research Database (Denmark)

    Levisen, Vinie Diana Hvidbak; Castaño, Francisco Mansilla; Jensen, Camilla Skovbjerg

    2017-01-01

    applications affect the level of physical activity amongst blue collar men as well as the frequency of how often they think and do something for their own physical health. Methods: Controlled clinical trial, men, aged 19–62 years, working in industrial companies, who are assigned to an intervention group (n=35.......9 to 68.8 kg (P=0.02); oxygen absorption in the fitness test, from 3.09 to 3.22 L/min (P=0.03); VAS, how often the men do something to improve their own physical health, from 6.00 to 7.00 (P=0.0051). There are improved parameters in the intervention group for resting heart rate (RHR), fitness test, fat......-by-step control increases the physical activity level of blue-collar men as well as how often they think and do something to improve their physical health. Significant improvement is seen in their muscle mass and oxygen uptake as well as in relation to how often they do something to improve their own health....

  7. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    Directory of Open Access Journals (Sweden)

    Odeyemi IA

    2013-03-01

    Full Text Available Isaac AO Odeyemi,1 John Nixon21Senior Director and Head of Health Economics and Outcomes Research, Astellas Pharma UK Ltd, Chertsey, UK; 2Teaching Associate in Health Economics, Department of Economics and Related Studies, University of York, York, UKBackground: Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI. This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity.Methods: A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity.Results: In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system.Conclusion: PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications

  8. Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality

    Science.gov (United States)

    Keller, Abiola; Litzelman, Kristin; Wisk, Lauren E.; Maddox, Torsheika; Cheng, Erika Rose; Creswell, Paul D.; Witt, Whitney P.

    2012-01-01

    Objective This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally-representative sample of U.S. adults. Methods Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to healthcare factors. Results 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.20, 1.71]). Conclusions High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death. PMID:22201278

  9. Personality affects aspects of health-related quality of life in parkinson's disease via psychological coping strategies

    DEFF Research Database (Denmark)

    Whitworth, Stephanie R.; Loftus, Andrea M.; Skinner, Timothy C.

    2013-01-01

    , choice of coping strategy, and their subsequent effect on HRQoL remains unclear. OBJECTIVE: The objective of this study was to examine whether personality (neuroticism and extraversion) indirectly affects HRQoL through the use of specific psychological coping strategies. Methods: One hundred and forty......Background: Personality traits influence health-related quality of life (HRQoL) in Parkinson's disease (PD). Further, an individual's personality traits can influence the strategies they use to cope with a particular stressful situation. However, in PD, the interplay between personality traits...... for gender, age at diagnosis, and age at testing, the emotion-focused coping strategy of escape-avoidance was significantly correlated with neuroticism and certain aspects of HRQoL (cognitive impairment and social support). This suggests that neurotic personality traits may negatively impact on some aspects...

  10. Privacy-related context information for ubiquitous health.

    Science.gov (United States)

    Seppälä, Antto; Nykänen, Pirkko; Ruotsalainen, Pekka

    2014-03-11

    Ubiquitous health has been defined as a dynamic network of interconnected systems. A system is composed of one or more information systems, their stakeholders, and the environment. These systems offer health services to individuals and thus implement ubiquitous computing. Privacy is the key challenge for ubiquitous health because of autonomous processing, rich contextual metadata, lack of predefined trust among participants, and the business objectives. Additionally, regulations and policies of stakeholders may be unknown to the individual. Context-sensitive privacy policies are needed to regulate information processing. Our goal was to analyze privacy-related context information and to define the corresponding components and their properties that support privacy management in ubiquitous health. These properties should describe the privacy issues of information processing. With components and their properties, individuals can define context-aware privacy policies and set their privacy preferences that can change in different information-processing situations. Scenarios and user stories are used to analyze typical activities in ubiquitous health to identify main actors, goals, tasks, and stakeholders. Context arises from an activity and, therefore, we can determine different situations, services, and systems to identify properties for privacy-related context information in information-processing situations. Privacy-related context information components are situation, environment, individual, information technology system, service, and stakeholder. Combining our analyses and previously identified characteristics of ubiquitous health, more detailed properties for the components are defined. Properties define explicitly what context information for different components is needed to create context-aware privacy policies that can control, limit, and constrain information processing. With properties, we can define, for example, how data can be processed or how components

  11. Factors affecting patients' online health information-seeking behaviours: The role of the Patient Health Engagement (PHE) Model.

    Science.gov (United States)

    Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea; Riva, Giuseppe

    2017-10-01

    To identify the variables affecting patients' online health information-seeking behaviours by examining the relationships between patient participation in their healthcare and online health information-seeking behaviours. A cross-sectional survey of Italian chronic patients (N=352) was conducted on patient's online health information-seeking behaviours and patient participation-related variables. Structural equation modeling analysis was conducted to test the hypothesis. This study showed how the healthcare professionals' ability to support chronic patients' autonomy affect patients' participation in their healthcare and patient's online health information-seeking behaviours. However, results do not confirm that the frequency of patients' online health-information seeking behavior has an impact on their adherence to medical prescriptions. Assuming a psychosocial perspective, we have discussed how patients' engagement - conceived as the level of their emotional elaboration of the health condition - affects the patients' ability to search for and manage online health information. To improve the effectiveness of patients' online health information-seeking behaviours and to enhance the effectiveness of technological interventions in this field, healthcare providers should target assessing and improving patient engagement and patient empowerment in their healthcare. It is important that health professionals acknowledge patients' online health information-seeking behaviours that they discuss the information offered by patients and guide them to reliable and accurate web sources. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Developing an Extended Model of the Relation between Work Motivation and Health as Affected by the Work Ability as Part of a Corporate Age Management Approach.

    Science.gov (United States)

    Feißel, Annemarie; Peter, Richard; Swart, Enno; March, Stefanie

    2018-04-17

    Due to demographic changes, the employee structure in companies is changing dramatically. It will be necessary to offer employees suitable, age-adequate jobs. As one of its foremost goals, optimized business management strategies must create conditions for guaranteeing a person’s health, work ability, and work motivation. In the context of corporate age management concepts, the literature recommends to retain and integrate older employees in the organization. This paper aims at developing an extended model of the relation between work motivation and health as affected by work ability and at deriving a host of measures that enterprises can apply as part of a corporate age management policy to counteract the impact of demographic changes. The model also takes into consideration factors influencing the relation between work motivation and health as affected by work ability (socio-demographic parameters, occupation, work-related stress). Additionally, the extended model translates the literature-based results into a corporate setting by way of a corporate age management program. The model comprises a process focusing on retaining and promoting work ability in order to maintain or boost work motivation and health. The host of measures presented serves as a basis to preventively counter demographic change on an individual, interpersonal, and structural level.

  13. Developing an Extended Model of the Relation between Work Motivation and Health as Affected by the Work Ability as Part of a Corporate Age Management Approach

    Science.gov (United States)

    Feißel, Annemarie; Peter, Richard; Swart, Enno

    2018-01-01

    Due to demographic changes, the employee structure in companies is changing dramatically. It will be necessary to offer employees suitable, age-adequate jobs. As one of its foremost goals, optimized business management strategies must create conditions for guaranteeing a person’s health, work ability, and work motivation. In the context of corporate age management concepts, the literature recommends to retain and integrate older employees in the organization. This paper aims at developing an extended model of the relation between work motivation and health as affected by work ability and at deriving a host of measures that enterprises can apply as part of a corporate age management policy to counteract the impact of demographic changes. The model also takes into consideration factors influencing the relation between work motivation and health as affected by work ability (socio-demographic parameters, occupation, work-related stress). Additionally, the extended model translates the literature-based results into a corporate setting by way of a corporate age management program. The model comprises a process focusing on retaining and promoting work ability in order to maintain or boost work motivation and health. The host of measures presented serves as a basis to preventively counter demographic change on an individual, interpersonal, and structural level. PMID:29673218

  14. Developing an Extended Model of the Relation between Work Motivation and Health as Affected by the Work Ability as Part of a Corporate Age Management Approach

    Directory of Open Access Journals (Sweden)

    Annemarie Feißel

    2018-04-01

    Full Text Available Due to demographic changes, the employee structure in companies is changing dramatically. It will be necessary to offer employees suitable, age-adequate jobs. As one of its foremost goals, optimized business management strategies must create conditions for guaranteeing a person’s health, work ability, and work motivation. In the context of corporate age management concepts, the literature recommends to retain and integrate older employees in the organization. This paper aims at developing an extended model of the relation between work motivation and health as affected by work ability and at deriving a host of measures that enterprises can apply as part of a corporate age management policy to counteract the impact of demographic changes. The model also takes into consideration factors influencing the relation between work motivation and health as affected by work ability (socio-demographic parameters, occupation, work-related stress. Additionally, the extended model translates the literature-based results into a corporate setting by way of a corporate age management program. The model comprises a process focusing on retaining and promoting work ability in order to maintain or boost work motivation and health. The host of measures presented serves as a basis to preventively counter demographic change on an individual, interpersonal, and structural level.

  15. Factors Affecting Health Related Quality of Life in Hospitalized Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Georgia Audi

    2017-01-01

    Full Text Available This study identified factors affecting health related quality of life (HRQOL in 300 hospitalized patients with heart failure (HF. Data were collected by the completion of a questionnaire which included patients’ characteristics and the Minnesota Living with Heart Failure Questionnaire (MLHFQ. Analysis of data showed that the median of the total score of MLHFQ was 46 and the median of the physical and mental state was 22 and 6, respectively. Also, participants who were householders or had “other” professions had lower score of 17 points and therefore better quality of life compared to patients who were civil/private employees (p<0.001 and p<0.001, resp.. Patients not receiving anxiolytics and antidepressants had lower quality of life scores of 6 and 15.5 points, respectively, compared to patients who received (p=0.003 and p<0.001, resp.. Patients with no prior hospitalization had lower score of 7 points compared to those with prior hospitalization (p=0.002, whereas patients not retired due to the disease had higher score of 7 points (p=0.034. Similar results were observed for the physical and mental state. Improvement of HF patients’ quality of life should come to the forefront of clinical practice.

  16. Appearance-based rejection sensitivity: implications for mental and physical health, affect, and motivation.

    Science.gov (United States)

    Park, Lora E

    2007-04-01

    Appearance-Based Rejection Sensitivity (Appearance-RS) is a personality-processing system characterized by anxious concerns and expectations about being rejected based on one's physical attractiveness. People differ in their sensitivity to rejection based on appearance, with consequences for mental and physical health, self-esteem, affect, and feelings of belonging. Study 1 describes the development and validation of the Appearance-RS scale, its relation to personality variables and to health-related outcomes. Study 2 provides experimental evidence that high Appearance-RS people feel more alone and rejected when asked to think about negative aspects of their appearance. Finally, Study 3 tests ways to reduce the negative effects of receiving an appearance threat among high Appearance-RS participants. Specifically, high Appearance-RS participants who engaged in self-affirmation (thought of their personal strengths) or received a secure attachment prime (thought of a close, caring relationship) were buffered from the negative effects of an appearance threat on subsequent state self-esteem and mood.

  17. Mental health in war-affected populations

    NARCIS (Netherlands)

    Scholte, W.F.

    2013-01-01

    This book addresses mental health problems in populations in nonwestern war-affected regions, and methods to mitigate these problems through interventions focusing on social reintegration. It describes a number of studies among war-affected populations in widely different areas: refugees from the

  18. Contemporary paradigms for research related to women's mental health.

    Science.gov (United States)

    Doucet, Shelley Anne; Letourneau, Nicole Lyn; Stoppard, Janet M

    2010-04-01

    Mental health problems are serious health concerns that affect women across diverse settings internationally. Knowledge of this population historically has been informed by research using a positivist approach. This article is a critical examination of contemporary paradigms for research related to women's mental health. We begin the article with an introduction to women's mental health, followed by an overview of the postpositivist, critical theory, and constructivist paradigms. We then present a critical examination of the benefits and limitations of these paradigms in relation to the study of women's mental health. We conclude with implications for research and practice.

  19. Privacy-Related Context Information for Ubiquitous Health

    Science.gov (United States)

    Nykänen, Pirkko; Ruotsalainen, Pekka

    2014-01-01

    Background Ubiquitous health has been defined as a dynamic network of interconnected systems. A system is composed of one or more information systems, their stakeholders, and the environment. These systems offer health services to individuals and thus implement ubiquitous computing. Privacy is the key challenge for ubiquitous health because of autonomous processing, rich contextual metadata, lack of predefined trust among participants, and the business objectives. Additionally, regulations and policies of stakeholders may be unknown to the individual. Context-sensitive privacy policies are needed to regulate information processing. Objective Our goal was to analyze privacy-related context information and to define the corresponding components and their properties that support privacy management in ubiquitous health. These properties should describe the privacy issues of information processing. With components and their properties, individuals can define context-aware privacy policies and set their privacy preferences that can change in different information-processing situations. Methods Scenarios and user stories are used to analyze typical activities in ubiquitous health to identify main actors, goals, tasks, and stakeholders. Context arises from an activity and, therefore, we can determine different situations, services, and systems to identify properties for privacy-related context information in information-processing situations. Results Privacy-related context information components are situation, environment, individual, information technology system, service, and stakeholder. Combining our analyses and previously identified characteristics of ubiquitous health, more detailed properties for the components are defined. Properties define explicitly what context information for different components is needed to create context-aware privacy policies that can control, limit, and constrain information processing. With properties, we can define, for example, how

  20. Pediatric health-related quality of life: a structural equation modeling approach.

    Directory of Open Access Journals (Sweden)

    Ester Villalonga-Olives

    Full Text Available OBJECTIVES: One of the most referenced theoretical frameworks to measure Health Related Quality of Life (HRQoL is the Wilson and Cleary framework. With some adaptions this framework has been validated in the adult population, but has not been tested in pediatric populations. Our goal was to empirically investigate it in children. METHODS: The contributory factors to Health Related Quality of Life that we included were symptom status (presence of chronic disease or hospitalizations, functional status (developmental status, developmental aspects of the individual (social-emotional behavior, and characteristics of the social environment (socioeconomic status and area of education. Structural equation modeling was used to assess the measurement structure of the model in 214 German children (3-5 years old participating in a follow-up study that investigates pediatric health outcomes. RESULTS: Model fit was χ2 = 5.5; df = 6; p = 0.48; SRMR  = 0.01. The variance explained of Health Related Quality of Life was 15%. Health Related Quality of Life was affected by the area education (i.e. where kindergartens were located and development status. Developmental status was affected by the area of education, socioeconomic status and individual behavior. Symptoms did not affect the model. CONCLUSIONS: The goodness of fit and the overall variance explained were good. However, the results between children' and adults' tests differed and denote a conceptual gap between adult and children measures. Indeed, there is a lot of variety in pediatric Health Related Quality of Life measures, which represents a lack of a common definition of pediatric Health Related Quality of Life. We recommend that researchers invest time in the development of pediatric Health Related Quality of Life theory and theory based evaluations.

  1. The Effects of Daily Co-Occurrence of Affect on Older Adults’ Reactivity to Health Stressors

    Science.gov (United States)

    Ramsey, Jennifer L.; Neupert, Shevaun D.; Mroczek, Daniel K.; Spiro, Avron

    2015-01-01

    Objectives The present study examined age differences among older adults in the daily co-occurrence of affect and its potential role in buffering the negative effects of health stressors. Design Participants were from the Veterans Affairs Normative Aging Study (NAS) and included 249 young-old adults (age = 60–79 years, M=71.6) and 64 old-old adults (age = 80–89, M = 82.9) who completed questionnaires assessing stressors, physical health symptoms, and positive and negative affect on eight consecutive days. Results An independent samples t-test showed young-old and old-old adults did not significantly differ in their mean levels of daily co-occurrence of affect. The between-person relationships among stressors, health, and daily co-occurrence of affect revealed that neither stressors nor health were significantly related to daily co-occurrence of affect. However, results from a multilevel model revealed a three-way cross-level interaction (Health Stressor X Age Group X Co-Occurrence of Affect) where old-old adults with higher levels of co-occurrence of affect were less emotionally reactive to health stressors than young-old adults. Conclusion These findings provide support for the assertion that co-occurrence of affect functions in an adaptive capacity and highlight the importance of examining domain specific stressors. PMID:26518259

  2. The effects of daily co-occurrence of affect on older adults' reactivity to health stressors.

    Science.gov (United States)

    Ramsey, Jennifer L; Neupert, Shevaun D; Mroczek, Daniel K; Spiro, Avron

    2016-01-01

    The present study examined age differences among older adults in the daily co-occurrence of affect and its potential role in buffering the negative effects of health stressors. Participants were from the Veterans Affairs Normative Aging Study and included 249 young-old adults (age = 60-79 years, M = 71.6) and 64 old-old adults (age = 80-89, M = 82.9) who completed questionnaires assessing stressors, physical health symptoms, and positive and negative affect for eight consecutive days. An independent samples t-test showed young-old and old-old adults did not significantly differ in their mean levels of daily co-occurrence of affect. The between-person relationships among stressors, health and daily co-occurrence of affect revealed that neither stressors nor health were significantly related to daily co-occurrence of affect. However, results from a multilevel model revealed a three-way cross-level interaction (health stressor × age group × co-occurrence of affect) where old-old adults with higher levels of co-occurrence of affect were less emotionally reactive to health stressors than young-old adults. These findings provide support for the assertion that co-occurrence of affect functions in an adaptive capacity and highlight the importance of examining domain-specific stressors.

  3. The importance of gender analysis in research for health systems strengthening.

    Science.gov (United States)

    Theobald, Sally; Morgan, Rosemary; Hawkins, Kate; Ssali, Sarah; George, Asha; Molyneux, Sassy

    2017-12-01

    This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening. The findings from these papers collectively show how gender intersects with other axes of inequity within specific contexts to shape experiences of health and health seeking within households, communities and health systems; illustrate how gender power relations affect access to important resources; and demonstrate that gender norms, poverty and patriarchy interplay to limit women's choices and chances both within household interactions and within the health sector. Health systems researchers have a responsibility to promote the incorporation of gender analyses into their studies in order to inform more strategic, effective and equitable health systems interventions, programmes, and policies. Responding to gender inequitable systems, institutions, and services in this sector requires an 'all hands-on deck' approach. We cannot claim to take a 'people-centred approach' to health systems if the status quo continues. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  4. Hawaii's public mental health system.

    Science.gov (United States)

    VanderVoort, Debra J

    2005-03-01

    The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

  5. NHRIC (National Health Related Items Code)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Related Items Code (NHRIC) is a system for identification and numbering of marketed device packages that is compatible with other numbering...

  6. Mental health and psychosocial wellbeing of Syrians affected by armed conflict.

    Science.gov (United States)

    Hassan, G; Ventevogel, P; Jefee-Bahloul, H; Barkil-Oteo, A; Kirmayer, L J

    2016-04-01

    This paper is based on a report commissioned by the United Nations High Commissioner for Refugees, which aims to provide information on cultural aspects of mental health and psychosocial wellbeing relevant to care and support for Syrians affected by the crisis. This paper aims to inform mental health and psychosocial support (MHPSS) staff of the mental health and psychosocial wellbeing issues facing Syrians who are internally displaced and Syrian refugees. We conducted a systematic literature search designed to capture clinical, social science and general literature examining the mental health of the Syrian population. The main medical, psychological and social sciences databases (e.g. Medline, PubMed, PsycInfo) were searched (until July 2015) in Arabic, English and French language sources. This search was supplemented with web-based searches in Arabic, English and French media, and in assessment reports and evaluations, by nongovernmental organisations, intergovernmental organisations and agencies of the United Nations. This search strategy should not be taken as a comprehensive review of all issues related to MHPSS of Syrians as some unpublished reports and evaluations were not reviewed. Conflict affected Syrians may experience a wide range of mental health problems including (1) exacerbations of pre-existing mental disorders; (2) new problems caused by conflict related violence, displacement and multiple losses; as well as (3) issues related to adaptation to the post-emergency context, for example living conditions in the countries of refuge. Some populations are particularly vulnerable such as men and women survivors of sexual or gender based violence, children who have experienced violence and exploitation and Syrians who are lesbian, gay, bisexual, transgender or intersex. Several factors influence access to MHPSS services including language barriers, stigma associated with seeking mental health care and the power dynamics of the helping relationship. Trust

  7. Loss of job-related right to healthcare associated with employment turnover: challenges for the Mexican health system.

    Science.gov (United States)

    Guerra, Germán; Gutiérrez-Calderón, Emilio; Salgado de Snyder, Nelly; Borja-Aburto, Víctor Hugo; Martínez-Valle, Adolfo; González-Block, Miguel Ángel

    2018-06-15

    The Mexican health system segments access and right to healthcare according to worker position in the labour market. In this contribution we analyse how access and continuity of healthcare gets interrupted by employment turnover in the labour market, including its formal and informal sectors, as experienced by affiliates to the Mexican Institute of Social Security (IMSS) at national level, and of workers with type 2 diabetes (T2DM) in Mexico City. Using data from the National Employment and Occupation Survey, 2014, and from IMSS electronic medical records for workers in Mexico City, we estimated annual employment turnover rates to measure the loss of healthcare access due to labour market dynamics. We fitted a binary logistic regression model to analyse the association between sociodemographic variables and employment turnover. Lastly we analysed job-related access to health care in relation to employment turnover events. At national level, 38.3% of IMSS affiliates experienced employment turnover at least once, thus losing the right to access to healthcare. The turnover rate for T2DM patients was 22.5%. Employment turnover was more frequent at ages 20-39 (38.6% national level; 28% T2DM) and among the elderly (62.4% national level; 26% T2DM). At the national level, higher educational levels (upper-middle, OR = 0.761; upper, OR = 0.835) and income (5 minimum wages or more, OR = 0.726) were associated with lower turnover. Being single and younger were associated with higher turnover (OR = 1.413). T2DM patients aged 40-59 (OR = 0.655) and with 5 minimum wages or more (OR = 0.401) experienced less turnover. Being a T2DM male patient increased the risk of experiencing turnover (OR = 1.166). Up to 89% of workers losing IMSS affiliation and moving on to other jobs failed to gain job-related access to health services. Only 9% gained access to the federal workers social security institute (ISSSTE). Turnover across labour market sectors is

  8. Perceived relevance and foods with health-related claims

    DEFF Research Database (Denmark)

    Dean, M.; Lampila, P.; Shepherd, R.

    2012-01-01

    consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims...... affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed...... risk reduction with detailed information about function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utility of all claims, regardless of whether they were health or nutrition claims. However, to be influenced...

  9. Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov

    2013-01-01

    (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthesis (RDP). The minimally important difference (MID), effect size (ES), and standard error......Background: The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. Methods: OHRQoL was measured by the Oral Health Impact Profile 49......L regardless of level of NA and self-esteem. High NA is associated with a large effect, but both high NA and low self-esteem is associated with poorer OHRQoL both before and after treatment....

  10. Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

    Science.gov (United States)

    Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

    2015-10-29

    Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (PTwitter were found to be false based on expert

  11. Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale.

    Science.gov (United States)

    MacGregor, Hayley; Bloom, Gerald

    2016-12-01

    This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where 'country ownership' of HSR is relatively well established and where there is significant involvement of local researchers and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

  12. [Health related quality of life among patients with type 2 diabetes mellitus].

    Science.gov (United States)

    Urzúa M, Alfonso; Chirino, Alejandra; Valladares, Geraldine

    2011-03-01

    Type 2 diabetes mellitus may affect profoundly the quality of life of patients. To assess health related quality of life among patients with Type 2 Diabetes Mellitus. The Diabetes Quality of Life (DQOL) questionnaire was applied to 296 patients with diabetes mellitus aged 63 ± lO years (201 women) seen in primary health care centers. The concern about the future effects of diabetes was the worst evaluated domain. Women perceived a lower health related quality of life than men. There was an inverse correlation between age and satisfaction with treatment, concern about vocational, social and future effects of the disease. Type 2 diabetes affects health related quality of life, especially in some specific domains such as perception of the future.

  13. Attribute framing affects the perceived fairness of health care allocation principles

    Directory of Open Access Journals (Sweden)

    Eyal Gamliel

    2010-02-01

    Full Text Available Health care resource allocation is a central moral issue in health policy, and opinions about it have been studied extensively. Allocation situations have typically been described and presented in a positive manner (i.e., who should receive medical aid. On the other hand, the negative valence allocation situation (i.e., who should not receive medical aid has been relatively neglected. This paper demonstrates how positive versus negative framing of the exact same health care resource allocation situation can affect the perceived fairness of allocation principles. Participants usually perceived non-egalitarian principles (i.e., need, equity and tenure to be fairer in positively framed situations (i.e., to deliver health care resources to certain patients than negatively framed situation (i.e., not to deliver health care resources to other patients. However, framing did not affect the perceived fairness of the equality principle (i.e., a random draw. The paper offers a theoretical explanation for the effect of framing on the perceived fairness of heath care resource allocation and discusses implications for both researchers and policy makers.

  14. Affective disorders and Health-Related Quality of Life (HRQoL) in adolescents and young adults with Multiple Sclerosis (MS): the moderating role of resilience.

    Science.gov (United States)

    Rainone, Nunzia; Chiodi, Alessandro; Lanzillo, Roberta; Magri, Valeria; Napolitano, Anna; Morra, Vincenzo Brescia; Valerio, Paolo; Freda, Maria Francesca

    2017-03-01

    To investigate the moderating role of resilience in the relationship between affective disorders and Health-Related Quality of Life (HRQoL) for adolescents and young adults with multiple sclerosis (MS). A quantitative methodology was adopted. Fifty-three adolescents and young adults were interviewed to assess resilience as a personality trait (Ego-Resiliency Scale) and resilience as an interactive competence (CYRM-28), Health-Related Quality of Life (PedsQL 4.0), depression and anxiety (BDI-II and STAI-Y). Affective disorders, both depression (β = -.38, p moderating role of resilience competence using individual resources on the relationship between the Depression Cognitive Factor and Emotional Functioning. Data show that in step 2 of the regression analysis, we obtained a variation of β = -.45 (p moderating effect of resilience was significant regarding the increase in R 2 (p moderates the relationship between the Depression Cognitive Factor and Emotional Functioning in adolescents with MS. Our study suggests that to improve well-being for adolescents with MS resilience could play a key role.

  15. Oral health-related quality of life among Belgrade adolescents

    Directory of Open Access Journals (Sweden)

    Gajić Milica

    2018-01-01

    Full Text Available Background/Aim. Adolescents are vulnerable group in term of acquisition of oral health-related knowledge, habits and attitudes. That is why the aim of this study was to investigate the associations between dental status, dental anxiety and oral health-related behavior and oral healthrelated quality of life as captured by Oral Impacts on Daily Performances (OIDP index. Methods. This crosssectional survey included representative sample of 404 adolescents (15 years old, randomly recruited from high schools in Belgrade, Serbia. The adolescents were interviewed using Serbian versions of eight-item OIDP index, Hiroshima University Dental Behavior Inventory (HUDBI and modified Corah’s Dental Anxiety Scale (MDAS. Three previously trained and calibrated dentists examined the subjects in the classrooms to determine the oral health status of adolescents [the Decayed, missing, filled teeth (DMFT index and visual signs of gingivitis]. Results. At least one oral impact was reported in 49.50% of adolescents. Most frequently, oral health problems affected eating (26.73%, tooth cleaning (27.47% and sleep and relaxation (16.83%. In comparison with adolescents without oral impacts, the adolescents with at least one oral impact reported, had higher DMFT score, more often reported problems with bleeding gums, usage of hard toothbrush, worries about the color of their teeth and seeing the dentist because of the symptoms. Logistic regression showed that dental anxiety (MDAS score, dental behavior (HUDBI score and worrying about the color of the teeth significantly affected OIDP score. Conclusion. Oral healthrelated quality of life among adolescents was affected by their behavior and dental anxiety levels. Implementing public health policies that target adolescents with poor oral health or bad habits might be helpful in improving their oral health-related quality of life.

  16. Insufficient DNA methylation affects healthy aging and promotes age-related health problems.

    Science.gov (United States)

    Liu, Liang; van Groen, Thomas; Kadish, Inga; Li, Yuanyuan; Wang, Deli; James, Smitha R; Karpf, Adam R; Tollefsbol, Trygve O

    2011-08-01

    DNA methylation plays an integral role in development and aging through epigenetic regulation of genome function. DNA methyltransferase 1 (Dnmt1) is the most prevalent DNA methyltransferase that maintains genomic methylation stability. To further elucidate the function of Dnmt1 in aging and age-related diseases, we exploited the Dnmt1+/- mouse model to investigate how Dnmt1 haploinsufficiency impacts the aging process by assessing the changes of several major aging phenotypes. We confirmed that Dnmt1 haploinsufficiency indeed decreases DNA methylation as a result of reduced Dnmt1 expression. To assess the effect of Dnmt1 haploinsufficiency on general body composition, we performed dual-energy X-ray absorptiometry analysis and showed that reduced Dnmt1 activity decreased bone mineral density and body weight, but with no significant impact on mortality or body fat content. Using behavioral tests, we demonstrated that Dnmt1 haploinsufficiency impairs learning and memory functions in an age-dependent manner. Taken together, our findings point to the interesting likelihood that reduced genomic methylation activity adversely affects the healthy aging process without altering survival and mortality. Our studies demonstrated that cognitive functions of the central nervous system are modulated by Dnmt1 activity and genomic methylation, highlighting the significance of the original epigenetic hypothesis underlying memory coding and function.

  17. Disability and health-related rehabilitation in international disaster relief

    Science.gov (United States)

    Reinhardt, Jan D.; Li, Jianan; Gosney, James; Rathore, Farooq A.; Haig, Andrew J.; Marx, Michael; Delisa, Joel A.

    2011-01-01

    Background Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. Objectives To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. Design Qualitative literature review and secondary data analysis. Results Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested. Conclusion Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related

  18. Relational self-esteem, psychological well-being, and social support in children affected by HIV.

    Science.gov (United States)

    Du, Hongfei; Li, Xiaoming; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2015-12-01

    Self-esteem can be derived from the relationships with significant others (relational self-esteem). However, it is unclear what the importance of relational self-esteem is for mental health and whether social support from others promotes relational self-esteem. The aim of this study was to examine the relationship between relational self-esteem and a multitude of indicators of psychological well-being among children affected by HIV. We also examined how social support from others would affect relational self-esteem. Results indicated that relational self-esteem was positively associated with psychological well-being. Support from significant others rather than others predicted increased relational self-esteem. Implications and directions for future research are discussed. © The Author(s) 2014.

  19. Building health research systems to achieve better health

    Directory of Open Access Journals (Sweden)

    González Block Miguel

    2006-11-01

    Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

  20. Soil Resources Area Affects Herbivore Health

    Directory of Open Access Journals (Sweden)

    Chad M. Dacus

    2011-06-01

    Full Text Available Soil productivity effects nutritive quality of food plants, growth of humans and animals, and reproductive health of domestic animals. Game-range surveys sometimes poorly explained variations in wildlife populations, but classification of survey data by major soil types improved effectiveness. Our study evaluates possible health effects of lower condition and reproductive rates for wild populations of Odocoileus virginianus Zimmerman (white-tailed deer in some physiographic regions of Mississippi. We analyzed condition and reproductive data for 2400 female deer from the Mississippi Department of Wildlife, Fisheries, and Parks herd health evaluations from 1991–1998. We evaluated age, body mass (Mass, kidney mass, kidney fat mass, number of corpora lutea (CL and fetuses, as well as fetal ages. Region affected kidney fat index (KFI, which is a body condition index, and numbers of fetuses of adults (P ≤ 0.001. Region affected numbers of CL of adults (P ≤ 0.002. Mass and conception date (CD were affected (P ≤ 0.001 by region which interacted significantly with age for Mass (P ≤ 0.001 and CD (P < 0.04. Soil region appears to be a major factor influencing physical characteristics of female deer.

  1. Substantiation of health related power lifting training methodic for univeristies students with muscular skeletal apparatuse affections.

    Directory of Open Access Journals (Sweden)

    San. Zhen Qiang

    2015-11-01

    Full Text Available Purpose: substantiation of health related power lifting training methodic for universities students, who have disorders of muscular skeletal apparatus. Material: in experimental researches 126 students of 18-24 years’ age, having disorders of muscular skeletal apparatus, participated. With the help of testing we registered changes of students’ functional, physical and psycho-physiological fitness indicators. Results: optimal correlation of specific and non specific loads was found: 60% of specific and 40% of non specific. It is recommended to follow certain correlation of exercises in easy and complicated conditions: for first year students - 3:2; for second year students - 3:2; for third year - 2:3; for forth year - 2:3; for fifth year students - 1:3. Specific only for power lifting conditions and temps of students’ (with muscular skeletal apparatus affections functional, physical and psycho-physiological fitness improvement were determined. Conclusions: The requirements of the training methodic envisage correction of loads for bringing every indicator on proper level.

  2. Comprehensively Measuring Health-Related Subjective Well-Being: Dimensionality Analysis for Improved Outcome Assessment in Health Economics.

    Science.gov (United States)

    de Vries, Marieke; Emons, Wilco H M; Plantinga, Arnoud; Pietersma, Suzanne; van den Hout, Wilbert B; Stiggelbout, Anne M; van den Akker-van Marle, M Elske

    2016-01-01

    Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions. To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure. We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors. Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments. We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bahia Luciana

    2012-06-01

    Full Text Available Abstract Background Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS. Methods Population attributable risk (PAR was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR ≥ 1.20 or RR ≥1.10 and  Results The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity. Conclusion The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.

  4. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Science.gov (United States)

    Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

    2015-01-01

    Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p

  5. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    Science.gov (United States)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  6. Influence of self-esteem and negative affectivity on oral health related quality of life in patients with partial tooth loss

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov

    2013-01-01

    NA would be associated with worse OHRQoL.Methods: OHRQoL measured by the Oral Health Impact Profile 49 (OHIP-49), self-esteem measured by the Rosenberg Self-Esteem Scale (RSES), NA measured by the Eysenck Personality Inventory Questionnaire (EPI-Q), global oral rating of oral comfort and controlling......To meaningfully interpret oral health-related quality of life (OHRQoL) measures, the influence of personality traits must be investigated. Objectives:To investigate and quantify the influence of self-esteem and negative affectivity (NA) on OHRQoL. It was hypothesized that low self-esteem and high...... and clinically significantly higher and self-esteem was statistically significantly lower in patients reporting worse oral comfort. Conclusion: NA had the strongest and most clinically meaningful influence, but both NA and self-esteem was found to influence OHRQoL; low self-esteem and high NA was associated...

  7. Theory of constraints for publicly funded health systems.

    Science.gov (United States)

    Sadat, Somayeh; Carter, Michael W; Golden, Brian

    2013-03-01

    Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.

  8. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-10-01

    Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

  9. Household characteristics affecting drinking water quality and human health

    International Nuclear Information System (INIS)

    Kausar, S.; Maann, A.A.; Zafar, I.; Ali, T.

    2009-01-01

    Pakistan's water crisis, especially serious water shortages have had a great impact on the health of the general population. Today majority of Pakistanis have no access to improved water sources which force people to consume polluted drinking water that results in the shape of waterborne diseases. In addition to this, household characteristics, includes mother's education and family income, also have an impact on drinking water quality and ultimately on human health. This study was conducted in three districts of Province Punjab both in urban and rural areas. The sample size of this study was 600 females of age group 20-60 years. From the data, it was concluded that mother's education and family income were affecting drinking water quality and human health. As the mother's years of education increased, the health issues decreased. Similarly, as the level of income increased, people suffered from water related diseases decreased. (author)

  10. Institutional analysis of health system governance.

    Science.gov (United States)

    Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

    2017-11-01

    It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system

  11. Shift work-related health problems in

    Directory of Open Access Journals (Sweden)

    S. Khavaji

    2010-04-01

    Full Text Available Background and aimsShift work is a major feature of working life that affects diverse aspects of human life. The main purposes of this study were to investigate shift work-related health problems and their risk factors among workers of "12-hour shift" schedule.MethodsThis cross-sectional study was carried out at 8 petrochemical industries in Asalooyeh area. Study population consisted of 1203 workers including 549 shift worker (46% and 654 day worker (54%. Data on personal details, shift schedule and adverse effects of shift work werecollected by anonymous questionnaire. Statistical analyses were performed using SPSS, version 11.5. The level of significance was set at 5%.ResultsAlthough, the results showed that health problems among shift workers was more prevalent than day workers, but the differences were just significant in gastrointestinal and musculoskeletal disorders (p<0.05. Multiple linear regressions indicated that in addition to shift working, other variants such as long work hours, type of employment, second job, number of children and job title were associated with health problems.ConclusionPrevalence rates of gastrointestinal and musculoskeletal problems among shift workers were significantly higher than that of day workers. Although, working in shift system was the main significant factor associated with the reported problems, but other demographic andwork variables were also found to have association.

  12. Factors associated with health-related quality of life among university students

    Directory of Open Access Journals (Sweden)

    Klemenc-Ketis Zalika

    2011-01-01

    Full Text Available Introduction. University students are subjected to different kinds of stressors, i.e. academic pressures, social issues and financial problems. This can affect their academic achievements and quality of life. Objective. The aim of this study was to determine the health-related quality of life of university students, and how it is affected by the presence of chronic diseases, mental disorders comorbidity, and patterns of medical services’ use. Methods. This web-based study included a sample of 1,410 Slovenian university students. We used a self-administered questionnaire, containing a sheet with demographic data, Zung’s self-assessment inventories about anxiety and depression, and EQ-5D questionnaire. The main outcome measures were scores on EQ-5D part and VAS part of the EQ-5D questionnaire. Results. Independent factors associated with the health-related quality of life of university students, were the presence of chronic pain, the presence of depression and anxiety, need for urgent medical help and at least one visit to a clinical specialist in the past year. The independent factors associated with the health status of university students were the presence of chronic diseases, chronic pain, depression and anxiety, a visit to a clinical specialist, a need for urgent medical help and a visit to an emergency unit in the past year. Conclusion. Health-related quality of life of university students can be seriously affected by the presence of mental disorders and chronic pain. Appropriate health-related measures should be adopted to achieve early recognition of worse health-related quality of life, the presence of mental disorders and other chronic conditions, and to enable their effective treatment.

  13. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

  14. Transcriptomics, NF-κB Pathway, and Their Potential Spaceflight-Related Health Consequences.

    Science.gov (United States)

    Zhang, Ye; Moreno-Villanueva, Maria; Krieger, Stephanie; Ramesh, Govindarajan T; Neelam, Srujana; Wu, Honglu

    2017-05-31

    In space, living organisms are exposed to multiple stress factors including microgravity and space radiation. For humans, these harmful environmental factors have been known to cause negative health impacts such as bone loss and immune dysfunction. Understanding the mechanisms by which spaceflight impacts human health at the molecular level is critical not only for accurately assessing the risks associated with spaceflight, but also for developing effective countermeasures. Over the years, a number of studies have been conducted under real or simulated space conditions. RNA and protein levels in cellular and animal models have been targeted in order to identify pathways affected by spaceflight. Of the many pathways responsive to the space environment, the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) network appears to commonly be affected across many different cell types under the true or simulated spaceflight conditions. NF-κB is of particular interest, as it is associated with many of the spaceflight-related health consequences. This review intends to summarize the transcriptomics studies that identified NF-κB as a responsive pathway to ground-based simulated microgravity or the true spaceflight condition. These studies were carried out using either human cell or animal models. In addition, the review summarizes the studies that focused specifically on NF-κB pathway in specific cell types or organ tissues as related to the known spaceflight-related health risks including immune dysfunction, bone loss, muscle atrophy, central nerve system (CNS) dysfunction, and risks associated with space radiation. Whether the NF-κB pathway is activated or inhibited in space is dependent on the cell type, but the potential health impact appeared to be always negative. It is argued that more studies on NF-κB should be conducted to fully understand this particular pathway for the benefit of crew health in space.

  15. Transcriptomics, NF-κB Pathway, and Their Potential Spaceflight-Related Health Consequences

    Directory of Open Access Journals (Sweden)

    Ye Zhang

    2017-05-01

    Full Text Available In space, living organisms are exposed to multiple stress factors including microgravity and space radiation. For humans, these harmful environmental factors have been known to cause negative health impacts such as bone loss and immune dysfunction. Understanding the mechanisms by which spaceflight impacts human health at the molecular level is critical not only for accurately assessing the risks associated with spaceflight, but also for developing effective countermeasures. Over the years, a number of studies have been conducted under real or simulated space conditions. RNA and protein levels in cellular and animal models have been targeted in order to identify pathways affected by spaceflight. Of the many pathways responsive to the space environment, the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB network appears to commonly be affected across many different cell types under the true or simulated spaceflight conditions. NF-κB is of particular interest, as it is associated with many of the spaceflight-related health consequences. This review intends to summarize the transcriptomics studies that identified NF-κB as a responsive pathway to ground-based simulated microgravity or the true spaceflight condition. These studies were carried out using either human cell or animal models. In addition, the review summarizes the studies that focused specifically on NF-κB pathway in specific cell types or organ tissues as related to the known spaceflight-related health risks including immune dysfunction, bone loss, muscle atrophy, central nerve system (CNS dysfunction, and risks associated with space radiation. Whether the NF-κB pathway is activated or inhibited in space is dependent on the cell type, but the potential health impact appeared to be always negative. It is argued that more studies on NF-κB should be conducted to fully understand this particular pathway for the benefit of crew health in space.

  16. Does health affect portfolio choice?

    Science.gov (United States)

    Love, David A; Smith, Paul A

    2010-12-01

    A number of recent studies find that poor health is empirically associated with a safer portfolio allocation. It is difficult to say, however, whether this relationship is truly causal. Both health status and portfolio choice are influenced by unobserved characteristics such as risk attitudes, impatience, information, and motivation, and these unobserved factors, if not adequately controlled for, can induce significant bias in the estimates of asset demand equations. Using the 1992-2006 waves of the Health and Retirement Study, we investigate how much of the connection between health and portfolio choice is causal and how much is due to the effects of unobserved heterogeneity. Accounting for unobserved heterogeneity with fixed effects and correlated random effects models, we find that health does not appear to significantly affect portfolio choice among single households. For married households, we find a small effect (about 2-3 percentage points) from being in the lowest of five self-reported health categories. Copyright © 2009 John Wiley & Sons, Ltd.

  17. Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

    Directory of Open Access Journals (Sweden)

    Natasha Khamisa

    2015-01-01

    Full Text Available Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate. Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.

  18. Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

    Science.gov (United States)

    Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

    2015-01-01

    Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes. PMID:25588157

  19. Work related stress, burnout, job satisfaction and general health of nurses.

    Science.gov (United States)

    Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

    2015-01-12

    Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.

  20. How Can Spirituality Affect Your Family's Health?

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español How Can Spirituality Affect Your Family's Health? KidsHealth / For Parents / ... found among those who strictly practiced their religion. Can Spiritual Beliefs Enhance Parenting? Attending organized religious services ...

  1. Arsenic in Drinking Water in Bangladesh: Factors Affecting Child Health

    Science.gov (United States)

    Aziz, Sonia N.; Aziz, Khwaja M. S.; Boyle, Kevin J.

    2014-01-01

    The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people’s individuals’ time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children’s health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health. PMID:24982854

  2. Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".

    Science.gov (United States)

    Blanchet, Karl

    2015-03-03

    International health is still highly dominated by equilibrium approaches. The emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. The public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and interventions. One possibility is to consider the properties of systems such as resilience and adaptability as entry points to better understand how health systems react to shocks. © 2015 by Kerman University of Medical Sciences.

  3. State-building and human resources for health in fragile and conflict-affected states: exploring the linkages.

    Science.gov (United States)

    Witter, Sophie; Falisse, Jean-Benoit; Bertone, Maria Paola; Alonso-Garbayo, Alvaro; Martins, João S; Salehi, Ahmad Shah; Pavignani, Enrico; Martineau, Tim

    2015-05-15

    Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages. An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country case reports were also developed for Afghanistan, Burundi and Timor-Leste, using secondary sources and the knowledge of the group. We find that the empirical evidence for most of the linkages is not strong, which is not surprising, given the complexity of the relationships. Nevertheless, some of the posited relationships are plausible, especially between development of health cadres and a strengthened public administration, which in the long run underlies a number of state-building features. The reintegration of factional health staff post-conflict is also plausibly linked to reconciliation and peace-building. The role of medical staff as part of national elites may also be important. The concept of state-building itself is highly contested, with a rich vein of scepticism about the wisdom or feasibility of this as an external project. While recognizing the inherently political nature of these processes, systems and sub-systems, it remains the case that state-building does occur over time

  4. Bulgaria health system review.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  5. Health related quality of life measure in systemic pediatric rheumatic diseases and its translation to different languages

    DEFF Research Database (Denmark)

    Moorthy, Lakshmi Nandini; Roy, Elizabeth; Kurra, Vamsi

    2014-01-01

    BACKGROUND: Rheumatic diseases in children are associated with significant morbidity and poor health-related quality of life (HRQOL). There is no health-related quality of life (HRQOL) scale available specifically for children with less common rheumatic diseases. These diseases share several......, Hungarian, Japanese, Romanian, Serbian and Xhosa. CONCLUSION: SMILY©-Illness is a brief, easy to administer and score HRQOL scale for children with systemic rheumatic diseases. It is suitable for use across different age groups and literacy levels. SMILY©-Illness with its available translations may be used...... features with systemic lupus erythematosus (SLE) such as their chronic episodic nature, multi-systemic involvement, and the need for immunosuppressive medications. HRQOL scale developed for pediatric SLE will likely be applicable to children with systemic inflammatory diseases. FINDINGS: We adapted Simple...

  6. Genuine federalism in the Russian health care system: changing roles of government.

    Science.gov (United States)

    Chernichovsky, D; Potapchik, E

    1999-02-01

    The reforms that have affected the Russian health care system since the breakup of the Soviet Union, principally those in the general administration of the Russian Federation, have suffered from inconsistency and the absence of a strategy. The various reforms have caused a shift from a national health system characterized by highly centralized management and control, typical of the totalitarian uniform state, to a highly decentralized but fragmented multitude of state systems. Each of these systems is relatively centralized at the local level and run by local administrations with limited government infrastructure and experience. The role of government in the emerging system, and in particular the role of the federal government, remains ill defined. As a result, there is a grave risk that the Russian health care system may disintegrate as a national system. This undermines (a) the prevailing universal and fairly equitable access to care, (b) stabilization of the system following a long period of transition, and (c) the long-term reform that is required to bring the Russian health care system up to par with the health care systems in other developed countries. A rapid transition to a genuine federal health system with well-articulated roles for different levels of government, in tandem with implementation of the 1993 Compulsory Health Insurance System, is essential for the stabilization and reform of the Russian health care system.

  7. [Public-private relations in the Colombian health system from 1991 to 2015].

    Science.gov (United States)

    Cárdenas, William Iván López; Pereira, Adelyne Maria Mendes; Machado, Cristiani Vieira

    2017-07-27

    The case of Colombia's health system exemplifies the neoliberal reforms conducted in Latin America, characterized by the private sector's broad participation in the administration of resources and provision of health services. The system includes a set of benefits for persons that can afford to pay and a package of basic services with state financing for poor persons. This study aimed to analyze the public-private arrangements in the Colombian health system from 1991 and 2015, including the dimensions of insurance and financing. A case study was performed that included a literature review and analysis of documents and secondary data. The results suggest that the 1993 reform conceived of health as a public service to be provided by the market. There were changes in the state's role, delegating health care functions to the private sector through regulatory and contractual measures. Beginning in 2000, incremental reforms included instrumental changes in the system, while other initiatives aimed to expand the state's responsibilities in guaranteeing the right to health. In terms of health insurance, the main advances were the expansion of insurance coverage and harmonization of baskets of benefits between different insurance systems (although late). As for financing, there are important inequities in per capita spending between the different insurance systems and inefficiency in the financial intermediation. The Colombian case underscores the limits of structuring health systems with heavy market participation, and the study contributes to the debate on the challenges for social protection in health in Latin American countries.

  8. Austria: health system review.

    Science.gov (United States)

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  9. Health related smartphone applications: a literature review

    Directory of Open Access Journals (Sweden)

    Pantelis Stergiannis

    2015-09-01

    Full Text Available The rapid evolution of technology, has offered access to a variety of applications and technologies to healthcare professionals. New operating systems developed in the field of mobile devices revolutionized the way in which they are used. One of the main features offered by advanced software of a smartphone is the user’s access to a wealth of new, impressive applications across several operating systems for smartphones. The health related applications provided through smartphones, promote more active involvement of patients and healthcare professionals to provided care and are a new tool for improving health. The purpose of this abstract paper or article was to refer to applications currently used in the health sector, indicating specific capabilities they offer through review of electronic literature, focusing on scientific articles published in databases (PubMed, Scopus, etc. referring to the potentials they offer. It seems that several health related applications have been developed, that can be classified into two main categories. One category comprises applications that are informative, i.e. provide information to the user about health issues, allowing a person to read, gather resources to make decisions, but also to introduce its own data. These applications are mostly used by health care professionals. The second major category of applications refers to those related to help with the diagnosis, treatment and decision-making on various health related issues and in some cases take the form of consultancy, substituting the health care professional. As technology advances, the development of new health related applications is expected, specialized, with new features. Finally, the use of such applications by health care professionals is essential.

  10. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  11. Integration of targeted health interventions into health systems: a conceptual framework for analysis.

    Science.gov (United States)

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-03-01

    The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

  12. How Does Electronic Health Information Exchange Affect Hospital Performance Efficiency? The Effects of Breadth and Depth of Information Sharing.

    Science.gov (United States)

    Cho, Na-Eun; Ke, Weiling; Atems, Bebonchu; Chang, Jongwha

    2018-01-01

    This research was motivated by the large investment in health information technology (IT) by hospitals and the inconsistent findings related to the effects of health IT adoption on hospital performance. Building on resource orchestration theory and the information systems literature, the authors developed a research model to investigate how the configuration strategies for sharing information under health IT systems affect hospital efficiency. The hypotheses were tested using data from the 2010 annual and IT surveys of the American Hospital Association, Centers for Medicare & Medicaid Services case mix index, and U.S. Census Bureau's small-area income and poverty estimates. The study revealed that in health IT systems, the breadth (extent) and depth (level of detail) of digital information sharing among stakeholders each has a curvilinear relationship with hospital efficiency. In addition, breadth and depth reinforce each other's positive effects and attenuate each other's negative effects, and their balance has a positive effect on hospital efficiency. The results of this research have the potential to enrich the literature on the value of adopting health IT systems as well as in providing practitioner guidelines for meaningful use.

  13. Health-related quality of life, depression, and self-esteem in adolescents with leprosy-affected parents: results of a cross-sectional study in Nepal.

    Science.gov (United States)

    Yamaguchi, Nobuko; Poudel, Krishna C; Jimba, Masamine

    2013-01-10

    Leprosy is a chronic infectious disease that has an impact on the Health-Related Quality of Life (HRQOL) of sufferers as well as their children. To date, no study has investigated the effects of parental leprosy on the well-being of adolescent children. A cross-sectional study was conducted in the Lalitpur and Kathmandu districts of Nepal. Adolescents with leprosy-affected parents (n = 102; aged 11-17 years) and those with parents unaffected by leprosy (n = 115; 11-17 years) were investigated. Self-reported data from adolescents were collected using the Kinder Lebensqualität Fragebogen (KINDLR) questionnaire to assess HRQOL, the Center for Epidemiological Studies-Depression Scale (CES-D), and the Rosenberg Self-esteem Scale (RSES). Analysis of covariance (ANCOVA) was used to compare scores between the two groups. Multiple regression analysis was conducted to explore the determinants of HRQOL for adolescents with leprosy-affected parents. ANCOVA revealed that the KINDLR and RSES scores were significantly lower among adolescents with leprosy-affected parents compared with unaffected parents. However, the scores of "Friends" and "School" subscales of KINDLR were similar between the two groups. The CES-D score was significantly higher among adolescents with leprosy-affected parents than for adolescents with unaffected parents. The KINDLR scores for adolescents with both parents affected (n = 41) were significantly lower than the scores for those with one parent affected (n = 61). Multiple regression analysis revealed that adolescents with leprosy-affected parents who had higher levels of depressive symptoms were more likely to have lower KINDLR scores. A similar result was seen for adolescents where both parents had leprosy. Adolescents with leprosy-affected parents had higher levels of depressive symptoms, lower levels of self-esteem, and lower HRQOL compared with adolescents whose parents were unaffected by leprosy. Thus, mental health support

  14. Slovenia: Health System Review.

    Science.gov (United States)

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  15. Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System: A Cross-sectional Study in Nanjing, China.

    Science.gov (United States)

    Li, Wen Zhen; Gan, Yong; Zhou, Yan Feng; Chen, Ya Wen; Li, Jing; Kkandawire, Naomiem; Hu, Sai; Qiao, Yan; Lu, Zu Xun

    2017-09-01

    The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  16. Circumpolar Inuit health systems.

    Science.gov (United States)

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic - Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Literature review. It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems' effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of methodology and timing of the available data

  17. Relations among exercise, coping, disordered eating, and psychological health among college students.

    Science.gov (United States)

    Thome, Jennifer; Espelage, Dorothy L

    2004-11-01

    Researchers have long been interested in the coping styles of individuals who display disordered eating characteristics. Recently, exercise has been recognized as both a behavior and coping strategy that might be present among individuals with disordered eating. The present study evaluates the role of exercise as both a coping mechanism and as a health behavior in relation to eating pathology and other measures of psychological health in a nonclinical university population. Female (n=235) and male (n=86) undergraduate students completed questionnaires that assessed exercise behavior, coping strategies, eating attitudes, self-esteem, life satisfaction, affect, depression, and anxiety. The results indicate that the relations among exercise, coping, and eating pathology is complex. Exercise was related to positive psychological health in males, whereas exercise in females was associated with both positive and negative psychological health. For women with high Eating Attitudes Test (EAT-26) scores, exercise was significantly associated with negative affect, and a trend existed in this group such that exercise was associated with higher levels of depression and anxiety. Conversely, for women with low EAT scores, exercise was associated with positive affect. This suggests that exercise might be differentially associated with mental health based on the presence or absence of eating pathology.

  18. On the system of monitoring ambient air quality in relation to the health of the population of the Czech Republic

    Energy Technology Data Exchange (ETDEWEB)

    Kazmarova, H. [National Inst. of Public Health, Prague (Czech Republic)

    1995-12-31

    In 1991 the Government of the Czech republic in Ruling No 369 approved a draft of a system for monitoring the health of the population in relation to the environment on the basis of a need to obtain purposefully targeted information for an appropriate policy for the protection of health and the environment. The aim of monitoring does not and cannot consist of determining the cause and effect relationship between the health status and pollutants. The system of monitoring is an open and comprehensive system of the continual collection, processing and evaluation of data concerned with the load on the organism and damage to human health in relation to environmental pollution. Air pollution and health are one of the six subsystems realised in the whole system (beside drinking water, noise, food, biomarkers, and demographic and health statistics). The aim of the monitoring is to obtain a data base that shall serve three main purposes: (1) Description of the status of health of the population and characteristics of the ambient air, (2) Evaluation of the trend of each index, (3) Assessment and evaluation of the risk to health of the parameters under study. Thirty cities and towns were selected in the Czech Republic for the realisation of the monitoring system. (author)

  19. On the system of monitoring ambient air quality in relation to the health of the population of the Czech Republic

    Energy Technology Data Exchange (ETDEWEB)

    Kazmarova, H [National Inst. of Public Health, Prague (Czech Republic)

    1996-12-31

    In 1991 the Government of the Czech republic in Ruling No 369 approved a draft of a system for monitoring the health of the population in relation to the environment on the basis of a need to obtain purposefully targeted information for an appropriate policy for the protection of health and the environment. The aim of monitoring does not and cannot consist of determining the cause and effect relationship between the health status and pollutants. The system of monitoring is an open and comprehensive system of the continual collection, processing and evaluation of data concerned with the load on the organism and damage to human health in relation to environmental pollution. Air pollution and health are one of the six subsystems realised in the whole system (beside drinking water, noise, food, biomarkers, and demographic and health statistics). The aim of the monitoring is to obtain a data base that shall serve three main purposes: (1) Description of the status of health of the population and characteristics of the ambient air, (2) Evaluation of the trend of each index, (3) Assessment and evaluation of the risk to health of the parameters under study. Thirty cities and towns were selected in the Czech Republic for the realisation of the monitoring system. (author)

  20. Factors affecting willingness to share electronic health data among California consumers.

    Science.gov (United States)

    Kim, Katherine K; Sankar, Pamela; Wilson, Machelle D; Haynes, Sarah C

    2017-04-04

    Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers' views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers' willingness to share electronic health information for healthcare and research. This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant (p-value ≤ 0.05) associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio (OR) = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46-0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers' choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems.

  1. Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.

    Science.gov (United States)

    Bachmann, Justin M; Goggins, Kathryn M; Nwosu, Samuel K; Schildcrout, Jonathan S; Kripalani, Sunil; Wallston, Kenneth A

    2016-12-01

    Evaluate the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). After multivariable adjustment, perceived health competence was highly associated with health behaviors (pperceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90days after discharge (pPerceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Moralized Health-Related Persuasion Undermines Social Cohesion

    Directory of Open Access Journals (Sweden)

    Susanne Täuber

    2018-06-01

    Full Text Available Integrating theory and research on persuasion, moralization, and intergroup relations, the present research aims to highlight the far-reaching impact of health-related persuasion on society. I propose that governments’ health-related persuasion leads to the emergence of new social norms, and in particular moral norms. Importantly, moral norms provide strong behavioral imperatives and are seen as binding for group members. This suggests that moralized persuasion has a strong potential to divide society along the lines of citizens who conform to and citizens who deviate from health-related moral norms. Thus, departing from the traditional focus on targets of persuasion, the present research focuses on those holding a moralized view on health and lifestyle. Key aspects of social cohesion as defined by the OECD (2011 have been tested across four studies. The main hypothesis tested is that those conforming to the norm (e.g., non-smokers, normal weight people, people with healthy lifestyles will stigmatize those deviating from the norm (e.g., smokers, overweight people, people with unhealthy lifestyles. Flowing from stigmatization, less inclusion, lower solidarity with and greater endorsement of unequal treatment of those deviating from the moral norm are predicted. Four survey studies (total N = 1568 examining the proposed associations among non-smokers, normal weight people, and employees with healthy lifestyles are presented. The studies provide unanimous support for the hypothesis, with meta-analysis providing further support for the reliability of the findings. Consistent across studies, social cohesion indicators were negatively affected by health moralization through stigmatization of those deviating from health-related moral norms. Findings highlight an under-acknowledged potential of moralized health-related persuasion to divide society, thereby undermining cohesion and the achievement of important societal goals. In the discussion

  3. Absolute and Relative Socioeconomic Health Inequalities across Age Groups.

    Science.gov (United States)

    van Zon, Sander K R; Bültmann, Ute; Mendes de Leon, Carlos F; Reijneveld, Sijmen A

    2015-01-01

    The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome

  4. Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.

    Science.gov (United States)

    Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne

    2016-01-01

    Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs.

  5. Health consequences and health systems response to the Pacific U.S. Nuclear Weapons Testing Program.

    Science.gov (United States)

    Palafox, Neal A; Riklon, Sheldon; Alik, Wilfred; Hixon, Allen L

    2007-03-01

    Between 1946 and 1958, the United States detonated 67 thermonuclear devices in the Pacific as part of their U.S. Nuclear Weapons Testing Program (USNWTP). The aggregate explosive power was equal to 7,200 Hiroshima atomic bombs. Recent documents released by the U.S. government suggest that the deleterious effects of the nuclear testing were greater and extended farther than previously known. The Republic of the Marshall Islands (RMI) government and affected communities have sought refress through diplomatic routes with the U.S. government, however, existing medical programs and financial reparations have not adequately addressed many of the health consequences of the USNWTP. Since radiation-induced cancers may have a long latency, a healthcare infrastructure is needed to address both cancer and related health issues. This article reviews the health consequences of the Pacific USNWTP and the current health systems ability to respond.

  6. The role of affect in consumer evaluation of health care services.

    Science.gov (United States)

    Ng, Sandy; Russell-Bennett, Rebekah

    2015-01-01

    Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes.

  7. Industry and traffic related particles and their role in human health

    Energy Technology Data Exchange (ETDEWEB)

    Oravisjaervi, K.

    2013-11-01

    Combustion generated ultrafine particles have been found to be responsible for adverse effects on human health. New emission reduction technologies and fuels will change the composition of particle emissions. It is important to confirm that the new reduction technologies are designed to minimise the adverse health effects. In this doctoral thesis the potential health effects caused by traffic and industrially generated particles were studied using epidemiological, experimental and in silico studies. The effects of short-term changes in PM2.5 on the respiratory health of symptomatic children living near a steel works were studied to investigate whether specific sources of PM2.5 have the possible health effects. The PM2.5 emission sources were identified: long-range transport, a steel works, soil and street dust and a mechanical engineering works. Significant associations were not found between respiratory symptoms and PM2.5 or the sources markers. The deposition of traffic-related particles into the human respiratory system was computed using the lung deposition model. Particle size distribution was measured from diesel- and compressed natural gas (CNG)-fuelled busses and an off-road diesel engine under different combustion situations. The majority of the measured traffic-related particle numbers reach the alveolar region of the lungs. There were differences in the deposition of particles when different catalysts, engines or fuels were used. CNG or a diesel particulate filter (DPF) significantly reduced lung exposure to particles. Also physical activity, age and gender affected the deposition of particles. The diesel particles comprised compounds (carcinogenic PAHs, transition metals), which may have the ability to generate reactive oxygen. This study provides new knowledge how of the emission abatement technologies and fuels affects particle number and their composition, as well health hazards. Cleaner technology (CNG, DPF), emits significantly fewer particles in

  8. Mobile health information system: a mobile app. to aid health ...

    African Journals Online (AJOL)

    Mobile health information system: a mobile app. to aid health workers relate health information. ... Global Journal of Mathematical Sciences ... phones in delivering vital health information and effective fieldwork reporting is of significance.

  9. "It's a complex mesh"- how large-scale health system reorganisation affected the delivery of the immunisation programme in England: a qualitative study.

    Science.gov (United States)

    Chantler, Tracey; Lwembe, Saumu; Saliba, Vanessa; Raj, Thara; Mays, Nicholas; Ramsay, Mary; Mounier-Jack, Sandra

    2016-09-15

    The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically. The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance

  10. [Rethinking how health is promoted in the Colombian general health-related social security system (Sistema General de Seguridad Social en Salud)].

    Science.gov (United States)

    Eslava-Castañeda, Juan C

    2006-12-01

    This article takes stock of how promoting health (PH) (promoción de la salud - PS) has been understood within an international setting and gives three meanings for promotion: as general policy orientation, as a set of actions and as a special dimension of sanitary work. Interest expressed in giving it a specific basis distinguishing it from prevention, transcending educational work, has emerged from the subtle differences established from such different ways of coming to terms with PH. After recognising the challenge posed by PH in the field of health, the text succinctly describes how discourse regarding PH has been introduced in Colombia and discusses how an attempt has been made to be more precise regarding its place in the general health-related social security system. Efforts currently being made in Colombia regarding making PH become a reality within the Colombian health system are then mentioned.

  11. Discourse analysis: A useful methodology for health-care system researches.

    Science.gov (United States)

    Yazdannik, Ahmadreza; Yousefy, Alireza; Mohammadi, Sepideh

    2017-01-01

    Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular research strategy for researchers in various disciplines which has been little employed by health-care researchers. The methodology involves a focus on the sociocultural and political context in which text and talk occur. DA adds a linguistic approach to an understanding of the relationship between language and ideology, exploring the way in which theories of reality and relations of power are encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and productive qualitative methodology but has been underutilized within health-care system research. Without a clear understanding of discourse theory and DA it is difficult to comprehend important research findings and impossible to use DA as a research strategy. To redress this deficiency, in this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical background, DA types and analysis strategy. Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system.

  12. How and why do countries differ in their governance and financing-related administrative expenditure in health care? An analysis of OECD countries by health care system typology.

    Science.gov (United States)

    Hagenaars, Luc L; Klazinga, Niek S; Mueller, Michael; Morgan, David J; Jeurissen, Patrick P T

    2018-01-01

    Administration is vital for health care. Its importance may increase as health care systems become more complex, but academic attention has remained minimal. We investigated trends in administrative expenditure across OECD countries, cross-country spending differences, spending differences between health care system typologies, and differences in the scale and scope of administrative functions across typologies. We used OECD data, which include health system governance and financing-related administrative activities by regulators, governance bodies, and insurers (macrolevel), but exclude administrative expenditure by health care providers (mesolevel and microlevel). We find that governance and financing-related administrative spending at the macrolevel has remained stable over the last decade at slightly over 3% of total health spending. Cross-country differences range from 1.3% of health spending in Iceland to 8.3% in the United States. Voluntary private health insurance bears much higher administrative costs than compulsory schemes in all countries. Among compulsory schemes, multiple payers exhibit significantly higher administrative spending than single payers. Among single-payer schemes, those where entitlements are based on residency have significantly lower administrative spending than those with single social health insurance, albeit with a small difference. These differences can partially be explained because multi-payer and voluntary private health insurance schemes require additional administrative functions and enjoy less economies of scale. Studies in hospitals and primary care indicate similar differences in administrative costs across health system typologies at the mesolevel and microlevel of health care delivery, which warrants more research on total administrative costs at all the levels of health systems. Copyright © 2017 John Wiley & Sons, Ltd.

  13. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    Science.gov (United States)

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2014-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms. Results: Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms. Implications: The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving. PMID:23690056

  14. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

    Science.gov (United States)

    Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

    2014-01-01

    As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease

  15. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results: 1 Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2 Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3 Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4 Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5 Information and research: Data that can be used for planning and management (including population and epidemiological

  16. Ideal affect in daily life: implications for affective experience, health, and social behavior.

    Science.gov (United States)

    Tsai, Jeanne L

    2017-10-01

    Over the last decade, researchers have increasingly demonstrated that ideal affect-the affective states that people value and ideally want to feel-shapes different aspects of daily life. Here I briefly review Affect Valuation Theory (AVT), which integrates ideal affect into existing models of affect and emotion by identifying the causes and consequences of variation in ideal affect. I then describe recent research that applies AVT to the valuation of negative states as well as more complex states, examines how ideal affect shapes momentary affective experience, suggests that ideal affect has both direct and indirect effects on health, and illustrates that people's ideal affect shapes how they judge and respond to others. Finally, I discuss the implications of cultural and individual differences in ideal affect for clinical, educational, work, and leisure settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Belgium: Health system review.

    Science.gov (United States)

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

  18. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

    Science.gov (United States)

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2012-05-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

  19. Affect regulation, brain development, and behavioral/emotional health in adolescence.

    Science.gov (United States)

    Dahl, R E

    2001-01-01

    This paper addresses the importance of affect regulation (AR) in relation to a broad range of behavioral and emotional health problems that emerge during adolescence. AR is defined as the adaptive modulation of emotional experience to serve a goal or purpose. This conceptualization of AR emphasizes the use of cognitive skills to guide, inhibit, or modify emotion and behavior, including the expression of emotional responses, in learned, strategic ways-skills that ultimately underpin adult levels of social maturity and the ability to show "responsible" behavior across a range of emotional situations. Neurobehavioral systems that subserve these AR skills include areas of the inferior and orbital prefrontal cortex (PFC), with rich interconnections to several limbic structures and other cortical areas, including the dorsolateral PFC. Adolescence represents an important developmental period in the functional maturation of adult AR skills; it is also a critical time in the development of clinical disorders of AR (eg, rates of depression increase dramatically and gender differences in depression emerge). Maturational changes in AR that occur during adolescence-particularly with respect to the role of emotions influencing responsible decision making-are also relevant to understanding key aspects of the developmental pathways of some behavioral health problems, such as alcohol use and nicotine dependence. A strong case is made for developmental research in affective neuroscience aimed at this important maturational period, particularly the kind of transdisciplinary research leading toward mechanistic understanding of the development of adolescent-onset disorders. Improving understanding in these areas could ultimately lead to the development of early interventions in targeted high-risk populations, and has enormous clinical and social policy relevance.

  20. The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations.

    Science.gov (United States)

    Asi, Yara M; Williams, Cynthia

    2018-06-01

    The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas. First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments, and discuss potential policy solutions. Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of

  1. Health-related quality of life of patients of Brazilian primary health care

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    Bruna de Oliveira Ascef

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  2. Motivation and Factors Affecting It among Health Professionals in the Public Hospitals, Central Ethiopia.

    Science.gov (United States)

    Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign

    2015-07-01

    Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables. The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors' motivation compared to nurses' (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables. Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.

  3. Environmental health risk assessment: Energy systems

    International Nuclear Information System (INIS)

    Krewski, D.; Somers, E.; Winthrop, S.O.

    1984-01-01

    Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

  4. Let It Go: Lingering Negative Affect in Response to Daily Stressors Is Associated With Physical Health Years Later.

    Science.gov (United States)

    Leger, Kate A; Charles, Susan T; Almeida, David M

    2018-03-01

    The way we respond to life's daily stressors has strong implications for our physical health. Researchers have documented the detrimental effects of initial emotional reactivity to daily stressors on future physical health outcomes but have yet to examine the effects of emotions that linger after a stressor occurs. The current study investigated how negative affect that lingers the day after a minor stressor occurs is associated with health-related outcomes. Participants ( N = 1,155) in a community-based, nationwide study answered questions about daily stressors and affect across 8 consecutive days and about their physical health almost 10 years later. Multilevel models indicated that people experience heightened levels of negative affect the day after a stressor occurs. Furthermore, higher levels of lingering negative affect are associated with greater numbers of chronic conditions and worse functional limitations 10 years later. Findings suggest that affective recovery from daily stressors has unique importance for long-term physical health.

  5. Health-related quality of life, depression, and self-esteem in adolescents with leprosy-affected parents: results of a cross-sectional study in Nepal

    Directory of Open Access Journals (Sweden)

    Yamaguchi Nobuko

    2013-01-01

    Full Text Available Abstract Background Leprosy is a chronic infectious disease that has an impact on the Health-Related Quality of Life (HRQOL of sufferers as well as their children. To date, no study has investigated the effects of parental leprosy on the well-being of adolescent children. Methods A cross-sectional study was conducted in the Lalitpur and Kathmandu districts of Nepal. Adolescents with leprosy-affected parents (n = 102; aged 11–17 years and those with parents unaffected by leprosy (n = 115; 11–17 years were investigated. Self-reported data from adolescents were collected using the Kinder Lebensqualität Fragebogen (KINDLR questionnaire to assess HRQOL, the Center for Epidemiological Studies-Depression Scale (CES-D, and the Rosenberg Self-esteem Scale (RSES. Analysis of covariance (ANCOVA was used to compare scores between the two groups. Multiple regression analysis was conducted to explore the determinants of HRQOL for adolescents with leprosy-affected parents. Results ANCOVA revealed that the KINDLR and RSES scores were significantly lower among adolescents with leprosy-affected parents compared with unaffected parents. However, the scores of “Friends” and “School” subscales of KINDLR were similar between the two groups. The CES-D score was significantly higher among adolescents with leprosy-affected parents than for adolescents with unaffected parents. The KINDLR scores for adolescents with both parents affected (n = 41 were significantly lower than the scores for those with one parent affected (n = 61. Multiple regression analysis revealed that adolescents with leprosy-affected parents who had higher levels of depressive symptoms were more likely to have lower KINDLR scores. A similar result was seen for adolescents where both parents had leprosy. Conclusions Adolescents with leprosy-affected parents had higher levels of depressive symptoms, lower levels of self-esteem, and lower HRQOL compared with adolescents whose

  6. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Directory of Open Access Journals (Sweden)

    Yong-Bing Liu

    2015-08-01

    Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors

  7. FEMALE FARMWORKERS’ PERCEPTIONS OF HEAT-RELATED ILLNESS AND PREGNANCY HEALTH

    OpenAIRE

    Flocks, Joan; Mac, Valerie Vi Thien; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A.

    2013-01-01

    While agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women’s perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack c...

  8. Intelligent Integrated Health Management for a System of Systems

    Science.gov (United States)

    Smith, Harvey; Schmalzel, John; Figueroa, Fernando

    2008-01-01

    implemented in the present IIHMS, is to enable automated analysis of physical phenomena in imitation of human reasoning, including the use of qualitative methods. Intelligent integration is said to occur in a system in which all elements are intelligent and can acquire, maintain, and share knowledge and information. In the HDNIE of the present IIHMS, an SoS is represented as being operationally organized in a hierarchical-distributed format. The elements of the SoS are considered to be intelligent in that they determine their own conditions within an integrated scheme that involves consideration of data, information, knowledge bases, and methods that reside in all elements of the system. The conceptual framework of the HDNIE and the methodologies of implementing it enable the flow of information and knowledge among the elements so as to make possible the determination of the condition of each element. The necessary information and knowledge is made available to each affected element at the desired time, satisfying a need to prevent information overload while providing context-sensitive information at the proper level of detail. Provision of high-quality data is a central goal in designing this or any IIHMS. In pursuit of this goal, functionally related sensors are logically assigned to groups denoted processes. An aggregate of processes is considered to form a system. Alternatively or in addition to what has been said thus far, the HDNIE of this IIHMS can be regarded as consisting of a framework containing object models that encapsulate all elements of the system, their individual and relational knowledge bases, generic methods and procedures based on models of the applicable physics, and communication processes (Figure 2). The framework enables implementation of a paradigm inspired by how expert operators monitor the health of systems with the help of (1) DIaK from various sources, (2) software tools that assist in rapid visualization of the condition of the system, (3

  9. Circumpolar Inuit health systems

    Directory of Open Access Journals (Sweden)

    Leanna Ellsworth

    2013-08-01

    Full Text Available Background . The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska and Russia (Chukotka. In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective . To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska and Russia (Chukotka and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design . Literature review. Results . It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of

  10. Moderation of the effects of discrimination-induced affective responses on health outcomes.

    Science.gov (United States)

    Gerrard, Meg; Gibbons, Frederick X; Fleischli, Mary E; Cutrona, Carolyn E; Stock, Michelle L

    2018-02-01

    The goal of the study was to examine differential mediation of long-term effects of discrimination on health behaviour and health status by internalising (anxiety and depression) and externalising (hostility and anger), and to explore moderation of these effects, specifically, by the presence of support networks and coping tendencies. The current analyses employed structural equation modelling of five waves of data from Black female participants of the Family and Community Health Study over 11 years (M age 37-48). The main outcome variables were health status and alcohol use (frequency and problematic consumption). Perceived racial discrimination was associated with increases in internalising and externalising. In addition, internalising reactions to discrimination were associated with deterioration in health status and increases in problematic drinking; externalising reactions were associated with increases in frequency of drinking. These relations were attenuated by availability of support networks, and exacerbated by use of avoidance coping. The current study (a) replicated previous research suggesting that two different types of affective reactions mediate the relations between perceived racial discrimination and physical health status vs. health-impairing behaviours: internalising and externalising, and (b) revealed moderation of these effects by coping mechanisms.

  11. Kazakhstan's Environment-Health system, a Big Data challenge

    Science.gov (United States)

    Vitolo, Claudia; Bella Gazdiyeva, Bella; Tucker, Allan; Russell, Andrew; Ali, Maged; Althonayan, Abraham

    2016-04-01

    Kazakhstan has witnessed a remarkable economic development in the past 15 years, becoming an upper-middle-income country. However it is still widely regarded as a developing nation, partially because of its population's low life expectancy which is 5 years below the average in similar economies. The environment is in a rather fragile state, affected by soil, water, air pollution, radioactive contamination and climate change. However, Kazakhstan's government is moving towards clean energy and environmental protection and calling on scientists to help prioritise investments. The British Council-funded "Kazakhstan's Environment-Health Risk Analysis (KEHRA)" project is one of the recently launched initiatives to support Kazakhstan healthier future. The underlying hypothesis of this research is that the above mentioned factors (air/water/soil pollution, etc.) affecting public health almost certainly do not act independently but rather trigger and exacerbate each other. Exploring the environment-health links in a multi-dimensional framework is a typical Big Data problem, in which the volume and variety of the data needed poses technical as well as scientific challenges. In Kazakhstan, the complexities related to managing and analysing Big Data are worsened by a number of obstacles at the data acquisition step: most of the data is not in digital form, spatial and temporal attributes are often ambiguous and the re-use and re-purpose of the information is subject to restrictive licenses and other mechanisms of control. In this work, we document the first steps taken towards building an understanding of the complex environment-health system in Kazakhstan, using interactive visualisation tools to identify and compare hot-spots of pollution and poor health outcomes, Big Data and web technologies to collect, manage and explore available information. In the future, the knowledge acquired will be modelled to develop evidence-based recommendation systems for decision makers in

  12. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

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    Li Zhijian

    2012-06-01

    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  13. Health-related quality-of-life scales in Parkinson's disease: critique and recommendations

    NARCIS (Netherlands)

    Martinez-Martin, Pablo; Jeukens-Visser, Martine; Lyons, Kelly E.; Rodriguez-Blazquez, C.; Selai, Caroline; Siderowf, Andrew; Welsh, Mickie; Poewe, Werner; Rascol, Oliver; Sampaio, Cristina; Stebbins, Glenn T.; Goetz, Christopher G.; Schrag, Anette

    2011-01-01

    Health-related quality of life is an important patient-reported outcome used in intervention trials and for monitoring the consequences of health status on physical, mental, and social domains. Parkinson's disease is a complex disorder that strongly affects patients' quality of life. Several

  14. The Relation Between the Health Workforce distribution and Maternal and Child Health Inequalities

    NARCIS (Netherlands)

    M.A. Sousa (Angelica)

    2016-01-01

    markdownabstractWeak health systems with a shortage of qualified staff, and lack of equipment and medicines impede the delivery of quality health care that is required to prevent maternal and newborn deaths and the attainment of the health-related Millennium Development Goals (MDGs). Using the cases

  15. A Study of Factors Affecting the Renewal of Health Insurance Policy

    OpenAIRE

    Bhat Ramesh; Jain Nishant

    2007-01-01

    Health insurance policies are generally one-year policies and to remain part of the insurance poll, policyholders are required to renew their policies each year. Understanding the factors that affect the demand and renewal decisions to continue in health insurance programme is imperative for future growth and development of the insurance sector. We extend our previous work on factors affecting the decision to purchase health insurance to understand the factors affecting the renewal of insuran...

  16. Positive and negative affect in the future teacher: relationships with their academic achievement, mental health and satisfaction with life

    Directory of Open Access Journals (Sweden)

    Ruth Pinedo González

    2017-02-01

    Full Text Available Affects are composed of two key dimensions: the positive affect (PA and negative affect (NA. Both dimensions are related to psychological adjustment of the person and life satisfaction. This study is exploratory in nature and aims to make a first correlational analysis between different constructs: emotional disposition, academic achievement, mental health and life satisfaction in a sample of 143 student teachers. We have used the following scales adapted to the culture: The Positive and Negative Affect Schedule (PANAS, the Mental Health Inventory (MHI-5 and the Satisfaction With Life Scale (SWLS. Among the most interesting results it was found that positive affect was associated with academic achievement, mental health and life satisfaction. Positive and negative affects and satisfaction with life were formed as predictors of future teachers’ mental health. Extensive analysis and discussion of the results is included in the document.

  17. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    Science.gov (United States)

    Odeyemi, Isaac Ao; Nixon, John

    2013-01-01

    Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity. A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia) that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity. In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system. PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications and the factors that affect its uptake and equity in different health care systems. The results are anticipated to be helpful in informing how developing countries may utilize PHI to meet the aim of achieving universal health care.

  18. Transformation of health system in Ecuador

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    Wilson Giovanni Jiménez Barbosa

    2017-05-01

    Full Text Available Objective: To describe the transformations of the structure of the health system in Ecuador, taking into account the constitutional and policy context of that country, and to reflect on the historical context in which it occurred and its implications for the welfare of the people from Ecuador. Materials and methods: A bibliographic review was made, beginning with the regulations of Ecuador since the Constitution of 1979, where health is considered as a right, passing by the Organic Law of Health, the Social Security Act, among others, including the last reform of the Constitution in 2008. Results: The transformation of the Health System of Ecuador is the result of the action of economic and political forces, both internal and external, that have affected this country throughout the studied period.

  19. Poland health system review.

    Science.gov (United States)

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  20. The impact of positive affect on health cognitions and behaviours: a meta-analysis of the experimental evidence.

    Science.gov (United States)

    Cameron, David S; Bertenshaw, Emma J; Sheeran, Paschal

    2015-01-01

    Several reviews suggest that positive affect is associated with improved longevity, fewer physical symptoms, and biological indicators of good health. It is possible that positive affect could influence these outcomes by promoting healthful cognitions and behaviours. The present review identified conceptual pathways from positive affect to health cognitions and behaviour, and used random effects meta-analysis to quantify the impact of positive affect inductions (versus neutral affect conditions) on these outcomes. Literature searches located 54 independent tests that could be included in the review. Across all studies, the findings revealed no reliable effects on intentions (d+ = -.12, 95% CI = -.32 to .08, k = 15) or behaviour (d+ = .15, 95% CI = -.03 to .33, k = 23). There were four reliable effects involving specific cognitions and behaviours, but little clear evidence for generalised benefits or adverse effects of positive emotions on health-related cognitions or actions. Conclusions must be cautious given the paucity of tests available for analysis. The review offers suggestions about research designs that might profitably be deployed in future studies, and calls for additional tests of the impact of discrete positive emotions on health cognitions and behaviour.

  1. On residents' satisfaction with community health services after health care system reform in Shanghai, China, 2011.

    Science.gov (United States)

    Li, Zhijian; Hou, Jiale; Lu, Lin; Tang, Shenglan; Ma, Jin

    2012-01-01

    Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents' satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents' satisfaction. Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1) the health insurance system; 2) essential drugs; 3) basic clinical services; and 4) public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied) and the public health/preventive services (average score=3.62); but less satisfied with the provision of essential drugs (average score=3.20) and health insurance schemes (average score=3.23). The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes) had overall poorer satisfaction levels on these four aspects of health care (Phealth services/interventions (average score=3.79); and less satisfaction with the health insurance system (average score=3.23) and the essential drug system (average score=3.20). Disadvantaged groups showed lower satisfaction levels overall relative to non-disadvantaged groups.

  2. Integrating health belief model and technology acceptance model: an investigation of health-related internet use.

    Science.gov (United States)

    Ahadzadeh, Ashraf Sadat; Pahlevan Sharif, Saeed; Ong, Fon Sim; Khong, Kok Wei

    2015-02-19

    attitude toward Internet use for health purposes for women who were health conscious and who perceived their health to be at risk. The integrated model proposed and tested in this study shows that the HBM, when combined with the TAM, is able to predict Internet use for health purposes. For women who subjectively evaluate their health as vulnerable to diseases and are concerned about their health, cognition beliefs in and positive affective feelings about the Internet come into play in determining the use of health-related Internet use. Furthermore, this study shows that engaging in health-related Internet use is a proactive behavior rather than a reactive behavior, suggesting that TAM dimensions have a significant mediating role in Internet health management.

  3. Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

    Science.gov (United States)

    Munro, Neil; Duckett, Jane

    2016-06-01

    To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  4. Dynamic artificial neural networks with affective systems.

    Directory of Open Access Journals (Sweden)

    Catherine D Schuman

    Full Text Available Artificial neural networks (ANNs are processors that are trained to perform particular tasks. We couple a computational ANN with a simulated affective system in order to explore the interaction between the two. In particular, we design a simple affective system that adjusts the threshold values in the neurons of our ANN. The aim of this paper is to demonstrate that this simple affective system can control the firing rate of the ensemble of neurons in the ANN, as well as to explore the coupling between the affective system and the processes of long term potentiation (LTP and long term depression (LTD, and the effect of the parameters of the affective system on its performance. We apply our networks with affective systems to a simple pole balancing example and briefly discuss the effect of affective systems on network performance.

  5. Overt and subtle discrimination, subjective well-being and physical health-related quality of life in an obese sample.

    Science.gov (United States)

    Magallares, Alejandro; Benito de Valle, Pilar; Irles, Jose Antonio; Jauregui-Lobera, Ignacio

    2014-10-27

    Obesity represents a serious health issue affecting millions of people in Western industrialized countries. The severity of the medical problems it causes is paralleled by the fact that obesity has become a social stigma that affects the psychological health-related quality of life of individuals with weight problems. Our study, with 111 obese patients of a Spanish hospital, focused specifically on how overt and subtle discrimination is related to subjective well-being (affect balance and life satisfaction) and physical health-related quality of life. It was shown that overt (r = -.28, p life satisfaction) and subtle discrimination (r = -.28, p life satisfaction) were negatively linked with subjective well-being, and that there was a negative correlation between overt discrimination and physical health-related quality of life (r = -.26, p quality of life and subjective well-being using the Baron and Kenny procedure. Finally, it is discussed the relationship between discrimination, subjective well-being and physical health-related quality of life in obese people.

  6. Low Calorie Diet Affects Aging-Related Factors

    Science.gov (United States)

    ... Current Issue Past Issues Research News From NIH Low Calorie Diet Affects Aging-Related Factors Past Issues / ... to learn more about the effects of sustained low-calorie diets in humans on factors affecting aging. ...

  7. Can "giving preference to my patients" be explained as a role related duty in public health care systems?

    Science.gov (United States)

    Holm, Søren

    2011-03-01

    Most of us have two strong intuitions (or sets of intuitions) in relation to fairness in health care systems that are funded by public money, whether through taxation or compulsory insurance. The first intuition is that such a system has to treat patients (and other users) fairly, equitably, impartially, justly and without discrimination. The second intuition is that doctors, nurses and other health care professionals are allowed to, and may even in some cases be obligated to give preference to the interests of their particular patients or clients over the interests of other patients or clients of the system. These two intuitions are in potential conflict. One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the 'right' to give their patients preferential treatment. And one of the possible side-effects of allowing individual health care professionals to give preference to 'their clients' is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to 'your' patients in certain circumstances.

  8. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  9. Use of Electronic Health Records and Administrative Data for Public Health Surveillance of Eye Health and Vision-Related Conditions

    Science.gov (United States)

    Elliott, Amanda; Davidson, Arthur; Lum, Flora; Chiang, Michael; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E.; Chou, Chiu-Fang

    2014-01-01

    Purpose To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Methods We describe three currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Results Each of the three sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Conclusions Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. PMID:23158225

  10. Defining health-related quality of life for young wheelchair users: A qualitative health economics study.

    Directory of Open Access Journals (Sweden)

    Nathan Bray

    Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this

  11. Coping and emotional distress in relation to health-related quality of life in Slovene patients with cancer

    Directory of Open Access Journals (Sweden)

    Tanja Žagar

    2011-08-01

    Full Text Available Managing emotional distress triggers different coping strategies for coping with stress in cancer patients. Effective coping affects healthrelated quality of life and psychosocial adaptation. This study was performed to determine coping strategies, and their connectedness to emotional distress (anxiety and depression and healthrelated quality of life in cancer patients. Study was carried out on 70 cancer patients, in inpatient and outpatient setting. Depressive symptoms were measured with Beck Depression Inventory BDI-SH, anxiety with State Trait Anxiety Inventory STAI-1, coping strategies with Coping Response Inventory CRI and healthrelated quality of life with Quality of Life Questionnaire QOLQ- 30. A negative, statistically important relationship was found between active strategies, emotional distress and quality of life. Recognition of emotional distress and ways of coping in cancer patients are important for quality of health care.

  12. Welcome to health information science and systems.

    Science.gov (United States)

    Zhang, Yanchun

    2013-01-01

    Health Information Science and Systems is an exciting, new, multidisciplinary journal that aims to use technologies in computer science to assist in disease diagnoses, treatment, prediction and monitoring through the modeling, design, development, visualization, integration and management of health related information. These computer-science technologies include such as information systems, web technologies, data mining, image processing, user interaction and interface, sensors and wireless networking and are applicable to a wide range of health related information including medical data, biomedical data, bioinformatics data, public health data.

  13. Neural systems supporting cognitive-affective interactions in adolescence: The role of puberty and implications for affective disorders

    Directory of Open Access Journals (Sweden)

    Cecile D. Ladouceur

    2012-08-01

    Full Text Available Evidence from longitudinal studies suggests that adolescence may represent a period of vulnerability that, in the context of adverse events, could contribute to developmental trajectories toward behavioral and emotional health problems, including affective disorders. Adolescence is also a sensitive period for the development of neural systems supporting cognitive-affective processes, which have been implicated in the pathophysiology of affective disorders such as anxiety and mood disorders. In particular, the onset of puberty brings about a cascade of physical, hormonal, psychological, and social changes that contribute in complex ways to the development of these systems. This article provides a brief overview of neuroimaging research pertaining to the development of cognitive-affective processes in adolescence. It also includes a brief review of evidence from animal and human neuroimaging studies suggesting that sex steroids influence the connectivity between prefrontal cortical and subcortical limbic regions in ways that contribute to increased reactivity to emotionally salient stimuli. We integrate these findings in the context of a developmental affective neuroscience framework suggesting that the impact of rising levels of sex steroids during puberty on fronto-limbic connectivity may be even greater in the context of protracted development of prefrontal cortical regions in adolescence. We conclude by discussing the implications of these findings for future research aimed at identifying neurodevelopmental markers of risk for future onset of affective disorders.

  14. Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents

    Science.gov (United States)

    Punamäki, Raija-Leena; Qouta, Samir R.; Peltonen, Kirsi

    2017-01-01

    ABSTRACT Background: Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective: This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children’s mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers (N = 325) and their children (one per family; 49.4% girls; 10–13 years old; mean ± SD age = 11.35 ± 0.57 years) after the Gaza War of 2008–2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child’s internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children’s Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children’s Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n = 44). Further, families with discrepant experiences (23.0%; n = 65) and moderate security and neutral relationships (25.2%; n = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic

  15. Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents.

    Science.gov (United States)

    Punamäki, Raija-Leena; Qouta, Samir R; Peltonen, Kirsi

    2017-01-01

    Background : Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective : This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children's mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers ( N  = 325) and their children (one per family; 49.4% girls; 10-13 years old; mean ±  SD age = 11.35 ± 0.57 years) after the Gaza War of 2008-2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child's internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children's Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children's Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n  = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n  = 44). Further, families with discrepant experiences (23.0%; n  = 65) and moderate security and neutral relationships (25.2%; n  = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic interventions for

  16. Beyond Negative Pain-Related Psychological Factors: Resilience Is Related to Lower Pain Affect in Healthy Adults.

    Science.gov (United States)

    Hemington, Kasey S; Cheng, Joshua C; Bosma, Rachael L; Rogachov, Anton; Kim, Junseok A; Davis, Karen D

    2017-09-01

    Resilience, a characteristic that enhances adaptation in response to stressful events, is a positive psychological factor that can predict and modulate health outcomes. However, resilience is rarely considered in pain research. Conversely, negative psychological factors (eg, anxiety, depression) are known to be related to the affective dimension of pain. It is critical to understand all potential psychological drivers of pain affect, a prominent component of chronic pain. We tested the hypothesis that higher resilience is associated with lower pain affect, above and beyond the predictive value of negative psychological factors. Healthy adults underwent psychophysical testing to acquire ratings of heat pain intensity and unpleasantness and completed the Resilience Scale, the State-Trait Anxiety Inventory (trait form), Beck Depression Inventory, Pain Catastrophizing Scale, and the Pain Vigilance and Attention Questionnaire. Multiple regression modeling (n = 68) showed resilience to be a negatively associated with pain affect (unpleasantness). Furthermore, in individuals with higher anxiety scores, resilience was protective against higher pain affect. This highlights the importance of resilience, a positive psychological factor, in the affective dimension of pain. This study is the first to assess a positive psychological factor and experimental pain affect, and has the potential to improve prediction of and treatment strategies for clinical pain. We report that resilience, a positive psychological factor, interacts with anxiety and is associated with heat pain affect (unpleasantness) in healthy individuals. Resilience may provide predictive value of chronic pain affect and treatment outcomes, and could be a target for behavioral therapy. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  17. Open Source, Open Standards, and Health Care Information Systems

    Science.gov (United States)

    2011-01-01

    Recognition of the improvements in patient safety, quality of patient care, and efficiency that health care information systems have the potential to bring has led to significant investment. Globally the sale of health care information systems now represents a multibillion dollar industry. As policy makers, health care professionals, and patients, we have a responsibility to maximize the return on this investment. To this end we analyze alternative licensing and software development models, as well as the role of standards. We describe how licensing affects development. We argue for the superiority of open source licensing to promote safer, more effective health care information systems. We claim that open source licensing in health care information systems is essential to rational procurement strategy. PMID:21447469

  18. Stress response and health affecting compounds in Brassicaceae

    NARCIS (Netherlands)

    Jahangir, Muhammad

    2010-01-01

    Summary of the Thesis: Vegetables have always been considered as healthy food. So also Brassica vegetables are well known all over the world as a common food due to the presence of health affecting compounds (Chapter 2). A vast amount of data is available for health promoting compounds in

  19. [Health services research for the public health service (PHS) and the public health system].

    Science.gov (United States)

    Hollederer, A; Wildner, M

    2015-03-01

    There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

  20. Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

    Science.gov (United States)

    Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

    2015-01-01

    Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

  1. [Work-related diseases and health-related compensation claims, Northeastern Brazil, 2000].

    Science.gov (United States)

    Souza, Norma Suely Souto; Santana, Vilma Sousa; Albuquerque-Oliveira, Paulo Rogério; Barbosa-Branco, Anadergh

    2008-08-01

    To estimate the contribution of work-related diseases to sick leaves due to general and occupational health problems. Sociodemographic, occupational and health data from 29,658 records of temporary disability benefits, granted on account of health problems by the Instituto Nacional do Seguro Social (National Institute of Social Security) in the state of Bahia (Northeastern Brazil), were analyzed. All constant ICD-10 clinical diagnoses were taken into consideration, except for those referring to external causes and factors that influence contact with health services. The link between diagnosis and occupation was based on the ICD-10 code and whether the type of compensation was due to a "work-related accident/disease" or not. From all the benefits, 3.1% were granted due to work-related diseases: 70% were musculoskeletal system and connective tissue diseases, while 14.5% were related to the nervous system. In general, benefits granted at more than two times the expected frequency were as follows: tenosynovitis in the manufacturing sector (Proportion Ratio-PR=2.70), carpal tunnel syndrome in the financial intermediation sector (PR=2.43), and lumbar disc degeneration in the transportation, postal service and telecommunications sectors (PR=2.17). However, no causal connection could be established for these diseases, in these activity sectors, in a significant percentage of benefits. Results suggest the existence of possible occupational risk factors for diseases in these fields of activity, as well as the underreporting of the link between diseases and work, thus disguising the responsibility of companies and the perspective of prevention through work reorganization.

  2. Individual Differences on Job Stress and Related Ill Health

    Directory of Open Access Journals (Sweden)

    Miodraga Stefanovska Petkovska

    2014-03-01

    Conclusion: Employees are exposed to many potential work related stressors which differently affect their job satisfaction and result in ill health. A better understanding of the individual characteristics and potential stressors should subsequently help managers' better deal with this problem. This underlines the need for further research and design of stress reduction interventions.

  3. Do dialysis- and transplantation-related medical factors affect perceived health status?

    NARCIS (Netherlands)

    Rosenberger, J.; van Dijk, J.P.; Nagyova, I.; Roland, R.; Geckova, A.M.; van den Heuvel, W.J.; Groothoff, J.W.

    2005-01-01

    Background. Quality of life and perceived health status (PHS) are important indicators of patient care together with morbidity, mortality and health-care resource utilization. The aim of this study is to explore how various medical conditions might influence perceived health status. Methods. The

  4. Indirect environmental effects of nuclear war affecting health

    International Nuclear Information System (INIS)

    Leaf, A.

    1984-01-01

    The indirect effects of a nuclear war that will affect the health of survivors are considered to include consequences to: (a) the economies of nations, (b) food and nutrition, (c) water supplies, (d) the climate and the ecosphere, and (e) sanitation and public health; and they include long-term radiation effects

  5. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  6. Preparing for Ebola Virus Disease in West African countries not yet affected: perspectives from Ghanaian health professionals.

    Science.gov (United States)

    Nyarko, Yaw; Goldfrank, Lewis; Ogedegbe, Gbenga; Soghoian, Sari; de-Graft Aikins, Ama

    2015-02-26

    The current Ebola Virus Disease (EVD) epidemic has ravaged the social fabric of three West African countries and affected people worldwide. We report key themes from an agenda-setting, multi-disciplinary roundtable convened to examine experiences and implications for health systems in Ghana, a nation without cases but where risk for spread is high and the economic, social and political impact of the impending threat is already felt. Participants' personal stories and the broader debates to define fundamental issues and opportunities for preparedness focused on three inter-related themes. First, the dangers of the fear response itself were highlighted as a threat to the integrity and continuity of quality care. Second, healthcare workers' fears were compounded by a demonstrable lack of societal and personal protections for infection prevention and control in communities and healthcare facilities, as evidenced by an ongoing cholera epidemic affecting over 20,000 patients in the capital Accra alone since June 2014. Third, a lack of coherent messaging and direction from leadership seems to have limited coordination and reinforced a level of mistrust in the government's ability and commitment to mobilize an adequate response. Initial recommendations include urgent investment in the needed supplies and infrastructure for basic, routine infection control in communities and healthcare facilities, provision of assurances with securities for frontline healthcare workers, establishment of a multi-sector, "all-hazards" outbreak surveillance system, and engaging directly with key community groups to co-produce contextually relevant educational messages that will help decrease stigma, fear, and the demoralizing perception that the disease defies remedy or control. The EVD epidemic provides an unprecedented opportunity for West African countries not yet affected by EVD cases to make progress on tackling long-standing health systems weaknesses. This roundtable discussion

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

    OpenAIRE

    Simon Munyua; Dr. Gladys Rotich; Dr. Michael Kimwele

    2015-01-01

    Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting...

  8. Female farmworkers' perceptions of heat-related illness and pregnancy health.

    Science.gov (United States)

    Flocks, Joan; Vi Thien Mac, Valerie; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A

    2013-01-01

    Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women's perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.

  9. Effect of Personalized System of Instruction on Health-Related Fitness Knowledge and Class Time Physical Activity

    Science.gov (United States)

    Prewitt, Steven L.; Hannon, James C.; Colquitt, Gavin; Brusseau, Timothy A.; Newton, Maria; Shaw, Janet

    2015-01-01

    In previous studies, researchers have identified a general low level of health-related fitness (HRF) knowledge among secondary students that can effect levels of physical activity (PA). An instructional strategy that may increase HRF knowledge without decreasing PA is the personalized system of instruction (PSI). Two classes from a private urban…

  10. Biodiversity, air quality and human health

    Science.gov (United States)

    David J. Nowak; Sarah Jovan; Christina Branquinho; Sofia Augusto; Manuel C. Ribeiro; Conor E. Kretsch

    2015-01-01

    Air pollution is a significant problem in cities across the world. It affects human health and well-being, ecosystem health, crops, climate, visibility and human-made materials. Health effects related to air pollution include its impact on the pulmonary, cardiac, vascular and neurological systems (Section 2). Trees affect air quality through a number of means (Section...

  11. Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes

    Science.gov (United States)

    Hatcher, Abigail M.; Weiser, Sheri D.; Johnson, Mallory O.; Rice, Whitney S.; Turan, Janet M.

    2017-01-01

    We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health. PMID:28426316

  12. Stress in nurses: stress-related affect and its determinants examined over the nursing day.

    Science.gov (United States)

    Johnston, Derek W; Jones, Martyn C; Charles, Kathryn; McCann, Sharon K; McKee, Lorna

    2013-06-01

    Nurses are a stressed group and this may affect their health and work performance. The determinants of occupational stress in nurses and other occupational groups have almost invariably been examined in between subject studies. This study aimed to determine if the main determinants of occupation stress, i.e. demand, control, effort and reward, operate within nurses. A real time study using personal digital-assistant-based ecological momentary assessment to measure affect and its hypothesised determinants every 90 min in 254 nurses over three nursing shifts. The measures were negative affect, positive affect, demand/effort, control and reward. While the effects varied in magnitude between people, in general increased negative affect was predicted by high demand/effort, low control and low reward. Control and reward moderated the effects of demand/effort. High positive affect was predicted by high demand/effort, control and reward. The same factors are associated with variations in stress-related affect within nurses as between.

  13. Mobile health monitoring system for community health workers

    CSIR Research Space (South Africa)

    Sibiya, G

    2014-09-01

    Full Text Available of hypertension as it provides real time information and eliminates the need to visit a healthcare facility to take blood pressure readings. Our proposed mobile health monitoring system enables faster computerization of data that has been recorded... pressure, heart rate and glucose readings. These reading closely related to most common NCDs. D. Feedback to health worker and the subject of care Community health workers are often not professionally trained on health. As a result they are not expected...

  14. Working on reform. How workers' compensation medical care is affected by health care reform.

    Science.gov (United States)

    Himmelstein, J; Rest, K

    1996-01-01

    The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

  15. Analysis of Influencing Factors Related to Health Promotion Behavior in Hospital Radiological Technologists

    International Nuclear Information System (INIS)

    Ko, Jong Kyung; Kwon, Duk Mun; Kang, Yeong Han

    2009-01-01

    The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's α=0.79). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to be was sufficient (Cronbach's α=0.93). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.

  16. Analysis of Influencing Factors Related to Health Promotion Behavior in Hospital Radiological Technologists

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jong Kyung [Kim, In Hwan Internal Medicine Health Promotion Cnter, Youngcheon (Korea, Republic of); Kwon, Duk Mun [Dept. of Radiology Technology, Daegu Health College, Daegu (Korea, Republic of); Kang, Yeong Han [Dept. of Diagnostic Radiology, Daegu Catholic Univesity Hospital, Daegu (Korea, Republic of)

    2009-12-15

    The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's {alpha}=0.79). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to be was sufficient (Cronbach's {alpha}=0.93). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.

  17. Developing Automatic Form and Design System Using Integrated Grey Relational Analysis and Affective Engineering

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Liu

    2018-01-01

    Full Text Available In the modern highly competitive marketplace and global market environment, product quality improvements that abridge development time and reduce the production costs are effective methods for promoting the business competitiveness of a product in shorter lifecycles. Since the design process is the best time to control such parameters, systematically designing the processes to develop a product that more closely fits the demand requirements for the market is a key factor for developing a successful product. In this paper, a combined affective engineering method and grey relational analysis are used to develop a product design process. First, design image scale technology is used to acquire the best the design criteria factors, and then affective engineering methods are used to set the relationships between customer needs and production factors. Finally, grey relational analysis is used to select the optimal design strategy. Using this systematic design method, a higher quality product can be expanded upon in a shorter lead-time for improving business competition.

  18. Measuring the mental health care system responsiveness: results of an outpatient survey in Tehran

    Directory of Open Access Journals (Sweden)

    Setareh eForouzan

    2016-01-01

    Full Text Available AbstractAs explained by the World Health Organisation (WHO in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health care system of Tehran. Utilising the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Autonomy, quality of basic amenities and clear communication were responsiveness dimensions that performed poorly but were considered to be important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health care systems to become more patient orientated and provide patients with more respect.

  19. Health-related behaviors among pregnant women with hypertension

    Directory of Open Access Journals (Sweden)

    Agnieszka Maria Bień

    2017-01-01

    Full Text Available Introduction. The healthy and unhealthy behaviors of a pregnant woman influence both her own health and that of her unborn child, affecting its future development. The purpose of the study was to evaluate the health-related behaviors of pregnant women with hypertension.   Material i method. The study was performed between November 2011 and February 2012 and included 80 hypertensive pregnant women hospitalized in a high risk pregnancy ward. The study used a diagnostic survey with questionnaires. Results. Statistical analyses showed a correlation between the respondents’ health-related behaviors and their socio-demographic characteristics: exercise was correlated with age (p=0.01, and rest during the day was correlated with support in everyday responsibilities (p<0.00001, and with the respondents’ socio-economic standing (p=0.03. Correlations were also found between healthy eating habits and residence (0.006, education (p=0.05, and sodium intake (p=0.0003, as well as between education and substance use (p=0.0003. Conclusion. Health-related behaviors of pregnant women with hypertension are influenced by their education, support they receive in daily responsibilities, and their socio-economic standing. The diagnosis of hypertension in pregnant women does not necessarily prompt them to discontinue all unhealthy behaviors.

  20. Differences in the health-related quality of life, affective status, and personality between irritable bowel syndrome and inflammatory bowel disease patients.

    Science.gov (United States)

    Tkalcić, Mladenka; Hauser, Goran; Stimac, Davor

    2010-07-01

    To investigate differences in the health-related quality of life (HRQoL), number of stressful life events, affective status, and some personality characteristics between patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) as well as their possible role in disease activity. Fifty-six IBS outpatients, age range 25-75 years (mean = 48.64; SD = 13.04) and 43 outpatients with IBD, age range 19-74 years (mean = 42.90; SD = 15.44), participated in this study. Patients filled out the following questionnaires: Short-Form 36 Health Survey, Beck Depression Inventory, Spielberger's Trait-Anxiety Inventory, Big Five Inventory, and Stressful Life Events Questionnaire. There were significant differences in the physical component (F = 10.80, Ppersonality trait. The results of this study show that the patients with IBS are more prone to the effect of psychosocial variables on gastrointestinal symptoms compared with patients with organic gastrointestinal diseases such as IBD. IBS patients experienced a higher level of anxiety and expressed a higher level of neuroticism as a personality trait compared with IBD patients.

  1. Affect and Health Behavior Co-Occurrence: The Emerging Roles of Transdiagnostic Factors and Sociocultural Factors.

    Science.gov (United States)

    Zvolensky, Michael J; Leventhal, Adam M

    2016-01-01

    The majority of scientific work addressing relations among affective states and health correlates has focused primarily on their co-occurrence and a limited range of health conditions. We have developed a Special Issue to highlight recent advances in this emerging field of work that addresses the nature and interplay between affective states and disorders, in terms of their impact and consequences from health status and behavior. This Special Issue is organized into three parts classified as (a) co-occurrence and interplay between (b) transdiagnostic factors and (c) sociocultural factors. It is hoped that this issue will (a) alert readers to the significance of this work at different levels of analysis, (b) illustrate the many domains currently being explored via innovative approaches, and (c) identify fecund areas for future systematic study. © The Author(s) 2016.

  2. Does the Relation between Volunteering and Well-Being Vary with Health and Age?

    Science.gov (United States)

    Okun, Morris A.; Rios, Rebeca; Crawford, Aaron V.; Levy, Roy

    2011-01-01

    Previous studies have established a positive association between organizational volunteering and well-being. In the current study, we examined whether the relations between organizational volunteering and positive affect, negative affect, and resilience are modified by respondents' age and number of chronic health conditions. This study used…

  3. How extractive industries affect health: Political economy underpinnings and pathways.

    Science.gov (United States)

    Schrecker, Ted; Birn, Anne-Emanuelle; Aguilera, Mariajosé

    2018-06-07

    A systematic and theoretically informed analysis of how extractive industries affect health outcomes and health inequities is overdue. Informed by the work of Saskia Sassen on "logics of extraction," we adopt an expansive definition of extractive industries to include (for example) large-scale foreign acquisitions of agricultural land for export production. To ground our analysis in concrete place-based evidence, we begin with a brief review of four case examples of major extractive activities. We then analyze the political economy of extractivism, focusing on the societal structures, processes, and relationships of power that drive and enable extraction. Next, we examine how this global order shapes and interacts with politics, institutions, and policies at the state/national level contextualizing extractive activity. Having provided necessary context, we posit a set of pathways that link the global political economy and national politics and institutional practices surrounding extraction to health outcomes and their distribution. These pathways involve both direct health effects, such as toxic work and environmental exposures and assassination of activists, and indirect effects, including sustained impoverishment, water insecurity, and stress-related ailments. We conclude with some reflections on the need for future research on the health and health equity implications of the global extractive order. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Organizational Structure and Management in Romanian Health System

    OpenAIRE

    Boldureanu Daniel; Boldureanu Gabriela

    2010-01-01

    The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

  5. The Economics of Public Health: Missing Pieces to the Puzzle of Health System Reform.

    Science.gov (United States)

    Mays, Glen P; Atherly, Adam J; Zaslavsky, Alan M

    2017-12-01

    The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks. The Affordable Care Act and related health reform initiatives are generating new interest in the question of how best to expand and integrate public health approaches into the larger U.S. health system. The research articles featured in this issue of Health Services Research cluster around two broad topics: how public health agencies can deliver services efficiently and how public health agencies can interact productively with other elements of the health system. The results suggest promising avenues for aligning medical care and public health practices. © Health Research and Educational Trust.

  6. Using a plant health system framework to assess plant clinic performance in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, Frank B.

    2016-01-01

    and expand, new analytical frameworks and tools are needed to identify factors influencing performance of services and systems in specific contexts, and to guide interventions. In this paper we apply a plant health system framework to assess plant clinic performance, using Uganda as a case study...... factors, influenced by basic operational and financial concerns, inter-institutional relations and public sector policies. Overall, there was a fairly close match between the plant health system attributes and plant clinic performance, suggesting that the framework can help explain system functioning....... A comparative study of plant clinics was carried out between July 2010 and September 2011 in the 12 districts where plant clinics were operating at that time. The framework enabled us to organise multiple issues and identify key features that affected the plant clinics. Clinic performance was, among other...

  7. Health-related behaviors moderate the association between age and self-reported health literacy among Taiwanese women.

    Science.gov (United States)

    Duong, Tuyen-Van; Sørensen, Kristine; Pelikan, Jürgen M; Van den Broucke, Stephan; Lin, I-Feng; Lin, Ying-Chin; Huang, Hsiao-Ling; Chang, Peter Wushou

    2017-05-24

    The role of health-related behaviors in the association between age and health literacy has not been well-elucidated. The present cross-sectional study evaluated the interactions between age and health-related behaviors in 942 women in Taiwan between February and October 2013. Women aged 18-78 years were randomly sampled and recruited from the national administrative system. Self-reported health literacy was measured by the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in Mandarin, asking about sociodemographics and essential health-related behaviors (watching health-related television, community involvement). The interviews were conducted confidentially by well-trained interviewers after having participants' consent. In multiple linear regression models adjusted for education attainment, self-perceived social status, ability to pay for medication, and health-related behaviors, health literacy was significantly negatively related to age (unstandardized regression coefficient, B = -0.04; 95% confidence interval [CI] = (-0.07; 0.00); p = .03). The lower health literacy among older women was significantly modified by watching health-related television programs (from "rarely/not-at-all", B = -0.08 (-0.12, -0.04), p women's health literacy and likely their health.

  8. HealthStyles: a new psychographic segmentation system for health care marketers.

    Science.gov (United States)

    Endresen, K W; Wintz, J C

    1988-01-01

    HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior.

  9. Building-related health impacts in European and Chinese cities

    DEFF Research Database (Denmark)

    Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki

    2015-01-01

    consumption of buildings. In addition, the model should be usable for policy comparisons by non-health experts on city level with city-specific data, it should give guidance on the particular climate mitigation questions but at the same time increase understanding on the related health impacts and the model......BACKGROUND: Public health is often affected by societal decisions that are not primarily about health. Climate change mitigation requires intensive actions to minimise greenhouse gas emissions in the future. Many of these actions take place in cities due to their traffic, buildings, and energy...... consumption. Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health. Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power...

  10. A decision technology system for health care electronic commerce.

    Science.gov (United States)

    Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

    1999-08-01

    Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.

  11. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  12. Health and illness in a connected world: how might sharing experiences on the internet affect people's health?

    Science.gov (United States)

    Ziebland, Sue; Wyke, Sally

    2012-06-01

    The use of the Internet for peer-to-peer connection has been one of its most dramatic and transformational features. Yet this is a new field with no agreement on a theoretical and methodological basis. The scientific base underpinning this activity needs strengthening, especially given the explosion of web resources that feature experiences posted by patients themselves. This review informs a National Institute for Health Research (NIHR) (UK) research program on the impact of online patients' accounts of their experiences with health and health care, which includes the development and validation of a new e-health impact questionnaire. We drew on realist review methods to conduct a conceptual review of literature in the social and health sciences. We developed a matrix to summarize the results, which we then distilled from a wide and diverse reading of the literature. We continued reading until we reached data saturation and then further refined the results after testing them with expert colleagues and a public user panel. We identified seven domains through which online patients' experiences could affect health. Each has the potential for positive and negative impacts. Five of the identified domains (finding information, feeling supported, maintaining relationships with others, affecting behavior, and experiencing health services) are relatively well rehearsed, while two (learning to tell the story and visualizing disease) are less acknowledged but important features of online resources. The value of first-person accounts, the appeal and memorability of stories, and the need to make contact with peers all strongly suggest that reading and hearing others' accounts of their own experiences of health and illnesss will remain a key feature of e-health. The act of participating in the creation of health information (e.g., through blogging and contributing to social networking on health topics) also influences patients' experiences and has implications for our

  13. WHAT CAN TANZANIA'S HEALTH CARE SYSTEM LEARN FROM OECD COUNTRIES?

    OpenAIRE

    Kajuna, Dezidery Theobard

    2014-01-01

    Abstract Healthcare systems around the world have different shapes that are largely affected by socio-economic and political situations of a particular country. It is essential for the population to have better health services which requires the country to have better health policies, enough funding for health care sector, and a well structured delivery system. Tanzania like any other developing countries continue to face different challenges in healthcare sector greatly influenced by poor ec...

  14. Work–Family Conflict and Mental Health Among Female Employees: A Sequential Mediation Model via Negative Affect and Perceived Stress

    Science.gov (United States)

    Zhou, Shiyi; Da, Shu; Guo, Heng; Zhang, Xichao

    2018-01-01

    After the implementation of the universal two-child policy in 2016, more and more working women have found themselves caught in the dilemma of whether to raise a baby or be promoted, which exacerbates work–family conflicts among Chinese women. Few studies have examined the mediating effect of negative affect. The present study combined the conservation of resources model and affective events theory to examine the sequential mediating effect of negative affect and perceived stress in the relationship between work–family conflict and mental health. A valid sample of 351 full-time Chinese female employees was recruited in this study, and participants voluntarily answered online questionnaires. Pearson correlation analysis, structural equation modeling, and multiple mediation analysis were used to examine the relationships between work–family conflict, negative affect, perceived stress, and mental health in full-time female employees. We found that women’s perceptions of both work-to-family conflict and family-to-work conflict were significant negatively related to mental health. Additionally, the results showed that negative affect and perceived stress were negatively correlated with mental health. The 95% confidence intervals indicated the sequential mediating effect of negative affect and stress in the relationship between work–family conflict and mental health was significant, which supported the hypothesized sequential mediation model. The findings suggest that work–family conflicts affected the level of self-reported mental health, and this relationship functioned through the two sequential mediators of negative affect and perceived stress. PMID:29719522

  15. Work-Family Conflict and Mental Health Among Female Employees: A Sequential Mediation Model via Negative Affect and Perceived Stress.

    Science.gov (United States)

    Zhou, Shiyi; Da, Shu; Guo, Heng; Zhang, Xichao

    2018-01-01

    After the implementation of the universal two-child policy in 2016, more and more working women have found themselves caught in the dilemma of whether to raise a baby or be promoted, which exacerbates work-family conflicts among Chinese women. Few studies have examined the mediating effect of negative affect. The present study combined the conservation of resources model and affective events theory to examine the sequential mediating effect of negative affect and perceived stress in the relationship between work-family conflict and mental health. A valid sample of 351 full-time Chinese female employees was recruited in this study, and participants voluntarily answered online questionnaires. Pearson correlation analysis, structural equation modeling, and multiple mediation analysis were used to examine the relationships between work-family conflict, negative affect, perceived stress, and mental health in full-time female employees. We found that women's perceptions of both work-to-family conflict and family-to-work conflict were significant negatively related to mental health. Additionally, the results showed that negative affect and perceived stress were negatively correlated with mental health. The 95% confidence intervals indicated the sequential mediating effect of negative affect and stress in the relationship between work-family conflict and mental health was significant, which supported the hypothesized sequential mediation model. The findings suggest that work-family conflicts affected the level of self-reported mental health, and this relationship functioned through the two sequential mediators of negative affect and perceived stress.

  16. Work–Family Conflict and Mental Health Among Female Employees: A Sequential Mediation Model via Negative Affect and Perceived Stress

    Directory of Open Access Journals (Sweden)

    Shiyi Zhou

    2018-04-01

    Full Text Available After the implementation of the universal two-child policy in 2016, more and more working women have found themselves caught in the dilemma of whether to raise a baby or be promoted, which exacerbates work–family conflicts among Chinese women. Few studies have examined the mediating effect of negative affect. The present study combined the conservation of resources model and affective events theory to examine the sequential mediating effect of negative affect and perceived stress in the relationship between work–family conflict and mental health. A valid sample of 351 full-time Chinese female employees was recruited in this study, and participants voluntarily answered online questionnaires. Pearson correlation analysis, structural equation modeling, and multiple mediation analysis were used to examine the relationships between work–family conflict, negative affect, perceived stress, and mental health in full-time female employees. We found that women’s perceptions of both work-to-family conflict and family-to-work conflict were significant negatively related to mental health. Additionally, the results showed that negative affect and perceived stress were negatively correlated with mental health. The 95% confidence intervals indicated the sequential mediating effect of negative affect and stress in the relationship between work–family conflict and mental health was significant, which supported the hypothesized sequential mediation model. The findings suggest that work–family conflicts affected the level of self-reported mental health, and this relationship functioned through the two sequential mediators of negative affect and perceived stress.

  17. The State Public Health Laboratory System.

    Science.gov (United States)

    Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

  18. [Systematic review of health-related utilities in Spain: the case of mental health].

    Science.gov (United States)

    García-Pérez, Lidia; Aguiar-Ibáñez, Raquel; Pinilla-Domínguez, Pilar; Arvelo-Martín, Alejandro; Linertová, Renata; Rivero-Santana, Amado

    2014-01-01

    Currently, there is no registry of utility values for the Spanish population that could potentially be used in economic evaluations. Consequently, a systematic review of utilities or preferences for health states in the Spanish population was conducted. The results related to mental health are reported. A systematic review of the literature was conducted. The main databases searched were MEDLINE, CRD, Embase, PsycINFO, CINAHL, and Cochrane. The search strategy combined terms related to utilities and Spain. The inclusion criteria comprised the resident population in Spain, whether affected by any disease or not; the reported utilities had to be evaluated through a tool validated in Spain (i.e., EQ-5D, HUI, SF-6D) and/or following accepted techniques (e.g., time trade-off, standard gamble, or the visual analog scale). A narrative synthesis of articles was undertaken and the results related to mental health summarized. A total of 103 articles were finally included, from which 742 utility values were extracted. Sixty-nine utility values related to mental health and behavioral disorders were extracted from 12 studies. The most widely used tool was the E5-QD questionnaire. Most of the excluded articles evaluated quality of life but did not provide an estimation of utilities. This review adds value to research on utilities in Spain by gathering values to be included in economic evaluations, as well as by identifying research gaps in this field. The utility values related to mental health identified in this study are similar to those reported in international publications. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    Science.gov (United States)

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. FEMALE FARMWORKERS’ PERCEPTIONS OF HEAT-RELATED ILLNESS AND PREGNANCY HEALTH

    Science.gov (United States)

    Flocks, Joan; Mac, Valerie Vi Thien; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A.

    2017-01-01

    While agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women’s perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy. PMID:24125050

  1. Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: the al-Ándalus project.

    Science.gov (United States)

    Segura-Jiménez, Víctor; Álvarez-Gallardo, Inmaculada C; Carbonell-Baeza, Ana; Aparicio, Virginia A; Ortega, Francisco B; Casimiro, Antonio J; Delgado-Fernández, Manuel

    2015-04-01

    To characterize a representative sample of fibromyalgia women based on a set of relevant factors known to be related to this disease. To distinguish specific factors of the disease from other symptoms that might also exist in non-fibromyalgia women. To test whether fibromyalgia affects more severely physical or psychological outcomes. A total of 459 fibromyalgia women vs. 214 non-fibromyalgia (control) women from Southern Spain (Andalusia) took part in this cross-sectional study. Several instruments were used to assess tenderness, impact of fibromyalgia, fatigue, health-related quality of life, mental health, and cognitive performance. Overall, fibromyalgia women showed a worse status in pain, fatigue, health-related quality of life, depression, and anxiety than controls (P fibromyalgia and controls were observed in cognitive and memory performance, except for delayed recall, but the observed effect size was low (~0.25). The effect size observed for the global physical component (~3.3) was larger than that for the global psychological component (~1.3), all P fibromyalgia as a polysymptomatic distress condition with pain as its main symptom. Our findings support that fibromyalgia seems to have a greater impact on physical than on psychological outcomes, though both are largely affected. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study.

    Science.gov (United States)

    Nguyen, Amanda J; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

    2016-01-01

    A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Data were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers. Multiple mental health and psychosocial problems emerged, including 'bad psychological health', 'depression', 'stress and nervous people', and 'problems in the family'. Aggression, 'emotional blowing', and 'not adequate' behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers. Chechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of 'emotional blowing' mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.

  3. Relations between mental health team characteristics and work role performance.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Farand, Lambert

    2017-01-01

    Effective mental health care requires a high performing, interprofessional team. Among 79 mental health teams in Quebec (Canada), this exploratory study aims to 1) determine the association between work role performance and a wide range of variables related to team effectiveness according to the literature, and to 2) using structural equation modelling, assess the covariance between each of these variables as well as the correlation with other exogenous variables. Work role performance was measured with an adapted version of a work role questionnaire. Various independent variables including team manager characteristics, user characteristics, team profiles, clinical activities, organizational culture, network integration strategies and frequency/satisfaction of interactions with other teams or services were analyzed under the structural equation model. The later provided a good fit with the data. Frequent use of standardized procedures and evaluation tools (e.g. screening and assessment tools for mental health disorders) and team manager seniority exerted the most direct effect on work role performance. While network integration strategies had little effect on work role performance, there was a high covariance between this variable and those directly affecting work role performance among mental health teams. The results suggest that the mental healthcare system should apply standardized procedures and evaluation tools and, to a lesser extent, clinical approaches to improve work role performance in mental health teams. Overall, a more systematic implementation of network integration strategies may contribute to improved work role performance in mental health care.

  4. Italian regional health system structure and expected cancer survival.

    Science.gov (United States)

    Vercelli, Marina; Lillini, Roberto; Quaglia, Alberto; Capocaccia, Riccardo

    2014-01-01

    Few studies deal with the association of socioeconomic and health system resource variables with cancer survival at the Italian regional level, where the greatest number of decisions about social and health policies and resource allocations are taken. The present study aimed to describe the causal relationships between socioeconomic and health system resource factors and regional cancer survival and to compute the expected cancer survival at provincial, regional and area levels. Age-standardized relative survival at 5 years from diagnosis of cases incident in 1995-1998 and followed up to 2004 were derived by gender for 11 sites from the Italian Association of Cancer Registries data bank. The socioeconomic and health system resource variables, describing at a regional level the macro-economy, demography, labor market, and health resources for 1995-2005, came from the Health for All database. A principal components factor analysis was applied to the socioeconomic and health system resource variables. For every site, linear regression models were computed considering the relative survival at 5 years as a dependent variable and the principal components factor analysis factors as independent variables. The factors described the socioeconomic and health-related features of the regional systems and were causally related to the characteristics of the patient taken in charge. The models built by the factors allowed computation of the expected relative survival at 5 years with very good concordance with those observed at regional, macro-regional and national levels. In the regions without any cancer registry, survival was coherent with that of neighboring regions with similar socioeconomic and health system resources characteristics. The models highlighted the causal correlations between socioeconomic and health system resources and cancer survival, suggesting that they could be good evaluation tools for the efficiency of the resources allocation and use.

  5. Case studies on employment-related health inequalities in countries representing different types of labor markets.

    Science.gov (United States)

    Kim, Il-Ho; Muntaner, Carles; Chung, Haejoo; Benach, Joan

    2010-01-01

    The authors selected nine case studies, one country from each cluster of their labor market inequalities typology, to outline the macro-political and economic roots of employment relations and their impacts on health. These countries illustrate variations in labor markets and health, categorized into a global empirical typology. The case studies illustrated that workers' health is significantly connected with labor market characteristics and the welfare system. For a core country, the labor market is characterized by a formal sector. The labor institutions of Sweden traditionally have high union density and collective bargaining coverage and a universal health care system, which correlate closely with positive health, in comparison with Spain and the United States. For a semi-periphery country, the labor market is delineated by a growing informal economy. Although South Korea, Venezuela, and El Salvador provide some social welfare benefits, a high proportion of irregular and informal workers are excluded from these benefits and experience hazardous working conditions that adversely affect their health. Lastly, several countries in the global periphery--China, Nigeria, and Haiti--represent informal work and severe labor market insecurity. In the absence of labor market regulations, the majority of their workers toil in the informal sector in unsafe conditions with inadequate health care.

  6. 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.

  7. [Work-related stress and mental health - can work lead to mental disorders?

    Science.gov (United States)

    Ptáček, Radek; Vňuková, Martina; Raboch, Jiří

    2017-01-01

    In the past two decades, special attention was paid to mental health issues. The available literature suggests, for example, the relationship between the workload and mental discomfort and the occurrence of myocardial infarction. This article focuses mainly on the issue of work-related stress and its impact on mental health. In this context, it must be acknowledged that possible psychological problems due to work are not only employees problem. These difficulties can significantly affect performance - and thus they should be the concern of the employer, but also of customers, clients and patients who come into contact with the worker who might develop some mental problems, due to the nature of his work and working conditions. This article provides an overview of the various factors affecting the mental health of employees. These are, for example, work demands, working hours and workplace relations. In conclusion, it brings results of Czech study examining job stress among working population.

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

    Directory of Open Access Journals (Sweden)

    Simon Munyua

    2015-08-01

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

  9. Impacts of age-related failures on nuclear systems

    International Nuclear Information System (INIS)

    Meale, B.M.; Satterwhite, D.G.; Krantz, E.A.; MacDonald, P.E.

    1986-01-01

    Aging-related failure data from nine light water reactor safety, support, and power conversion systems have been extracted from an operational data base. Systems and components within the systems that are most affected by aging are identified. In addition, information on aging-related root causes of component failures has been extracted for service water and Class 1E electrical power distribution systems. Engineering insights are presented, and preliminary quantification of the importance of aging-related root causes for a service water system is provided

  10. Leading toward value: the role of strategic human resource management in health system adaptability.

    Science.gov (United States)

    Garman, Andrew N; Polavarapu, Nandakishor; Grady, Jane C; Canar, W Jeffrey

    2013-01-01

    Personnel costs typically account for 60% or more of total operating expenses in health systems, and as such become a necessary focus in most if not all substantive health reform adaptations. This study sought to assess whether strategic alignment of the human resource (HR) and learning functions was associated with greater adaptive capacity in U.S. health systems. Data were gathered using a survey that was distributed electronically to chief human resource officers from two U.S.-based associations. The survey included questions about organizational structure, strategic human resource management, strategic learning, and organizational response to health reform. Significant correlations were found between strategic alignment of HR and HR's involvement in responses related to cost control (r = 0.46, p strategic alignment of organizational learning and HR involvement with these responses. Results suggest that HR structure may affect an organization's capacity for adaptive response. Top-management teams in health systems should consider positioning HR as part of the core leadership team, with a reporting relationship that allows HR to maximally participate in formulating and implementing organizational adaptation.

  11. Assessing clergy work-related psychological health : reliability and validity of the Francis Burnout Inventory

    OpenAIRE

    Francis, Leslie J.; Laycock, Patrick; Crea, Giuseppe

    2017-01-01

    Drawing on the classic model of balanced affect, the Francis Burnout Inventory (FBI) conceptualised good work-related psychological health among clergy in terms of negative affect being balanced by positive affect. In the FBI negative affect is assessed by the Scale of Emotional Exhaustion in Ministry (SEEM) and positive affect is assessed by the Satisfaction in Ministry Scale (SIMS). In support of the idea of balanced affect, previous work had shown a significant interaction between the effe...

  12. Factors Affecting Successful Implementation of Hospital Information Systems.

    Science.gov (United States)

    Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

    2016-02-01

    Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

  13. Health promoting schools and children's oral health related quality of life.

    Science.gov (United States)

    Yusof, Zamros Y M; Jaafar, Nasruddin

    2013-12-10

    The study objective was to compare children's oral health related quality of life (OHRQoL) in schools with 6 years of implementation of a health promoting school model in Malaysia, i.e. the Doktor Muda Programme (DMP) and in schools without the DMP. This report was part of a larger study to evaluate the DMP impact on schoolchildren's oral health knowledge, attitudes, behaviour, caries progression and OHRQoL. It was conducted in Negri Sembilan state. The sample comprised 3455, Year 6 (11-12 year old) children; 1282 from DMP (intervention) and 2173 from non-DMP (control) schools. The Malay Child-OIDP index was used to evaluate children's levels of oral impacts on 8 daily performances after 6 years of DMP implementation (2006-2011). Prevalence, score, impact intensity, causes and extent of impacts were compared. Chi-square and Mann-Whitney tests were used in the data analysis. Overall response rate was 95.1%. Prevalence of overall impacts was 57.8% and 60.8% (mean total impact score was 7.10 and 7.77) in the intervention and control group, respectively. The three most frequently affected performances in both groups were eating, cleaning teeth and emotional stability. Significantly less DMP children had oral impact on cleaning teeth (p = 0.034). The majority of children with impacts in both groups reported 'very little' to 'moderate' levels of impact intensity. Significantly more DMP children reported having 'very little' and 'little' levels of impact intensity on cleaning teeth (p = 0.037) and emotional stability (p = 0.020), respectively. Significantly less DMP children reported having 'very severe' level of impact intensity on speaking (p = 0.038). The most prevalent cause of impacts in both groups was toothache. Significantly less DMP children reported bleeding gums (p = 0.016) and presence of plaque/calculus as causes of impacts (p = 0.032). About 75% of children with impacts in both groups reported having up to four daily performances affected. This study showed

  14. Adaptive coping strategies of affected family members of a relative with substance misuse: A qualitative study.

    Science.gov (United States)

    McCann, Terence V; Lubman, Dan I

    2018-01-01

    To explore the coping strategies used by affected family members of a relative with substance misuse. Families play an important role in supporting a relative with substance misuse. However, the experience often has an adverse effect on their general well-being, the extent of which depends largely on their coping strategies. An interpretative phenomenological analysis study. Data were collected between January - December 2015. Semistructured, audio-recorded qualitative interviews were conducted with 31 affected family members. Three main themes and related subthemes were abstracted from the data illustrating how participants coped with their relative's substance misuse: (1) Seeking timely access to evidence-based information; (2) Enhancing personal coping strategies and (3) Accessing informal and formal support. Greater investment is needed in support services for affected family members, particularly in regional and rural areas. A wide range of accessible evidence-based information and informal and formal support, including telephone and online support, is needed to assist them to cope in this crucial support-giving role. Affected family members need to adopt a flexible set of coping strategies while supporting a relative with substance misuse. Family and friends, alcohol and other drug services, mental health nurses and other clinicians have a critical role providing emotional, instrumental and educational support to affected family members to enhance their adaptive coping strategies. © 2017 John Wiley & Sons Ltd.

  15. Factors Affecting Healthful Eating Among Touring Popular Musicians and Singers.

    Science.gov (United States)

    Cizek, Erin; Kelly, Patrick; Kress, Kathleen; Mattfeldt-Beman, Mildred

    2016-06-01

    Maintaining good health is essential for touring musicians and singers. The stressful demands of touring may impact food choices, leading to detrimental effects on health and performance. This exploratory pilot study aimed to assess factors affecting healthful eating of touring musicians and singers. A 46-item survey was used to assess food- and nutrition-related attitudes, knowledge and behaviors, and environmental factors, as well as lifestyle, musical background, and demographic data. Participants (n=35) were recruited from a musicians' assistance foundation as well as touring musical theater productions and a music festival. Results indicate that touring musicians and singers had positive attitudes regarding healthful foods. Of 35 respondents, 80.0% indicated eating healthful food was important to them. Respondents reported feeling confident selecting (76.5%) and preparing (82.4%) healthful foods; however, they showed uncertainty when determining if carbohydrate-containing foods should be consumed or avoided. Respondents indicated environmental factors including availability and cost of healthy food options and tour schedules limited access to healthful foods. Venues (73.5%), fast food restaurants (67.6%), and airports (64.7%) were the most frequently identified locations in need of offering more healthful food choices. Respondents (52.9%) indicated more support from others while touring would help them make healthier food choices. More research is needed to develop mobile wellness programs as well as performance-based nutrition guidelines for musicians and singers that address the unique demands associated with touring.

  16. Choir singing and health status in people affected by cancer.

    Science.gov (United States)

    Reagon, C; Gale, N; Dow, R; Lewis, I; van Deursen, R

    2017-09-01

    Cancer survival rates have improved dramatically over recent years, however, health-related quality of life (HRQoL) for many patients, survivors and their families remains low even after successful treatment. This mixed-methods observational study explored the effects of participation in community choirs on HRQoL in individuals who have had cancer (patients) or have been affected by cancer (non-patients). This included a longitudinal analysis of choristers commencing the Tenovus Cancer Care "Sing with Us" choirs across Wales and a series of semi-structured interviews and focus groups. Participants completed the Short-form 36 and the Hospital Anxiety and Depression Scale on commencement of the choir and 3 and 6 months later. On joining the choir, several domains of the SF36 were lower, indicating worse HRQoL and greater depression in patients than non-patients (p < .05). In patients, choir participation improved vitality, overall mental health and anxiety. In non-patients, choir participation improved anxiety (p < .05). Participants experienced the choirs as both an uplifting musical activity and a supportive community group. The results support the provision of a spectrum of support options to meet the different needs and preferences of people affected by cancer. © 2016 John Wiley & Sons Ltd.

  17. Mood Swings: An Affective Interactive Art System

    Science.gov (United States)

    Bialoskorski, Leticia S. S.; Westerink, Joyce H. D. M.; van den Broek, Egon L.

    The progress in the field of affective computing enables the realization of affective consumer products, affective games, and affective art. This paper describes the affective interactive art system Mood Swings, which interprets and visualizes affect expressed by a person. Mood Swings is founded on the integration of a framework for affective movements and a color model. This enables Mood Swings to recognize affective movement characteristics as expressed by a person and display a color that matches the expressed emotion. With that, a unique interactive system is introduced, which can be considered as art, a game, or a combination of both.

  18. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis

    OpenAIRE

    Vallejo-Torres, Laura; Hale, Daniel; Morris, Stephen; Viner, Russell M

    2014-01-01

    Background Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore ‘equalisation’ in adolescence. Methods We used five years of data (2006–2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstan...

  19. Interactions among poverty, gender, and health systems affect women's participation in services to prevent HIV transmission from mother to child: A causal loop analysis.

    Science.gov (United States)

    Yourkavitch, Jennifer; Hassmiller Lich, Kristen; Flax, Valerie L; Okello, Elialilia S; Kadzandira, John; Katahoire, Anne Ruhweza; Munthali, Alister C; Thomas, James C

    2018-01-01

    Retention in care remains an important issue for prevention of mother-to-child transmission (PMTCT) programs according to WHO guidelines, formerly called the "Option B+" approach. The objective of this study was to examine how poverty, gender, and health system factors interact to influence women's participation in PMTCT services. We used qualitative research, literature, and hypothesized variable connections to diagram causes and effects in causal loop models. We found that many factors, including antiretroviral therapy (ART) use, service design and quality, stigma, disclosure, spouse/partner influence, decision-making autonomy, and knowledge about PMTCT, influence psychosocial health, which in turn affects women's participation in PMTCT services. Thus, interventions to improve psychosocial health need to address many factors to be successful. We also found that the design of PMTCT services, a modifiable factor, is important because it affects several other factors. We identified 66 feedback loops that may contribute to policy resistance-that is, a policy's failure to have its intended effect. Our findings point to the need for a multipronged intervention to encourage women's continued participation in PMTCT services and for longitudinal research to quantify and test our causal loop model.

  20. Diarrhea outbreaks in northeastern Brazil in 2013, according to media and health information systems - Surveillance of climate risk and health emergencies.

    Science.gov (United States)

    Rufino, Renata; Gracie, Renata; Sena, Aderita; de Freitas, Carlos Machado; Barcellos, Christovam

    2016-03-01

    This study has the objective of analyzing information about diarrhea outbreaks in Brazil's northeast in the year 2013. Information came from electronic media and from health information systems. A total of 33 news events related to diarrhea outbreaks were identified, some of them mentioning causes and aggravating factors. The analysis of spatial and temporal distribution of the news, admissions and deaths showed that more than 100,000 persons were affected and, according to the news analyzed, the most affected states were Alagoas and Pernambuco, with a greater extent in the months from May to July. The use of alternative sources of water such as ponds, wells, water trucks and household water reservoirs were identified as the most immediate causes of these outbreaks. However, other underlying factors such as precarious water supply systems in the semi-arid region, the exceptional conditions of drought, considered the worst in the last 60 years, as well as the capacity of the health sector to respond to a large number of cases, should be considered to recover the context in which these outbreaks are produced.

  1. Factors Affecting Initial Intimate Partner Violence-Specific Health Care Seeking in the Tokyo Metropolitan Area, Japan.

    Science.gov (United States)

    Kamimura, Akiko; Bybee, Deborah; Yoshihama, Mieko

    2014-09-01

    This study examined the factors affecting a women's initial intimate partner violence (IPV)-specific health care seeking event which refers to the first health care seeking as a result of IPV in a lifetime. Data were collected using the Life History Calendar method in the Tokyo metropolitan area from 101 women who had experienced IPV. Discrete-time survival analysis was used to assess the time to initial IPV-specific health care seeking. IPV-related injury was the most significant factor associated with increased likelihood of seeking IPV-specific health care seeking for the first time. In the presence of a strong effect of formal help seeking, physical and sexual IPV were no longer significantly related to initial IPV-specific health care seeking. The results suggest some victims of IPV may not seek health care unless they get injured. The timing of receiving health care would be important to ensure the health and safety of victims. © The Author(s) 2014.

  2. How Does What I Eat Affect My Oral Health?

    Science.gov (United States)

    ... be just as satisfying and better for your dental health. One caution: malnutrition (bad nutrition) can result from too much nourishment as easily ... dentist if you're not sure how your nutrition (diet) may affect your oral health. Conditions such as tooth loss, pain or joint ...

  3. Impact of DNA mismatch repair system alterations on human fertility and related treatments.

    Science.gov (United States)

    Hu, Min-hao; Liu, Shu-yuan; Wang, Ning; Wu, Yan; Jin, Fan

    2016-01-01

    DNA mismatch repair (MMR) is one of the biological pathways, which plays a critical role in DNA homeostasis, primarily by repairing base-pair mismatches and insertion/deletion loops that occur during DNA replication. MMR also takes part in other metabolic pathways and regulates cell cycle arrest. Defects in MMR are associated with genomic instability, predisposition to certain types of cancers and resistance to certain therapeutic drugs. Moreover, genetic and epigenetic alterations in the MMR system demonstrate a significant relationship with human fertility and related treatments, which helps us to understand the etiology and susceptibility of human infertility. Alterations in the MMR system may also influence the health of offspring conceived by assisted reproductive technology in humans. However, further studies are needed to explore the specific mechanisms by which the MMR system may affect human infertility. This review addresses the physiological mechanisms of the MMR system and associations between alterations of the MMR system and human fertility and related treatments, and potential effects on the next generation.

  4. Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications

    Directory of Open Access Journals (Sweden)

    Elizabeth Skidmore Edwards

    2016-01-01

    Full Text Available This article reviews psychosocial influences on women's participation in physical activity as they differ from men and how associated activity differences impact women's risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women's health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male counterparts. These lower rates of physical activity are directly related to both incidence of and outcomes from cardiovascular disease, type 2 diabetes, and breast and gynecological cancers. The relationship between psychosocial factors that are understood to affect physical activity differs between men and women. Specifically, self-efficacy, social support, and motivation are empirically substantiated factors that found to impact physical activity participation among women differently than men. Understanding these relationships is integral to designing effective interventions to target physical activity participation in women so that the related health risks are adequately addressed.

  5. Somatic-Affective, But Not Cognitive-Depressive Symptoms are Associated With Reduced Health-Related Quality of Life in Patients With Congestive Heart Failure.

    Science.gov (United States)

    Patron, Elisabetta; Messerotti Benvenuti, Simone; Lopriore, Vincenzo; Aratari, Jenny; Palomba, Daniela

    Depression has been associated with poor health-related quality of life (HRQoL) in patients with congestive heart failure (CHF). However, to date, whether somatic-affective and cognitive-depressive symptoms differently contribute to poor HRQoL and behavioral functional capacity in patients with CHF has yet to be investigated. To examine the differential influence of somatic-affective vs cognitive-depressive symptoms on HRQoL and behavioral functional capacity in CHF patients. Overall, 55 patients with CHF completed a psychologic evaluation, including the Minnesota Living with Heart Failure Questionnaire, the Beck Depression Inventory-II, and the Beck Anxiety Inventory for HRQoL, depressive, and anxiety symptoms, respectively. The patients completed the Instrumental Activities of Daily Living Questionnaire and the 6-minute walk test for behavioral functional capacity. Hierarchical regression analyses were used to predict HRQoL and behavioral functional capacity from Beck Depression Inventory-II and Beck Anxiety Inventory scores. Somatic-affective depressive symptoms were associated with physical (β = 0.37, p = 0.005) and emotional (β = 0.39, p = 0.008) Minnesota Living with Heart Failure Questionnaire subscale scores. Likewise, somatic-affective depressive symptoms predicted Instrumental Activities of Daily Livings Scores (β = 0.43, p = 0.004) and distance ambulated during the 6-minute walk test (β = -0.36, p = 0.029). By contrast, cognitive-depressive symptoms and anxiety were unrelated to HRQoL and behavioral functional capacity (all p > 0.05). These findings showed that somatic-affective depressive symptoms, but not cognitive-depressive symptoms and anxiety, are associated with poor HRQoL and behavioral functional capacity independent of age, clinical functional status, and medical comorbidities. This study suggests that patients with CHF with somatic-affective rather than cognitive-depressive symptoms or anxiety may be at greater risk of poor HRQoL and

  6. Depression and health related quality of life in breast cancer patients

    International Nuclear Information System (INIS)

    Ardebil, M. D.; Bouzari, Z.; Shenas, M. H.; Keighobadi, M.

    2013-01-01

    Objective: To investigate the prevalence of depression in women with breast cancer and relate it to their health-related quality of life. Methods: The cross-sectional study was conducted at the Imam Khomeini Hospital in Iran between January and December 2009, and comprised 60 women with breast cancer with a mean age of 43.8+-47.12 years. In order to assess the health-related quality of life, the study used the parameters of the Iranian version of the Functional Assessment of Cancer Therapy for Breast Cancer. To identify expressive symptoms, the Beck Depression Inventory was used. General linear model regression and SPSS 14 were used to analyse the data. Results: Significant differences in the prevalence of depression between treatment types was found. The presence of depression was significantly correlated with poorer overall health-related quality of life and the four subscales of the protocol. The patients reported statistically significant effects of depression in the overall category (p= 0.001). Participants with depression were more likely to have a poorer overall health-related quality of life, the exception being the social/family well-being subscale. Conclusions: Depression affects health-related quality of life in breast cancer patients. Although further studies are necessary to confirm our findings, but our results emphasise the necessity for better mental health strategies for such patients. (author)

  7. Exploring Workarounds Related to Electronic Health Record System Usage: A Study Protocol

    NARCIS (Netherlands)

    Blijleven, Vincent; Koelemeijer, Kitty; Jaspers, Monique

    2017-01-01

    Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow that are unintentionally imposed by electronic health record (EHR) systems. Although workarounds may seem favorable at first sight, they are generally suboptimal and may

  8. Potential impact of climate change on air pollution-related human health effects.

    Science.gov (United States)

    Tagaris, Efthimios; Liao, Kuo-Jen; Delucia, Anthony J; Deck, Leland; Amar, Praveen; Russell, Armistead G

    2009-07-01

    The potential health impact of ambient ozone and PM2.5 concentrations modulated by climate change over the United States is investigated using combined atmospheric and health modeling. Regional air quality modeling for 2001 and 2050 was conducted using CMAQ Modeling System with meteorology from the GISS Global Climate Model, downscaled regionally using MM5,keeping boundary conditions of air pollutants, emission sources, population, activity levels, and pollution controls constant. BenMap was employed to estimate the air pollution health outcomes at the county, state, and national level for 2050 caused by the effect of meteorology on future ozone and PM2.5 concentrations. The changes in calculated annual mean PM2.5 concentrations show a relatively modest change with positive and negative responses (increasing PM2.5 levels across the northeastern U.S.) although average ozone levels slightly decrease across the northern sections of the U.S., and increase across the southern tier. Results suggest that climate change driven air quality-related health effects will be adversely affected in more then 2/3 of the continental U.S. Changes in health effects induced by PM2.5 dominate compared to those caused by ozone. PM2.5-induced premature mortality is about 15 times higher then that due to ozone. Nationally the analysis suggests approximately 4000 additional annual premature deaths due to climate change impacts on PM2.5 vs 300 due to climate change-induced ozone changes. However, the impacts vary spatially. Increased premature mortality due to elevated ozone concentrations will be offset by lower mortality from reductions in PM2.5 in 11 states. Uncertainties related to different emissions projections used to simulate future climate, and the uncertainties forecasting the meteorology, are large although there are potentially important unaddressed uncertainties (e.g., downscaling, speciation, interaction, exposure, and concentration-response function of the human health studies).

  9. [Control of cervical cancer in Colombia: the perspective of the health system].

    Science.gov (United States)

    Wiesner-Ceballos, Carolina; Murillo Moreno, Raúl Hernando; Piñeros Petersen, Marion; Tovar-Murillo, Sandra Lourdes; Cendales Duarte, Ricardo; Gutiérrez, Martha Cielo

    2009-01-01

    To characterize the health system stakeholder's perspective on the basics of the political, economic, and sanitary context, as well as the ways in which control activities are being realized in four of Colombia's health departments. This was a qualitative study of four Colombian health departments chosen for their differing cervical cancer mortality rates and their planned disease control efforts (Boyacá, Caldas, Magdalena, and Tolima). Semistructured interviews were conducted of health care managers, insurance coordinators, and public and private health institutions at the departmental and municipals levels. Focus groups comprised of professionals from health insurance companies and health care services providers were convened. Data analysis was based on the grounded theory with open codes related to the roles of health care managers, insurance companies, and heath care services provided. The technical reports were compared to the testimonies of interviewees. Thirty-eight interviews and 14 focus groups (70.9% response rate) were conducted and 12 technical reports reviewed. Cervical cancer is not perceived to be a public health priority. Interest centers on the flow of financial resources within the health system. Findings indicated unsatisfactory communication among the stakeholders and no consensus on the subject. Planning is limited to meeting the status quo. Staffing is inadequate. Cases with positive outcomes are lost to follow-up due to the fragmentation that results from affiliation with different health care systems. The financial situation, normative planning, and the challenges of decentralization affect the skill-building, at-risk coverage, and the control activities needed for effective screening programs. What is needed is an integrated, more efficiently organized program in which all the health system stakeholders participate.

  10. Determining Barriers and Facilitators Associated With Willingness to Use a Personal Health Information Management System to Support Worksite Wellness Programs.

    Science.gov (United States)

    Neyens, David M; Childers, Ashley Kay

    2017-07-01

    To determine the barriers and facilitators associated with willingness to use personal health information management (PHIM) systems to support an existing worksite wellness program (WWP). The study design involved a Web-based survey. The study setting was a regional hospital. Hospital employees comprised the study subjects. Willingness, barriers, and facilitators associated with PHIM were measured. Bivariate logit models were used to model two binary dependent variables. One model predicted the likelihood of believing PHIM systems would positively affect overall health and willingness to use. Another predicted the likelihood of worrying about online security and not believing PHIM systems would benefit health goals. Based on 333 responses, believing PHIM systems would positively affect health was highly associated with willingness to use PHIM systems (p < .01). Those comfortable online were 7.22 times more willing to use PHIM systems. Participants in exercise-based components of WWPs were 3.03 times more likely to be willing to use PHIM systems. Those who worried about online security were 5.03 times more likely to believe PHIM systems would not help obtain health goals. Comfort with personal health information online and exercise-based WWP experience was associated with willingness to use PHIM systems. However, nutrition-based WWPs did not have similar effects. Implementation barriers relate to technology anxiety and trust in security, as well as experience with specific WWP activities. Identifying differences between WWP components and addressing technology concerns before implementation of PHIM systems into WWPs may facilitate improved adoption and usage.

  11. Choosing a physician depends on how you want to feel: the role of ideal affect in health-related decision making.

    Science.gov (United States)

    Sims, Tamara; Tsai, Jeanne L; Koopmann-Holm, Birgit; Thomas, Ewart A C; Goldstein, Mary K

    2014-02-01

    When given a choice, how do people decide which physician to select? Although significant research has demonstrated that how people actually feel (their "actual affect") influences their health care preferences, how people ideally want to feel (their "ideal affect") may play an even greater role. Specifically, we predicted that people trust physicians whose affective characteristics match their ideal affect, which leads people to prefer those physicians more. Consistent with this prediction, the more participants wanted to feel high arousal positive states on average (ideal HAP; e.g., excited), the more likely they were to select a HAP-focused physician. Similarly, the more people wanted to feel low arousal positive states on average (ideal LAP; e.g., calm), the more likely they were to select a LAP-focused physician. Also as predicted, these links were mediated by perceived physician trustworthiness. Notably, while participants' ideal affect predicted physician preference, actual affect (how much people actually felt HAP and LAP on average) did not. These findings suggest that people base serious decisions on how they want to feel, and highlight the importance of considering ideal affect in models of decision making preferences. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  12. Health Promotion Behaviors of Women and Affecting Factors

    Directory of Open Access Journals (Sweden)

    Naile Bilgili

    2009-12-01

    Full Text Available AIM: Women should be healthy and have health promotion behaviors, so they can accomplish both their maternal and social tasks. This descriptive study was conducted to determine the healthy life-style behaviors of married women and the factors which could affect those behaviors. METHOD: The population comprised all married women older than 15 years and who live in Ankara Kale region. Three hundred-sixty five married women were included in the study. The questionnaire form and the healthy life-style behaviors scale was used for data collection. RESULTS: The mean score taken from scale was 112.2±19.4. The scores of the women who graduated from middle school / high school, who have sufficient income and good socio-economic status, who have a perception of physical health fairly good and who have any chronic disease in their families, have significantly higher mean scores from healthy life-style behaviors scale and subgroups (p<0.05 CONCLUSION: Health promotion behaviors of the women was low and some factors like education level, income, socioeconomic status, perception of health, having any chronic illness and using regular medicine affected healthy life-style behaviors. It is recommended that nurses, who have education and consultation roles, should inform the women about health promotion behaviors and encourage them to use that information in their lives. [TAF Prev Med Bull 2009; 8(6.000: 497-502

  13. Health-Related Quality of Life, Cachexia and Overall Survival After Major Upper Abdominal Surgery: A Prospective Cohort Study.

    Science.gov (United States)

    Aahlin, E K; Tranø, G; Johns, N; Horn, A; Søreide, J A; Fearon, K C; Revhaug, A; Lassen, K

    2017-03-01

    Major upper abdominal surgery is often associated with reduced health-related quality of life and reduced survival. Patients with upper abdominal malignancies often suffer from cachexia, represented by preoperative weight loss and sarcopenia (low skeletal muscle mass) and this might affect both health-related quality of life and survival. We aimed to investigate how health-related quality of life is affected by cachexia and how health-related quality of life relates to long-term survival after major upper abdominal surgery. From 2001 to 2006, 447 patients were included in a Norwegian multicenter randomized controlled trial in major upper abdominal surgery. In this study, six years later, these patients were analyzed as a single prospective cohort and survival data were retrieved from the National Population Registry. Cachexia was derived from patient-reported preoperative weight loss and sarcopenia as assessed from computed tomography images taken within three months preoperatively. In the original trial, self-reported health-related quality of life was assessed preoperatively at trial enrollment and eight weeks postoperatively with the health-related quality of life questionnaire Short Form 36. A majority of the patients experienced improved mental health-related quality of life and, to a lesser extent, deteriorated physical health-related quality of life following surgery. There was a significant association between preoperative weight loss and reduced physical health-related quality of life. No association between sarcopenia and health-related quality of life was observed. Overall survival was significantly associated with physical health-related quality of life both pre- and postoperatively, and with postoperative mental health-related quality of life. The association between health-related quality of life and survival was particularly strong for postoperative physical health-related quality of life. Postoperative physical health-related quality of life

  14. Health Communication in Social Media: Message Features Predicting User Engagement on Diabetes-Related Facebook Pages.

    Science.gov (United States)

    Rus, Holly M; Cameron, Linda D

    2016-10-01

    Social media provides unprecedented opportunities for enhancing health communication and health care, including self-management of chronic conditions such as diabetes. Creating messages that engage users is critical for enhancing message impact and dissemination. This study analyzed health communications within ten diabetes-related Facebook pages to identify message features predictive of user engagement. The Common-Sense Model of Illness Self-Regulation and established health communication techniques guided content analyses of 500 Facebook posts. Each post was coded for message features predicted to engage users and numbers of likes, shares, and comments during the week following posting. Multi-level, negative binomial regressions revealed that specific features predicted different forms of engagement. Imagery emerged as a strong predictor; messages with images had higher rates of liking and sharing relative to messages without images. Diabetes consequence information and positive identity predicted higher sharing while negative affect, social support, and crowdsourcing predicted higher commenting. Negative affect, crowdsourcing, and use of external links predicted lower sharing while positive identity predicted lower commenting. The presence of imagery weakened or reversed the positive relationships of several message features with engagement. Diabetes control information and negative affect predicted more likes in text-only messages, but fewer likes when these messages included illustrative imagery. Similar patterns of imagery's attenuating effects emerged for the positive relationships of consequence information, control information, and positive identity with shares and for positive relationships of negative affect and social support with comments. These findings hold promise for guiding communication design in health-related social media.

  15. Global income related health inequalities

    Directory of Open Access Journals (Sweden)

    Jalil Safaei

    2007-01-01

    Full Text Available Income related health inequalities have been estimated for various groups of individuals at local, state, or national levels. Almost all of theses estimates are based on individual data from sample surveys. Lack of consistent individual data worldwide has prevented estimates of international income related health inequalities. This paper uses the (population weighted aggregate data available from many countries around the world to estimate worldwide income related health inequalities. Since the intra-country inequalities are subdued by the aggregate nature of the data, the estimates would be those of the inter-country or international health inequalities. As well, the study estimates the contribution of major socioeconomic variables to the overall health inequalities. The findings of the study strongly support the existence of worldwide income related health inequalities that favor the higher income countries. Decompositions of health inequalities identify inequalities in both the level and distribution of income as the main source of health inequality along with inequalities in education and degree of urbanization as other contributing determinants. Since income related health inequalities are preventable, policies to reduce the income gaps between the poor and rich nations could greatly improve the health of hundreds of millions of people and promote global justice. Keywords: global, income, health inequality, socioeconomic determinants of health

  16. Understanding and valuing the broader health system benefits of Uganda's national Human Resources for Health Information System investment.

    Science.gov (United States)

    Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail

    2015-08-31

    To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in

  17. A dynamical-systems approach for computing ice-affected streamflow

    Science.gov (United States)

    Holtschlag, David J.

    1996-01-01

    A dynamical-systems approach was developed and evaluated for computing ice-affected streamflow. The approach provides for dynamic simulation and parameter estimation of site-specific equations relating ice effects to routinely measured environmental variables. Comparison indicates that results from the dynamical-systems approach ranked higher than results from 11 analytical methods previously investigated on the basis of accuracy and feasibility criteria. Additional research will likely lead to further improvements in the approach.

  18. Micro-Level Affect Dynamics in Psychopathology Viewed From Complex Dynamical System Theory

    NARCIS (Netherlands)

    Wichers, M.; Wigman, J. T. W.; Myin-Germeys, I.

    2015-01-01

    This article discusses the role of moment-to-moment affect dynamics in mental disorder and aims to integrate recent literature on this topic in the context of complex dynamical system theory. First, we will review the relevance of temporal and contextual aspects of affect dynamics in relation to

  19. The Designed Environment and How it Affects Brain Morphology and Mental Health.

    Science.gov (United States)

    Golembiewski, Jan A

    2016-01-01

    The environment is inextricably related to mental health. Recent research replicates findings of a significant, linear correlation between a childhood exposure to the urban environment and psychosis. Related studies also correlate the urban environment and aberrant brain morphologies. These findings challenge common beliefs that the mind and brain remain neutral in the face of worldly experience. There is a signature within these neurological findings that suggests that specific features of design cause and trigger mental illness. The objective in this article is to work backward from the molecular dynamics to identify features of the designed environment that may either trigger mental illness or protect against it. This review analyzes the discrete functions putatively assigned to the affected brain areas and a neurotransmitter called dopamine, which is the primary target of most antipsychotic medications. The intention is to establish what the correlations mean in functional terms, and more specifically, how this relates to the phenomenology of urban experience. In doing so, environmental mental illness risk factors are identified. Having established these relationships, the review makes practical recommendations for those in public health who wish to use the environment itself as a tool to improve the mental health of a community through design. © The Author(s) 2015.

  20. How does real affect affect affect recognition in speech?

    NARCIS (Netherlands)

    Truong, Khiet Phuong

    2009-01-01

    The automatic analysis of affect is a relatively new and challenging multidisciplinary research area that has gained a lot of interest over the past few years. The research and development of affect recognition systems has opened many opportunities for improving the interaction between man and

  1. The role of affect and cognition in health decision making.

    Science.gov (United States)

    Keer, Mario; van den Putte, Bas; Neijens, Peter

    2010-03-01

    Both affective and cognitive evaluations of behaviours have been allocated various positions in theoretical models of decision making. Most often, they have been studied as direct determinants of either intention or overall evaluation, but these two possible positions have never been compared. The aim of this study was to determine whether affective and cognitive evaluations influence intention directly, or whether their influence is mediated by overall evaluation. A sample of 300 university students filled in questionnaires on their affective, cognitive, and overall evaluations in respect of 20 health behaviours. The data were interpreted using mediation analyses with the application of path modelling. Both affective and cognitive evaluations were found to have significantly predicted intention. The influence of affective evaluation was largely direct for each of the behaviours studied, whereas that of cognitive evaluation was partially direct and partially mediated by overall evaluation. These results indicate that decisions regarding the content of persuasive communication (affective vs. cognitive) are highly dependent on the theoretical model chosen. It is suggested that affective evaluation should be included as a direct determinant of intention in theories of decision making when predicting health behaviours.

  2. Internet Use for Health-Related Information via Personal Computers and Cell Phones in Japan: A Cross-Sectional Population-Based Survey

    Science.gov (United States)

    Takahashi, Yoshimitsu; Ohura, Tomoko; Ishizaki, Tatsuro; Okamoto, Shigeru; Miki, Kenji; Naito, Mariko; Akamatsu, Rie; Sugimori, Hiroki; Yoshiike, Nobuo; Miyaki, Koichi; Shimbo, Takuro

    2011-01-01

    Background The Internet is known to be used for health purposes by the general public all over the world. However, little is known about the use of, attitudes toward, and activities regarding eHealth among the Japanese population. Objectives This study aimed to measure the prevalence of Internet use for health-related information compared with other sources, and to examine the effects on user knowledge, attitudes, and activities with regard to Internet use for health-related information in Japan. We examined the extent of use via personal computers and cell phones. Methods We conducted a cross-sectional survey of a quasi-representative sample (N = 1200) of the Japanese general population aged 15–79 years in September 2007. The main outcome measures were (1) self-reported rates of Internet use in the past year to acquire health-related information and to contact health professionals, family, friends, and peers specifically for health-related purposes, and (2) perceived effects of Internet use on health care. Results The prevalence of Internet use via personal computer for acquiring health-related information was 23.8% (286/1200) among those surveyed, whereas the prevalence via cell phone was 6% (77). Internet use via both personal computer and cell phone for communicating with health professionals, family, friends, or peers was not common. The Internet was used via personal computer for acquiring health-related information primarily by younger people, people with higher education levels, and people with higher household incomes. The majority of those who used the Internet for health care purposes responded that the Internet improved their knowledge or affected their lifestyle attitude, and that they felt confident in the health-related information they obtained from the Internet. However, less than one-quarter thought it improved their ability to manage their health or affected their health-related activities. Conclusions Japanese moderately used the Internet via

  3. Internet use for health-related information via personal computers and cell phones in Japan: a cross-sectional population-based survey.

    Science.gov (United States)

    Takahashi, Yoshimitsu; Ohura, Tomoko; Ishizaki, Tatsuro; Okamoto, Shigeru; Miki, Kenji; Naito, Mariko; Akamatsu, Rie; Sugimori, Hiroki; Yoshiike, Nobuo; Miyaki, Koichi; Shimbo, Takuro; Nakayama, Takeo

    2011-12-14

    The Internet is known to be used for health purposes by the general public all over the world. However, little is known about the use of, attitudes toward, and activities regarding eHealth among the Japanese population. This study aimed to measure the prevalence of Internet use for health-related information compared with other sources, and to examine the effects on user knowledge, attitudes, and activities with regard to Internet use for health-related information in Japan. We examined the extent of use via personal computers and cell phones. We conducted a cross-sectional survey of a quasi-representative sample (N = 1200) of the Japanese general population aged 15-79 years in September 2007. The main outcome measures were (1) self-reported rates of Internet use in the past year to acquire health-related information and to contact health professionals, family, friends, and peers specifically for health-related purposes, and (2) perceived effects of Internet use on health care. The prevalence of Internet use via personal computer for acquiring health-related information was 23.8% (286/1200) among those surveyed, whereas the prevalence via cell phone was 6% (77). Internet use via both personal computer and cell phone for communicating with health professionals, family, friends, or peers was not common. The Internet was used via personal computer for acquiring health-related information primarily by younger people, people with higher education levels, and people with higher household incomes. The majority of those who used the Internet for health care purposes responded that the Internet improved their knowledge or affected their lifestyle attitude, and that they felt confident in the health-related information they obtained from the Internet. However, less than one-quarter thought it improved their ability to manage their health or affected their health-related activities. Japanese moderately used the Internet via personal computers for health purposes, and rarely

  4. Exploring pathways for building trust in vaccination and strengthening health system resilience

    Directory of Open Access Journals (Sweden)

    Sachiko Ozawa

    2016-11-01

    Full Text Available Abstract Background Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. We then explore key pathways for overcoming system vulnerabilities in order to restore trust, to strengthen the resilience of health systems and communities, and to promote vaccine utilization. Methods Utilizing secondary data and a review of the literature, we developed a causal loop diagram (CLD to map the determinants of building trust in immunizations. Using the CLD, we devised three scenarios to illustrate common vulnerabilities that compromise trust and pathways to strengthen trust and utilization of vaccines, specifically looking at weak health systems, harmful communication channels, and role of social capital. Spill-over effects, interactions and other dynamics in the CLD were then examined to assess leverage points to counter these vulnerabilities. Results Trust in vaccination arises from the interactions among experiences with the health system, the various forms of communication and social capital – both external and internal to communities. When experiencing system-wide shocks such as the case in Ebola-affected countries, distrust is reinforced by feedback between the health and immunization systems where distrust often lingers even after systems are restored and spills over beyond vaccination in the broader health system. Vaccine myths or anti-vaccine movements reinforce distrust. Social capital – the collective value of social networks of community members – plays a central role in increasing levels of trust. Conclusions Trust is important, yet underexplored, in the context of vaccine utilization. Using a CLD to

  5. Questioning context: a set of interdisciplinary questions for investigating contextual factors affecting health decision making

    Science.gov (United States)

    Charise, Andrea; Witteman, Holly; Whyte, Sarah; Sutton, Erica J.; Bender, Jacqueline L.; Massimi, Michael; Stephens, Lindsay; Evans, Joshua; Logie, Carmen; Mirza, Raza M.; Elf, Marie

    2011-01-01

    Abstract Objective  To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making. Background  Decision‐making processes and outcomes may be shaped by a range of non‐medical or ‘contextual’ factors particular to an individual including social, economic, political, geographical and institutional conditions. Research concerning contextual factors occurs across many disciplines and theoretical domains, but few conceptual tools have attempted to integrate and translate this wide‐ranging research for health decision‐making purposes. Methods  To formulate this tool we employed an iterative, collaborative process of scenario development and question generation. Five hypothetical health decision‐making scenarios (preventative, screening, curative, supportive and palliative) were developed and used to generate a set of exploratory questions that aim to highlight potential contextual factors across a range of health decisions. Findings  We present an exploratory tool consisting of questions organized into four thematic domains – Bodies, Technologies, Place and Work (BTPW) – articulating wide‐ranging contextual factors relevant to health decision making. The BTPW tool encompasses health‐related scholarship and research from a range of disciplines pertinent to health decision making, and identifies concrete points of intersection between its four thematic domains. Examples of the practical application of the questions are also provided. Conclusions  These exploratory questions provide an interdisciplinary toolkit for identifying the complex contextual factors affecting decision making. The set of questions comprised by the BTPW tool may be applied wholly or partially in the context of clinical practice, policy development and health‐related research. PMID:21029277

  6. Health-Related Quality of Life of Adolescent and Young Adult Survivors of Central Nervous System Tumors: Identifying Domains From a Survivor Perspective.

    Science.gov (United States)

    Kuhlthau, Karen; Luff, Donna; Delahaye, Jennifer; Wong, Alicia; Yock, Torunn; Huang, Mary; Park, Elyse R

    2015-01-01

    This article uses qualitative methods to describe the domains of health-related quality of life (HRQoL) that adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors identify as important. Survivors clearly attributed aspects of their current HRQoL to their disease or its treatment. We identified 7 key domains of AYA CNS tumor survivorship: physical health, social well-being, mental health, cognitive functioning, health behaviors, sexual and reproductive health, and support systems. Although most aspects of HRQoL that survivors discussed represented new challenges, there were several areas where survivors pointed out positive outcomes. There is a need for a HRQoL tool designed for this population of survivors, given their unique treatment and survivorship experience. Aspects of HRQoL related to cognition, sexual and reproductive health, health behaviors, and support systems are not typically included in generic HRQoL tools but should be assessed for this population. Developing HRQoL measurement instruments that capture the most significant aspects of HRQoL will improve the ability to track HRQoL in AYA CNS tumor survivors and in the long-term management of common sequelae from CNS tumors and their treatments. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  7. Improvement in Fatigue, Sleepiness, and Health-Related Quality of Life with Bright Light Treatment in Persons with Seasonal Affective Disorder and Subsyndromal SAD

    Directory of Open Access Journals (Sweden)

    Cecilia Rastad

    2011-01-01

    Full Text Available Objective. To investigate the effects of bright light treatment for secondary outcome measures and to explore and validate empirically derived subgroups and treatment effects in subgroups. Methods. A descriptive design. A sample of forty-nine persons (mean age of 45.8 with clinically assessed seasonal affective disorder (SAD or subsyndromal SAD (S-SAD participated in a two-group clinical trial evaluating the effects of treatment with bright light therapy. A person-oriented cluster analysis was applied to study treatment effects in subgroups. Results. For the merged group, sleepiness (Epworth Sleepiness Scale, fatigue (fatigue questionnaire, and health-related quality of life (SF-36 were improved at posttreatment, and results were maintained at the one-month followup. Three distinct subgroups had a high level of fatigue in common, while the level of excessive daytime sleepiness and depressed mood differed between the subgroups. Over time, all subgroups improved following ten days treatment in a light room. Conclusion. Fatigue, excessive daytime sleepiness, and health-related quality of life improve in a similar way as depressed mood following treatment with bright light. The treatment was effective irrespective of the severity of the disorder, that is, for persons with SAD and subsyndromal SAD.

  8. NEUROGENETIC ASPECTS OF PERINATAL HYPOXIC-ISCHEMIC AFFECTIONS OF THE CENTRAL NERVOUS SYSTEM

    Directory of Open Access Journals (Sweden)

    George A. Karkashadze

    2016-01-01

    Full Text Available Neurogenetics is a thriving young science greatly contributing to the generally accepted concept of the brain development in health and disease. Thereby; scientists are not only able to highlight new key points in traditional ideas about the origin of diseases; but also to completely rethink their view on the problem of pathology development. In particular; new data on neurogenetics of perinatal affections of the central nervous system (CNS has appeared. Genetic factors in varying degrees affect perinatal hypoxic-ischemic CNS affections. Prematurity determination stays the most studied among them. Nevertheless; there is increasing evidence of significant epigenetic regulations of neuro-expression caused by hypoxia; malnutrition of a pregnant woman; stress; smoking; alcohol; drugs that either directly pathologically affect the developing brain; or form a brain phenotype sensitive to a perinatal CNS affection. New data obliges to change the approaches to prevention of perinatal CNS affections.

  9. Passion for a Cause: How It Affects Health and Subjective Well-Being.

    Science.gov (United States)

    St-Louis, Ariane C; Carbonneau, Noémie; Vallerand, Robert J

    2016-06-01

    Using the dualistic model of passion (Vallerand et al., 2003), this research investigated how harmonious passion (HP) or obsessive passion (OP) for a cause can affect volunteers' health and subjective well-being. Three studies with volunteers for local (local emergency crises and community help) and international (humanitarian missions) causes assessed physical and psychological health using cross-sectional and longitudinal designs. Study 1 (N = 108) showed that HP was positively related to satisfaction with one's involvement in the cause and unrelated to physical injuries due to cause involvement. OP was unrelated to satisfaction but positively associated with injuries. Findings were replicated in Study 2 (N = 83). Moreover, self-neglect mediated the positive and negative effects of HP and OP, respectively, on injuries. Study 3 (N = 77) revealed that HP predicted an increase in satisfaction and health over a 3-month mission. OP predicted an increase in physical symptoms and a decrease in health. Furthermore, OP before a mission was positively related to self-neglect that was positively associated with physical symptoms after a mission. OP also positively predicted rumination that was conducive to posttraumatic stress disorder. HP was unrelated to these variables. Findings underscore the role of passion for a cause in predicting intrapersonal outcomes of volunteers. © 2014 Wiley Periodicals, Inc.

  10. Criminal Justice Contact, Stressors, and Obesity-Related Health Problems Among Black Adults in the USA.

    Science.gov (United States)

    Archibald, Paul C; Parker, Lauren; Thorpe, Roland

    2018-04-01

    Criminal justice contact-defined as lifetime arrest, parole, or incarceration, seems to exacerbate chronic conditions, and those who are most likely to have had contact with the criminal justice system, such as Black adults, often already have pre-existing disproportionately high rates of stress and chronic conditions due to the social determinants of health that affect underrepresented minorities. Findings from this study suggest that there is a mechanism that links the stressors among Black adults manifested by such factors as family, financial, neighborhood, and personal problems with criminal justice contact to obesity-related health status. Using the National Survey of American Life (NSAL), modified Poisson regression analyses were used to determine the association between criminal justice contact, stressors, and obesity-related health problems among a national sample of Black adults (n = 5008). In the full model, the odds of experiencing obesity-related health problems for Black adults who had criminal justice contact was reduced (PR, 1.23 to 1.14) and not statistically significant. Black adults who reported experiencing family stressors (PR, 1.21; 95% CI, 1.08, 1.36), financial stressors (PR, 1.30; 95% CI, 1.16, 1.47), and personal stressors (PR, 1.16; 95% CI, 1.02, 1.31) were statistically significant and higher than those who reported not experiencing any of these stressors; neighborhood stressors was not statistically significant. The evidence suggests a relationship between the stressors associated with criminal justice contact and obesity-related health status. These findings emphasize the need to further explore the family, financial, and personal stressors for Black adults with criminal justice contact in order to further our understanding of their obesity-related health problems.ᅟ.

  11. Stress and Health

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej

    2014-01-01

    and behavioral mechanisms. Stress is a complex concept and in order to better understand the relation between stress and health, the dissertation works with a clear distinction between the health consequences of different types of stress including external stressors, perceived stress, and measures of the stress......’s disease patients. Results The combined evidence of this dissertation shows a moderately higher risk of some common chronic disorders including cardiovascular disease and atopic disorders among individuals exposed to work-related stressors and perceived stress. Most empirical studies also report higher...... of pathways. The physiological stress response has the ability to directly affect vital body systems including the cardiovascular, immune, and metabolic systems. Further, stress can lead to unfavorable changes in health-related behavior, impaired sleep and poor mental health. An increasing number of well...

  12. Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study

    OpenAIRE

    Nguyen, Amanda J.; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

    2016-01-01

    Background A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Methods Data were collected in July 20...

  13. Improving the use of health data for health system strengthening

    Directory of Open Access Journals (Sweden)

    Tara Nutley

    2013-02-01

    Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

  14. Network position and related power : how they affect and are affected by network management and outcomes

    NARCIS (Netherlands)

    Oukes, Tamara

    2018-01-01

    In network position and related power you learn more about how network position and related power affect and are affected by network management and outcomes. First, I expand our present understanding of how startups with a fragile network position manage business relationships by taking an

  15. Greece: Health system review.

    Science.gov (United States)

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  16. Health Disparities and Relational Well-Being between Multi- and Mono-Ethnic Asian Americans

    Science.gov (United States)

    Zhang, Wei

    2013-01-01

    Focusing on Hawaii, a state with 21.3% of the population being multi-racial according to the 2010 U.S. Census, this study aims to examine the existence and nature of health disparities between mono- and multi-ethnic Asian Americans and the importance of Relational Well-Being in affecting the health of Asian Americans. A series of ordinary least…

  17. Use of electronic health records and administrative data for public health surveillance of eye health and vision-related conditions in the United States.

    Science.gov (United States)

    Elliott, Amanda F; Davidson, Arthur; Lum, Flora; Chiang, Michael F; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E; Chou, Chiu-Fang

    2012-12-01

    To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Perspective, comparing systems. We describe 3 currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Each of the 3 sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Ensuring right to organic food in public health system.

    Science.gov (United States)

    Pashkov, Vitalii; Batyhina, Olena; Leiba, Liudmyla

    2018-01-01

    Introduction: Human health directly depends on safety and quality of food. In turn, quality and safety of food directly depend on its production conditions and methods. There are two main food production methods: traditional and organic. Organic food production is considered safer and more beneficial for human health. Aim: to determine whether the organic food production method affects human health. Materials and methods: international acts, data of international organizations and conclusions of scientists have been examined and used in the study. The article also summarizes information from scientific journals and monographs from a medical and legal point of view with scientific methods. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. The problems of effects of food production methods and conditions on human health have been analyzed within the framework of the system approach. Conclusions: Food production methods and conditions ultimately affect the state and level of human health. The organic method of production activity has a positive effect on human health.

  19. Wearable ballistocardiogram and seismocardiogram systems for health and performance.

    Science.gov (United States)

    Etemadi, Mozziyar; Inan, Omer T

    2018-02-01

    Cardiovascular diseases (CVDs) are prevalent in the US, and many forms of CVD primarily affect the mechanical aspects of heart function. Wearable technologies for monitoring the mechanical health of the heart and vasculature could enable proactive management of CVDs through titration of care based on physiological status as well as preventative wellness monitoring to help promote lifestyle choices that reduce the overall risk of developing CVDs. Additionally, such wearable technologies could be used to optimize human performance in austere environments. This review describes our progress in developing wearable ballistocardiogram (BCG)- and seismocardiogram-based systems for monitoring relative changes in cardiac output, contractility, and blood pressure. Our systems use miniature, low-noise accelerometers to measure the movements of the body in response to the heartbeat and novel machine learning algorithms to provide robustness against motion artifacts and sensor misplacement. Moreover, we have mathematically related wearable BCG signals-representing local, cardiogenic movements of a point on the body-to better understood whole body BCG signals, and thereby improved estimation of key health parameters. We validated these systems with experiments in healthy subjects, studies in patients with heart failure, and measurements in austere environments such as water immersion. The systems can be used in future work as a tool for clinicians and physiologists to measure the mechanical aspects of cardiovascular function outside of clinical settings, and to thereby titrate care for patients with CVDs, provide preventative screening, and optimize performance in austere environments by providing real-time in-depth information regarding performance and risk.

  20. The health impacts of climate-related migration.

    Science.gov (United States)

    Schwerdtle, Patricia; Bowen, Kathryn; McMichael, Celia

    2017-12-11

    Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate-related migration, including planned relocation and forced displacement, have not been thoroughly examined. The Intergovernmental Panel on Climate Change stated that migration is currently, and will increasingly be, influenced by environmental degradation and climate change, and that it needs to be addressed in a focused and coordinated manner. This paper examines the links between climate change, migration, and health, considering diverse migration responses, including immobility, forced displacement and planned migration, as well as the associated health risks and opportunities in different contexts. Using case studies, the paper illustrates strategies to reduce the health risks associated with climate change-related migration. While there is an increasing body of research examining the climate change-migration nexus, a dual approach is now required. This approach must include debate and further research regarding the health consequences and responses associated with climate migration as well as immediate strengthening of health systems to make them both climate resilient and migrant inclusive.

  1. Factors related to perceived health among elderly people: the Albertina Project.

    Science.gov (United States)

    Lindgren, A M; Svärdsudd, K; Tibblin, G

    1994-07-01

    The Albertina Project is an epidemiological study of the medical, social and economic situation among people aged 75 years or older in Uppsala, Sweden. In this report, health conditions, quality-of-life measures and housing problems affecting it are presented. A postal questionnaire was sent to an 11% random sample (n = 959) of the eligible population out of which 706 (74%) persons responded. Nearly one-third of the elderly people could not read a newspaper with or without glasses, more than one-third had impaired hearing, 47% had some sort of mobility problem and 66% reported some form of sleeping problem. Forty-two per cent felt lonely sometimes or often and 65% were worried, in most cases about the risk of falling. In spite of this, 87% rated their health as good and 79% were content or rather content with their situation. Even though eyesight and hearing problems were common in this study, they did not affect perceived health to any large extent. Mobility problems and sleeping problems had a greater impact. The most important factors related to perceived health were activity score, contentment and mobility problems. Contentment was affected by activity score and loneliness and the latter was in turn affected by age and type of dwelling. The practical implication of these findings is that perhaps more attention should be focused on efforts to improve old people's satisfaction with their life situation rather than on marginal improvements of their medical situation.

  2. Using public relations strategies to prompt populations at risk to seek health information: the Hanford Community Health Project.

    Science.gov (United States)

    Thomas, Gregory D; Smith, Stephen M; Turcotte, Joseph A

    2009-01-01

    The Hanford Community Health Project (HCHP) addressed health concerns among "downwinders" exposed to releases of radioactive iodine (I-131) from the Hanford Nuclear Reservation in the 1940s and 1950s. After developing educational materials and conducting initial outreach, HCHP had to decide whether to apply its limited resources to an advertising or public relations approach. The decision to apply public relations strategies was effective in driving awareness of the risk communication message at the community level, reinvigorating the affected community, and ultimately increasing the number of people who sought information about their risk of exposure and related health issues. HCHP used a series of communication tools to reach out to local and regional media, medical and health professionals, and community organizations. The campaign was successful in increasing the number of unique visitors to HCHP Web site and educating and activating the medical community around the releases of I-131 and patient care choices.

  3. Health financing for universal coverage and health system performance: concepts and implications for policy.

    Science.gov (United States)

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  4. Does Socio-Economic Status and Health Consciousness Influence How Women Respond to Health Related Messages in Media?

    Science.gov (United States)

    Iversen, Anette Christine; Kraft, Pal

    2006-01-01

    During the past few decades, people have been increasingly exposed to health-related messages in the mass media, conveying recommendations for healthy lifestyles. The present study investigates whether these messages represent a stressor, and whether coping responses increase levels of motivation or levels of negative affect. A sample of 403 women…

  5. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

    Directory of Open Access Journals (Sweden)

    Rashid N

    2016-10-01

    Full Text Available Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affairs, Genetech Inc., San Francisco, 5Health Economics and Outcomes, Genentech Inc., San Francisco, CA, USA Background: Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden.Objective: The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC in an integrated health care delivery system.Methods: Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost.Results: A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%] related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33

  6. Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative.

    Science.gov (United States)

    Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie

    2016-05-01

    Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements.

  7. Understanding Health and Health-Related Behavior of Users of Internet Health Information.

    Science.gov (United States)

    Wimble, Matt

    2016-10-01

    Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.

  8. Ethical Tensions Related to Systemic Constraints: Occupational Alienation in Occupational Therapy Practice.

    Science.gov (United States)

    Durocher, Evelyne; Kinsella, Elizabeth Anne; McCorquodale, Lisa; Phelan, Shanon

    2016-09-03

    Ethical tensions arise daily in health care practice and are frequently related to health care system structures or policies. Collective case study methodology was adopted to examine ethical tensions reported by occupational therapists practicing in different settings in Southwestern Ontario, Canada. Inductive analysis involving multiple layers of coding was conducted. This article focuses on tensions related to systemic constraints. Participants reported ethical tensions related to balancing client priorities with those of health care services. Four themes related to systemic constraints were identified including imposed practices, ineffective processes, resource limitations, and lack of services. Therapists' aims could be seen to align with an "ethic of care" and were seen to be in tension in light of systemic constraints. The findings raise issues related to occupational justice, particularly related to occupational alienation in occupational therapy practice, and open conversations related to neoliberalist health care agendas. © The Author(s) 2016.

  9. [Socioeconomic differentials in health and health related behaviors: findings from the Korea Youth Panel Survey].

    Science.gov (United States)

    Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song

    2005-11-01

    status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.

  10. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado

    2018-01-01

    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  11. Validation study in four health-care databases: upper gastrointestinal bleeding misclassification affects precision but not magnitude of drug-related upper gastrointestinal bleeding risk.

    Science.gov (United States)

    Valkhoff, Vera E; Coloma, Preciosa M; Masclee, Gwen M C; Gini, Rosa; Innocenti, Francesco; Lapi, Francesco; Molokhia, Mariam; Mosseveld, Mees; Nielsson, Malene Schou; Schuemie, Martijn; Thiessard, Frantz; van der Lei, Johan; Sturkenboom, Miriam C J M; Trifirò, Gianluca

    2014-08-01

    To evaluate the accuracy of disease codes and free text in identifying upper gastrointestinal bleeding (UGIB) from electronic health-care records (EHRs). We conducted a validation study in four European electronic health-care record (EHR) databases such as Integrated Primary Care Information (IPCI), Health Search/CSD Patient Database (HSD), ARS, and Aarhus, in which we identified UGIB cases using free text or disease codes: (1) International Classification of Disease (ICD)-9 (HSD, ARS); (2) ICD-10 (Aarhus); and (3) International Classification of Primary Care (ICPC) (IPCI). From each database, we randomly selected and manually reviewed 200 cases to calculate positive predictive values (PPVs). We employed different case definitions to assess the effect of outcome misclassification on estimation of risk of drug-related UGIB. PPV was 22% [95% confidence interval (CI): 16, 28] and 21% (95% CI: 16, 28) in IPCI for free text and ICPC codes, respectively. PPV was 91% (95% CI: 86, 95) for ICD-9 codes and 47% (95% CI: 35, 59) for free text in HSD. PPV for ICD-9 codes in ARS was 72% (95% CI: 65, 78) and 77% (95% CI: 69, 83) for ICD-10 codes (Aarhus). More specific definitions did not have significant impact on risk estimation of drug-related UGIB, except for wider CIs. ICD-9-CM and ICD-10 disease codes have good PPV in identifying UGIB from EHR; less granular terminology (ICPC) may require additional strategies. Use of more specific UGIB definitions affects precision, but not magnitude, of risk estimates. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The use of qualitative methods in developing the descriptive systems of preference-based measures of health-related quality of life for use in economic evaluation.

    Science.gov (United States)

    Stevens, Katherine; Palfreyman, Simon

    2012-12-01

    To describe how qualitative methods can be used in the development of descriptive systems of preference-based measures (PBMs) of health-related quality of life. The requirements of the National Institute for Health and Clinical Excellence and other agencies together with the increasing use of patient-reported outcome measures has led to an increase in the demand for PBMs. Recently, interest has grown in developing new PBMs and while previous research on PBMs has mainly focused on the methods of valuation, research into the methods of developing descriptive systems is an emerging field. Traditionally, descriptive systems of PBMs were developed by using top-down methods, where content was derived from existing measures, the literature, or health surveys. A contrasting approach is a bottom-up methodology, which takes the views of patients or laypeople on how their life is affected by their health. This approach generally requires the use of qualitative methods. Qualitative methods lend themselves well to the development of PBMs. They also ensure that the measure has appropriate language, content validity, and responsiveness to change. While the use of qualitative methods in the development of non-PBMs is fairly standard, their use in developing PBMs was until recently nonexistent. In this article, we illustrate the use of qualitative methods by presenting two case studies of recently developed PBMs, one generic and one condition specific. We outline the stages involved, discuss the strengths and weaknesses of the approach, and compare with the top-down approach used in the majority of PBMs to date. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association

    Science.gov (United States)

    Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-01-01

    Background The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students’ maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. Objective The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Methods Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. Results eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on

  14. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. Work-related health complaints in surgical residents and the influence of social support and job-related autonomy.

    Science.gov (United States)

    Boerjan, Martine; Bluyssen, Simone J M; Bleichrodt, Robert P; van Weel-Baumgarten, Evelyn M; van Goor, Harry

    2010-08-01

    The aim of this cross-sectional study was to investigate the influence of job-related autonomy and social support provided by consultants and colleagues on the stress-related health complaints of surgical residents in the Netherlands. All (n = 400) Dutch residents in training in general surgery were sent validated self-report questionnaires. Odds ratios were calculated predicting health and exposure to long-term stress for gender, number of working hours, type of hospital, level of social support, job-related autonomy and training phase. The interactions between job-related autonomy and level of social support provided by consultants and colleagues, and all variables, were analysed. A total of 254 of 400 (64%) residents returned questionnaires that were eligible for analysis. Residents experienced more health complaints than the average member of the Dutch working population (4.0 versus 2.5; p = 0.000). Male and senior residents were significantly 'healthier' than female and junior residents, respectively. Social support by consultants was a strong predictor of health and social support by colleagues showed a significant interaction with gender. Women and residents in university hospitals experienced less social support by consultants than men and residents in general teaching hospitals. Residents working in university hospitals experienced lower levels of job-related autonomy and less support from colleagues in comparison with those working in general teaching hospitals. A working week of > 60 hours adversely affected health and job-related autonomy. Social support provided by consultants and colleagues, and job control, are important factors that interact with the work-associated, stress-related health of residents in training in general surgery. Residents report a greater number of health complaints than the average member of the working population, especially female and junior residents. General teaching hospitals seem to provide better support at work than

  16. Big Data and Public Health Systems: Issues and Opportunities

    Directory of Open Access Journals (Sweden)

    David Rojas

    2018-03-01

    Full Text Available Over the last years, the need for changing the current model of European public health systems has been repeatedly addressed, in order to ensure their sustainability. Following this line, IT has always been referred to as one of the key instruments for enhancing the information management processes of healthcare organizations, thus contributing to the improvement and evolution of health systems. On the IT field, Big Data solutions are expected to play a main role, since they are designed for handling huge amounts of information in a fast and efficient way, allowing users to make important decisions quickly. This article reviews the main features of the European public health system model and the corresponding healthcare and management-related information systems, the challenges that these health systems are currently facing, and the possible contributions of Big Data solutions to this field. To that end, the authors share their professional experience on the Spanish public health system, and review the existing literature related to this topic.

  17. Risk factors that affect metabolic health status in obese children.

    Science.gov (United States)

    Elmaogullari, Selin; Demirel, Fatma; Hatipoglu, Nihal

    2017-01-01

    While some obese children are metabolically healthy (MHO), some have additional health problems, such as hypertension, dyslipidemia, insulin resistance, and hepatosteatosis, which increase mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. These children are metabolically unhealthy obese (MUO) children. In this study we assessed the factors that affect metabolic health in obesity and the clinical and laboratory findings that distinguish between MHO and MUO children. In total, 1085 patients aged 6-18 years, with age- and sex-matched BMI exceeding the 95th percentile were included in the study (mean 11.1±2.9 years, 57.6% female, 59.7% pubertal). Patients without dyslipidemia, insulin resistance, hepatosteatosis, or hypertension were considered as MHO. Dyslipidemia was defined as total cholesterol level over 200 mg/dL, triglyceride over 150 mg/dL, LDL over 130 mg/dL, or HDL under 40 mg/dL. Insulin resistance was calculated using the homeostasis model of assesment for insulin resistance (HOMA-IR) index. Hepatosteatosis was evaluated with abdominal ultrasound. Duration of obesity, physical activity and nutritional habits, screen time, and parental obesity were questioned. Thyroid and liver function tests were performed. Six hundred and forty-two cases (59.2%) were MUO. Older age, male sex, increased BMI-SDS, and sedentary lifestyle were associated with MUO. Excessive junk food consumption was associated with MUO particularly among the prepubertal obese patients. Our results revealed that the most important factors that affect metabolic health in obesity are age and BMI. Positive effects of an active lifestyle and healthy eating habits are prominent in the prepubertal period and these habits should be formed earlier in life.

  18. A Simple and Reliable Health Monitoring System For Shoulder Health: Proposal

    Science.gov (United States)

    Lee, Yann-Long

    2014-01-01

    Background The current health care system is complex and inefficient. A simple and reliable health monitoring system that can help patients perform medical self-diagnosis is seldom readily available. Because the medical system is vast and complex, it has hampered or delayed patients in seeking medical advice or treatment in a timely manner, which may potentially affect the patient’s chances of recovery, especially those with severe sicknesses such as cancer, and heart disease. Objective The purpose of this paper is to propose a methodology in designing a simple, low cost, Internet-based health-screening platform. Methods This health-screening platform will enable patients to perform medical self-diagnosis over the Internet. Historical data has shown the importance of early detection to ensure patients receive proper treatment and speedy recovery. Results The platform is designed with special emphasis on the user interface. Standard Web-based user-interface design is adopted so the user feels ease to operate in a familiar Web environment. In addition, graphics such as charts and graphs are used generously to help users visualize and understand the result of the diagnostic. The system is developed using hypertext preprocessor (PHP) programming language. One important feature of this system platform is that it is built to be a stand-alone platform, which tends to have better user privacy security. The prototype system platform was developed by the National Cheng Kung University Ergonomic and Design Laboratory. Conclusions The completed prototype of this system platform was submitted to the Taiwan Medical Institute for evaluation. The evaluation of 120 participants showed that this platform system is a highly effective tool in health-screening applications, and has great potential for improving the medical care quality for the general public. PMID:24571980

  19. A simple and reliable health monitoring system for shoulder health: proposal.

    Science.gov (United States)

    Liu, Shuo-Fang; Lee, Yann-Long

    2014-02-26

    The current health care system is complex and inefficient. A simple and reliable health monitoring system that can help patients perform medical self-diagnosis is seldom readily available. Because the medical system is vast and complex, it has hampered or delayed patients in seeking medical advice or treatment in a timely manner, which may potentially affect the patient's chances of recovery, especially those with severe sicknesses such as cancer, and heart disease. The purpose of this paper is to propose a methodology in designing a simple, low cost, Internet-based health-screening platform. This health-screening platform will enable patients to perform medical self-diagnosis over the Internet. Historical data has shown the importance of early detection to ensure patients receive proper treatment and speedy recovery. The platform is designed with special emphasis on the user interface. Standard Web-based user-interface design is adopted so the user feels ease to operate in a familiar Web environment. In addition, graphics such as charts and graphs are used generously to help users visualize and understand the result of the diagnostic. The system is developed using hypertext preprocessor (PHP) programming language. One important feature of this system platform is that it is built to be a stand-alone platform, which tends to have better user privacy security. The prototype system platform was developed by the National Cheng Kung University Ergonomic and Design Laboratory. The completed prototype of this system platform was submitted to the Taiwan Medical Institute for evaluation. The evaluation of 120 participants showed that this platform system is a highly effective tool in health-screening applications, and has great potential for improving the medical care quality for the general public.

  20. [Terrorism, public health and health services].

    Science.gov (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  1. Healthy co-twins of patients with affective disorders show reduced risk-related activation of the insula during a monetary gambling task

    DEFF Research Database (Denmark)

    Macoveanu, Julian; Miskowiak, Kamilla; Kessing, Lars V

    2016-01-01

    BACKGROUND: Healthy first-degree relatives of patients with affective disorders are at increased risk for affective disorders and express discrete structural and functional abnormalities in the brain reward system. However, value-based decision making is not well understood in these at-risk indiv......BACKGROUND: Healthy first-degree relatives of patients with affective disorders are at increased risk for affective disorders and express discrete structural and functional abnormalities in the brain reward system. However, value-based decision making is not well understood in these at...

  2. The Astronomy of Africa's Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

    Science.gov (United States)

    Phillips, James F; Sheff, Mallory; Boyer, Christopher B

    2015-09-01

    Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as "galaxies" of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. "Black holes" are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the relationship

  3. Comparison of knowledge of and attitudes toward dementia between health-related and non-health-related university students.

    Science.gov (United States)

    Yong, Mi-Hyun; Yoo, Chan-Uk; Yang, Yeong-Ae

    2015-12-01

    [Purpose] This study compared the knowledge of and attitudes toward dementia between health-related and non-health-related students. [Subjects] The subjects consisted of a total of 416 people, 213 health-related students and 203 non-health-related students, at K University, which is located in Gyeongsangbuk-do, Republic of Korea, between May 1 and 14, 2014. [Methods] The subjects answered a self-administered questionnaire about their knowledge of and attitudes toward dementia. [Results] There was a significant difference in knowledge of and attitudes toward dementia between the two groups examined. [Conclusion] Health-related students displayed higher knowledge of dementia and a more positive attitude toward dementia compared with non-health-related students. In the future, education to cultivate professional knowledge about dementia and enhance positive attitudes toward dementia should be provided continuously to health-related students. This is because students in health-related fields will likely provide services to patients with dementia in the clinical field. Additionally, as they will likely provide support to the elderly in the future, non-health-related students also need to be educated about and develop positive attitudes toward dementia.

  4. Toxicological assessment of drugs that affect the endocrine system in puberty-related disorders.

    Science.gov (United States)

    Maranghi, Francesca; Tassinari, Roberta; Mantovani, Alberto

    2013-10-01

    Toxicologists must ensure that clinical risk-to-benefit analysis should be made both for genders and age groups, with any treatment. Puberty concerns physiological changes leading to organism's maturation. Pubertal growth disorders are increasing in last decades: besides causing physical and psychological distress, they may signal underlying endocrine-metabolic abnormalities with serious health consequences later on. Therapeutic approaches for some health conditions in childhood and adolescence are considered. The authors discuss how some diseases and treatments can impact pubertal growth. The authors look at particular immunological disorders such as asthma and how both the disease and treatment affects pubertal growth. They also discuss how the provision of available data can help to assess the dose-response of the drug, in these cases, and minimize the chance of side effects. The authors also discuss pediatric inflammatory bowel disease and how both the disease and treatment can mitigate the growth delay. Last, but not least, the authors discuss how the effects of the drugs used in the treatment of psychiatric disorders may accentuate endocrine issues in juvenile patients. Hyperprolactinemia induction by some antipsychotics is highlighted as an example. Appropriate risk-benefit analysis of drugs prescribed during childhood and adolescence and intended to be used in the long term is required. Furthermore, future treatment strategies and safer compounds development should be supported by the knowledge of mechanisms underlying adverse side effects in pubertal growth and development.

  5. Multilevel Dynamic Systems Affecting Introduction of HIV/STI Prevention Innovations among Chinese Women in Sex Work Establishments

    Science.gov (United States)

    Weeks, Margaret R.; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei

    2013-01-01

    Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the…

  6. Xpey’ Relational Environments: an analytic framework for conceptualizing Indigenous health equity

    Directory of Open Access Journals (Sweden)

    Alexandra Kent

    2017-12-01

    Full Text Available Introduction: Both health equity research and Indigenous health research are driven by the goal of promoting equitable health outcomes among marginalized and underserved populations. However, the two fields often operate independently, without collaboration. As a result, Indigenous populations are underrepresented in health equity research relative to the disproportionate burden of health inequities they experience. In this methodological article, we present Xpey’ Relational Environments, an analytic framework that maps some of the barriers and facilitators to health equity for Indigenous peoples. Methods: Health equity research needs to include a focus on Indigenous populations and Indigenized methodologies, a shift that could fill gaps in knowledge with the potential to contribute to ‘closing the gap’ in Indigenous health. With this in mind, the Equity Lens in Public Health (ELPH research program adopted the Xpey’ Relational Environments framework to add a focus on Indigenous populations to our research on the prioritization and implementation of health equity. The analytic framework introduced an Indigenized health equity lens to our methodology, which facilitated the identification of social, structural and systemic determinants of Indigenous health. To test the framework, we conducted a pilot case study of one of British Columbia’s regional health authorities, which included a review of core policies and plans as well as interviews and focus groups with frontline staff, managers and senior executives. Conclusion: ELPH’s application of Xpey’ Relational Environments serves as an example of the analytic framework’s utility for exploring and conceptualizing Indigenous health equity in BC’s public health system. Future applications of the framework should be embedded in Indigenous research methodologies.

  7. Health system strengthening and hypertension management in China.

    Science.gov (United States)

    Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

    2016-01-01

    Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

  8. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  9. Relative deprivation in the Nordic countries-child mental health problems in relation to parental financial stress.

    Science.gov (United States)

    Gunnarsdóttir, Hrafnhildur; Hensing, Gunnel; Povlsen, Lene; Petzold, Max

    2016-04-01

    The Nordic welfare system has been acknowledged as favourable for children, successfully contributing to low child mortality and poverty rates. Nevertheless, mental health problems among children and adolescents are common and the economic situation of the family has been highlighted as an important determinant. In spite of similar social, political and cultural structures, the Nordic countries differ; Iceland was most affected by the global financial crisis in 2008. The aim of this study was to examine potential differences in parental financial stress and the associations to child mental health between the Nordic countries as well as age and gender differences.  The study sample consisted of 6330 children aged 4-16 years old included in the 2011 version of the Nordic Study of Children's Health, Wellbeing and Quality of life. The Strengths and Difficulties Questionnaire was used to measure mental health problems.  In Iceland, 47.7% of the parents reported financial stress while ≤20% did so in the other countries except for Finland (33.5%). However, in case of parental financial stress the OR of mental health problems comparing children to parents with and without financial stress was significantly lower among the Icelandic children (OR 1.60, 95% CI 1.15-2.24) than among the others: Denmark OR 3.07 (95% CI 2.15-4.39), Finland OR 2.28 (95% CI 1.60-3.25), Norway OR 2.77 (95% CI 1.86-4.12), Sweden OR 3.31(95% CI 2.26-4.86). No significant age or gender differences in the ORs were observed.  Besides socioeconomic situation, relative deprivation should be considered an important determinant of child mental health. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. How Does Adult Attachment Affect Human Recognition of Love-related and Sex-related Stimuli: An ERP Study

    Science.gov (United States)

    Hou, Juan; Chen, Xin; Liu, Jinqun; Yao, Fangshu; Huang, Jiani; Ndasauka, Yamikani; Ma, Ru; Zhang, Yuting; Lan, Jing; Liu, Lu; Fang, Xiaoyi

    2016-01-01

    In the present study, we investigated the relationship among three emotion-motivation systems (adult attachment, romantic love, and sex). We recorded event-related potentials in 37 healthy volunteers who had experienced romantic love while they viewed SEX, LOVE, FRIEND, SPORT, and NEUTRAL images. We also measured adult attachment styles, level of passionate love and sexual attitudes. As expected, results showed that, firstly, response to love-related image-stimuli and sex-related image-stimuli on the electrophysiological data significantly different on N1, N2, and positive slow wave (PSW) components. Secondly, the different adult attachment styles affected individuals’ recognition processing in response to love-related and sex-related images, especially, to sex-related images. Further analysis showed that voltages elicited by fearful attachment style individuals were significantly lower than voltages elicited by secure and dismissing attachment style individuals on sex-related images at frontal sites, on N1 and N2 components. Thirdly, from behavior data, we found that adult attachment styles were not significantly related to any dimension of sexual attitudes but were significantly related to passionate love scale (PLS) total points. Thus, the behavior results were not in line with the electrophysiological results. The present study proved that adult attachment styles might mediate individuals’ lust and attraction systems. PMID:27199830

  11. 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

  12. Daily relations among affect, urge, targeted naltrexone, and alcohol use in young adults.

    Science.gov (United States)

    Bold, Krysten W; Fucito, Lisa M; Corbin, William R; DeMartini, Kelly S; Leeman, Robert F; Kranzler, Henry R; O'Malley, Stephanie S

    2016-10-01

    Heavy drinking among young adults is a serious public health problem. Naltrexone, an opioid antagonist, has been shown to reduce drinking in young adults compared to placebo and can be taken on a targeted (i.e., as needed) basis. Understanding risk factors for drinking and naltrexone effects within-person in young adults may help to optimize the use of targeted naltrexone. The current study was a secondary analysis of daily diary data from 127 (n = 40 female) young adults (age 18-25) enrolled in a double-blind clinical trial of daily (25 mg) plus targeted (25 mg) naltrexone versus placebo. Hierarchical linear models were used to examine the effects of daily affect, urge, and taking targeted medication on same-day risk of drinking to intoxication (defined as estimated blood-alcohol-concentration, BAC ≥ .08 g%). Results indicated urge significantly mediated within-person positive affect-drinking relations on a daily level. Specifically, positive affect was associated with greater urge to drink, which in turn was associated with greater odds of BAC ≥ .08 g%. Furthermore, days of greater positive affect and urge were associated with taking a targeted dose of medication, which reduced the likelihood of intoxication by nearly 23% in the naltrexone group compared to placebo. Gender and family history of alcohol dependence were examined as moderators of these daily level effects. These results provide further evidence of naltrexone's ability to reduce alcohol consumption in young adults and identify potential within-person risk processes related to heavy drinking that could inform alcohol-related interventions for this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Income-related inequalities in diseases and health conditions over the business cycle.

    Science.gov (United States)

    Ásgeirsdóttir, Tinna Laufey; Jóhannsdóttir, Hildur Margrét

    2017-12-01

    How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men's inequality increases but women's decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.

  14. Health-seeking behavior and hospital choice in China's New Cooperative Medical System.

    Science.gov (United States)

    Brown, Philip H; Theoharides, Caroline

    2009-07-01

    Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice.

  15. An exploration of decision aid effectiveness: the impact of promoting affective vs. deliberative processing on a health-related decision.

    Science.gov (United States)

    Davis, Esther L; McCaffery, Kirsten; Mullan, Barbara; Juraskova, Ilona

    2015-12-01

    Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes. To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory. One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses. The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing. Controlling for the experiment-wise error rate at P processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction. This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information. © 2014 John Wiley & Sons Ltd.

  16. The role of health-related claims and health-related symbols in consumer behaviour: Design and conceptual framework of the CLYMBOL project and initial results.

    Science.gov (United States)

    Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G

    2015-03-01

    Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project R ole of health-related   CLaims   and   sYMBOLs   in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies ( i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking ( i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided.

  17. Religiousness and health-related quality of life of older adults

    Directory of Open Access Journals (Sweden)

    Gina Andrade Abdala

    2015-01-01

    Full Text Available OBJECTIVE To examine whether religiousness mediates the relationship between sociodemographic factors, multimorbidity and health-related quality of life of older adults.METHODS This population-based cross-sectional study is part of the Survey on Health, Well-Being, and Aging (SABE. The sample was composed by 911 older adults from Sao Paulo, SP, Southeastern Brazil. Structural equation modeling was performed to assess the mediator effect of religiousness on the relationship between selected variables and health-related quality of life of older adults, with models for men and women. The independent variables were: age, education, family functioning and multimorbidity. The outcome variable was health-related quality of life of older adults, measured by SF-12 (physical and mental components. The mediator variables were organizational, non-organizational and intrinsic religiousness. Cronbach’s alpha values were: physical component = 0.85; mental component = 0.80; intrinsic religiousness = 0.89 and family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve = 0.91.RESULTS Higher levels of organizational and intrinsic religiousness were associated with better physical and mental components. Higher education, better family functioning and fewer diseases contributed directly to improved performance in physical and mental components, regardless of religiousness. For women, organizational religiousness mediated the relationship between age and physical (β = 2.401, p CONCLUSIONS Organizational and intrinsic religiousness had a beneficial effect on the relationship between age, education and health-related quality of life of these older adults.

  18. Religiousness and health-related quality of life of older adults

    Science.gov (United States)

    Abdala, Gina Andrade; Kimura, Miako; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; dos Santos, Bernardo

    2015-01-01

    OBJECTIVE To examine whether religiousness mediates the relationship between sociodemographic factors, multimorbidity and health-related quality of life of older adults. METHODS This population-based cross-sectional study is part of the Survey on Health, Well-Being, and Aging (SABE). The sample was composed by 911 older adults from Sao Paulo, SP, Southeastern Brazil. Structural equation modeling was performed to assess the mediator effect of religiousness on the relationship between selected variables and health-related quality of life of older adults, with models for men and women. The independent variables were: age, education, family functioning and multimorbidity. The outcome variable was health-related quality of life of older adults, measured by SF-12 (physical and mental components). The mediator variables were organizational, non-organizational and intrinsic religiousness. Cronbach’s alpha values were: physical component = 0.85; mental component = 0.80; intrinsic religiousness = 0.89 and family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) = 0.91. RESULTS Higher levels of organizational and intrinsic religiousness were associated with better physical and mental components. Higher education, better family functioning and fewer diseases contributed directly to improved performance in physical and mental components, regardless of religiousness. For women, organizational religiousness mediated the relationship between age and physical (β = 2.401, p religiousness mediated the relationship between education and mental component (β = 7.158, p religiousness had a beneficial effect on the relationship between age, education and health-related quality of life of these older adults. PMID:26274870

  19. [Religiousness and health-related quality of life of older adults].

    Science.gov (United States)

    Abdala, Gina Andrade; Kimura, Miako; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; dos Santos, Bernardo

    2015-01-01

    To examine whether religiousness mediates the relationship between sociodemographic factors, multimorbidity and health-related quality of life of older adults. This population-based cross-sectional study is part of the Survey on Health, Well-Being, and Aging (SABE). The sample was composed by 911 older adults from Sao Paulo, SP, Southeastern Brazil. Structural equation modeling was performed to assess the mediator effect of religiousness on the relationship between selected variables and health-related quality of life of older adults, with models for men and women. The independent variables were: age, education, family functioning and multimorbidity. The outcome variable was health-related quality of life of older adults, measured by SF-12 (physical and mental components). The mediator variables were organizational, non-organizational and intrinsic religiousness. Cronbach's alpha values were: physical component = 0.85; mental component = 0.80; intrinsic religiousness = 0.89 and family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) = 0.91. Higher levels of organizational and intrinsic religiousness were associated with better physical and mental components. Higher education, better family functioning and fewer diseases contributed directly to improved performance in physical and mental components, regardless of religiousness. For women, organizational religiousness mediated the relationship between age and physical (β = 2.401, p religiousness mediated the relationship between education and mental component (β = 7.158, p religiousness had a beneficial effect on the relationship between age, education and health-related quality of life of these older adults.

  20. How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

    Science.gov (United States)

    Lin, Chia-Yen; Yeh, Wei-Ju

    2017-12-04

    The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad's regulatory focus is promotion focus, viewers' attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents' regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW.

  1. Measuring the effect of intimate partner violence on health-related quality of life: a qualitative focus group study

    Directory of Open Access Journals (Sweden)

    Thomas Kristie A

    2007-12-01

    Full Text Available Abstract Background Health related quality of life (HRQOL can be measured by a wide range of instruments, many of which have been designed for specific conditions or uses. "Preference-based" measures assess the value individuals place on health, and are included in economic evaluations of treatments and interventions (such as cost effectiveness analysis. As economic evaluation becomes more common, it is important to assess the applicability of preference-based health related quality of life (HRQOL measures to public health issues. This study investigated the usefulness of such instruments in the context of intimate partner violence (IPV, a public health concern that that can seriously affect quality of life. Methods The study consisted of focus groups with abused women to determine the aspects of life affected by IPV, and an analysis of existing HRQOL measures. Eight focus groups (n = 40 were conducted in which participants discussed the domains of health affected by IPV. Results were content analyzed and compared with the domains of health included in four commonly-used, preference-based HRQOL measures. Results The average focus group participant was 43 years old, unemployed, African American, with 3 children. Domains of health reported to be affected by IPV included physical functioning, emotional and psychological functioning, social functioning and children's functioning. Psychological health was the most severely affected domain. The Short Form 36, the Health Utilities Index, the EuroQol 5D, and the Quality of Well-being Scale were found to vary in the degree to which they include domains of health important in IPV. Psychological health is included to a limited extent, and the spill-over effect of a condition on other family members, including children, is not included at all. Conclusion Emotional and psychological health plays an important role in the overall HRQOL of abused women but is relatively underemphasized in preference-based HRQOL

  2. Positive and negative affect in the future teacher: relationships with their academic achievement, mental health and satisfaction with life

    OpenAIRE

    Ruth Pinedo González; María José Arroyo González; César Caballero San José

    2017-01-01

    Affects are composed of two key dimensions: the positive affect (PA) and negative affect (NA). Both dimensions are related to psychological adjustment of the person and life satisfaction. This study is exploratory in nature and aims to make a first correlational analysis between different constructs: emotional disposition, academic achievement, mental health and life satisfaction in a sample of 143 student teachers. We have used the following scales adapted to the culture: The Positive and Ne...

  3. Human likeness: cognitive and affective factors affecting adoption of robot-assisted learning systems

    Science.gov (United States)

    Yoo, Hosun; Kwon, Ohbyung; Lee, Namyeon

    2016-07-01

    With advances in robot technology, interest in robotic e-learning systems has increased. In some laboratories, experiments are being conducted with humanoid robots as artificial tutors because of their likeness to humans, the rich possibilities of using this type of media, and the multimodal interaction capabilities of these robots. The robot-assisted learning system, a special type of e-learning system, aims to increase the learner's concentration, pleasure, and learning performance dramatically. However, very few empirical studies have examined the effect on learning performance of incorporating humanoid robot technology into e-learning systems or people's willingness to accept or adopt robot-assisted learning systems. In particular, human likeness, the essential characteristic of humanoid robots as compared with conventional e-learning systems, has not been discussed in a theoretical context. Hence, the purpose of this study is to propose a theoretical model to explain the process of adoption of robot-assisted learning systems. In the proposed model, human likeness is conceptualized as a combination of media richness, multimodal interaction capabilities, and para-social relationships; these factors are considered as possible determinants of the degree to which human cognition and affection are related to the adoption of robot-assisted learning systems.

  4. Efficiency performance of China's health care delivery system.

    Science.gov (United States)

    Zhang, Luyu; Cheng, Gang; Song, Suhang; Yuan, Beibei; Zhu, Weiming; He, Li; Ma, Xiaochen; Meng, Qingyue

    2017-07-01

    Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports. The results indicate that over the last decade, health outcomes compared with health investment were relatively higher in China than in most other countries worldwide, and the trend was stable. The overall efficiency and total factor productivity increased after the reform, indicating that the reform was likely to have had a positive impact on the efficiency performance of the health care delivery system. However, the health care delivery structure showed low system efficiency, mainly attributed to the weakened primary health care system. Strengthening the primary health care system is central to enhancing the future performance of China's health care delivery system. Copyright © 2017 John Wiley & Sons, Ltd.

  5. [Polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women].

    Science.gov (United States)

    Orio, Francesco; Cascella, Teresa; Giallauria, Francesco; Palomba, Stefano; De Lorenzo, Anna; Lucci, Rosa; Ambrosino, Elena; Lombardi, Gaetano; Colao, Annamaria; Vigorito, Carlo

    2006-03-01

    Polycystic ovary syndrome (PCOS) is a good example of obesity-related cardiovascular complication affecting young women. PCOS is not only considered a reproductive problem but rather represents a complex endocrine, multifaceted syndrome with important health implications. Several evidences suggest an increased cardiovascular risk of cardiovascular disease associated with this syndrome, characterized by an impairment of heart structure and function, endothelial dysfunction and lipid abnormalities. All these features, probably linked to insulin-resistance, are often present in obese PCOS patients. Cardiovascular abnormalities represent important long-term sequelae of PCOS that need further investigations.

  6. Childhood bruxism: Related factors and impact on oral health-related quality of life.

    Science.gov (United States)

    Antunes, Lívia Azeredo Alves; Castilho, Thuanny; Marinho, Marcello; Fraga, Renato Silva; Antunes, Leonardo Santos

    2016-01-01

    This study aimed to assess childhood bruxism relating associated factors and the bruxism's impact on oral health-related quality of life (OHRQoL). A case-control study was performed with 3- to 6-year-old children obtained from public preschools in Brazil. The case and control groups had 21 and 40 children, respectively. Associations between bruxism and respiratory problems (p = 0.04, OR: 0.33, CI: 0.09 to 1.14), dental wear (p 0.05). The association between presence and absence of impact with bruxism or other variables showed no statistical relationship (p > 0.05). It could be concluded that childhood bruxism is related to respiratory problems, dental wear, dental caries, and malocclusion. Despite being a topic that demands special care in dentistry, bruxism does not significantly affect the OHRQoL. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  7. A comprehensive health plan: The lifestyle affecting factors in iranian youth

    Directory of Open Access Journals (Sweden)

    Ahdieh Chinekesh

    2018-01-01

    Full Text Available Background: Factors affecting lifestyle become one of the most priorities of the research field, especially in adolescents and youth. Using a qualitative approach, this study aimed to understand what factors are affecting young people's healthy lifestyle. Methods: Using the conventional content analysis, and used the semi-structured in-depth interviews, we conducted a qualitative study to elicit the youth opinion considering their lifestyle affecting factors. Initially, purposeful sampling method was considered for data collection. Participants were selected from volunteered youths 18–30 years whom were selected from the Tehran city. Inclusion criteria for the participants were; (a willingness to participate in the study, and (b ability to express experiences. Results: According to findings, although the majority of participants agreed on the important role of lifestyle related behaviors in their healthy life, the lack of essential motivation and the pressure of educational assignments remove it from their daily program priorities. The most important barrier to observing the healthy lifestyle was expressed as; the acceptance of the concept by the individual and the social and economic potential of the individual. It was also suggested that practical interventions should focus on improving more participator engagement of all of the related stakeholders. Conclusions: We proposed the participatory strategies for youth healthy lifestyle promotion. Through which based on a specific needs the assessment of different target groups, designing, development, and implementation of health programs led to more effective interventions.

  8. Design of smart neonatal health monitoring system using SMCC.

    Science.gov (United States)

    De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

    2017-02-01

    Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

  9. Paying for and receiving benefits from health services in South Africa: is the health system equitable?

    Science.gov (United States)

    Ataguba, John E; McIntyre, Di

    2012-03-01

    There is a global challenge for health systems to ensure equity in both the delivery and financing of health care. However, many African countries still do not have equitable health systems. Traditionally, equity in the delivery and the financing of health care are assessed separately, in what may be termed 'partial' analyses. The current debate on countries moving toward universal health systems, however, requires a holistic understanding of equity in both the delivery and the financing of health care. The number of studies combining these aspects to date is limited, especially in Africa. An assessment of overall health system equity involves assessing health care financing in relation to the principles of contributing to financing according to ability to pay and benefiting from health services according to need for care. Currently South Africa is considering major health systems restructuring toward a universal system. This paper examines together, for both the public and the private sectors, equity in the delivery and financing of health care in South Africa. Using nationally representative datasets and standard methodologies for assessing progressivity in health care financing and benefit incidence, this paper reports an overall progressive financing system but a pro-rich distribution of health care benefits. The progressive financing system is driven mainly by progressive private medical schemes that cover a small portion of the population, mainly the rich. The distribution of health care benefits is not only pro-rich, but also not in line with the need for health care; richer groups receive a far greater share of service benefits within both public and private sectors despite having a relatively lower share of the ill-health burden. The importance of the findings for the design of a universal health system is discussed.

  10. Elaborating on systems thinking in health promotion practice.

    Science.gov (United States)

    Naaldenberg, Jenneken; Vaandrager, Lenneke; Koelen, Maria; Wagemakers, Anne-Marie; Saan, Hans; de Hoog, Kees

    2009-03-01

    Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and

  11. Barriers to men who have sex with men attending HIV related health ...

    African Journals Online (AJOL)

    2014-04-22

    Apr 22, 2014 ... The objectives of the study were to: (i) determine how stigma and discrimination affect MSM attendance to HIV related health services; .... Data analysis .... go to private hospitals where they will pay and get proper services ..... Commission, Zanzibar AIDS Commission, National Bureau of Statistics, Office of ...

  12. How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

    Directory of Open Access Journals (Sweden)

    Chia-Yen Lin

    2017-12-01

    Full Text Available The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention × 2 (message framing: gain framing vs. loss framing two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad’s regulatory focus is promotion focus, viewers’ attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA, and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents’ regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW.

  13. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association.

    Science.gov (United States)

    Britt, Rebecca Katherine; Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-12-19

    The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students' maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on vaccinations, and maintaining a balanced

  14. Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation.

    Science.gov (United States)

    Özhayat, Esben Boeskov

    2013-10-24

    The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthesis (RDP). The minimally important difference (MID), effect size (ES), and standard error of the measurement (SEM) were used to clinically interpret the patient-reported effect. The OHIP-49 score was significantly higher and exceeded the MID pre- and post-treatment in participants with high EPI-Q and low RSES score compared to participants with low EPI-Q and high RSES score. The improvement in OHIP-49 score was significant and not limited by high EPI-Q and low RSES score. High EPI-Q score was associated high improvement in OHIP-49 score and the ES of the improvement in participants with high EPI-Q was large and exceeded the MID and SEM. Treatment with RDP improves the OHRQoL regardless of level of NA and self-esteem. High NA is associated with a large effect, but both high NA and low self-esteem is associated with poorer OHRQoL both before and after treatment.

  15. Violence related to health work

    OpenAIRE

    Juliana da Silva Oliveira; Roberta Laíse Gomes Leite Morais; Elisama Nascimento Rocha; Sérgio Donha Yarid; Edite Lago da Silva Sena; Rita Narriman Silva de Oliveira Boery

    2014-01-01

    This study aimed to present a critical and reflective literature review on the violence related to health work. The survey was conducted through an integrated search in the Virtual Health Library in the months of May and June 2011. We selected 24 articles. The reading of the material led us to the following division results: studies characterization and bioethical reflection on violence related to health work. The work-related violence has consequences not only direct on ...

  16. Feeling old today? Daily health, stressors, and affect explain day-to-day variability in subjective age.

    Science.gov (United States)

    Kotter-Grühn, Dana; Neupert, Shevaun D; Stephan, Yannick

    2015-01-01

    Subjective age is an important correlate of health, well-being, and longevity. So far, little is known about short-term variability in subjective age and the circumstances under which individuals feel younger/older in daily life. This study examined whether (a) older adults' felt age fluctuates on a day-to-day basis, (b) daily changes in health, stressors, and affect explain fluctuations in felt age, and (c) the daily associations between felt age and health, stressors, or affect are time-ordered. Using an eight-day daily diary approach, N = 43 adults (60-96 years, M = 74.65, SD = 8.19) filled out daily questionnaires assessing subjective age, health, daily stressors, and affect. Data were analysed using multilevel modelling. Subjective age, health, daily stressors, affect. Intra-individual variability in felt age was not explained by time but by short-term variability in other variables. Specifically, on days when participants experienced more than average health problems, stress, or negative affect they felt older than on days with average health, stress, or negative affect. No time-ordered effects were found. Bad health, many stressors, and negative affective experiences constitute circumstances under which older adults feel older than they typically do. Thus, daily measures of subjective age could be markers of health and well-being.

  17. Smoking is Associated with Higher Disease-related Costs and Lower Health-related Quality of Life in Inflammatory Bowel Disease

    NARCIS (Netherlands)

    Severs, M.; Mangen, M.J.; Valk, M.E. van der; Fidder, H.H.; Dijkstra, G.; Have, M. van der; Bodegraven, A.A. van; Jong, D.J. de; Woude, C.J. van der; Romberg-Camps, M.J.; Clemens, C.H.; Jansen, J.M.; Meeberg, P.C. van de; Mahmmod, N.; Ponsioen, C.Y.; Vermeijden, J.R.; Jong, A E F de; Pierik, M.; Siersema, P.D.; Oldenburg, B.

    2017-01-01

    Background and Aims: Smoking affects the course of inflammatory bowel disease [IBD]. We aimed to study the impact of smoking on IBD-specific costs and health-related quality-of-life [HrQoL] among adults with Crohn's disease [CD] and ulcerative colitis [UC]. Methods: A large cohort of IBD patients

  18. Evaluation of socio-economic factors affecting the demand for health

    Directory of Open Access Journals (Sweden)

    Abdosaleh Jafari

    2014-04-01

    Full Text Available Introduction: Individual health has been proved to be under the influence of various factors such as the use of health care services, diet, smoking and alcohol, physical environment, and health-related behaviors. Therefore, the main determinants of health are factors such as income, education, and access to health services, and systematic changes in these factors lead to socio-economic injustice in health. The present study was carried out through library and internet search. Medline and Google Scholar databases were also utilized. Combining Contents and Results: According to the present study, an increase in health input expenses would inevitably lead to aggravation of the health situation and decrease in income would result in the worst health status of the poor. Moreover, people with higher education use less health inputs; however, they enjoy higher status than those with lower educational levels. Conclusion: Health demand approach provides only a part of the information needed for policy-makers and decision-makers in health system. Theoretical and empirical analyses of the health claim could indicate that policy actions are likely to be more effective in overcoming barriers to health but are not capable of determining which one is likely to be more cost-effective . The demand for information about the health only provides the necessary tools about the benefits of special policy making decisions. So the tool should be combined with other techniques including cost-effectiveness and cost-benefit analyses.

  19. Performance analysis of online health care system | Kohli ...

    African Journals Online (AJOL)

    This paper deals with selection of appropriate indexing techniques applied on MySQL database for a health care system and its related performance issues. The proposed Smart Card based Online Health Care System deals with frequent data storage, exchange and retrieval of data from the database servers. Speed and ...

  20. Global health initiative investments and health systems strengthening: a content analysis of global fund investments.

    Science.gov (United States)

    Warren, Ashley E; Wyss, Kaspar; Shakarishvili, George; Atun, Rifat; de Savigny, Don

    2013-07-26

    Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities - through conventional 'vertical-programming' approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. This study shows that a substantial portion of Global Fund's Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and

  1. Croatia: health system review.

    Science.gov (United States)

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  2. Health for All - Italia, an informative health system

    Directory of Open Access Journals (Sweden)

    Marzia Loghi

    2008-06-01

    Full Text Available

    Background: On ISTAT website the informative system Health for All – Italia is available. It collects indicators on health coming from various sources to make up a basis for constructing an organic and joint framework on the country’s health reality. The system includes more than 4000 indicators about: demographic and socioeconomic context; causes of death; life styles; disease prevention; chronic and infectious diseases; disability; health status and life expectancy; health facilities; hospital discharges by diagnosis; health care resources. The database-related software was developed by the World Health Organization to make it easier for any user to access the information available either as tables, graphs and territorial maps.

    Methods: The system has been built considering data coming from different sources and using, if possible, the same definitions, classifications and desegregations. Time series goes from 1980 to the last year available (which can differ among the different sources. Indicators are calculated by provinces (if possible, regions, big areas and Italy. In order to compare indicators over time and space, standardised rates are calculated, using the same population reference. For each indicator metadata are available to give users additional notes necessary to correctly read and use the data, and publications or internet websites to examine more in-depth the argument.

    Results: Different kind of users find Health for All – Italia very useful for their aims: students, researchers, doctors, socio-sanitary operators, policy makers. Some examples of official reports from public institutions are briefly described in the paper.

    Conclusions: The increasing number of users of Health for All – Italia make necessary the online version and an English version for international comparisons.

  3. Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach.

    Science.gov (United States)

    Risso-Gill, Isabelle; Balabanova, Dina; Majid, Fadhlina; Ng, Kien Keat; Yusoff, Khalid; Mustapha, Feisul; Kuhlbrandt, Charlotte; Nieuwlaat, Robby; Schwalm, J-D; McCready, Tara; Teo, Koon K; Yusuf, Salim; McKee, Martin

    2015-07-03

    The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia. A health systems appraisal was undertaken in the capital, Kuala Lumpur, and poorer-resourced rural sites in Peninsular Malaysia and Sabah. Building on two systematic reviews of barriers to hypertension control, a conceptual framework was developed that guided analysis of survey data, documentary review and semi-structured interviews with key informants, health professionals and patients. The analysis followed the patients as they move through the health system, exploring the main modifiable system-level barriers to effective hypertension management, and seeking to explain obstacles to improved access and health outcomes. The study highlighted the need for the proposed intervention to take account of how Malaysian patients seek treatment in both the public and private sectors, and from western and various traditional practitioners, with many patients choosing to seek care across different services. Patients typically choose private care if they can afford to, while others attend heavily subsidised public clinics. Public hypertension clinics are often overwhelmed by numbers of patients attending, so health workers have little time to engage effectively with patients. Treatment adherence is poor, with a widespread belief, stemming from concepts of traditional medicine, that hypertension is a transient disturbance rather than a permanent asymptomatic condition. Drug supplies can be erratic in rural areas. Hypertension awareness and education material are limited, and what exist are poorly developed and ineffective. Despite having a relatively well funded health system offering good access to

  4. The health-related behaviors and attitudes of student nurses

    Science.gov (United States)

    Vowell, Maribeth

    Nurses are an important component of primary medical care, and patient education is a common and important role of most nurses. Patient education and positive role modeling by nurses have the potential to influence patients' life style choices and the serious diseases that may be affected by those choices. A greater understanding of the ways nurses think about their own health could help facilitate healthier choices for them and in their patients. The purpose of this inquiry was to examine the experiences, attitudes and beliefs of student nurses related to their personal health, and to investigate those experiences, attitudes and beliefs as they relate to their education, relationships, values and career choice. The purpose was achieved through phenomenological interviews with eleven senior nursing students, nine females and two males, encouraging them to provide in as much detail as possible their attitudes and values about their personal health. The interviews were tape recorded, transcribed verbatim, and phenomenologically analyzed. A thematic structure emerged such that the nursing students experiences were represented by the four interrelated themes of caring for myself/caring for others ; I control my health/my world controls my health; I have energy/I'm tired; and feeling good/looking good. The contextual grounds for the themes that emerged during the analysis were the Body and Time. This structure was presented in terms of its relationship to health education, other research and to current theory.

  5. Violence related to health work

    Directory of Open Access Journals (Sweden)

    Juliana da Silva Oliveira

    2014-10-01

    Full Text Available This study aimed to present a critical and reflective literature review on the violence related to health work. The survey was conducted through an integrated search in the Virtual Health Library in the months of May and June 2011. We selected 24 articles. The reading of the material led us to the following division results: studies characterization and bioethical reflection on violence related to health work. The work-related violence has consequences not only direct on professionals’ health, but also for the citizen and society as a whole. Make it visible is the first action needed for prevention / control and to promote healthier workplaces.

  6. VIOLENCE RELATED TO HEALTH WORK

    Directory of Open Access Journals (Sweden)

    Juliana da Silva Oliveira

    2014-03-01

    Full Text Available This study aimed to present a critical and reflective literature review on the violence related to health work. The survey was conducted through an integrated search in the Virtual Health Library in the months of May and June 2011. We selected 24 articles. The reading of the material led us to the following division results: studies characterization and bioethical reflection on violence related to health work. The work-related violence has consequences not only direct on professionals’ health, but also for the citizen and society as a whole. Make it visible is the first action needed for prevention / control and to promote healthier workplaces.

  7. Gender policies and advertising and marketing practices that affect women's health

    Science.gov (United States)

    Cambronero-Saiz, Belén

    2013-01-01

    Background The three papers of this doctoral thesis are based on the social construction of reality through the analysis of communication relating to health issues. We have analysed the contents of parliamentary, institutional, and mass media to uncover whether their communications create, transmit, and perpetuate gender biases and/or stereotypes, which may have an impact on people's health, with a particular focus on women. Objective To analyse decision making and the creation of gender awareness policies and actions affecting women's health: (1) political debates about abortion, (2) gender awareness communication campaigns and educational actions, and (3) pharmaceutical advertising strategies. Design Quantitative and qualitative methods were employed, and the research included observational studies and systematic reviews. To apply a gender perspective, we used the level of gender observation proposed by S. Harding, which states that: (1) gender is the basis of social norms and (2) gender is one of the organisers of the social structure. Results Sixty percentage of the bills concerning abortion introduced in the Spanish Parliament were initiated and led by pro-choice women's groups. Seventy-nine percent of institutional initiatives aimed at promoting equality awareness and were in the form of educational actions, while unconventional advertising accounted for 6 percent. Both initiatives focused on occupational equality, and very few actions addressed issues such as shared responsibility or public policy. With regard to pharmaceutical advertising, similar traditional male–female gender roles were used between 1975 and 2005. Conclusions Gender sensitivity continues to be essential in changing the established gender system in Spanish institutions, which has a direct and indirect impact on health. Greater participation of women in public policy and decision-making are critical for womens’ health, such as the issue of abortion. The predominance of women as the

  8. Gender policies and advertising and marketing practices that affect women's health.

    Science.gov (United States)

    Cambronero-Saiz, Belén

    2013-06-26

    The three papers of this doctoral thesis are based on the social construction of reality through the analysis of communication relating to health issues. We have analysed the contents of parliamentary, institutional, and mass media to uncover whether their communications create, transmit, and perpetuate gender biases and/or stereotypes, which may have an impact on peoples' health, with a particular focus on women. To analyse decision making and the creation of gender awareness policies and actions affecting women's health: (1) political debates about abortion, (2) gender awareness communication campaigns and educational actions, and (3) pharmaceutical advertising strategies. Quantitative and qualitative methods were employed, and the research included observational studies and systematic reviews. To apply a gender perspective, we used the level of gender observation proposed by S. Harding, which states that: (1) gender is the basis of social norms and (2) gender is one of the organisers of the social structure. Sixty percentage of the bills concerning abortion introduced in the Spanish Parliament were initiated and led by pro-choice women's groups. Seventy-nine percent of institutional initiatives aimed at promoting equality awareness and were in the form of educational actions, while unconventional advertising accounted for 6 percent. Both initiatives focused on occupational equality, and very few actions addressed issues such as shared responsibility or public policy. With regard to pharmaceutical advertising, similar traditional male-female gender roles were used between 1975 and 2005. Gender sensitivity continues to be essential in changing the established gender system in Spanish institutions, which has a direct and indirect impact on health. Greater participation of women in public policy and decision-making are critical for womens' health, such as the issue of abortion. The predominance of women as the target group of institutional gender awareness campaigns

  9. Gender policies and advertising and marketing practices that affect women's health

    Directory of Open Access Journals (Sweden)

    Belén C. Saiz

    2013-06-01

    Full Text Available Background: The three papers of this doctoral thesis are based on the social construction of reality through the analysis of communication relating to health issues. We have analysed the contents of parliamentary, institutional, and mass media to uncover whether their communications create, transmit, and perpetuate gender biases and/or stereotypes, which may have an impact on people's health, with a particular focus on women. Objective: To analyse decision making and the creation of gender awareness policies and actions affecting women's health: (1 political debates about abortion, (2 gender awareness communication campaigns and educational actions, and (3 pharmaceutical advertising strategies. Design: Quantitative and qualitative methods were employed, and the research included observational studies and systematic reviews. To apply a gender perspective, we used the level of gender observation proposed by S. Harding, which states that: (1 gender is the basis of social norms and (2 gender is one of the organisers of the social structure. Results: Sixty percentage of the bills concerning abortion introduced in the Spanish Parliament were initiated and led by pro-choice women's groups. Seventy-nine percent of institutional initiatives aimed at promoting equality awareness and were in the form of educational actions, while unconventional advertising accounted for 6 percent. Both initiatives focused on occupational equality, and very few actions addressed issues such as shared responsibility or public policy. With regard to pharmaceutical advertising, similar traditional male–female gender roles were used between 1975 and 2005. Conclusions: Gender sensitivity continues to be essential in changing the established gender system in Spanish institutions, which has a direct and indirect impact on health. Greater participation of women in public policy and decision-making are critical for womens’ health, such as the issue of abortion. The predominance

  10. [The Health Plan for Catalonia: an instrument to transform the health system].

    Science.gov (United States)

    Constante i Beitia, Carles

    2015-11-01

    The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  12. Measuring health systems strength and its impact: experiences from the African Health Initiative.

    Science.gov (United States)

    Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

    2017-12-21

    Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

  13. Exercise alleviates depression related systemic inflammation in ...

    African Journals Online (AJOL)

    Exercise alleviates depression related systemic inflammation in chronic obstructive pulmonary disease patients. ... African Health Sciences ... Currently, physical activity is an important lifestyle factor that has the potential to modify inflammatory ...

  14. Informed decision making does not affect health-related quality of life in lung cancer screening (NELSON trial)

    NARCIS (Netherlands)

    van den Bergh, Karien A. M.; Essink-Bot, Marie-Louise; van Klaveren, Rob J.; de Koning, Harry J.

    2010-01-01

    Background: It is believed that making an informed decision about (screening) participation is associated with better health-related quality of life (HRQoL) outcomes. This is the first study in cancer screening to explore this association in subjects participating in a lung cancer computed

  15. Systems Health Care: daily measurement and lifestyle change

    Science.gov (United States)

    Nakajima, Hiroshi; Tsuchiya, Naoki; Shiga, Toshikazu; Hata, Yutaka

    2012-06-01

    Health is quite important to be realized in our daily life. However, its idea covers wide area and has individual dependency. Activities in health care have been widely developed by medical, drag, insurance, food, and other types of industries mainly centering diseases. In this article, systems approach named Systems Health Care is introduced and discussed to generate new and precious values based on measurements in daily life to change lifestyle habits for realizing each health. Firstly, issues related to health such as its definitions are introduced and discussed by centering health rather than disease. In response to the discussions on health, Home and Medical Care is continuously introduced to point out the important role causality between life style and vital signal such as exercise and blood pressure based on detailed sampling time. Systems approaches of Systems Health Care are discussed from various points of views. Real applications of devices and services are used to make the studies and discussions deeper on the subjects of the article.

  16. Demographic Differences in District-Level Policies Related to School Mental Health and Social Services--United States, 2012

    Science.gov (United States)

    Demissie, Zewditu; Brener, Nancy

    2017-01-01

    Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…

  17. [Current status of occupational health and related countermeasures in Guangzhou, China].

    Science.gov (United States)

    Zeng, W F; Wu, S H; Wang, Z; Liu, Y M

    2016-02-20

    To investigate the current status of occupational health and related countermeasures in Guangzhou, China. Related data were collected from occupational poisoning accident investigation, diagnosis and identification of occupational diseases, and the occupational disease hazard reporting system, and the statistical data of occupational health in Guangzhou were analyzed retrospectively. The number of enterprises reporting for occupational disease hazards in Guangzhou was 20 890, and the total number of workers was 1 457 583. The number of workers exposed to occupational hazards was 284 233, and the cumulative number of workers with occupational diseases was 1 502. There were many risk factors for occupational diseases in enterprises, and there were a large number of workers with occupational diseases, as well as newly diagnosed cases. From 2001 to 2014, the total number of cases of occupational diseases was 958. The situation for the prevention and control of occupational diseases is grim in Guangzhou. Occupational health supervision and law enforcement should be enhanced, the three-level supervision system should be established and perfected, and the occupational health supervision system with a combination of "prevention, treatment, and protection" should be established and promoted, so as to gradually establish a technical service support system for occupational health.

  18. Predictors of health-related quality of life in children with chronic heart disease.

    Science.gov (United States)

    Niemitz, Mandy; Gunst, Diana C M; Hövels-Gürich, Hedwig H; Hofbeck, Michael; Kaulitz, Renate; Galm, Christoph; Berger, Felix; Nagdyman, Nicole; Stiller, Brigitte; Borth-Bruhns, Thomas; Konzag, Ines; Balmer, Christian; Goldbeck, Lutz

    2017-10-01

    Chronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease. Patients and methods The Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers. Greater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart-lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R2=0.41; proxy-report: R2=0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child's health-related quality of life. Beyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs.

  19. Playing-Related Health Problems Among Instrumental Music Students at a University in Malaysia.

    Science.gov (United States)

    Lonsdale, Karen; Boon, Ong Kuan

    2016-09-01

    Musicians from a wide range of backgrounds experience playing-related health problems including musculoskeletal disorders, hearing loss, and performance anxiety. Few studies have focused specifically on the health concerns of musicians in Malaysia. This study aimed to investigate playing-related health problems among student musicians at a university in Malaysia as well as their knowledge and awareness of playing-related health problems. Instrumental music students enrolled in undergraduate and post-graduate university music courses (n=98) participated in a self-report online survey which addressed aspects such as educational background, playing experience, knowledge and awareness of musicians' health issues, history of physical problems, lifestyle factors, and prevention and management strategies. Of the total participants, 28.9% reported that they were currently experiencing playing-related pain in a body part, and 46.4% had experienced playing-related pain at some time. More than half (56.7%) felt that they have not received enough information or advice on playing-related health during their current studies. Musicians who experienced playing-related pain, tension, and discomfort reported the main problem sites to be the fingers and hands, arms, neck, and shoulders. The study results demonstrate that Malaysian university music students are affected by similar types of playing-related physical problems as their counterparts around the world. A greater awareness and knowledge of injury prevention and management strategies is needed so that these music students can sustain healthy playing careers.

  20. Productivity loss at work; health-related and work-related factors.

    Science.gov (United States)

    van den Heuvel, Swenne G; Geuskens, Goedele A; Hooftman, Wendela E; Koppes, Lando L J; van den Bossche, Seth N J

    2010-09-01

    Productivity loss is an increasing problem in an aging working population that is decreasing in numbers. The aim of this study is to identify work-related and health-related characteristics associated with productivity loss, due to either sickness absence or reduced performance at work. In this cross-sectional study, data of the Netherlands Working Conditions Survey of 2007 were used, which includes a national representative sample of 22,759 employees aged 15 to 64 years. Demographic characteristics, health-related and work-related factors were assessed with a questionnaire. Logistic regression analyses were carried out to study the relationship of work-related and health-related factors with low performance at work and sickness absence in the past 12 months. Poor general health, the number of longstanding health conditions, and most types of longstanding health conditions were associated with productivity loss. Health-related factors were in general stronger associated with sickness absence than with low performance at work. Performance: poor health OR 1.54 CI 1.38-1.71, >1 health conditions OR 1.21 CI 1.09-1.35; sickness absence: poor health OR 2.62 CI 2.33-2.93, >1 health conditions OR 2.47 CI 2.21-2.75. Of the different types of longstanding health conditions, only psychological complaints and to a small extent musculoskeletal symptoms, were associated with low performance (respectively OR 1.54 CI 1.27-1.87; OR 1.09 CI 1.00-1.18). Low performance at work was less likely among employees with high physically demanding work (shift work OR 0.70 CI 0.63-0.76, using force OR 0.78 CI 0.72-0.84, and repetitive movements OR 0.74 CI 0.70-0.79). Psychosocial factors were stronger associated with low performance at work than with sickness absence (performance: job autonomy OR 1.28 CI 1.21-1.37, job demands OR 1.23 CI 1.16-1.31, emotionally demanding work OR 1.73 CI 1.62-1.85; sickness absence: job autonomy ns, job demands OR 1.09 CI 1.03-1.17, emotionally demanding work OR

  1. Income-related inequalities in diseases and health conditions over the business cycle

    OpenAIRE

    Asgeirsdottir, Tinna Laufey; Hildur Margrét, Jóhannsdóttir

    2017-01-01

    How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to an...

  2. Realigning government action with public health evidence: the legal and policy environment affecting sex work and HIV in Asia.

    Science.gov (United States)

    Gruskin, Sofia; Pierce, Gretchen Williams; Ferguson, Laura

    2014-01-01

    The HIV epidemic has shed light on how government regulation of sex work directly affects the health and well-being of sex workers, their families and communities. A review of the public health evidence highlights the need for supportive legal and policy environments, yet criminalisation of sex work remains standard around the world. Emerging evidence, coupled with evolving political ideologies, is increasingly shaping legal environments that promote the rights and health of sex workers but even as new legislation is created, contradictions often exist with standing problematic legislation. As a region, Asia provides a compelling example in that progressive HIV policies often sit side by side with laws that criminalise sex work. Data from the 21 Asian countries reporting under the UN General Assembly Special Session on HIV in 2010 were analysed to provide evidence of how countries' approach to sex-work regulation might affect HIV-related outcomes. Attention to the links between law and HIV-related outcomes can aid governments to meet their international obligations and ensure appropriate legal environments that cultivate the safe and healthy development and expression of sexuality, ensure access to HIV and other related services and promote and protect human rights.

  3. Does donor proliferation in development aid for health affect health service delivery and population health? Cross-country regression analysis from 1995 to 2010.

    Science.gov (United States)

    Pallas, Sarah Wood; Ruger, Jennifer Prah

    2017-05-01

    Previous literature suggests that increasing numbers of development aid donors can reduce aid effectiveness but this has not been tested in the health sector, which has experienced substantial recent growth in aid volume and number of donors. Based on annual data for 1995-2010 on 139 low- and middle-income countries that received health sector aid from donors reporting to the OECD's Creditor Reporting System, the study used two-step system generalized method of moments regression models to test whether the number of health aid donors and an index of health aid donor fragmentation affect health services (measured by DTP3 immunization rate) or health outcomes (measured by infant mortality rate) for three subsectors of health aid. For total health aid and for the general and basic health aid subsector, controlling for economic and political conditions, increases in the number of donors were associated with increases in DTP3 immunization rate and reductions in infant mortality while increases in the donor fragmentation index were associated with decreases in DTP3 immunization rate and increases in infant mortality, though none of these relationships were statistically significant. For the population and reproductive health aid subsector, a one percent increase in the number of donors was associated with a 0.23 percent decrease in DTP3 immunization ( P <  0.01) while a one percent increase in donor fragmentation was associated with a 0.54 percent increase in DTP3 immunization rate ( P <  0.01); associations with infant mortality rates for this subsector were similar to those for total health aid. The results do not provide clear evidence in support of the hypothesis that donor proliferation negatively impacts development results in the health sector. Aid effectiveness policy prescriptions should distinguish responses to donor proliferation versus donor fragmentation and be adapted to specific subsectors of health aid. © The Author 2016. Published by Oxford

  4. The Canadian systemic sclerosis oral health study II: the relationship between oral and global health-related quality of life in systemic sclerosis.

    Science.gov (United States)

    Baron, Murray; Hudson, Marie; Tatibouet, Solène; Steele, Russell; Lo, Ernest; Gravel, Sabrina; Gyger, Geneviève; El Sayegh, Tarek; Pope, Janet; Fontaine, Audrey; Masetto, Ariel; Matthews, Debora; Sutton, Evelyn; Thie, Norman; Jones, Niall; Copete, Maria; Kolbinson, Dean; Markland, Janet; Nogueira-Filho, Getulio; Robinson, David; Gornitsky, Mervyn

    2015-04-01

    Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc. Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders. This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score. Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Health-related quality of life of irritable bowel syndrome patients in different cultural settings

    Science.gov (United States)

    Faresjö, Åshild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

    2006-01-01

    Background Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. Methods This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Results Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting. PMID:16566821

  6. Health-related quality of life of irritable bowel syndrome patients in different cultural settings.

    Science.gov (United States)

    Faresjö, Ashild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

    2006-03-27

    Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting.

  7. Comparison of the Determinants of the Health Service System and the Health Status of the People in the Greater Mekong Subregion (GMS).

    Science.gov (United States)

    Phanphairoj, Kanjanee; Loa, Ritzmond

    2017-12-01

    Health is influenced by numerous factors that affect the health service system and health status of the people in every country. This article aims to compare the determinants of the health service system and the health status of the people in Thailand, the Lao PDR, Vietnam, and Cambodia; and to recommend policies that impact the population's health and the country's development. Methods: A comprehensive search of the literature from a variety of online search and academic databases, and synthesis of previous study was used in this paper. Data on country indicators were taken from published online databases of the Ministry of Public Health of Cambodia, Lao PDR, Thailand,and Vietnam; the World Health Organization, and the World Bank. In Thailand, the determinants of the health service system and health status of the people are medical information and technology because of the government initiatives to improve the quality of healthcare services through the use of modern technology. In Vietnam, the society and culture, and the strengths and weaknesses of the hospital significantly affect the health status and health service system there because of the religious beliefs of the people. However, in Cambodia, the strengths and weaknesses of the hospital are the primary determinant of the health service system and health status of the people due to the condition of the hospitals, the availability of new medical devices, and the number of healthcare professionals. In the Lao PDR, trade and investment, and medical information and technology, significantly influence the health service system and health status of the people because of the government efforts to outsource capital expenditures and medical technology. The strengths and weaknesses of the hospital are the key determinants of the health service system and health status of the people in all GMS countries. Understanding the determinants of health is essential in order to develop policies and programs that impact the

  8. Role of nursing professionals in the Colombian health system

    Directory of Open Access Journals (Sweden)

    Oneys del Carmen De Arco-Canoles

    2018-05-01

    Full Text Available Introduction: The nursing professional is able to provide care to people and communities from the different roles he or she assumes in the health system and that affect the quality of life of society. Objective: To identify in the scientific evidence published between 2011 and 2017 the role of nursing in the health system. Materials and methods: The bibliographic search was carried out in the data bases SciELO, PubMed, LILACS and Science Direct. Complete articles were selected in Spanish and English that presented in their titles the descriptors: nursing, role of nursing, health systems, advanced professional practice. Results: Fifty published studies were selected, which studied the health systems in Latin America, seeking to orient the role of nursing between 2011 and 2017. Three categories of interest could be found: Internships in the field of hospitality, community-based practices and teaching and research management. Conclusion: Despite the importance of the role played by nursing professionals in Colombia, there is no differentiation of profiles and functions within the health team; therefore, it is necessary to delimit some functions, to recover fields of action, strengthen leadership, autonomy and humanization in the provision of services.

  9. Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

    Science.gov (United States)

    Sowicz, Timothy Joseph; Bradway, Christine K

    2018-03-01

    Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

  10. Health-Related Internet Use by Children and Adolescents: Systematic Review.

    Science.gov (United States)

    Park, Eunhee; Kwon, Misol

    2018-04-03

    internet use among youth were identified. A major objective of health-related internet use is to gain information, but there are inconsistencies in adolescents' perceptions of health-related internet use. This study's findings provide important information on how youth seek information and related support systems for their health care on the internet. The conceptual and methodological limitations of the identified studies, such as the lack of a theoretical background and unrepresentative samples, are discussed, and gaps within the studies are identified for future research. This review also suggests important features for potential Web-based health interventions for children and adolescents. ©Eunhee Park, Misol Kwon. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.04.2018.

  11. Geographic information systems (GIS) for Health Promotion and Public Health: a review.

    Science.gov (United States)

    Nykiforuk, Candace I J; Flaman, Laura M

    2011-01-01

    The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.

  12. Examining direct and indirect pathways to health behaviour: the influence of cognitive and affective probability beliefs.

    Science.gov (United States)

    Janssen, Eva; van Osch, Liesbeth; de Vries, Hein; Lechner, Lilian

    2013-01-01

    This study aimed to extricate the influence of rational (e.g., 'I think …') and intuitive (e.g., 'I feel …') probability beliefs in the behavioural decision-making process regarding skin cancer prevention practices. Structural equation modelling was used in two longitudinal surveys (sun protection during winter sports [N = 491]; sun protection during summer [N = 277]) to examine direct and indirect behavioural effects of affective and cognitive likelihood (i.e. unmediated or mediated by intention), controlled for attitude, social influence and self-efficacy. Affective likelihood was directly related to sun protection in both studies, whereas no direct effects were found for cognitive likelihood. After accounting for past sun protective behaviour, affective likelihood was only directly related to sun protection in Study 1. No support was found for the indirect effects of affective and cognitive likelihood through intention. The findings underscore the importance of feelings of (cancer) risk in the decision-making process and should be acknowledged by health behaviour theories and risk communication practices. Suggestions for future research are discussed.

  13. Health systems around the world - a comparison of existing health system rankings.

    Science.gov (United States)

    Schütte, Stefanie; Acevedo, Paula N Marin; Flahault, Antoine

    2018-06-01

    Existing health systems all over the world are different due to the different combinations of components that can be considered for their establishment. The ranking of health systems has been a focal points for many years especially the issue of performance. In 2000 the World Health Organization (WHO) performed a ranking to compare the Performance of the health system of the member countries. Since then other health system rankings have been performed and it became an issue of public discussion. A point of contention regarding these rankings is the methodology employed by each of them, since no gold standard exists. Therefore, this review focuses on evaluating the methodologies of each existing health system performance ranking to assess their reproducibility and transparency. A search was conducted to identify existing health system rankings, and a questionnaire was developed for the comparison of the methodologies based on the following indicators: (1) General information, (2) Statistical methods, (3) Data (4) Indicators. Overall nine rankings were identified whereas six of them focused rather on the measurement of population health without any financial component and were therefore excluded. Finally, three health system rankings were selected for this review: "Health Systems: Improving Performance" by the WHO, "Mirror, Mirror on the wall: How the Performance of the US Health Care System Compares Internationally" by the Commonwealth Fund and "the Most efficient Health Care" by Bloomberg. After the completion of the comparison of the rankings by giving them scores according to the indicators, the ranking performed the WHO was considered the most complete regarding the ability of reproducibility and transparency of the methodology. This review and comparison could help in establishing consensus in the field of health system research. This may also help giving recommendations for future health rankings and evaluating the current gap in the literature.

  14. Regional economic development programs related to the registration systems for the health records of radiation workers

    International Nuclear Information System (INIS)

    Nakagawa, Haruo; Kanda, Keiji

    2000-01-01

    The two policies, 'Promotion of Health Care for Elderly Person' and Completion of Health Care System' are important for regional economic development. If we apply the Health Records Registration Systems for Radiation Workers to the Regional Health Care System, we can get a more effective plan for regional economic development. In Japan, most of the electric power companies depend on radiation works to the external labor. As the chance of employment usually depends on the time and the period of outage of nuclear power stations, the employment of radiation works lacks its stability. From the analysis on the mobility of radiation workers, we can see the stability of employment increases in proportion to the number of reactors. This paper proposes the need for such a registration system to be granted under three laws governing special accounts for power supply municipalities and to set up the system within regional medical information systems. It also proposes the founding of an Overall Health Insurance Cooperative, managed by contractors safety union in the municipalities as soon as the condition of founding, 3, 000 people, is satisfied. (author)

  15. Health-related quality of life of pregnant women with heartburn and regurgitation.

    Science.gov (United States)

    Dall'alba, Valesca; Callegari-Jacques, Sidia Maria; Krahe, Cláudio; Bruch, Juliana Paula; Alves, Bruna Cherubini; Barros, Sérgio Gabriel Silva de

    2015-01-01

    Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Sixty-two (76%) women had heartburn, and 58 (71%), regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43%) women had a family history of heartburn and/or regurgitation, and 57 (70%) were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women.

  16. HEALTH-RELATED QUALITY OF LIFE OF PREGNANT WOMEN WITH HEARTBURN AND REGURGITATION

    Directory of Open Access Journals (Sweden)

    Valesca DALL'ALBA

    2015-06-01

    Full Text Available Background Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. Objective To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Results Sixty-two (76% women had heartburn, and 58 (71%, regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43% women had a family history of heartburn and/or regurgitation, and 57 (70% were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Conclusion Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women

  17. The Astronomy of Africa’s Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

    Science.gov (United States)

    Sheff, Mallory; Boyer, Christopher B

    2015-01-01

    Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as “galaxies” of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. “Black holes” are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the

  18. Tuberculosis in Asia and the pacific: the role of socioeconomic status and health system development.

    Science.gov (United States)

    Wu, Jie; Dalal, Koustuv

    2012-01-01

    To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological-behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation.

  19. Health locus of control, acculturation, and health-related Internet use among Latinas.

    Science.gov (United States)

    Roncancio, Angelica M; Berenson, Abbey B; Rahman, Mahbubur

    2012-01-01

    Among individuals residing in the United States, the Internet is the third most used source for obtaining health information. Little is known, however, about its use by Latinas. To understand health-related Internet use among Latinas, the authors examined it within the theoretical frameworks of health locus of control and acculturation. The authors predicted that acculturation would serve as a mediator between health locus of control and health-related Internet use, age and health-related Internet use, income and health-related Internet use, and education and health-related Internet use. Data were collected via a 25-minute self-report questionnaire. The sample consisted of 932 young (M age = 21.27 years), low-income Latinas. Using structural equation modeling, the authors observed that acculturation partially mediated the relation between health locus of control and health-related Internet use and fully mediated the relations among age, income, and Internet use. An internal health locus of control (p income (p Internet use. The Internet is a powerful tool that can be used to effectively disseminate information to Latinas with limited access to health care professionals. These findings can inform the design of Internet-based health information dissemination studies targeting Latinas.

  20. An assessment of interactions between global health initiatives and country health systems.

    Science.gov (United States)

    Samb, Badara; Evans, Tim; Dybul, Mark; Atun, Rifat; Moatti, Jean-Paul; Nishtar, Sania; Wright, Anna; Celletti, Francesca; Hsu, Justine; Kim, Jim Yong; Brugha, Ruairi; Russell, Asia; Etienne, Carissa

    2009-06-20

    Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.

  1. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  2. Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

    Science.gov (United States)

    Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

    2018-04-10

    In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or

  3. Satisfaction with dietary life affects oral health-related quality of life and subjective well-being in very elderly people.

    Science.gov (United States)

    Iinuma, Toshimitsu; Arai, Yasumichi; Takayama, Midori; Takayama, Michiyo; Abe, Yukiko; Osawa, Yusuke; Fukumoto, Motoko; Fukui, Yusuke; Shioda, Yohei; Hirose, Nobuyoshi; Komiyama, Kazuo; Gionhaku, Nobuhito

    2017-01-01

    Age-related deterioration in physical and oral health reduces healthy life expectancy and is thus an important problem for very elderly people. We investigated the effects of satisfaction with dietary life (SDL) in everyday life on oral health-related quality of life (OHRQoL) and subjective well-being and examined associations between these factors. We evaluated 426 elders aged 85 years or older. All participants completed a questionnaire that inquired about age, gender, drinking status, body mass index, cognitive function, disability, and comorbidities, among other covariates. Oral, physical, and mental health conditions were also examined. Associations of questionnaire results for SDL with items on subjective well-being (Philadelphia Geriatric Center Morale Scale [PGC] and World Health Organization-5 [WHO-5]) and OHRQoL (Geriatric Oral Health Assessment Index [GOHAI]) were confirmed with multiple logistic regression analysis. In a multivariate model adjusted for various confounders, participants with self-reported "enjoyable" SDL had significantly lower risks for having the lowest scores on the GOHAI, PGC, and WHO-5 (odds ratio [OR] = 0.460, 95% confidence interval [CI] = 0.277-0.762; OR = 0.589, 95% CI = 0.348-0.996; and OR = 0.452, 95% CI = 0.263-0.775, respectively). These associations remained after further adjustment for number of teeth.

  4. ACTUAL WAYS FOR OVERCOMING THE FACTORS ADVERSELY AFFECTING THE CHILDREN AND ADOLESCENTS’ HEALTH IN EDUCATIONAL INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    N. N. Malyarchuk

    2014-01-01

    Full Text Available The paper analyzes a widely discussed problem of the negative health dynamics of the growing generation, and points out the necessity of complex consideration of all the factors adversely affecting children’s health. The special emphasis is on the fallowing harmful factors: intensification of training process; discrepancy between the applied training methods and techniques on the one side, and children’s age, sex and functional specifics and capabilities on the other side; shortcomings in organizing children’s physical activities; limitations of the expositive illustrative methods for developing the healthy lifestyle habits. The other group of factors is related to the teaching style and professional characteristics of the teachers. They include the common practice of «stress» tactics; incompetence in health saving technologies; personal indisposition and psychological drawbacks. The situation is exacerbated by the absence of psychologists and pediatricians in educational institutions. The multilevel approach to solving the problems of students’ health preservation and promotion involves the elicitation of objective, subjective, inschool and out-of-school health determining factors. The paper denotes the actual ways of children’s health preservation at the level of related ministries, departments, and educational institutions.

  5. Denmark: Health system review

    DEFF Research Database (Denmark)

    Juul, Annegrete; Krasnik, Allan; Rudkjøbing, Andreas

    The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

  6. The impact of leprosy on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Anselmo Alves Lustosa

    2011-10-01

    Full Text Available INTRODUCTION: Leprosy is a potentially disabling infectious disease that evolves into emotional issues due to the prejudice that persists about the illness. The endemic has declined substantially with multidrug therapy (MDT in the 80's; however, new demands associated with the reduction of stigma and the improvement of the affected people's quality of life have emerged. In Brazil, leprosy is still a public health problem. Piauí is the second state in the Northeast in prevalence and detection, and Teresina is a hyperendemic city. This study aimed to analyze the health-related quality of life (HRQoL of people in treatment for leprosy in Teresina/PI. METHODS: An observational study was conducted using the SF-36 (a specific questionnaire for assessing quality of life, which sought the determinants of poor quality of life among people with leprosy, outlining the sociodemographic, clinical, and epidemiological characteristics of the 107 patients interviewed. RESULTS: The correlations between the variables showed five determinants of HRQoL: late diagnosis, multibacillary forms, reactions, disability diagnosis grade II, and prejudice. The profile of the participants showed that leprosy still affects the lower social classes in historically endemic areas, causing high percentages of secondary injuries that compromise the work capacity and quality of life of the affected people, perpetuating the stigma associated with the disease. CONCLUSIONS: The study reinforces the need to implement more effective strategies of disease control, due to the development of severe and disabling forms of leprosy is directly related to poor HRQoL in the same cured patient.

  7. United Kingdom (England): Health system review.

    Science.gov (United States)

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  8. Public health preparedness in Alberta: a systems-level study

    Directory of Open Access Journals (Sweden)

    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  9. Declining amenable mortality: a reflection of health care systems?

    Science.gov (United States)

    Gianino, Maria Michela; Lenzi, Jacopo; Fantini, Maria Pia; Ricciardi, Walter; Damiani, Gianfranco

    2017-11-15

    Some studies have analyzed the association of health care systems variables, such as health service resources or expenditures, with amenable mortality, but the association of types of health care systems with the decline of amenable mortality has yet to be studied. The present study examines whether specific health care system types are associated with different time trend declines in amenable mortality from 2000 to 2014 in 22 European OECD countries. A time trend analysis was performed. Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74 years per 100,000 inhabitants. We classified health care systems according to a deductively generated classification by Böhm. This classification identifies three dimensions that are not entirely independent of each other but follow a clear order: the regulation dimension is first, followed by the financing dimension and finally service provision. We performed a hierarchical semi-log polynomial regression analysis on the annual SDRs to determine whether specific health care systems were associated with different SDR trajectories over time. The results showed a clear decline in SDRs in all 22 health care systems between 2000 and 2014 although at different annual changes (slopes). Regression analysis showed that there was a significant difference among the slopes according to provision dimension. Health care systems with a private provision exhibited a slowdown in the decline of amenable mortality over time. It therefore seems that ownership is the most relevant dimension in determining a different pattern of decline in mortality. All countries experienced decreases in amenable mortality between 2000 and 2014; this decline seems to be partially a reflection of health care systems, especially when affected by the provision dimension. If the private ownership is maintained or promoted by health systems, these findings might be

  10. eHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives.

    Science.gov (United States)

    Halwas, Nikolaus; Griebel, Lena; Huebner, Jutta

    2017-11-01

    The aim of our study was to investigate Internet and eHealth usage, with respect to eHealth literacy, by cancer patients and their relatives. Using a standardized questionnaire we asked patients who attended lectures on complementary medicine in 2016. We received 142 questionnaires. The frequency of general Internet usage was directly associated with younger age and better Internet connection. Younger participants were not only more confident in allocating health-related Internet information into reliable or unreliable facts, but also more confident and capable of gaining medical knowledge through eHealth services. A regular use of eHealth services facilitated the decision-making process. Reading ability was associated with a better understanding regarding eHealth offers. In a modern health care system, emphasis should be on skills contributing to eHealth literacy among patients to improve their ability to profit from eHealth offers and improve health care.

  11. Health-Related Internet Use by Children and Adolescents: Systematic Review

    Science.gov (United States)

    Kwon, Misol

    2018-01-01

    access among youth, and the purpose and patterns of health-related internet use among youth were identified. A major objective of health-related internet use is to gain information, but there are inconsistencies in adolescents’ perceptions of health-related internet use. Conclusions This study’s findings provide important information on how youth seek information and related support systems for their health care on the internet. The conceptual and methodological limitations of the identified studies, such as the lack of a theoretical background and unrepresentative samples, are discussed, and gaps within the studies are identified for future research. This review also suggests important features for potential Web-based health interventions for children and adolescents. PMID:29615385

  12. Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin.

    Science.gov (United States)

    Malmusi, Davide; Borrell, Carme; Benach, Joan

    2010-11-01

    In this paper, we briefly review theories and findings on migration and health from the health equity perspective, and then analyse migration-related health inequalities taking into account gender, social class and migration characteristics in the adult population aged 25-64 living in Catalonia, Spain. On the basis of the characterisation of migration types derived from the review, we distinguished between immigrants from other regions of Spain and those from other countries, and within each group, those from richer or poorer areas; foreign immigrants from low-income countries were also distinguished according to duration of residence. Further stratification by sex and social class was applied. Groups were compared in relation to self-assessed health in two cross-sectional population-based surveys, and in relation to indicators of socio-economic conditions (individual income, an index of material and financial assets, and an index of employment precariousness) in one survey. Social class and gender inequalities were evident in both health and socio-economic conditions, and within both the native and immigrant subgroups. Migration-related health inequalities affected both internal and international immigrants, but were mainly limited to those from poor areas, were generally consistent with their socio-economic deprivation, and apparently more pronounced in manual social classes and especially for women. Foreign immigrants from poor countries had the poorest socio-economic situation but relatively better health (especially men with shorter length of residence). Our findings on immigrants from Spain highlight the transitory nature of the 'healthy immigrant effect', and that action on inequality in socio-economic determinants affecting migrant groups should not be deferred. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Health related quality of life and influencing factors among welders.

    Directory of Open Access Journals (Sweden)

    Jingxiang Qin

    Full Text Available BACKGROUND: Occupational exposure to welding fumes is a serious occupational health problem all over the world. Welders are exposed to many occupational hazards; these hazards might cause some occupational diseases. The aim of the study was to assess the health related quality of life (HRQL of electric welders in Shanghai China and explore influencing factors to HRQL of welders. METHODS: 301 male welders (without pneumoconiosis and 305 non-dust male workers in Shanghai were enrolled in this study. Short Form-36 (SF-36 health survey questionnaires were applied in this cross-sectional study. Socio-demographic, working and health factors were also collected. Multiple stepwise regress analysis was used to identify significant factors related to the eight dimension scores. RESULTS: Six dimensions including role-physical (RP, bodily pain (BP, general health (GH, validity (VT, social function (SF, and mental health (MH were significantly worse in welders compared to non-dust workers. Multiple stepwise regress analysis results show that native place, monthly income, quantity of children, drinking, sleep time, welding type, use of personal protective equipment (PPE, great events in life, and some symptoms including dizziness, discomfort of cervical vertebra, low back pain, cough and insomnia may be influencing factors for HRQL of welders. Among these factors, only sleep time and the use of PPE were salutary. CONCLUSIONS: Some dimensions of HRQL of these welders have been affected. Enterprises which employ welders should take measures to protect the health of these people and improve their HRQL.

  14. What are health-related users tweeting? A qualitative content analysis of health-related users and their messages on twitter.

    Science.gov (United States)

    Lee, Joy L; DeCamp, Matthew; Dredze, Mark; Chisolm, Margaret S; Berger, Zackary D

    2014-10-15

    Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals' behavior on Twitter. Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a "testable" claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6% (61/346) were personal in nature; 61% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users-especially patients-interpret the content of tweets posted by health providers.

  15. [Knowledge and use of the Information System on Public Health Budgets (SIOPS) by municipal health administrators, Pernambuco State, Brazil].

    Science.gov (United States)

    Silva, Keila Silene de Brito E; Bezerra, Adriana Falangola Benjamin; Sousa, Islândia Maria Carvalho de; Gonçalves, Rogério Fabiano

    2010-02-01

    Considering the importance of Brazil's Information System on Public Health Budgets (SIOPS) as a tool for planning, management, and social control of public expenditures in health, this article aimed to evaluate the relationship between the regularity of data entry into the SIOPS and knowledge and use of the system by municipal health administrators in Pernambuco State, Brazil. Ten municipalities were selected from the State's five meso-regions, five of which entered information into the system and five only on an irregular basis. Semi-structured interviews were performed with the municipal health secretaries. Analysis of the data showed that command of information technology and knowledge of the System do not affect the regularity of data entry, as a function of the distance between the Municipal Health Secretariat administrators and the SIOPS, such that the data are normally entered by outsourced services. Thus, the resulting information has not been fully explored by systems administrators as a management tool.

  16. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

    Science.gov (United States)

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

    2017-01-01

    To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

  17. Social relationships and health: the meaning of social "connectedness" and how it relates to health concerns for rural Scottish adolescents.

    Science.gov (United States)

    Hendry, L B; Reid, M

    2000-12-01

    Adolescence has been posited as an important period for the onset of mental health problems and for the need to adapt successfully to many psychosocial changes. The assumption has been made that social belonging is both a health-related goal and an antidote for other sorts of emotional crises, but there is little research on how normal adolescents themselves view connections between social relationships and their physical and mental health. This qualitative study examines how social connectedness represents both a content and process variable in northern Scottish young people's discussion of their health concerns, that is, it was both a source of distress and implicated as a helpful or harmful factor in relation to other health concerns. Analyses revealed both the potency of all of these concerns and participants' belief that skills acquired now could affect their future life goals and health. Suggestions are given for building new approaches for conceptualizing rural young people's health problems and helping them cope with the social contexts involved within and around them. Copyright 2000 The Association for Professionals in Services for Adolescents.

  18. The Role of Negative Affect on Headache-Related Disability Following Traumatic Physical Injury.

    Science.gov (United States)

    Pacella, Maria L; Hruska, Bryce; George, Richard L; Delahanty, Douglas L

    2018-03-01

    Acute postinjury negative affect (NA) may contribute to headache pain following physical injury. Early psychiatric-headache comorbidity conveys increased vulnerability to chronic headache-related disability and impairment. Yet, it is unknown whether NA is involved in the transition to chronic headache related-disability after injury. This prospective observational study examined the role of acute postinjury NA on subacute and chronic headache-related disability above and beyond nonpsychiatric factors. Eighty adult survivors of single-incident traumatic physical injury were assessed for negative affect (NA): a composite of depression and anxiety symptoms, and symptoms of posttraumatic stress disorder (PTSS) during the acute 2-week postinjury phase. NA was examined as the primary predictor of subacute (6-week) and chronic (3-month) headache-related disability; secondary analyses examined whether the individual NA components differentially impacted the outcomes. Hierarchical linear regression confirmed NA as a unique predictor of subacute (Cohen's f  2  = 0.130; P = .005) and chronic headache related-disability (Cohen's f  2  = 0.160; P = .004) beyond demographic and injury-related factors (sex, prior headaches, and closed head injury). Upon further analysis, PTSS uniquely predicted greater subacute (Cohen's f  2  = 0.105; P = .012) and chronic headache-related disability (Cohen's f  2  = 0.103; P = .022) above and beyond demographic and injury-related factors, depression, and anxiety. Avoidance was a robust predictor of subacute headache impairment (explaining 15% of the variance) and hyperarousal was a robust predictor of chronic headache impairment (10% of the variance). Although NA consistently predicted headache-related disability, PTSS alone was a unique predictor above and beyond nonpsychiatric factors, depression, and anxiety. These results are suggestive that early treatment of acute postinjury PTSS may correlate with

  19. Health-related behaviors in women with lifestyle-related diseases.

    Science.gov (United States)

    Kozica, Samantha L; Deeks, Amanda A; Gibson-Helm, Melanie E; Teede, Helena J; Moran, Lisa J

    2012-01-01

    Lifestyle related diseases associated with physical inactivity and poor diet quality, represent a major health burden. This study assessed negative and positive health habits and health care utilization in healthy women (n = 50) and women with lifestyle related diseases such as polycystic ovary syndrome (PCOS) (n = 50), gestational diabetes mellitus (GDM) (n = 44) and type 2 diabetes (DM2) (n = 43). A significant difference existed across groups for negative health habits (P = .012) with a trend for positive health habits (P = .06) elevated in women with PCOS. Women with DM2 had the highest amount of health care utilization including doctors office visits (P women with DM2 but there were no differences in positive health habits across sub-groups. Encouraging lifestyle modification in women with precursor diseases such as GDM and PCOS is vital in order to prevent progression to DM2.

  20. Negative and positive affect are independently associated with patient-reported health status following percutaneous coronary intervention.

    Science.gov (United States)

    Versteeg, Henneke; Pedersen, Susanne S; Erdman, Ruud A M; van Nierop, Josephine W I; de Jaegere, Peter; van Domburg, Ron T

    2009-10-01

    We examined the association between negative and positive affect and 12-month health status in patients treated with percutaneous coronary intervention (PCI) with drug-eluting stents. Consecutive PCI patients (n = 562) completed the Global Mood Scale at baseline to assess affect and the EuroQoL-5D (EQ-5D) at baseline and 12-month follow-up to assess health status. Negative affect [F(1, 522) = 17.14, P positive affect [F(1, 522) = 5.11, P = .02] at baseline were independent associates of overall health status at 12-month follow-up, adjusting for demographic and clinical factors. Moreover, there was a significant interaction for negative by positive affect [F(1, 522) = 6.11, P = .01]. In domain-specific analyses, high negative affect was associated with problems in mobility, self-care, usual activities, pain/discomfort, and anxiety/depression with the risk being two to fivefold. Low positive affect was only associated with problems in self-care (OR: 8.14; 95% CI: 1.85-35.9; P = .006) and usual activities (OR: 1.87; 95% CI: 1.17-3.00; P = .009). Baseline negative and positive affect contribute independently to patient-reported health status 12 months post PCI. Positive affect moderated the detrimental effects of negative affect on overall health status. Enhancing positive affect might be an important target to improve patient-centered outcomes in coronary artery disease.

  1. Information technology law and health systems in the European Union.

    Science.gov (United States)

    Mossialos, Elias; Thomson, Sarah; Ter Linden, Annemarie

    2004-01-01

    This study aims to examine the impact of European Union (EU) law relating to information technology (IT) on health systems. The study identifies EU directives relating to IT, analyzes them in terms of their impact on the use of IT in health systems, and outlines their implications for health technology assessment (HTA). Analysis is based on a review of literature identified through relevant databases and Internet searches. Developments in IT have serious implications for EU health systems, presenting policy makers with new challenges. The European Commission has adopted a range of legal measures to protect consumers in the "information society" However, as few of them are health-specific, it is not evident that they have implications for health, health systems, or HTA, and they may not be effective in protecting consumers in the health sector. In light of the growing importance of IT in the health sector, legal and nonlegal measures need to be further developed at EU and international level. Where possible, future initiatives should pay attention to the particular characteristics of health goods and services and health systems. Although definitions of HTA usually recognize the importance of evaluating both the indirect, unintended consequences of health technologies and the legal aspects of their application, it seems that, in practice, HTA often overlooks or underestimates legislative matters. Those involved in HTA should be aware of the legal implications of using IT to provide health goods and services and compile, store, transfer, and disseminate health information electronically.

  2. Reusable Rocket Engine Turbopump Health Management System

    Science.gov (United States)

    Surko, Pamela

    1994-01-01

    A health monitoring expert system software architecture has been developed to support condition-based health monitoring of rocket engines. Its first application is in the diagnosis decisions relating to the health of the high pressure oxidizer turbopump (HPOTP) of Space Shuttle Main Engine (SSME). The post test diagnostic system runs off-line, using as input the data recorded from hundreds of sensors, each running typically at rates of 25, 50, or .1 Hz. The system is invoked after a test has been completed, and produces an analysis and an organized graphical presentation of the data with important effects highlighted. The overall expert system architecture has been developed and documented so that expert modules analyzing other line replaceable units may easily be added. The architecture emphasizes modularity, reusability, and open system interfaces so that it may be used to analyze other engines as well.

  3. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis.

    Science.gov (United States)

    Vallejo-Torres, Laura; Hale, Daniel; Morris, Stephen; Viner, Russell M

    2014-07-01

    Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore 'equalisation' in adolescence. We used five years of data (2006-2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstanding illness, limiting longstanding illness, psychosocial wellbeing, obesity and smoking status. We ran separate analyses by age/gender groups. Inequality was measured using concentration indices. Our findings for longstanding illnesses, psychosocial wellbeing and obesity were consistent with the equalisation hypothesis. For these indicators, the extent of income-related inequality was lower among late adolescents (16-19 years) and young adults (20-24 years) compared to children and young adolescents (under 15 years), mid- and late-adults (25-44 and 45-64 years) and the elderly (65+ years). The remaining indicators showed lower inequality among adolescents compared to adults, but higher inequality when compared with children. Our work shows that inequalities occur across the life-course but that for some health issues there may be a period of equalisation in late adolescence and early adulthood. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Multiple Dimensions of Stigma and Health Related Factors Among Young Black Men Who Have Sex with Men

    Science.gov (United States)

    Quinn, Katherine; Voisin, Dexter R.; Bouris, Alida; Jaffe, Kate; Kuhns, Lisa; Eavou, Rebecca; Schneider, John

    2016-01-01

    This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91–1.00 and OR 0.50, 95 % CI 0.25–1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20–3.94) and psychological distress (OR 5.02, 95 % CI 1.54–16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports. PMID:27233249

  5. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  6. Capturing multi-stage fuzzy uncertainties in hybrid system dynamics and agent-based models for enhancing policy implementation in health systems research.

    Science.gov (United States)

    Liu, Shiyong; Triantis, Konstantinos P; Zhao, Li; Wang, Youfa

    2018-01-01

    In practical research, it was found that most people made health-related decisions not based on numerical data but on perceptions. Examples include the perceptions and their corresponding linguistic values of health risks such as, smoking, syringe sharing, eating energy-dense food, drinking sugar-sweetened beverages etc. For the sake of understanding the mechanisms that affect the implementations of health-related interventions, we employ fuzzy variables to quantify linguistic variable in healthcare modeling where we employ an integrated system dynamics and agent-based model. In a nonlinear causal-driven simulation environment driven by feedback loops, we mathematically demonstrate how interventions at an aggregate level affect the dynamics of linguistic variables that are captured by fuzzy agents and how interactions among fuzzy agents, at the same time, affect the formation of different clusters(groups) that are targeted by specific interventions. In this paper, we provide an innovative framework to capture multi-stage fuzzy uncertainties manifested among interacting heterogeneous agents (individuals) and intervention decisions that affect homogeneous agents (groups of individuals) in a hybrid model that combines an agent-based simulation model (ABM) and a system dynamics models (SDM). Having built the platform to incorporate high-dimension data in a hybrid ABM/SDM model, this paper demonstrates how one can obtain the state variable behaviors in the SDM and the corresponding values of linguistic variables in the ABM. This research provides a way to incorporate high-dimension data in a hybrid ABM/SDM model. This research not only enriches the application of fuzzy set theory by capturing the dynamics of variables associated with interacting fuzzy agents that lead to aggregate behaviors but also informs implementation research by enabling the incorporation of linguistic variables at both individual and institutional levels, which makes unstructured linguistic data

  7. [Health literacy as an element of the Polish occupational health system].

    Science.gov (United States)

    Dobras, Maciej

    Nowadays it is believed that a comprehensive approach towards one's health requires the development and subsequent mastering of health literacy. Although this term has no Polish equivalent, it applies to the ability of individuals to access, analyze and understand information necessary to make informed health decisions. In this publication it is suggested that 'biegłość zdrowotna' can be used as a corresponding Polish term. This publication is based on the review of the available literature (in Polish and in English) on health literacy. To illustrate the hypothetical level of health literacy among Polish employers and employees reports of the Chief Labour Inspectorate and individual items from the Second European Survey of Enterprises on New and Emerging Risks (ESENER-2) were used. The analysis proves that health literacy is a multidimensional concept which has been studied and investigated so far only in relation to chosen nosological units, but practically it does not appear in relation to occupational health. There are reasons to believe that in Poland the low level of health literacy among both employers and employees, lies at the forefront of a passive approach towards the safeguarding of workers health. The concept of health literacy needs further dissemination in Poland, whereas the main area of future research should be the design of the Polish tool for assessing health literacy. The national system of occupational health seems to offer a possible ground for implementing such a concept, especially bearing in mind that within the current system there are several entities and services, which have the legal mandate to undertake informative and advisory duties - exactly those, which help build and master health literacy skills. Med Pr 2016;67(5):681-689. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  8. A quantitative dynamic systems model of health-related quality of life among older adults

    Science.gov (United States)

    Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela

    2015-01-01

    Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722

  9. Motivation and Factors Affecting It among Health Professionals in ...

    African Journals Online (AJOL)

    BACKGROUND: Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. METHOD: Facility based cross-sectional survey ...

  10. Affective Influences on Energy-Related Decisions and Behaviors

    Energy Technology Data Exchange (ETDEWEB)

    Brosch, Tobias, E-mail: tobias.brosch@unige.ch [Department of Psychology, University of Geneva, Geneva (Switzerland); Swiss Center of Affective Sciences, University of Geneva, Geneva (Switzerland); Patel, Martin K. [Energy Group, Institute for Environmental Sciences, University of Geneva, Geneva (Switzerland); Energy Group, Forel Institute, University of Geneva, Geneva (Switzerland); Sander, David [Department of Psychology, University of Geneva, Geneva (Switzerland); Swiss Center of Affective Sciences, University of Geneva, Geneva (Switzerland)

    2014-03-17

    A successful energy transition will depend not only on the development of new energy technologies, but also on changes in the patterns of individual energy-related decisions and behaviors resulting in substantial reductions in energy demand. Across scientific disciplines, most theoretical approaches that try to understand energy-related decisions and behaviors focus mainly on cognitive processes, such as computations of utility (typically economic), the impact of cognitive heuristics, or the role of individual beliefs. While these models already explain important aspects of human decisions and behavior in the energy domain, we argue that an additional consideration of the contributions of emotional processes may be very fruitful for a deeper understanding of the issue. In this contribution, we outline a theoretical perspective on energy-related decisions and behaviors that integrates emotions, elicited by a cognitive-affective appraisal of the relevance of a situation, into a response system driving adaptive decisions and behaviors. We empirically investigate the explanatory power of the model variables to predict intentions to reduce energy use demonstrating that the appraisal–emotion variables are able to account for additional variance that is not explained by two established models focused on cognitive processes (theory of planned behavior and value-belief-norm theory). Finally, we discuss how the appraisal–emotion approach may be fruitfully integrated with other existing approaches and outline some questions for future research.

  11. Affective Influences on Energy-Related Decisions and Behaviors

    International Nuclear Information System (INIS)

    Brosch, Tobias; Patel, Martin K.; Sander, David

    2014-01-01

    A successful energy transition will depend not only on the development of new energy technologies, but also on changes in the patterns of individual energy-related decisions and behaviors resulting in substantial reductions in energy demand. Across scientific disciplines, most theoretical approaches that try to understand energy-related decisions and behaviors focus mainly on cognitive processes, such as computations of utility (typically economic), the impact of cognitive heuristics, or the role of individual beliefs. While these models already explain important aspects of human decisions and behavior in the energy domain, we argue that an additional consideration of the contributions of emotional processes may be very fruitful for a deeper understanding of the issue. In this contribution, we outline a theoretical perspective on energy-related decisions and behaviors that integrates emotions, elicited by a cognitive-affective appraisal of the relevance of a situation, into a response system driving adaptive decisions and behaviors. We empirically investigate the explanatory power of the model variables to predict intentions to reduce energy use demonstrating that the appraisal–emotion variables are able to account for additional variance that is not explained by two established models focused on cognitive processes (theory of planned behavior and value-belief-norm theory). Finally, we discuss how the appraisal–emotion approach may be fruitfully integrated with other existing approaches and outline some questions for future research.

  12. Affective influences on energy-related decisions and behaviors

    Directory of Open Access Journals (Sweden)

    Tobias eBrosch

    2014-03-01

    Full Text Available A successful energy transition will depend not only on the development of new energy technologies, but also on changes in the patterns of individual energy-related decisions and behaviors resulting in substantial reductions in energy demand. Across scientific disciplines, most theoretical approaches that try to understand energy-related decisions and behaviors focus mainly on cognitive processes, such as computations of utility (typically economic, the impact of cognitive heuristics, or the role of individual beliefs. While these models already explain important aspects of human decisions and behavior in the energy domain, we argue that an additional consideration of the contributions of emotional processes may be very fruitful for a deeper understanding of the issue. In this contribution, we outline a theoretical perspective on energy-related decisions and behaviors that integrates emotions, elicited by a cognitive-affective appraisal of the relevance of a situation, into a response system driving adaptive decisions and behaviors. We empirically investigate the explanatory power of the model variables to predict intentions to reduce energy use, demonstrating that the appraisal-emotion variables are able to account for additional variance that is not explained by two established models focused on cognitive processes (Theory of Planned Behavior and Value-Belief-Norm Theory. Finally, we discuss how the appraisal-emotion approach may be fruitfully integrated with other existing approaches and outline some questions for future research.

  13. Organisational Factors Affecting Policy and Programme Decision Making in a Public Health Policy Environment

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2015-01-01

    Organisational factors can affect the success of interventions aimed at increasing research use. Research is needed to identify organisational factors affecting research use in specific public health policy contexts. Qualitative interviews with decision makers from a specific public health context identified a range of organisational factors that…

  14. The health benefits of selective taxation as an economic instrument in relation to IHD and nutrition-related cancers.

    Science.gov (United States)

    Holm, Astrid L; Laursen, Mai-Britt; Koch, Maria; Jensen, Jørgen D; Diderichsen, Finn

    2013-12-01

    The present study aimed to estimate the health benefits of selective taxation of healthy and unhealthy food commodities in relation to CVD and nutrition-related cancers. The potential health effects of a selective taxation scenario were estimated as changes in the burden of disease, measured by disability-adjusted life years, from health outcomes affected by the changes in food intake. The change in burden of a disease was calculated as the change in incidence of the disease due to a modified exposure level, using the potential impact fraction. Estimates of relative risk for the associations between various foods and relevant diseases were found through a literature search and used in the calculation of potential impact fractions. The study was based in Denmark, estimating the health effects of a Danish selective taxation scenario. The potential health effects of selective taxation were modelled for the adult Danish population. Halving the rate of value-added tax on fruit and vegetables and increasing the tax on fats would result in moderate reductions in the burden of disease from IHD, ischaemic stroke, and colorectal, lung and breast cancer (0·4–2·4 % change). The largest effect could be obtained through increased intake of fruit and vegetables (0·9–2·4 %). Applying selective taxation to healthy and unhealthy foods can moderately reduce the burden of disease in the Danish population.

  15. The role of health-related claims and health-related symbols in consumer behaviour: Design and conceptual framework of the CLYMBOL project and initial results

    Science.gov (United States)

    Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G

    2015-01-01

    Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project Role of health-related CLaims and sYMBOLs in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies (i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking (i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided. PMID:25750587

  16. Relative deprivation in the Nordic countries-child mental health problems in relation to parental financial stress

    DEFF Research Database (Denmark)

    Gunnarsdóttir, Hrafnhildur; Hensing, Gunnel; Povlsen, Lene

    2016-01-01

    BACKGROUND: The Nordic welfare system has been acknowledged as favourable for children, successfully contributing to low child mortality and poverty rates. Nevertheless, mental health problems among children and adolescents are common and the economic situation of the family has been highlighted...... as an important determinant. In spite of similar social, political and cultural structures, the Nordic countries differ; Iceland was most affected by the global financial crisis in 2008. The aim of this study was to examine potential differences in parental financial stress and the associations to child mental...... to measure mental health problems.  RESULTS:  In Iceland, 47.7% of the parents reported financial stress while ≤20% did so in the other countries except for Finland (33.5%). However, in case of parental financial stress the OR of mental health problems comparing children to parents with and without financial...

  17. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  18. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  19. Association Between Health-Related Quality of Life and Being an Immigrant Among Adolescents, and the Role of Socioeconomic and Health-Related Difficulties

    Directory of Open Access Journals (Sweden)

    Michèle Baumann

    2014-01-01

    Full Text Available To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment. However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related QOL of European and non-European immigrant adolescents and the contributions of socioeconomic difficulties, unhealthy behaviors, and violence. It included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3; 1,451 French adolescents, 54 European immigrants and 54 non-European immigrants, who completed a self-administered questionnaire including sex, age, socioeconomic characteristics (family structure, parents’ education, occupation, and income, unhealthy behaviors (uses of tobacco/alcohol/cannabis/hard drugs, obesity, and involvement in violence, having sustained violence, sexual abuse, and the four QOL domains measured with the World Health Organization’s WHOQOL-BREF (poor: score < 25PthP percentile. Data were analyzed using logistic regression models. Poor physical health, psychological health, social relationships, and living environment affected more European immigrants (26% to 35% and non-European immigrants (43% to 54% than French adolescents (21% to 26%. European immigrants had a higher risk of poor physical health and living environment (gender-age-adjusted odds ratio 2.00 and 1.88, respectively while non-European immigrants had a higher risk for all poor physical health, psychological health, social relationships, and living environment (3.41, 2.07, 3.25, and 3.79, respectively. Between 20% and 58% of these risks were explained by socioeconomic difficulties, parts of which overlapped with unhealthy behaviors and violence. The associations between the two sets of covariates greatly differed among French adolescents and immigrants. Poor QOL was more common

  20. Students’ health engagement and affective relations in Danish upper secondary school

    DEFF Research Database (Denmark)

    Vitus, Kathrine

    2018-01-01

    within sensuous, social and political body-health assemblages, the students attempted to curb school stress, sustain social belonging in an individualistic school environment and both reproduce affirming power discourses and subvert their territorialisation. The study proposes an analytical shift...

  1. A Review of the Relationships among the Key Determinants Affecting the Mental Health Disorders of the People in Greater Mekong Subregion Countries.

    Science.gov (United States)

    Nget, Manndy; Muijeen, Kasorn

    2017-12-01

    related to mental health disorders are also caused by the environment and other related factors and therefore a stable and a well-balanced environment is an indicator of healthy mental status. In addition, the environment is a way to pursue both physical and mental health because green spaces serve as a mood freshener and can al-leviate anxiety, stress, and depression. Globalization and urbanization should follow sustainable development instructions and concerns about the population's health, especially regarding mental health. These key determinants affect the people's life, especially in terms of mental health thus leading to mental health disorders.

  2. Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.

    Science.gov (United States)

    Garg, Sachin K; Lyles, Courtney R; Ackerman, Sara; Handley, Margaret A; Schillinger, Dean; Gourley, Gato; Aulakh, Veenu; Sarkar, Urmimala

    2016-02-06

    Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited. We interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. We conducted telephone interviews with various stakeholders who volunteered from each of the eight California-based safety net systems that received external funding to pilot a texting-based program of their choosing to serve a primary care need. We developed a semi-structured interview guide based partly on the Consolidated Framework for Implementation Research (CFIR), which encompasses several domains: the intervention, individuals involved, contextual factors, and implementation process. We inductively and deductively (using CFIR) coded transcripts, and categorized themes into facilitators and barriers. We performed eight interviews (one interview per pilot site). Five sites had no prior texting experience. Sites applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. No site texted patient-identifying health information, and most sites manually obtained informed consent from each participating patient. Facilitators of implementation included perceived enthusiasm from patients, staff and management belief that texting is patient-centered, and the early identification of potential barriers through peer collaboration among grantees. Navigating government regulations that protect patient privacy and guide the handling of protected health information emerged as a crucial barrier. A related technical challenge in five sites was the labor-intensive tracking and documenting

  3. How will Brexit affect health and health services in the UK? Evaluating three possible scenarios.

    Science.gov (United States)

    Fahy, Nick; Hervey, Tamara; Greer, Scott; Jarman, Holly; Stuckler, David; Galsworthy, Mike; McKee, Martin

    2017-11-04

    The process of leaving the European Union (EU) will have profound consequences for health and the National Health Service (NHS) in the UK. In this paper, we use the WHO health system building blocks framework to assess the likely effects of three scenarios we term soft Brexit, hard Brexit, and failed Brexit. We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff. Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland. Governance concerns relate to public health, competition and trade law, and research. However, we identified a few potential opportunities for improvement in areas such as competition law and flexibility of training, should the UK Government take them. Overall, a soft version of Brexit would minimise health threats whereas failed Brexit would be the riskiest outcome. Effective parliamentary scrutiny of policy and legal changes will be essential, but the scale of the task risks overwhelming parliament and the civil service. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Postulated vasoactive neuropeptide immunopathology affecting the blood–brain/blood–spinal barrier in certain neuropsychiatric fatigue-related conditions: A role for phosphodiesterase inhibitors in treatment?

    Directory of Open Access Journals (Sweden)

    Sonya Marshall-Gradisnik

    2008-10-01

    Full Text Available Donald R Staines1,2, Ekua W Brenu2, Sonya Marshall-Gradisnik21Queensland Health, Gold Coast Population Health Unit, Southport, Gold Coast, Queensland, Australia; 2Faculty of Health Science and Medicine, Population Health and Neuroimmunology Unit, Bond University, Robina, Queensland, AustraliaAbstract: Neuropsychiatric symptoms occur in a number of neurological fatigue-related conditions including multiple sclerosis (MS, Parkinson’s disease (PD, amyotrophic lateral sclerosis (ALS, and chronic fatigue syndrome (CFS. These conditions have been attributed variably to neuroinflammatory and neurodegenerative processes. While autoimmune pathology, at least in part, has long been suspected in these conditions proof has been elusive. Autoimmune pathomechanisms affecting the blood–brain barrier (BBB or blood–spinal barrier (BSB may predispose the BBB/BSB to ‘leakiness’ and be a precursor to additional autoimmune events resulting in neuroinflammatory or neurodegenerative processes. The aim of the paper is to postulate immunopathology of the cerebrospinal perivascular compartment involving certain vasoactive neuropeptides, specifically pituitary adenylate cyclase-activating polypeptide (PACAP and vasoactive intestinal peptide (VIP, in the etiology of certain neuropsychiatric fatigue-related conditions such as MS, ALS, PD, and CFS. Vasoactive neuropeptides (VNs such as PACAP and VIP have critical roles as neurotransmitters, vasodilators including perfusion and hypoxia regulators, and immune and nociception modulators. PACAP and VIP are widely distributed in the central nervous system (CNS and have key roles in CNS blood vessels including maintaining functional integrity of the BBB and BSB. Autoimmunity affecting these VNs would likely have a detrimental effect on BBB and BSB functioning arguably predisposing to further pathological processes. Virchow–Robin spaces (VRS are perivascular compartments surrounding small vessels within the CNS which

  5. Health-related economic costs of the Three-Mile Island accident.

    Science.gov (United States)

    Hu, T W; Slaysman, K S

    1984-01-01

    On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

  6. Context matters: community characteristics and mental health among war-affected youth in Sierra Leone.

    Science.gov (United States)

    Betancourt, Theresa S; McBain, Ryan; Newnham, Elizabeth A; Brennan, Robert T

    2014-03-01

    Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics - social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth - in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores - indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p mental health outcomes was nonsignificant (p > .05). This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs

  7. Health Information Systems.

    Science.gov (United States)

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. A cross-cultural study on perceived health-related quality of life in children and adolescents with type 1 diabetes mellitus.

    Science.gov (United States)

    Kalyva, Efrosini; Abdul-Rasoul, Majedah; Kehl, Dániel; Barkai, László; Lukács, Andrea

    2016-04-01

    This study investigated whether culture can affect self- and proxy-reports of perceived diabetes-specific health-related quality of life of children and adolescents with type 1 diabetes when taking into account glycemic control, gender and age. A total of 416 patients aged between 8 and 18 years--84 (Greece), 135 (Hungary) and 197 (Kuwait)--and their parents completed the Pediatric Quality of Life Inventory 3.0. Diabetes Module. Gender and age did not have any effect on perceived diabetes-specific health-related quality of life. Significant differences were detected among countries in self- and proxy-reports of diabetes-specific health-related quality of life when controlling for glycemic control. More specifically, Greek patients with type 1 diabetes and their parents reported significantly worse disease-specific health-related quality of life than their peers from Kuwait and Hungary. Moreover, culture affected the level of agreement between self- and proxy-reports with parents from Kuwait underestimating their children's diabetes-specific health-related quality of life. The impact of culture on self- and proxy-reports of diabetes-specific health-related quality of life warrants further investigation, since it might suggest the need for differential psychosocial treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Science.gov (United States)

    Bhojani, Upendra; Devedasan, Narayanan; Mishra, Arima; De Henauw, Stefaan; Kolsteren, Patrick; Criel, Bart

    2014-01-01

    Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes and other chronic conditions.

  10. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Directory of Open Access Journals (Sweden)

    Upendra Bhojani

    Full Text Available BACKGROUND: Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. METHODS: We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. RESULT: There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. CONCLUSIONS: Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes

  11. Technical aspects of portal technology application for e-health systems.

    Science.gov (United States)

    Kosińska, Joanna; Słowikowski, Paweł

    2004-01-01

    E-health is an emerging field on the intersection of medical information technologies, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. Portal technology, allowing services to be accessible over the Internet is a perfect tool for providing e-health services. The use of portal technologies has had deep influence on the architecture of the whole e-health system, both regarding new subsystems and older ones which we want to integrate with the portal. Portals provide new possibilities for creating novel types of e-health applications as well. In this paper we provide a brief overview of e-health systems and portal technologies, and present many technical aspects of portal technology application for e-health systems such as the architecture of portal-based e-health systems, graphical user interfaces, access to various e-health systems' resources, personalization, security and privacy.

  12. Use of GIS in visualization of work-related health problems.

    Science.gov (United States)

    Delaunay, M; Van der Westhuizen, H; Godard, V; Agius, R; Le Barbier, M; Godderis, L; Bonneterre, V

    2015-11-01

    Occupational health and safety (OHS) information is often complex, diverse and unstructured and suffers from a lack of integration which usually precludes any systemic insight of the situation. To analyse to what extent the use of geographical information systems (GISs) can help to integrate, analyse and present OHS data in a comprehensive and communicable way relevant for surveillance purposes. We first developed a 'macro-approach' (from national to local level), mapping data related to economic activity (denominator of active workers displayed by activity sectors), as well as work-related ill-health (numerators of workers suffering from work-related ill-health). The latter data are composed of compensated occupational diseases on the one hand and work-related diseases investigated by specialized clinics on the other hand. Then, a 'micro-approach' was worked out, integrating at a plant level, using computer-aided drawing, occupational risks data and OHS surveillance data (e.g. use of medication and sickness absence data). At the macro-level, microelectronics companies and workers were mapped at different scales. For the first time, we were able to compare, up to the enterprise level, complementary data showing different pictures of work-related ill-health, allowing a better understanding of OH issues in this sector. At the micro-level, new information arose from the integration of risk assessment data and medical data. This work illustrates to what extent GIS is a promising tool in the OHS field, and discusses related challenges (technical, ethical, biases and interpretation) and research perspectives. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. How does the adult attachment affect human’s recognition to love-related and sex-related stimuli: an ERP study

    Directory of Open Access Journals (Sweden)

    Juan eHou

    2016-05-01

    Full Text Available In the present study, we investigated the relationship among three emotion-motivation systems (adult attachment, romantic love and sex. We recorded Event-related potentials (ERPs in 37 healthy volunteers who had experienced romantic love while they viewed SEX, LOVE, FRIEND, SPORT and NEUTRAL images. We also measured adult attachment styles, level of passionate love and sexual attitudes. As expected, results showed that, firstly, response to love-related image-stimuli and sex-related image-stimuli on the electrophysiological data significantly different on N1, N2 and PSW components. Secondly, the different adult attachment styles affected individuals’ recognition processing in response to love-related and sex-related images, especially, to sex-related images. Further analysis showed that voltages elicited by fearful attachment style individuals were significantly lower than voltages elicited by secure and dismissing attachment style individuals on sex-related images at frontal sites, on N1 and N2 components. Thirdly, from behavior data, we found that adult attachment styles were not significantly related to any dimension of sexual attitudes but were significantly related to passionate love scale total points. Thus, the behavior results were not in line with the electrophysiological results. The present study proved that adult attachment styles might mediate individuals’ lust and attraction systems.

  14. Gender relations and women's reproductive health in South Sudan

    Directory of Open Access Journals (Sweden)

    Sumit Kane

    2016-11-01

    Full Text Available Background: In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. Design: A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender. Results: Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health. Conclusions: Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities.

  15. Gender relations and women's reproductive health in South Sudan

    Science.gov (United States)

    Kane, Sumit; Rial, Matilda; Matere, Anthony; Dieleman, Marjolein; Broerse, Jacqueline E.W.; Kok, Maryse

    2016-01-01

    Background In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. Design A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender. Results Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health. Conclusions Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities. PMID:27900934

  16. How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era

    Directory of Open Access Journals (Sweden)

    Xing Chen

    2016-01-01

    Full Text Available Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization’s adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization’s intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization’s intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization’s adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.

  17. How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era.

    Science.gov (United States)

    Chen, Xing; Zhang, Xing

    2016-01-01

    Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.

  18. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    Science.gov (United States)

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  19. Consumers' intention to use health recommendation systems to receive personalized nutrition advice.

    Science.gov (United States)

    Wendel, Sonja; Dellaert, Benedict G C; Ronteltap, Amber; van Trijp, Hans C M

    2013-04-04

    Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector

  20. Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening

    Directory of Open Access Journals (Sweden)

    Neuhann Florian

    2011-08-01

    Full Text Available Abstract Background Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART. ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to

  1. Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

    Science.gov (United States)

    Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

    2011-08-01

    Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in

  2. Affective medicine. A review of affective computing efforts in medical informatics.

    Science.gov (United States)

    Luneski, A; Konstantinidis, E; Bamidis, P D

    2010-01-01

    Affective computing (AC) is concerned with emotional interactions performed with and through computers. It is defined as "computing that relates to, arises from, or deliberately influences emotions". AC enables investigation and understanding of the relation between human emotions and health as well as application of assistive and useful technologies in the medical domain. 1) To review the general state of the art in AC and its applications in medicine, and 2) to establish synergies between the research communities of AC and medical informatics. Aspects related to the human affective state as a determinant of the human health are discussed, coupled with an illustration of significant AC research and related literature output. Moreover, affective communication channels are described and their range of application fields is explored through illustrative examples. The presented conferences, European research projects and research publications illustrate the recent increase of interest in the AC area by the medical community. Tele-home healthcare, AmI, ubiquitous monitoring, e-learning and virtual communities with emotionally expressive characters for elderly or impaired people are few areas where the potential of AC has been realized and applications have emerged. A number of gaps can potentially be overcome through the synergy of AC and medical informatics. The application of AC technologies parallels the advancement of the existing state of the art and the introduction of new methods. The amount of work and projects reviewed in this paper witness an ambitious and optimistic synergetic future of the affective medicine field.

  3. Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment.

    Science.gov (United States)

    Dehury, Ranjit Kumar; Samal, Janmejaya

    2016-08-01

    A competent health system is of paramount importance in delivering the desired health services in a particular community. The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.

  4. Health-related quality of life among adolescents with polycystic ovary syndrome.

    Science.gov (United States)

    Jones, Georgina L; Hall, Jennie M; Lashen, Hany L; Balen, Adam H; Ledger, William L

    2011-01-01

    To explore health-related quality of life (HRQoL) among adolescents with polycystic ovary syndrome (PCOS). Qualitative study. Two out-patient gynecology clinics in Yorkshire, England. Fifteen young women diagnosed with PCOS were recruited. Semistructured interviews were carried out, transcribed verbatim, and subjected to thematic analysis using NVivo software version 2.0. A few areas were identified where PCOS had a positive impact upon HRQoL (e.g., improved relationships). However, overall the condition had a negative impact upon HRQoL. Weight problems (in particular the difficulties associated with managing/maintaining weight) and body perceptions appeared to be the most significant contributors to a reduced HRQoL. Menstrual dysfunction, fertility issues, and hirsutism also had adverse affects on emotional well-being, self-perception (including poor body image, self-consciousness, & low self-esteem), social functioning, and sexual behavior. A number of participants described receiving insufficient information from health care professionals (HCPs) and negative experiences in relation to the diagnosis and management of their condition. Overall, PCOS has a negative impact on the HR QoL of adolescent girls with the condition. Emotional and social functioning appeared to be most affected rather than areas of physical functioning. Future research is needed to identify ways to improve communication between adolescents with PCOS and their HCPs, particularly around the diagnosis and potential for infertility. Finally, HCPs need to be more aware of the emotional impact of PCOS upon adolescents' HRQoL and of the potential for poor sexual health through risk-taking behaviors that may occur due to the potential loss of fertility. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  5. Knowledge management systems for oral health in developing and developed countries.

    Science.gov (United States)

    Nattestad, Anders

    2012-10-01

    Knowledge management systems utilize information technology to manage knowledge in organizations with the purpose of creating, supporting, storing and disseminating information. These systems have been around for decades, but have significantly changed over time in complexity and features with the evolution of information technology and the Internet. With the development of these new technologies, the concept of knowledge management has thrived and has had significant impact on the way in which knowledge is accumulated, stored and accessed. This article will describe the historical development of knowledge management systems in oral health, illustrate the technology using examples and explore the future use of these systems with emerging technologies such as Google Wave®. One example of how knowledge management systems may affect the quality of dental education is the DentEd project, where a collaborative website was developed to coordinate dental school visitations and collection of reports from working groups, leading to several important publications. MEDLINE is another example of an effective knowledge management system in health care, providing access to health care-related scientific literature, which is highly organized under the auspices of the United States National Library of Medicine. Another and very differently organized example of an effective knowledge management system is Wikipedia, which is a free, web-based, collaborative, multilingual encyclopedia project supported by a nonprofit foundation. The final example of an effective knowledge management system is all of the social media, including Facebook and Twitter. These tools have proven very powerful in organizing and collaborating. In conclusion, the development of new technologies and the Internet have changed the way in which information is developed and accessed. This development is still ongoing and only the future will reveal how this will continue to change. © 2012 John Wiley & Sons A/S.

  6. France: Health System Review.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. World Health Organization 2015 (acting as the host organization for, and secretariat of, the

  7. [Health and health-related behaviors according to sexual attraction and behavior].

    Science.gov (United States)

    Pérez, Glòria; Martí-Pastor, Marc; Gotsens, Mercè; Bartoll, Xavier; Diez, Elia; Borrell, Carme

    2015-01-01

    to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Towards an understanding of resilience: responding to health systems shocks.

    Science.gov (United States)

    Hanefeld, Johanna; Mayhew, Susannah; Legido-Quigley, Helena; Martineau, Frederick; Karanikolos, Marina; Blanchet, Karl; Liverani, Marco; Yei Mokuwa, Esther; McKay, Gillian; Balabanova, Dina

    2018-04-01

    The recent outbreak of Ebola Virus Disease (EVD) in West Africa has drawn attention to the role and responsiveness of health systems in the face of shock. It brought into sharp focus the idea that health systems need not only to be stronger but also more 'resilient'. In this article, we argue that responding to shocks is an important aspect of resilience, examining the health system behaviour in the face of four types of contemporary shocks: the financial crisis in Europe from 2008 onwards; climate change disasters; the EVD outbreak in West Africa 2013-16; and the recent refugee and migration crisis in Europe. Based on this analysis, we identify '3 plus 2' critical dimensions of particular relevance to health systems' ability to adapt and respond to shocks; actions in all of these will determine the extent to which a response is successful. These are three core dimensions corresponding to three health systems functions: 'health information systems' (having the information and the knowledge to make a decision on what needs to be done); 'funding/financing mechanisms' (investing or mobilising resources to fund a response); and 'health workforce' (who should plan and implement it and how). These intersect with two cross-cutting aspects: 'governance', as a fundamental function affecting all other system dimensions; and predominant 'values' shaping the response, and how it is experienced at individual and community levels. Moreover, across the crises examined here, integration within the health system contributed to resilience, as does connecting with local communities, evidenced by successful community responses to Ebola and social movements responding to the financial crisis. In all crises, inequalities grew, yet our evidence also highlights that the impact of shocks is amenable to government action. All these factors are shaped by context. We argue that the '3 plus 2' dimensions can inform pragmatic policies seeking to increase health systems resilience.

  9. Health-related quality of life in type 2 diabetic patients

    International Nuclear Information System (INIS)

    Al-Shehri, Amer H.; Taha, Attia Z.; Bahnassy, Ahmed A.; Salah, M.

    2008-01-01

    Health-related quality of life (HRQOL) is an important health outcome, representing one of the most important goals of all health interventions. The objectives of this study were to determine HRQOL and the factors affecting it in type 2 diabetic patients. The cross-sectional study was conducted in 5 primary health care (PHC) centers in the Al-Khobar area. From a random sample of 225 type 2 diabetic patients, 216 patients were included in the study along with 216 age, sex and nationality-matched controls. Nine patients refused to participate. Type 2 diabetic patients and controls were interviewed with the translated Arabic SF-12 questionnaire. The mean ages were 50.0+-10.0 years for cases of 49.3+-10.3 years for controls (P=0.526). Type 2 diabetic patients had lower socioeconomic status and educational level than controls. Obesity was significantly higher in diabetic than controls. HRQOL in type 2 diabetic patients was significantly lower than controls. The mean physical component score was 41.3+-8.9 for cases vs. 47.5+-9.5 for controls (P 130 mg/dL) in comparison with controlled patients (FPG<-130130 mg/dL) (P<0.05). HRQOL was lower in type 2 diabetic patients than controls and was affected by many factors. Females had lower HRQOL than males, possibly because of a higher incidence of obesity. Uncontrolled diabetic patients had a lower HRQOL than controlled diabetics. Improving HRQOL in diabetic patients is important. (author)

  10. Risk factors in equine transport-related health problems: A survey of the Australian equine industry.

    Science.gov (United States)

    Padalino, B; Raidal, S L; Hall, E; Knight, P; Celi, P; Jeffcott, L; Muscatello, G

    2017-07-01

    Transportation can affect equine health and is a potential source of economic loss to the industry. To identify journey (duration, vehicle, commercial or noncommercial) and horse (sex, age, breed, use, amateur or professional status) characteristics associated with the development of transport-related health problems in horses. Cross-sectional online survey. An online survey was conducted targeting amateur and professional participants in the Australian equine industry; eligible respondents were required to organise horse movements at least monthly. Respondents provided details of the last case of a transport-related health problem that had affected their horse(s). Associations between type of health problem, journey and horse characteristics were examined with multivariable multinomial regression analysis. Based on 214 responses, health problems were classified as injuries, muscular problems, heat stroke, gastrointestinal and respiratory problems, and death or euthanasia. Respiratory problems were reported most frequently (33.7%), followed by gastrointestinal problems (23.8%) and traumatic injuries (16.3%). The type of health problem was associated with journey duration (Pproblems, and death or euthanasia) were more likely to occur on long journeys. Using Standardbreds as the reference group, Thoroughbreds, Arabians and Warmbloods were more likely to experience a severe illness than an injury. Self-selected participation in the study and the self-reported nature of transport-related problems. Horses undertaking journeys of longer than 24 h are at greater risk for the development of severe disease or death. Further studies on long-haul transportation effects are required to safeguard the welfare of horses moved over long distances. © 2016 EVJ Ltd.

  11. Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling.

    Science.gov (United States)

    Vadstrup, Eva S; Frølich, Anne; Perrild, Hans; Borg, Eva; Røder, Michael

    2011-12-07

    Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R). In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12) within the rehabilitation group and 5.6 points (p = 0.03) points among individual counselling participants.In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04). No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01) and 0.34 points within the individual counselling group (p group cardiovascular distress decreased 0.25 points (p = 0.01). A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling programme

  12. Health-related quality of life and self-related health in patients with type 2 diabetes: Effects of group-based rehabilitation versus individual counselling

    Directory of Open Access Journals (Sweden)

    Vadstrup Eva S

    2011-12-01

    Full Text Available Abstract Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36 and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R. Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12 within the rehabilitation group and 5.6 points (p = 0.03 points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04. No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01 and 0.34 points within the individual counselling group (p p = 0.01. Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling

  13. Switzerland: Health System Review.

    Science.gov (United States)

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  14. How changes to Irish healthcare financing are affecting universal health coverage.

    Science.gov (United States)

    Briggs, Adam D M

    2013-11-01

    In 2010, the World Health Organisation (WHO) published the World Health Report - Health systems financing: the path to universal coverage. The Director-General of the WHO, Dr Margaret Chan, commissioned the report "in response to a need, expressed by rich and poor countries alike, for practical guidance on ways to finance health care". Given the current context of global economic hardship and difficult budgetary decisions, the report offered timely recommendations for achieving universal health coverage (UHC). This article analyses the current methods of healthcare financing in Ireland and their implications for UHC. Three questions are asked of the Irish healthcare system: firstly, how is the health system financed; secondly, how can the health system protect people from the financial consequences of ill-health and paying for health services; and finally, how can the health system encourage the optimum use of available resources? By answering these three questions, this article argues that the Irish healthcare system is not achieving UHC, and that it is unclear whether recent changes to financing are moving Ireland closer or further away from the WHO's ambition for healthcare for all. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Malta: Health system review.

    Science.gov (United States)

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  16. Factors affecting medical waste management in lowlevel health ...

    African Journals Online (AJOL)

    African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

  17. Factors influencing the job satisfaction of health system employees in tabriz, iran.

    Science.gov (United States)

    Bagheri, Shokoufe; Kousha, Ahmad; Janati, Ali; Asghari-Jafarabadi, Mohammad

    2012-01-01

    Employees can be counseled on how they feel about their job. If any particular dimension of their job is causing them dissatisfaction, they can be assisted to appropriately change it. In this study, we investigated the factors affecting job satisfaction from the perspective of employees working in the health system and thereby a quantitative measure of job satisfaction. Using eight focus group discussions (n=70), factors affecting job satisfaction of the employees were discussed. The factors identified from literature review were categorized in four groups: structural and managerial, social, work in it-self, environmental and welfare factors. The findings confirmed the significance of structural and managerial, social, work in it-self, environmental and welfare factors in the level of job satisfaction. In addition, a new factor related to individual characteristics such as employee personal characteristics and development was identified. In order to improve the quality and productivity of work, besides, structural and managerial, social, work in it-self, environmental and welfare factors, policy makers should be taken into account individual characteristics of the employee as a factor affecting job satisfaction.

  18. Examining subjective wellbeing and health-related quality of life in women with endometriosis.

    Science.gov (United States)

    Rush, Georgia; Misajon, RoseAnne

    2018-03-01

    The purpose of this study was to explore the subjective wellbeing, health-related quality of life and lived experience of women living with endometriosis. In 2015 five hundred participants between the ages of 18-63 (M = 30.5, SD = 7.46) were recruited through Endometriosis Australia and social media, completing an online questionnaire comprising the Personal Wellbeing Index, the Endometriosis Health Profile-30 and various open-ended questions. Results found that women with endometriosis reported low levels of subjective wellbeing (mean PWI total scores of 51.5 ± 2.03), considerably below the normative range of 70-80 for western populations. The mean Endometriosis Health Profile total score indicated a very low health-related quality of life amongst the women in this sample (78.9, ±13.14). There was also a significant relationship between scores on the Endometriosis Health Profile and Personal Wellbeing Index. The findings from the qualitative data suggest that endometriosis impacts negatively on women's lives in several areas such as; social life, relationships and future plans, this in turn affects women's overall life quality. The study highlights the strong negative impact that endometriosis can have on women's subjective wellbeing and health related quality of life, contributing to productivity issues, relationship difficulties and social dissatisfaction and increasing the risk of psychological comorbidities.

  19. [Effectiveness of support for asbestos health consultation in health centers].

    Science.gov (United States)

    Nagamatsu, Yasuko

    2011-09-01

    In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

  20. Ukraine: health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. World Health Organization 2015 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  1. Prediction Over the Evolution of the Health System

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    Cătălin Ovidiu BABA

    2006-10-01

    Full Text Available The predictive analysis included in the present work begins with identifying the main areas of interest for the future situation of the public health system in Romania, or in any other European state for that matter; these areas of interest relate to the most arduously debated issues, either on a national level or in the proficient institutions of the European Union. However, as previously argued, we consider such an approach to be insufficient for an appropriate description of the potentialities existing at the level of the health systems; accordingly, we consider more relevant the approach of the prediction of future changes by using four variables that have to do, on the one hand, with all the problems of the national systems of public health, and on the other hand, with offering useful information to all states, irrespective of issues such as differences in giving funds, and/or inconsistencies related to the most prominent subjects.

  2. Electronic Health Record-Related Events in Medical Malpractice Claims.

    Science.gov (United States)

    Graber, Mark L; Siegal, Dana; Riah, Heather; Johnston, Doug; Kenyon, Kathy

    2015-11-06

    There is widespread agreement that the full potential of health information technology (health IT) has not yet been realized and of particular concern are the examples of unintended consequences of health IT that detract from the safety of health care or from the use of health IT itself. The goal of this project was to obtain additional information on these health IT-related problems, using a mixed methods (qualitative and quantitative) analysis of electronic health record-related harm in cases submitted to a large database of malpractice suits and claims. Cases submitted to the CRICO claims database and coded during 2012 and 2013 were analyzed. A total of 248 cases (<1%) involving health IT were identified and coded using a proprietary taxonomy that identifies user- and system-related sociotechnical factors. Ambulatory care accounted for most of the cases (146 cases). Cases were most typically filed as a result of an error involving medications (31%), diagnosis (28%), or a complication of treatment (31%). More than 80% of cases involved moderate or severe harm, although lethal cases were less likely in cases from ambulatory settings. Etiologic factors spanned all of the sociotechnical dimensions, and many recurring patterns of error were identified. Adverse events associated with health IT vulnerabilities can cause extensive harm and are encountered across the continuum of health care settings and sociotechnical factors. The recurring patterns provide valuable lessons that both practicing clinicians and health IT developers could use to reduce the risk of harm in the future. The likelihood of harm seems to relate more to a patient's particular situation than to any one class of error.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share thework provided it is properly cited. The work cannot be changed in any way or used

  3. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

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    Mirzoev, Tolib; Kane, Sumit

    2017-01-01

    Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health

  4. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework.

    Science.gov (United States)

    Mirzoev, Tolib; Kane, Sumit

    2017-01-01

    Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people's interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people's interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system

  5. Brain iron accumulation affects myelin-related molecular systems implicated in a rare neurogenetic disease family with neuropsychiatric features.

    Science.gov (United States)

    Heidari, M; Johnstone, D M; Bassett, B; Graham, R M; Chua, A C G; House, M J; Collingwood, J F; Bettencourt, C; Houlden, H; Ryten, M; Olynyk, J K; Trinder, D; Milward, E A

    2016-11-01

    The 'neurodegeneration with brain iron accumulation' (NBIA) disease family entails movement or cognitive impairment, often with psychiatric features. To understand how iron loading affects the brain, we studied mice with disruption of two iron regulatory genes, hemochromatosis (Hfe) and transferrin receptor 2 (Tfr2). Inductively coupled plasma atomic emission spectroscopy demonstrated increased iron in the Hfe -/- × Tfr2 mut brain (P=0.002, n ≥5/group), primarily localized by Perls' staining to myelinated structures. Western immunoblotting showed increases of the iron storage protein ferritin light polypeptide and microarray and real-time reverse transcription-PCR revealed decreased transcript levels (Pgross myelin structure and integrity appear unaffected (P>0.05). Overlap (P0.05). These results implicate myelin-related systems involved in NBIA neuropathogenesis in early responses to iron loading. This may contribute to behavioral symptoms in NBIA and hemochromatosis and is relevant to patients with abnormal iron status and psychiatric disorders involving myelin abnormalities or resistant to conventional treatments.

  6. The role of law in addressing mental health-related aspects of disasters and promoting resilience.

    Science.gov (United States)

    Rutkow, Lainie

    2012-01-01

    Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster occurs, certain legal mechanisms are activated to ensure that individuals' needs for mental health care are met, both for pre-existing and emergent conditions. This includes the rapid deployment of mental health care personnel and the implementation of crisis counseling programs in affected regions. By facilitating an influx of resources, including personnel, supplies, and financial assistance, the law can help communities quickly rebound and return to a sense of normal. Drawing on examples from the United States, this article illustrates the diverse ways in which the law simultaneously addresses mental health-related aspects of disasters and promotes resilience within affected communities.

  7. Modeling trends of health and health related indicators in Ethiopia (1995-2008: a time-series study

    Directory of Open Access Journals (Sweden)

    Nigatu Tilahun H

    2009-12-01

    Full Text Available Abstract Background The Federal Ministry of Health of Ethiopia has been publishing Health and Health related indicators of the country annually since 1987 E.C. These indicators have been of high importance in indicating the status of health in the country in those years. However, the trends/patterns of these indicators and the factors related to the trends have not yet been investigated in a systematic manner. In addition, there were minimal efforts to develop a model for predicting future values of Health and Health related indicators based on the current trend. Objectives The overall aim of this study was to analyze trends of and develop model for prediction of Health and Health related indicators. More specifically, it described the trends of Health and Health related indicators, identified determinants of mortality and morbidity indicators and developed model for predicting future values of MDG indicators. Methods This study was conducted on Health and Health related indicators of Ethiopia from the year 1987 E.C to 2000 E.C. Key indicators of Mortality and Morbidity, Health service coverage, Health systems resources, Demographic and socio-economic, and Risk factor indicators were extracted and analyzed. The trends in these indicators were established using trend analysis techniques. The determinants of the established trends were identified using ARIMA models in STATA. The trend-line equations were then used to predict future values of the indicators. Results Among the mortality indicators considered in this study, it was only Maternal Mortality Ratio that showed statistically significant decrement within the study period. The trends of Total Fertility Rate, physician per 100,000 population, skilled birth attendance and postnatal care coverage were found to have significant association with Maternal Mortality Ratio trend. There was a reversal of malaria parasite prevalence in 1999 E.C from Plasmodium Falciparum to Plasmodium Vivax. Based on

  8. Environmental Health assessment 200 Days after Earthquake-Affected Region in East Azerbaijan Earthquake, North-Western of Iran, 2012

    Directory of Open Access Journals (Sweden)

    Alihossein Zeinalzadeh

    2017-04-01

    assessment and pre-crisis coordination among various organizations led to negative effects of environmental factors on health status in villages. Providing intra-sector coordination for waste management with a sanitary disposal of sewage and detection hazardous materials aftermath as well as immediate measurements in the water supply system are necessary for health promotion of the affected population  in the disaster region.DOI: 10.20518/tjph.326814

  9. The employee retention triad in health care: Exploring relationships amongst organisational justice, affective commitment and turnover intention.

    Science.gov (United States)

    Perreira, Tyrone A; Berta, Whitney; Herbert, Monique

    2018-04-01

    To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care. Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis. The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention. The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees. Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing. © 2018 John Wiley & Sons Ltd.

  10. Examination of the mass media process and personal factors affecting the assessment of mass media-disseminated health information.

    Science.gov (United States)

    Avcı, Kadriye; Çakır, Tülin; Avşar, Zakir; Üzel Taş, Hanife

    2015-06-01

    This study examined the mass media and personal characteristics leading to health communication inequality as well as the role of certain factors in health communication's mass media process. Using both sociodemographic variables and Maletzke's model as a basis, we investigated the relationship between selected components of the mass communication process, the receiving of reliable health information as a result of health communication, and the condition of its use. The study involved 1853 people in Turkey and was structured in two parts. The first part dealt with questions regarding sociodemographic characteristics, the use of the mass media and the public's ability to obtain health information from it, the public's perception of the trustworthiness of health information, and the state of translating this information into health-promoting behaviours. In the second part, questions related to the mass communication process were posed using a five-point Likert scale. This section tried to establish structural equation modelling using the judgements prepared on the basis of the mass media model. Through this study, it has been observed that sociodemographic factors such as education and age affect individuals' use of and access to communication channels; individuals' trust in and selection of health information from the programme content and their changing health behaviours (as a result of the health information) are related to both their perception of the mass communication process and to sociodemographic factors, but are more strongly related to the former. © The Author(s) 2014.

  11. Health-related claims on food labels in Australia: understanding environmental health officers' roles and implications for policy.

    Science.gov (United States)

    Condon-Paoloni, Deanne; Yeatman, Heather R; Grigonis-Deane, Elizabeth

    2015-01-01

    Health and related claims on food labels can support consumer education initiatives that encourage purchase of healthier foods. A new food Standard on Nutrition, Health and Related Claims became law in January 2013. Implementation will need careful monitoring and enforcement to ensure that claims are truthful and have meaning. The current study explored factors that may impact on environmental health officers' food labelling policy enforcement practices. The study used a mixed-methods approach, using two previously validated quantitative questionnaire instruments that provided measures of the level of control that the officers exercised over their work, as well as qualitative, semi-structured, in-depth interviews. Local government; Australia. Thirty-seven officers in three Australian states participated in semi-structured in-depth interviews, as well as completing the quantitative questionnaires. Senior and junior officers, including field officers, participated in the study. The officers reported a high level of autonomy and control of their work, but also a heavy workload, dominated by concerns for public health and food safety, with limited time for monitoring food labels. Compliance of labels with proposed health claims regulations was not considered a priority. Lipsky's theory of street-level bureaucracy was used to enhance understanding of officers' work practices. Competing priorities affect environmental health officers' monitoring and enforcement of regulations. Understanding officers' work practices and their perceptions of enforcement is important to increase effectiveness of policy implementation and hence its capacity to augment education initiatives to optimize health benefits.

  12. Emotional versus cognitive rumination: are they differentially affecting long-term psychological health? The impact of stressors and personality in dental students.

    Science.gov (United States)

    Hamesch, Ulla; Cropley, Mark; Lang, Jessica

    2014-08-01

    In the process of recovery from work, rumination is considered as an important mediating variable in the relationship between work demands and psychological health outcomes. Past research differentiated affective rumination from problem-solving pondering. The aim of the present study was to test a moderated mediation model for these two distinct ruminative states and to show how personality (i.e. neuroticism and conscientiousness) can alter the mediating effect. The present study is based on 119 surveys from dental students with a time lag of 6 months. Participants filled out questionnaires assessing specific study-relevant performance demands, rumination and personality and a screening measure for psychological health status. Neuroticism was found to moderate the demand-affective rumination association, but conscientiousness did not moderate the demand-problem-solving pondering association. Moderated mediation analysis revealed that affective rumination mediates the impact of demands on psychological health only for individuals low in neuroticism. Findings are discussed regarding potential interventions for dental students to prevent negative psychological health outcomes due to increased work-related demands in the long term. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework

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    Onalenna Seitio-Kgokgwe

    2014-09-01

    Full Text Available Background Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF. We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40 and senior officers from stakeholder organizations (N= 14, and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved

  14. Gaming science innovations to integrate health systems science into medical education and practice.

    Science.gov (United States)

    White, Earla J; Lewis, Joy H; McCoy, Lise

    2018-01-01

    Health systems science (HSS) is an emerging discipline addressing multiple, complex, interdependent variables that affect providers' abilities to deliver patient care and influence population health. New perspectives and innovations are required as physician leaders and medical educators strive to accelerate changes in medical education and practice to meet the needs of evolving populations and systems. The purpose of this paper is to introduce gaming science as a lens to magnify HSS integration opportunities in the scope of medical education and practice. Evidence supports gaming science innovations as effective teaching and learning tools to promote learner engagement in scientific and systems thinking for decision making in complex scenarios. Valuable insights and lessons gained through the history of war games have resulted in strategic thinking to minimize risk and save lives. In health care, where decisions can affect patient and population outcomes, gaming science innovations have the potential to provide safe learning environments to practice crucial decision-making skills. Research of gaming science limitations, gaps, and strategies to maximize innovations to further advance HSS in medical education and practice is required. Gaming science holds promise to equip health care teams with HSS knowledge and skills required for transformative practice. The ultimate goals are to empower providers to work in complex systems to improve patient and population health outcomes and experiences, and to reduce costs and improve care team well-being.

  15. Impact of chronic Immune Thrombocytopenic Purpura (ITP on health-related quality of life: a conceptual model starting with the patient perspective

    Directory of Open Access Journals (Sweden)

    George James N

    2008-02-01

    Full Text Available Abstract Background Immune thrombocytopenic purpura (ITP, a condition characterized by autoimmune-mediated platelet destruction and suboptimal platelet production, is associated with symptoms such as bruising, epistaxis, menorrhagia, mucosal bleeding from the gastrointestinal and urinary tracts and, rarely central nervous system bleeding. The aim of this research is to develop a conceptual model to describe the impact of ITP and its treatment on patients' health-related quality of life (HRQoL. Methods A literature search and focus groups with adult ITP patients were conducted to identify areas of HRQoL affected by ITP. Published literature was reviewed to identify key HRQoL issues and existing questionnaires used to assess HRQoL. Focus group transcripts were reviewed, and common themes were extracted by grouping conceptual categories that described the impact on HRQoL. Results The literature synthesis and themes from the focus group data suggest that decreased platelet counts, disease symptoms, and treatment side effects influence multiple domains of HRQoL for ITP patients. Key areas affected by ITP and its treatments include emotional and functional health, work life, social and leisure activities, and reproductive health. Conclusion ITP affects various areas of HRQoL. This conceptual model will help inform the evaluation of therapeutic strategies for ITP.

  16. [The Japanese Health Care System: An Analysis of the Funding and Reimbursement System].

    Science.gov (United States)

    Rump, Alexis; Schöffski, Oliver

    2017-08-10

    Objective The modern Japanese health care system was established during the Meiji period (1868-1912) using the example of Germany. In this paper, the funding and remuneration of health services and products in Japan are described. The focus lies on the mechanisms used to implement health policy goals and to control costs. Method Selective literature search. Results All permanent residents in Japan are enrolled in one of more than 3,000 compulsory health funds. Employees and public servants are covered through company or government-related health insurance schemes. Independent workers, the unemployed and the pensioners are usually assigned to health insurance plans managed by local city governments. The elderly over 75 years are insured through special health funds managed at the prefectural level. To correct the fiscal disparities among the health insurance programs, a risk adjustment is realized by compensatory financial transfers between the funds and substantial subsidies from the central and local governments. The statutory benefits package that is identical for all insurance plans is regulated in a single comprehensive schedule. All the covered health services and products are listed with the fees and compensations, and the conditions for the service providers to be remunerated are also stated. This fee and compensation schedule is regularly revised every 2 years under the leadership of the Ministry of Health, Labor and Welfare. The revisions are intended to contain health expenditures and to set incentives for the achievement of health policy goals. Conclusion The funding of the Japanese health care system and the risk adjustment mechanisms among health funds are well established and show a rather static character. The short- and mid-term development of the system is mainly controlled on the side of the expenditures through the unique and comprehensive fee and compensation schedule. The regular revisions of this schedule permit to react at relatively short

  17. Short-Term Exposure to Lambda-Cyhalothrin Negatively Affects the Survival and Memory-Related Characteristics of Worker Bees Apis mellifera.

    Science.gov (United States)

    Liao, Chun-Hua; He, Xu-Jiang; Wang, Zi-Long; Barron, Andrew B; Zhang, Bo; Zeng, Zhi-Jiang; Wu, Xiao-Bo

    2018-07-01

    Pesticides are considered one of the major contemporary stressors of honey bee health. In this study, the effects of short-term exposure to lambda-cyhalothrin on lifespan, learning, and memory-related characteristics of Apis mellifera were systematically examined. Short-term exposure to lambda-cyhalothrin in worker bees reduced lifespan, affected learning and memory performance, reduced the homing ability, and influenced the expression levels of two learning and memory-related genes of A. mellifera. This research identifies the nature of the sublethal effects of lambda-cyhalothrin on bees and the level of exposure that can be harmful to bee health. This new information will assist in establishing guidelines for the safe use of lambda-cyhalothrin in the field.

  18. Partial Sleep Deprivation Attenuates the Positive Affective System: Effects Across Multiple Measurement Modalities.

    Science.gov (United States)

    Finan, Patrick H; Quartana, Phillip J; Remeniuk, Bethany; Garland, Eric L; Rhudy, Jamie L; Hand, Matthew; Irwin, Michael R; Smith, Michael T

    2017-01-01

    Ample behavioral and neurobiological evidence links sleep and affective functioning. Recent self-report evidence suggests that the affective problems associated with sleep loss may be stronger for positive versus negative affective state and that those effects may be mediated by changes in electroencepholographically measured slow wave sleep (SWS). In the present study, we extend those preliminary findings using multiple measures of affective functioning. In a within-subject randomized crossover experiment, we tested the effects of one night of sleep continuity disruption via forced awakenings (FA) compared to one night of uninterrupted sleep (US) on three measures of positive and negative affective functioning: self-reported affective state, affective pain modulation, and affect-biased attention. The study was set in an inpatient clinical research suite. Healthy, good sleeping adults (N = 45) were included. Results indicated that a single night of sleep continuity disruption attenuated positive affective state via FA-induced reductions in SWS. Additionally, sleep continuity disruption attenuated the inhibition of pain by positive affect as well as attention bias to positive affective stimuli. Negative affective state, negative affective pain facilitation, nor negative attention bias were altered by sleep continuity disruption. The present findings, observed across multiple measures of affective function, suggest that sleep continuity disruption has a stronger influence on the positive affective system relative to the negative affective affective system. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. Central nervous system affecting drugs and road traffic accidents ...

    African Journals Online (AJOL)

    Central nervous system affecting drugs and road traffic accidents among commercial motorcyclists. ... including driving under the influence of drugs that affect the central nervous system (CNS). ... Keywords: Brain, influence, riders, substances ...

  20. FIXING HEALTH SYSTEMS / Executive Summary (2008 update ...

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

    2010-12-14

    Dec 14, 2010 ... FIXING HEALTH SYSTEMS / Executive Summary (2008 update) ... In several cases, specific approaches recommended by the TEHIP team have been acted upon regionally and internationally, including the ... Related articles ...